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Swollen Vocal Chords

GUEST,Gern 19 Nov 01 - 09:13 AM
McGrath of Harlow 19 Nov 01 - 09:25 AM
GUEST,Alice 19 Nov 01 - 12:14 PM
Mary in Kentucky 19 Nov 01 - 01:08 PM
Alice 19 Nov 01 - 02:54 PM
Alice 19 Nov 01 - 03:02 PM
Don Firth 19 Nov 01 - 10:16 PM
Kaleea 20 Nov 01 - 01:01 AM
GUEST,Gern 20 Nov 01 - 08:51 AM
GUEST,Alice 20 Nov 01 - 10:50 AM
Don Firth 20 Nov 01 - 02:32 PM
Alice 20 Nov 01 - 03:43 PM
GUEST,Guest 20 Nov 01 - 07:51 PM
GUEST 20 Nov 01 - 08:10 PM
GUEST,McGrath of Harlow 20 Nov 01 - 08:10 PM
Celtic Soul 20 Nov 01 - 08:23 PM
Alice 20 Nov 01 - 11:32 PM
GUEST,Gern 21 Nov 01 - 08:59 AM
Alice 21 Nov 01 - 03:24 PM
GUEST,Heather 24 Jul 10 - 05:07 PM
MikeL2 25 Jul 10 - 11:01 AM
Don Firth 25 Jul 10 - 03:47 PM
Rumncoke 26 Jul 10 - 11:29 AM
GUEST,Laurie Wallenstein 29 Sep 11 - 11:32 AM
Don Firth 29 Sep 11 - 02:52 PM
Don Firth 29 Sep 11 - 02:55 PM
dick greenhaus 29 Sep 11 - 03:14 PM
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Subject: Swollen Vocal Chords
From: GUEST,Gern
Date: 19 Nov 01 - 09:13 AM

Got 'em again, and I'm starting to get concerned. I'll undergo x-ray to search for polyps. The last time this happened, I had to give up singing in bands and remain completely silent for six weeks -- try that some time! Anyone else going through this? What are my chances of recovering lost range and vocal strength? If steroids are recommended to heal scarred tissue, what factors should I consider? If surgery is advised, what will this do to my voice? Must I stop singing entirely? Or will I sound like Tom Waits, or an aging Sinatra?


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Subject: RE: Swollen Vocal Chords
From: McGrath of Harlow
Date: 19 Nov 01 - 09:25 AM

One trick which really does help reduce strain on the voice is to open up the voice box when you are singing.

How it was explained to me is, to identify how to do that, you push your lower jaw a bit forward, so that the upper and the lower front teeth line up, and you open them just slightly - and just feel with your fingers how your throat and the shape changes a little. And from there you can easily learn how to do it without going through this rigmarole.

With that adjustment you can roar away for hour on hour and you don't wake up croaking the next day.


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Subject: RE: Swollen Vocal Chords
From: GUEST,Alice
Date: 19 Nov 01 - 12:14 PM

Gern, there are links to medical help for singers on Threads on the Singing Voice. I'm at a different computer - can't add a link right now. Maybe someone else will add a link or I will do it later when I am back in my studio.

There are ways to maintain healthy vocal folds without damaging them when singing, and one of them is to NOT "belt" your voice out. Belting eventually leads to damage, no matter how you hold your jaw. You can get volume by floating the sound on a well supported cushion of air, rather than pushing against your vocal cords for volume. I'll write more later.

Alice


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Subject: RE: Swollen Vocal Chords
From: Mary in Kentucky
Date: 19 Nov 01 - 01:08 PM

Threads on the Singing Voice


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Subject: RE: Swollen Vocal Chords
From: Alice
Date: 19 Nov 01 - 02:54 PM

Gern, two sites in paticular that will give you lots of solid information on how a singer can protect the voice:
University of Pittsburgh Voice Center:http://www.upmc.edu/upmcvoice/

Center for Voice Disorders at Wake Forest University: http://www.bgsm.edu/voice/medicine_vocal_arts.html

Explore those two web sites completely, and you should have alot of information to make changes that will help save your voice.

Thanks for doing the thread link, Mary.

