Caring For Your Voice

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Pet Allergens

People who are allergic to certain animals are rarely allergic to the animals' fur or feathers. They are actually allergic to the small scales of skin (dander) that the animals shed. Some people are allergic to the animals' saliva, particularly cats. Cats have saliva that contains a protein that is known to cause allergy. A person can come into contact with animal saliva if licked by the pet, if the pet is touched after it has groomed itself, or if an object that the animal has recently licked or chewed is touched. People who are allergic to animals may need to avoid keeping pets. Frequent bathing and grooming of the pet (preferably by someone who is not allergic to the animal) may help. Allergy to animals may also include wool, which may contain tiny amounts of dander (skin).

Research data suggests that room air filters may be of some use against cat dust (dander) in houses but are much less effective against dust mites, (which does not prove that they are effective enough to make a difference in asthma caused by cats). Mite dust particles are larger than cat dust particles, and fall out of the air more quickly. In contrast, cat dust is much finer, and stays in the air much longer. However, installing an air filter is not a reasonable substitute for not having cats.

Mold and Mildew

While having sufficient humidity in the air is crucial to maintaining healthy lung and vocal fold function, having too much humidity in the air can be dangerous. Excessive humidity and dampness can lead to mold – a fuzzy growth on moist, organic matter - and mildew – a mold growing on fabric. Mold is most common indoors in damp locations such as basements, or bathrooms (washrooms). Fabrics, rugs, stuffed animals, books, or wallpaper can contain mold spores if they are frequently in contact with water or kept in a damp place. When mold spores land on damp organic material, such as wood, paper, feathers, hair, cellulose, petroleum products, rubber, carpet, etc., they may begin growing and digesting the material. If enough moisture is available for the mold to emerge from hibernation, they are very likely to start growing on walls.

Molds reproduce by spreading microscopic spores. In sensitive individuals, inhaling or touching mold or mold spores can cause allergic reactions that may include respiratory problems such as coughing, sneezing, wheezing, infection and/or difficulty in breathing, hay fever-type symptoms, nose and throat irritation, nasal or sinus congestion, and runny nose, just to name a few. The most common reactions are flu-like symptoms and asthma. Those with chronic lung or immune problems are at risk for more serious reactions like fever, lung infections and a pneumonia-like illness.

Toxic molds can produce several toxic chemicals called mycotoxins that can damage health. These chemicals are present on the spores and small mold fragments that are released into the air. In high concentrations, mold fragments, spores, and mycotoxins can trigger symptoms even in individuals who have no allergies. Toxic mold can be linked to the rapid rise of the asthma rate over the past twenty years, as well as chronic sinusitis, and can increase one’s susceptibility to a wide variety of diseases by weakening the immune system.

Minimize exposure to mold spores by keeping rooms dry (with a relative humidity below sixty percent), using a dehumidifier if necessary. Discard moldy or mildewed articles (books, toys, shoes, and so on). Use synthetic fabrics for clothing and household furnishings whenever possible. Disinfect bathrooms, basement walls, and furniture with diluted bleach or other appropriate disinfectant solution. Molds also tend to be more robust in poorly ventilated areas with little air movement to disrupt their growth, so it helps to open a window or two now and then. Sealing air leaks in the building's exterior and using a mechanical ventilation system to provide fresh filtered air can help to reduce entry of mold spores and make it easier to keep indoor humidity levels ideal.

Noise Pollution and Other Environmental Irritants

Many people injure their voices by trying to compete against the sounds of loud machinery, loud music or crowd noise. If that is the case, try to use amplification equipment (i.e. microphones and vocal monitors) if it is appropriate.

Environmental pollutants, such as cigarette smoke, dust, or smog, can cause a cough, which may cause irritation or inflammation in the throat.

Singing While Sick

While it is always best to rest and allow the body to recover naturally from mild illnesses such as colds, sometimes singing while sick can’t be avoided. If a singer has a performance scheduled and he or she feels it necessary, for the sake of his or her career, to participate in that performance, the singer should take some extra measures to speed up recovery and to ensure that injury to the voice is not sustained.

