I've also read that chewing papaya tablets help break up and thin out plegm in your throat, as well as sinus coating.... I found that bit of info when I was desperate with a year-long sinusitis. I'm not sure if it works, but it's cheap and safe, so you could give papaya tablets a try. Papain, in papaya, breaks down protein. The tablets are sold as a supplement for digesting protein. I think you should see a doctor if the problem continues... read on.

Here is something that may help explain the anatomical process of singing, from The Wake Forest University Center for Voice Disorders:

Pay note to the part about reflux - a symptom can be chronic throat clearing/cough. Maybe you should see an ENT (eye, nose, throat) physician and get it checked out.

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The voice is not an organ, but rather, the external phonatory output of the vocal tract. While this may seem obvious, it has important implications for all voice clinicians (laryngologist, speech language pathologist, voice teacher, voice coach, and voice scientist).

The vocal tract consists of four component systems:

1.The "Generator", which is the breath support provided by the lungs. A regulated breath stream is the principal force that drives the vibration of the vocal folds. Without air flowing through the larynx, the vocal folds can make no sound. Thus, the condition of the lungs and how efficiently the breath stream is utilized have a great influence on vocal function.

2.The "Vibrator", which is the larynx; specifically, the vocal folds themselves. The folds are actually little more than a vibrator. The richness of sound and the subtleties of articulation are the result of the "resonator" and the "articulator" above the larynx. Problems of the vibrator include all problems of the larynx and its supporting structures.

3.The "Resonator", which consists of the space above the larynx, and includes most of the pharynx. This resonating cavity gives the voice its harmonic overtones, its richness. (The trained opera singer is able to manipulate the resonator to produce resonance at 2,500 Hz, which allows the singer's voice to be heard above an entire orchestra.) Problems with the resonator are uncommon, although, for example, tonsillectomy in a singer may temporarily adversely alter the resonator.

4.The "Articulator", which is made up of the tongue, lips, cheeks, teeth, and palate. These structures shape the sound from below into words and other vocal gestures. Medical problems involving the articulator are uncommon; for the singer, most problems of the articulator are corrected by the voice coach or teacher.

The term voice disorder implies that the problem is laryngeal (within the vibrator); however, it is important to remember that the four component systems of the vocal tract interact in complex ways. For example, poor breath support often gives rise to muscle tension dysphonia (abnormal muscle tension in the larynx that alters the voice). It is also important to remember that the neural regulation of these systems is complex and involves many sensory, motor, and integrating pathways within the brain. In actuality, the vocal tract is the entire person, since any abnormality of the psyche or soma can give rise to an abnormality of the voice. The voice is therefore a measure of a person's overall sense of well-being.
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Gastroesophageal Reflux ("Reflux Laryngitis")

Gastroesophageal reflux, specifically laryngopharyngeal reflux, is the cause of, or an important cofactor in, voice disorders in approximately half of all professional voice patients who seek medical attention. In addition, these patients often appear to have "occult reflux," in that many deny having any heartburn or regurgitation, symptoms generally thought to be necessary to make a diagnosis of reflux. Voice patients who complain of chronic or intermittent hoarseness, "a lump in the throat" (globus pharyngeus), difficulty in swallowing (cervical dysphagia), excessive throat mucus or post-nasal drip, chronic throat clearing, and/or cough may have clinically significant laryngeal reflux. This diagnosis should be entertained in every patient with any of the above symptoms or findings of unexplained laryngeal swelling, particularly diffuse swelling. Reflux is a factor in the development of vocal fold granulomas, Reinke's edema (polypoid degeneration), and vocal fold carcinoma. In addition, reflux often is causally associated with the muscle tension dysphonias and vocal nodules.

Patients with laryngopharyngeal reflux are different from the "typical" reflux patients with esophagitis commonly encountered by gastroenterologists. Voice patients with reflux laryngitis appear to have a high incidence of upright (daytime) reflux, a low incidence of esophagitis, and a high rate of treatment failure using traditional antireflux therapy, such as dietary and lifestyle modifications and H2 blockers.

The most sensitive diagnostic test in the reflux laryngitis group of patients is ambulatory 24-hour double-probe pH monitoring. Omeprazole, 20 mg. b.i.d., appears to be the most effective treatment. Vocalists appear to be extraordinarily prone to develop reflux, but why they are so inclined remains unknown.

Vocal Abuse, Misuse, And Overuse Syndromes: The Muscle Tension Dysphonias

This group of disorders is very common in professional vocalists, and may be lumped together under the heading of muscle tension dysphonias (MTDs). The MTDs may occur in isolation, after a URI, or, as mentioned above, in association with reflux. It is important for the voice clinician to evaluate each patient for each of these possible causative factors, since every underlying cause must be identified and corrected if treatment is to be effective.

Vocal Abuse

Yelling, screaming, singing too loudly or "out of range," and using certain character voices may result in traumatic laryngeal damage, including the development of contact ulcers of the vocal processes, vocal fold hemorrhages, nodules (localized vocal fold swellings), or diffuse vocal fold swelling. These lesions are the consequences of traumatic vocal behavior and they result in vocal impairment. The best treatment for all of these dysphonias is prevention.

Vocalists should strictly avoid screaming (to the point of causing hoarseness) at athletic events and at other times, including when performing. Professional vocalists who demonstrate findings of vocal abuse should be offered a program of vocal education designed to modify the abusive vocal behavior(s). Vocal-fold hematomas are best treated by voice rest, occasionally by surgical drainage. Contact ulcers on the vocal processes may be due to use of a loud speaking voice alone, but also often are associated with poor breath support, very low pitching of the voice, and chronic throat clearing. Such ulcerations may produce referred pain to the ipsilateral ear (often during performance), and yet may only minimally alter the vocal quality. Patients with contact ulcers and granulomas usually need treatment for both reflux and vocal abuse/misuse (voice therapy).