Alice Flynn


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Subject: RE: Swollen Vocal Chords
From: Alice
Date: 19 Nov 01 - 03:02 PM

Something of interest to singers: there is a "voice handicap Index" question and answer form to evaluate problems you may be having. The Voice Handicap Index (PDF format) is a question and answer tool that has been developed to help patients and clinicians quantify the amount of disability that a voice disorder is causing. This instrument is comprised of 30 questions or statements that past voice disorder patients have frequently asked or stated.

alice


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Subject: RE: Swollen Vocal Chords
From: Don Firth
Date: 19 Nov 01 - 10:16 PM

Yes, Gern, it happened to me way back when. I had been singing regular gigs every weekend, came down with a bad cold, and kept right on singing. After that, I had trouble staying on pitch. I went to an ear, nose, and throat specialist to see what was going on. Chronic acute laryngitis. He sprayed my throat with something and suddenly I couldn't talk. He told me not to utter a sound for six weeks -- don't even whisper, which he said was also hard on the vocal cords, believe it or not. I did as he said. Came back for weekly checks. Finally, he told me not to talk until I went to a voice teacher he recommended and have the voice teacher bring my voice back. It was about two and a half months before I was back to singing again. I missed a lot of gigs, but the voice teacher really helped me, and the voice came back stronger that it had ever been.

Gawdawful experience! But I learned a lot about taking care of my voice. Hang in there, and stick with whatever the doctor tells you to do. And definitely check out the links that Alice posted. Good luck!!

Don Firth

P.S: Thanks, Alice! I've read many of your comments on the voice and the links you have posted. You do good work!


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Subject: RE: Swollen Vocal Chords
From: Kaleea
Date: 20 Nov 01 - 01:01 AM

When I was in college, I had a trying time as a voice student, with vocal problems. By the luck of the draw, I got a marvelous & well seasoned professor. He frequently consulted his teacher back in New York over my vocal problems. The teacher across the hall was notorious for destroying voices with improper technique (she was tenured!), to include a lovely woman who was on a very popular soap opera who, due to incorrect technique, had to have several nasty nodules removed from her vocal folds. She never completely regained her voice. She had left Mrs. bad technique's college studio & gone to Mrs. bad technique's crony in New York City to study. She never had a chance! #1. Follow the medical advice of a competent professional and if surgery is necessary, get a second opinion and find others who have gone through this & seek out their advice. #2. Get a GOOD vocal instructor who is reputable & has students with big full open voices. #3. Balanced life: Rest, Proper diet, NO ALCOHOL which is quite damaging to the vocal folds. #4. see #s ,2,3. Proper vocal technique is the most important thing, as incorrect technique leads to the problems you have described. Good Luck!


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Subject: RE: Swollen Vocal Chords
From: GUEST,Gern
Date: 20 Nov 01 - 08:51 AM

Excellent advice from all; well-appreciated. Don, your ordeal sounds familiar. Interesting thing about remaining silent -- people think you're an idiot. Good handicap simulation. Alice, thanks again. You've offered advice on my previous vocal inquiries. But just what is meant by supporting the sound on a cushion of air? 'Belting it out' comes so naturally, and some people manage careers out of such bad habits. Tell me more, when you can.


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Subject: RE: Swollen Vocal Chords
From: GUEST,Alice
Date: 20 Nov 01 - 10:50 AM

Gern, I will write again in response to good air support of the voice and why Belting will eventually catch up with you. I hope you have a doctor who specializes in vocal problems. An ENT once wanted to do surgery on my sinuses without even examining me. He is notorious for cashing in on insurance. As soon as he heard I didn't have health insurance, he backed off and gave me samples of antibiotics that cleared up the problem. Good luck.

Alice Flynn


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Subject: RE: Swollen Vocal Chords
From: Don Firth
Date: 20 Nov 01 - 02:32 PM

Gern, Alice will undoubtedly come through with the comprehensive information, but in the meantime -- it's a matter of breathing properly. When you inhale, try to feel like you're filling yourself with air, all the way down through your abdomen (but stay comfortable, don't take in too much air). Then, as you're singing, if you get a little tickle in your throat (about to cough) or you feel like you're clenching with your throat, or if anything else seems to be going wrong, ignore what your throat feels like and concentrate on good "breath support," i.e., tighten you abdominal muscles. It's kind of a matter of mental focus. Try to visualize the tone you are producing as riding or balancing on top of the column of air coming from below. But -- it doesn't take much air to produce a big sound.

Sounds weird, maybe, but that's pretty much the way my voice teachers have explained it, and in a TV interview, Placido Domingo say essentially the same thing. If you're breathing correctly and if you're voice is as relaxed and open as possible, you should be okay.

Looking forward to reading what Alice says. . . .