There are many products on the market that are designed to provide temporary relief of allergy and cold symptoms. Below is a general list of the types of over-the-counter and prescription medications to avoid. However, everyone responds differently to different products, and it is important to choose ones that are effective for oneself, and take into consideration how they will affect one’s singing voice, including hydration. Get the advice and recommendations of a doctor and a singing teacher, especially if the problem is a persistent one.

Acid Reflux

The throat and vocal cords are affected by multiple factors, including exposure to acid and stomach contents. In many individuals, stomach contents may travel up through the esophagus back into the throat. Some individuals experience this as a burning or sour taste in their throats, others as “heartburn”, and sometimes the urge to cough will be felt. Most, however, never feel or sense anything, except for hoarseness or a “lump” in their throat. These acid reflux symptoms are due to inflammation caused by exposure to enzymes and acid from the stomach. When the throat and vocal folds are inflamed, they do not function well, which in turn affects the voice.

If acid reflux symptoms are persistent and are interfering with singing, consult with a doctor about medications to keep it under control.

Laryngitis

Laryngitis is an inflammation of the larynx, where the vocal folds are located. The irritation suffered by the vocal folds causes hoarseness or a complete loss of the voice. Laryngitis may be caused by viral infection, bacterial or fungal infection, inflammations due to overuse of the vocal folds or excessive coughing.

If a vocalist requires analgesics or topical anesthetics to alleviate laryngeal discomfort, the laryngitis is severe enough to warrant canceling a voice commitment, as there is some risk associated with performing with laryngitis. Inflammation of the vocal folds is associated with increased capillary fragility and increased risk of vocal fold injury or hemorrhage. Many factors must be considered in determining whether a given performance or concert is important enough to justify the potential consequences.

Asthma and Other Respiratory Infections

Colds, influenza, bronchitis, pneumonia and other bacterial and viral respiratory infections cause inflammation in the lungs, making it difficult for a singer to breathe easily. Some chronic conditions, such as asthma, chronic bronchitis, emphysema, and cystic fibrosis, are characterized in part by a cough.

The effects of severe respiratory infection are obvious and will not be enumerated. Restrictive lung disease, such as that associated with obesity, may impair support by decreasing lung volume and respiratory efficiency. Even mild obstructive lung disease can impair support enough to result in increased neck and tongue muscle tension and abusive voice use capable of producing vocal nodules.

Most inhalers are not recommended for use by voice professionals. Many people develop contact inflammation from sensitivity to the propellants used in many inhalers, which may also cause a cough. Use of steroid inhalers for prolonged periods may result in candida laryngitis and may often cause laryngitis even without a chemical propellant. Prolonged steroid inhaler use, such as is common in asthmatic patients, also appears capable of causing wasting of the vocal muscles.

The best option is to get asthma symptoms under control as naturally as possible (e.g. avoid irritants that may trigger an asthma attack). However, if an asthmatic singer requires the use of fast-acting or steroid inhalers in order to breathe clearly – or to breathe at all – they are considered necessities.

Mucous (Phlegm) and Throat Clearing

Some irritants are problems because they cause the creation of thick mucous in abundance. A symptom of colds and allergies is excessive mucous production.

Chronic throat clearing is a potentially damaging habit. Because it is an unnatural use of the voice, excessively clearing the throat places stress on the vocal folds and can lead to inflammation that will only worsen as the habit becomes more persistent. Forceful throat clearing is also counter-productive because, as the throat becomes inflamed and irritated by the clearing action, the body will respond by creating more copious thick mucous to protect and soothe the throat.

A singer should avoid mucous-producing foods, such as dairy products for several hours before singing, especially if he or she is prone to developing excessive mucous (e.g. due to asthma, intolerance or sensitivity to dairy, seasonal allergies, etc.).

Instead of attempting to loosen up excess mucous or phlegm by clearing the throat, a singer should force a cough. Because coughing is a natural reflex that is designed to expel substances that are irritating the air passages, the body won’t be damaged by the activity (i.e. the throat and vocal folds won’t develop further inflammation) unless the coughing, too, becomes a persistent habit.

Lozenges, Cough Candies and Cough Suppressants

Another method of loosening up mucous or soothing a sore throat is to suck on lozenges or cough suppressants. However, lozenges and cough candies generally coat the throat – some even numb it – in order to soothe it. For some singers, the coating left by these cough medications can have the same irritating effect as the mucous that they are trying to get rid of, causing further discomfort in the throat.

