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Care of Voice

Submitted to Common Times by Mark Lawley, SWACDA President-Elect

The following material is provided courtesy of Amy Clift, Springfield, MO, Speech Pathologist

Hydration, hydration, hydration!

Water helps the vocal folds vibrate efficiently. “Drink until you pee pale.”

Caffeine (coffee, tea, soft drinks) and alcohol dehydrate your system and dry your vocal folds of needed lubrication. Small amounts of these beverages are acceptable but must be counterbalanced by drinking more water.

Dry air can be caused from gas furnaces, air conditioners, and climates with a low amount of moisture in the air. Using a humidifier at night can compensate for the dryness, using saline nasal spray can help as well.

The air in airplanes is extremely dry, drink at least 8 ounces of water per hour while flying.

Dr. Gould's Gargle (included in a previous article) can help with tissue dryness, as can sugar free hard candy, slippery elm lozenges. Entertainer’s Secret® (800 308-7452) throat spray is an effective way to help moisturize the vocal folds (follow the directions on the label).

Avoid throat clearing and coughing
These behaviors are traumatic to the vocal cords, and can result in injury. Dry vocal folds contribute to thick mucous, use a gentle, breathy productive cough when you must throat clear. Safe throat clear/cough: take in deep breath, momentarily hold your breath, and release your air with silent "H" sound.

Try to avoid throat clear by: swallowing, sipping water, suck on sugar free hard candy, gentle throat clear as above.

Medications and their effects
Antihistamines: typically prescribed for allergies. Use should be limited as they cause dryness. Prescription nasal steroid sprays such as Nasacort® (Phone-Poulenc Rorer), Nasonex® (Schering), Flonase® (Allen & Hansburys), etc. will often relieve the symptoms of nasal allergy without the drying side effects of antihistamines.

Analgesics: Aspirin products and non-steroidal anti-inflammatory drugs (ibuprofen) should be used sparingly as they may contribute to bleeding, which could happen within the vocal folds. Tylenol® (McNeil Consumer Products) is the best substitute for pain relief.

Mucolytic Agents: Drugs, such as Mucinex®, may be helpful for singers who complain of thick secretions, frequent throat clearing, or postnasal drip. Mucolytic agents need to be used with a lot of water through the day, to be effective.

Local Anesthetics: Avoid the use of over-the-counter local anesthetic preparations for the throat. If you are feeling throat discomfort, masking this with numbing agents may worsen your problem.

Progesterone/birth control: They may cause changes in vocal range. If you notice changes, consult your gynecologist.

Laryngopharyngeal Reflux Disease and Recommendations to Prevent Acid Reflux

What is Reflux?
The term REFLUX means “a backward or return flow,” and refers to the backward flow of stomach contents into the esophagus or throat.

What are GERD and LPRD?
GERD (Gastroesphageal Reflux Disease) refers to the abnormal amount of reflux of stomach acid that goes up through the lower sphincter of the food tube and into the esophagus. LPRD (Laryngopharyngeal Reflux Disease) is reflux that makes it into the throat. The structures of the throat, including the vocal folds, are very sensitive to even small amounts of acid. Unfortunately, these small amounts do not give us a burning sensation to let us know we are experiencing LPRD.

Common Symptoms of LPRD:
Hoarseness, chronic (ongoing) cough, frequent throat clearing, pain or sensation in throat, feeling of lump in throat, problems while swallowing, bad/bitter taste in mouth (especially in the morning), asthma-like symptoms, referred ear pain, post-nasal drip, singing difficulties (especially with high notes).

Medications for LPRD:
The most effective treatment for LPRD may be drugs in the class known as proton pump inhibitors. Included in this group are Prilosec®, Prevacid®, Protonix®, Aciphex®, or the new medication known as Nexium®. Ask your physician which may be appropriate for you.

Self-Destructive Behaviors
Avoid smoking cigarettes and other inhalants! Second hand smoke is included in this!