Don Firth


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Subject: RE: Swollen Vocal Chords
From: Alice
Date: 20 Nov 01 - 03:43 PM

Hi, Gern, Don's right - it is about breathing. It is really hard to descibe this in words without being able to show you AND at the same time see how you yourself are used to breathing when you sing. I think, as Kaleea points out, that finding a GOOD teacher, which can be tricky, is the route to go if you want to preserve your voice over a long life singing.

The problem with trying to learn this fundamental part of using your voice, breath support, is that each person is unique. Whatever I write may not be the point of development for each person reading this. Be that as it may, I can say there are other discussions on that long thread of links that include my comments on breath support, and I'll give it a try again here.

Maybe a list of do's and don'ts will be a good place to start

- Don't lift your shoulders when you breath in.
- Do expand your waist/abs when you breath in.
- RELAX!
- Do gradually develop those breathing muscles with continuous singing exercises/practicing on a regular basis (every day if possible).
- Don't leak air out with breathiness when you start - get a good hold on the note and sing it. A breathy quality fits some emotional lyrics, fine, but don't make it a habit of singing that way all the time. Use it for affect if the song warrants it.

- Don't sing through your nose or keep your mouth blocked up with tongue or stiff jaw - relax and let the air out... visualize it as a thread going straight out of your mouth and to your listeners. Some people block the sound by letting it hit the roof of the mouth, then try to compensate by pushing harder against their larynx to get more volume. That will eventually harm your voice, and doesn't sound pleasant, either. Lift the soft palate on the roof of your mouth. You can see in a mirror that the uvula goes up, when you lift the soft palate.

- If you can't feel ab muscles moving, lay on your back on the floor with a heavy book on your tummy. Breath in. You should see the book rise up as your lungs fill. Sing a note and control the release of air, keeping that book up as long as you can. If the air all rushes out quickly, you have alot of work to do on developing the strength of those muscles to control the air release. (That is breath support - being able to control taking in maximum amount and control how you release it as you sing.)

- Develop the ability to have enough breath to sing long phrases without having to break them for another breath. Breathe in, as described above, and sing one note softly, slowly counting to 8 as you build the volume louder, then counting back to one as you diminish the volume. ALL ON ONE BREATH. Do this exercise every day. You will gradually build up the muscle strength to control the breath support. Don't push air against your vocal folds to get volume. Let the volume be created by flooding the sound with air. If you run out of air before you've gotten to the end of the exercise, you just need to keep doing it every day. The muscles will strengthen, just like doing any other physical exercise on a routine basis.

- You can add even more air when you breathe in by consciously expanding your ribs at the same time as pulling down on the muscles in the floor of your abdomen. Don't try to do all these things at once if you are just starting. You can add the rib expansion later after you have mastered the exercises above.

All I have time to write for now. The main thing to remember is that singing is physical. Just being tall doesn't make a person a great basketball player. You can shoot hoops for fun, but learning good technique, practicing, and working out gives you greater use of your inate gift. It's the same with the voice. If you want to keep singing and avoid injuring your voice, if you want to have a strong voice into your old age, to be able to sing several hours in performance every night and sound even better at the end of the show than when you started, using these techniques will help you do that. IT DOES NOT mean you will sound like an opera singer - sing any type of music you want, but be careful about belting out your voice or singing too high or low for your natural range.

Alice


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Subject: RE: Swollen Vocal Chords
From: GUEST,Guest
Date: 20 Nov 01 - 07:51 PM

Cords.


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Subject: RE: Swollen Vocal Chords
From: GUEST
Date: 20 Nov 01 - 08:10 PM

"NO ALCOHOL"? Well, that's the folk scene in Ireland, Scotland and England down the pan...


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Subject: RE: Swollen Vocal Chords
From: GUEST,McGrath of Harlow
Date: 20 Nov 01 - 08:10 PM

"NO ALCOHOL"? Well, that's the folk scene in Ireland, Scotland and England down the pan...


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Subject: RE: Swollen Vocal Chords
From: Celtic Soul
Date: 20 Nov 01 - 08:23 PM

I would suggest getting more than one opinion, and seeking out Doctors that have had experience helping singers before. There are a few in my area that I could research for you (I have had several friends who have had issues, and sought help). But that won't help you any if you live in London.

In any case, from all I have personally heard, the potential prognosis ranges anywhere from "No, you'll never sing again", to "No worries, take a few steps and all will be right forever", and everything in between.

As an aside, Celine Dion had similar problems. Her Doc told her to *not* use her voice (not even for speaking) when she was on tour, and to warm up well before any performance. She would tap out in code (something like 1 for yes and 2 for no) with her Mom on the phone instead of speaking.