Fisherman’s Friends are a brand of lozenge, (made of eucalyptus and menthol), that can be taken immediately before a performance. Although many people don’t appreciate their strong flavour, they are very effective at suppressing coughs and clearing up mucous without leaving a coating on the throat. They are also helpful in providing temporary relief from the irritation of post-nasal drip due to mild colds and allergies, and are useful at bedtime as a substitute for antihistamines, which can have a drying effect on the air passages.

Avoid lozenges with analgesics. (See below for an explanation.)

Analgesics

Analgesics are colloquially known as a painkillers, and they include acetaminophen, the nonsteroidal anti-inflammatory drugs (NSAIDs) such as the salicylates, narcotic drugs such as morphine, synthetic drugs with narcotic properties such as tramadol, and various others. Some other classes of drugs not normally considered analgesics, including tricyclic antidepressants and anticonvulsants, are used to treat neuropathic pain syndromes but can have the same effects. Analgesics are frequently used in combination, such as the paracetamol and codeine preparations found in many non-prescription pain relievers (aspirin, ibuprofen, naproxen, etc.). They can also be found in combination with vasoconstrictor drugs such as pseudoephedrine for sinus-related preparations, or with antihistamine drugs for allergy sufferers.

Aspirin and other analgesics are frequently prescribed for relief of minor throat and laryngeal irritations. Besides masking pain – an important indicator of underlying physiological problems - aspirin and ibuprophen can make it easier to have a hemorage on the vocal folds. The platelet dysfunction caused by aspirin – it may interfere with the clotting mechanism - predisposes the patient to hemorrhage, especially in vocal folds traumatized by excessive voice use in the face of vocal dysfunction. Severe hemorrhage or mucousal scarring may result in permanent alterations in vocal fold vibratory function and can thus be devastating to a professional voice. In rare instances, surgical intervention may be necessary.

The use of analgesics, including topical sprays, is extremely dangerous and should be avoided. Pain is an important protective physiologic function, and masking it risks incurring significant vocal damage, which may be unrecognized until after the analgesic or anesthetic wears off.

If the analgesic is for headache or some other discomfort not intimately associated with voice production, symptomatic treatment should be discouraged until strenuous voice obligations have been completed. However, acetaminophen may be a worthwhile substitute for aspirin and ibuprofen.

Fatigue, Strain and Injury

Vocal fatigue is the inability to speak or sing for extended periods of time without experiencing a change in voice quality. Signs of vocal fatigue may include a “cracking voice” – this may also be a sign of insufficient hydration – a throat that feels strained and sore, a diminished natural vocal range, a changing timbre (tone quality) and hoarseness.

Injuries to the voice are common, especially amongst untrained or improperly trained singers. Vocal fold lesions, which include vocal nodes (calluses on the vocal folds due to overuse), vocal fold polyps and vocal fold cysts are the most common injuries sustained by singers. Lesions are thought to arise following "heavy" or traumatic use of the voice, including voice misuse such as speaking in an improper pitch, speaking excessively, screaming or yelling, or using the voice excessively while sick.

A change in voice quality and persistent hoarseness are often the first warning signs of a vocal fold lesion. Vocal fold lesions lead to a wide range of voice disturbances including an unreliable voice, vocal fatigue, voice breaks, an airy or breathy voice, an inability to sing in a high, soft voice, a hoarse or rough voice quality, frequent throat clearing, and an increased effort to speak or sing.

While pain during speaking or singing may indicate vocal fold lesions, or a number of other medical conditions, it is much more commonly caused by voice abuse with excessive muscle activity in the neck and tongue.

In all cases where pain and changes of vocal quality persist, a doctor should be consulted for diagnosis and treatment. The doctor should be made aware of the extent to which the voice is used (e.g. how the singer performs, how often, etc.) and whether upcoming performances are critical to the singer’s professional development. Treatment options should be discussed in view of how they may further affect use of the voice.

In many cases, rest is the best treatment for mild voice disturbances. However, depending on the cause, short-term use of prescription medication or voice therapy with a speech pathologist may be necessary.

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Last updated on Fri Sep 11 23:09:22 2009