Vocal nodules, small discrete swellings at the junction of the anterior and middle thirds of the vocal folds, are common in vocalists, and are always the result of vocal trauma. These swellings may represent nothing more than discrete areas of mucosal thickening, or the nodules may be keratinized (like a callus), or angioma-like (vascular).

Most patients with vocal nodules do not need to have them removed, and in many cases, the nodules do not significantly alter vocal quality. However, when the nodules are associated with an underlying submucosal cyst or have a red "angioma-like" appearance, then surgical treatment should be considered, but only after voice therapy has been instituted. It is important to remember that these are functional lesions and that, with the exception of cysts and "red nodules" (as above), they are reversible -- that is, they may resolve completely when vocally abusive behavior is eradicated. Relatively few patients with vocal nodules ever require surgery.

All patients with traumatic vocal-fold injuries should be subjected to intense scrutiny by the voice team. Abusive vocal behaviors, including chronic traumatic throat clearing, should be eliminated, and voice therapy designed to optimize vocal efficiency should be provided. Vocal abuse in a vocal professional is tantamount to a musician's leaving his or her instrument out in the rain: it is inappropriate and neglectful. For most vocal abuse patients, including those with vocal nodules, vocal education (or reeducation) is effective remedial therapy.

Vocal Misuse

Vocal misuse is somewhat different from abuse, in that misuse tends to be less acute, more habitual, and more insidious in its effects. Speaking or singing out of range and the use of certain character voices are the most common forms of misuse.

In many singers who seek medical attention for a voice problem, it is actually the speaking voice that is at the root of the problem. In both men and women, the habitual use of a very-low- pitched speaking voice may be the cause. To produce a low-pitched voice requires considerable muscular tension. This type of muscle tension dysphonia is termed Bogart-Bacall syndrome. (This syndrome is named after these two great actors, not because they had anything wrong with their voices, but because the term suggests that people with the voice disorder often have voices that are similar in pitch to Bogart's or Bacall's).

Patients with this condition almost always speak using the lowest note of the pitch range, and also usually demonstrate poor breath support. Why this condition occurs is conjectural; however, in contemporary society, a low-pitched speaking voice is considered desirable. In men, a low-pitched voice confers authority and masculinity; in woman, it confers sophistication, worldliness, and confidence. Diagnosis of the Bogart-Bacall syndrome requires a high index of suspicion, and correction of the syndrome depends upon the cooperative efforts of the patient, the laryngologist, and the speech pathologist.

Singing out of range is also a common problem. Most vocalists know their own tesitura, that is, their "best range", but occasionally, a vocalist will take on a role that is inappropriate, and when this happens, vocal difficulties may result.

Similarly, actors may take on roles that require use of a "character voice" that pushes beyond the limits of "safe vocal physiology." Laryngeal muscle tension increases dramatically when a vocalist is speaking or singing out of range, and thus the likelihood of laryngeal trauma increases. When singers and actors sound as if they are straining, they are straining. Occasionally, the voice clinician must point out the obvious when vocal misuse of this type occurs.

Table 5: Suggestions For The Professional Vocalist:

"How To Save Your Voice"

1.Avoid abusing your voice.
You should do nothing to your voice that results in hoarseness and/or throat pain.
Avoid yelling or screaming to the point of causing hoarseness.
Avoid singing so loudly that you develop hoarseness, and avoid singing in situations that are so noisy that you cannot hear yourself singing.
When you have a cold or laryngitis, do not try to talk or sing "over" the problem, since this can lead to vocal-fold damage. See your doctor.

2.Avoid misusing your voice.
Be careful when using "character voices" not to strain, and use especially good breath support.
Do not attempt to alter your "normal" speaking voice to create an effect; particularly avoid pitching your voice too low. (If you are using the lowest note of your pitch range for everyday conversation, this is too low).
Avoid taking on roles that you cannot do, that is, don't attempt roles that are out of your range.
Avoid using long run-on sentences and a rapid speaking rate that stresses the vocal apparatus; good breath support for conversational speech is every bit as important as good breath support for singing. (If you don't know what this means, you should consider taking voice lessons, and/or seeing a voice therapist).

3.Avoid overusing your voice.
In very noisy environments such as airplanes, keep conversation to a minimum.
Examine your "vocal schedule" carefully. Remember that all your vocal demands are not of equal importance. Avoid making a schedule that leaves no room for rest and recovery.
Use amplification when available and appropriate, especially for rehearsals.
Use "marking" techniques when appropriate, especially for rehearsals.

4.Monitor your work and home environments for possible problems.
Avoid, if possible, performing in smoky, dusty, and noisy environments.
Use humidification in your bedroom, especially during the winter.

5.Monitor your diet and life style.
Eat regularly, and eat a healthy diet.
Avoid fried and other fatty foods.
Avoid dehydration, since this adversely affects the vocal folds; drink plenty of water.
Avoid eating or drinking, particularly alcoholic beverages, within three hours of bedtime.
Minimize consumption of caffeine-containing foods and beverages.
Strictly avoid smoking or other tobacco consumption; if you already smoke, quit.
Exercise regularly; aerobic exercise is best.

6.Avoid unnecessary medications.
Don't treat yourself.
Avoid drying medications such as antihistamines.
Avoid anesthetic throat sprays.

7.Consider taking voice lessons, even if you have never had a voice problem; voice lessons have been shown to increase vocal efficiency, and decrease the likelihood of developing voice problems.

8.If you need a physician, consult with other singers to find an otolaryngologist who has experience in treating vocalists.

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The above is alot of info, but there is even more at this site: Center For Voice Disorders of Wake Forest University

Alice