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Subject: RE: Swollen Vocal Chords
From: Alice
Date: 20 Nov 01 - 11:32 PM

Gern, I just noticed your question about sounding like Tom Waits... well, he's made a success of that sound. Aside from all I wrote previously, I don't worry about having a perfect sound for folk music. My favorite songs are traditional songs, and yet I know that I can sing them with more confidence now that I've learned to have better control of my voice. If you listen to the tracks I have on my mp3 page, you will hear that they are all informally done, mostly unaccompanied, and I can hear "mistakes" here and there in each of them, but it's not all about technique to me. Singing for me is about the joy of doing it. I do belt out the occasional sea chantey, cause it's so much fun. You are in pain and facing a serious voice problem, so what I wrote regarding vocal technique is just to help you be informed about choices in what to do in avoiding future injury. All the best in recovering.

Alicec


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Subject: RE: Swollen Vocal Chords
From: GUEST,Gern
Date: 21 Nov 01 - 08:59 AM

Next week's x-ray will tell me more, but in the meantime thanks to Alice for such detailed instruction and others for kind wishes. Prohibition on alcohol reminds me of the reluctant kid who said, "Can't I just do it until I need glasses?" And Waits claimed that a doctor warned him that if he kept singing in his abrasive manner, he would wind up like Sinatra. "Oh, you mean rich and powerful?" But if all this treatment and training makes me sing like Celine Dion, I may just switch to instrumentals.


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Subject: RE: Swollen Vocal Chords
From: Alice
Date: 21 Nov 01 - 03:24 PM

Gern, here is a direct link to info on how medications affect the voice, including corticosteroids. If you go armed with print outs of some of what I linked to, your doctor will know you are serious about being fully informed of the treatment and risks he/she has in mind.

Effects Of Medications On Singers

Here is the page on Taking Herbal Medicines: What Singers Should Know
Be aware that herbs are not necessarily "safer". Chemicals found in botanicals can have side effects and risks, too. For example, long term use of chamomile can lead to rag weed allergy.

Many people have naturally open, relaxed singing voices, and that beautiful natural sound is what I like to hear in folk music, not the obviously 'trained' sound or 'styled' voice. I love to listen to Frank Harte and many others who give the music its authentic richness in the way it is sung. Again, my breath support comments are to help you avoid abusing your voice and causing damage to it.

Alice


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Subject: RE: Swollen Vocal Chords
From: GUEST,Heather
Date: 24 Jul 10 - 05:07 PM

have had a constant ache in my throat for about a month now i am a girl and have no adams apple but the ache is in about that area. as far as i can make out with online advice from vocal coaches and doctors it is a swollen voice box caused by voice strain... the scratchy throat thing is also a sign of voice strain and the only real cure is rest. i am trying to do this but i find it very difficult as i work in a call centre on varying shifts and i sing in a band... not good. i try not to talk where possible and i am trying to use a neutral relaxed tone when speaking on the phone at work but i am getting an uncomfortable tight ache in my throat which feels like when you get an emotional 'lump' that you get in your throat when you are about to cry. i have tried 'vocalzone' pastilles (tom jones swears by them) and letting the odd asprin disolve on my tongue (vile but seems to work) and sometimes these seem to ease my throat just enough for me to be able to carry out work committments but i have also been advised to stay away from any caffeinated foods/drinks (and alcohol) as these dry the throat... my children and husband still expect me to talk to them after work and i just dont get the opportunity to rest my voice... and then i have band rehearsals once a week and sometimes a gig too! i LOVE to sing and it is unthinkable for me to not do this... i am committed to them and can't let them down... so i am taking Alice's advice trying to sing without strain by making sure my mic is turned up enough to not push my voice to much and i am pushing my voice from the diaphram and trying to keep a good posture. i have actually been quite amazed that even with the discomfort the diaphram support makes my voice sound so much clearer... i had no idea how much i sang from my throat before as i thought that was the only way to hit those notes... thanks Alice x x


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Subject: RE: Swollen Vocal Chords
From: MikeL2
Date: 25 Jul 10 - 11:01 AM

hi Heather

You don't mention clearly if you have actually consulted your doctor with this.

If not I would advise that you go as soon as you can - just for the peace of mind that the problem is not serious.

It can't do any harm and you might find that the doctor can prescribe something that will get rid of it so that you will be able to sing and work without any problems

Regards

MikeL2


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Subject: RE: Swollen Vocal Chords
From: Don Firth
Date: 25 Jul 10 - 03:47 PM

Hi, Heather,

Take it from someone who has been there. Don't mess with this. See an otolaryngologist as soon as possible—if not sooner.

First, a small, nit-picky point:   you do have an "Adam's apple." This is simply your larynx, which houses the vocal folds, and both men and women have them. It's just that women's are smaller, with shorter vocal folds, which accounts for the average woman's voice being about an octave above the average man's.

But to the really important part. In 1961, I was singing regularly every Friday and Saturday night in a coffeehouse that paid well, and I was teaching folk guitar classes three evenings a week and giving private lessons in either folk or classic guitar during the afternoons. This was my livelihood. Also, in the mornings, I was taking music classes at the Cornish School of the Arts, a sort of music, dance, acting conservatory in Seattle.

My voice started bothering me. Singing, even talking, didn't feel comfortable, I was sounding a bit hoarse, and my pitch tended to be a bit "iffy." So I went to one of the voice teachers at Cornish (I had had lots of voice lessons before). This teacher ran me through a few vocal exercises, listened to me sing a couple of songs, then he asked me when this had all started.

I had a suspicion. About two months before, I'd come down with a bad cold. But with a regular coffeehouse job and classes to teach, I'd soldiered on. After all, this was how I made my living.

The teacher said he'd seen this sort of thing before, and he insisted that I go to a throat specialist (otolaryingologist—ear, nose, and throat doctor) that he recommended.

The doctor examined my vocal folds, said "Aha!" a couple of times, then he sprayed my throat with something. Suddenly, I couldn't talk at all!

He said that my vocal folds were badly inflamed, and if I kept using my voice in this condition, I would very quickly wind up sounding like Louis Armstrong—if, indeed, I could sing at all! He told me not to use my voice—not at all—until he told me I could. Do not talk!

I whispered, "How long?" He said, "Come back next week. But let me warn you. It might be several weeks."

"But . . . but. . . ." I tried to whisper. . . .

"Well," he said, "you have your choice. Do you want your voice back?"

I nodded.

"Then do as I tell you.   AND," he added, "don't even whisper. That, believe it or not, is harder on your vocal folds than speaking is."

I wrote a lot of notes, getting a friend to telephone my employer at the coffeehouse, explain the situation to him, and suggest someone I knew as a replacement singer; and call the University of Washington branch YM/YWCA and the Kirkland Creative Arts League where I was teaching guitar classes, explain things to them, and tell them I would have to discontinue the classes and pick them up again when my voice returned to normal. And call the music store where I rented a studio and have them notify my private pupils of the situation.

I made weekly visits to the doctor. Finally, after six weeks, he said, "Good. The inflammation and swelling are gone. What I want you to do now is to go back to your voice teacher at Cornish and have him 'restart' your voice. Don't try to talk until you see him, and do exactly what he says. Then come back and see me when he tells you to."

I did as I was told. And soon, I was back singing again, and actually sounding better than ever. With a much greater appreciation of using good vocal technique. Since then, I'm very careful about making sure I'm singing with good breath support and correct vocal placement, not overdoing it, never pushing my voice beyond what is comfortable, and resting my voice as much as possible if I get the sniffles or a chronic tickle in the throat.

The result is that I'm now 79 years old, I still have my singing voice, and some folks have told me that I sound as good as I ever did, if not better! The last time I went to an otolaryngologist (a couple of months ago), he said that my vocal folds were in good shape, but they seemed a bit dryer than they should be, so I should drink more water. So I do.

I don't want to have to go through that again! But if I do have problems, I know what to do.

So—don't mess with this! Get to a good otolaryngologist ASAP, and do what he or she tells you to do. Even if you don't like it, and especially if you have to take some time off from using your voice. Better that than winding up with no voice at all.

I don't want to scare you. But as the doctor told me back in 1961, "You have your choice."

Good luck! And take care!

And keep us posted as to what you're doing and how it's going.

Don Firth


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Subject: RE: Swollen Vocal Chords
From: Rumncoke
Date: 26 Jul 10 - 11:29 AM

I remember getting jeered at by another woman singer, way back when I first lived in Portsmouth - she sang with a couple of male instrumentalists. I was always having to try to get some fresh air into the pubs as they were full of smoke. She used to have a strong loud voice and belted out the songs.

Then she began to cough a bit.

Then one day her voice vanished and never came back.

I saw one of the men playing solo when I lived in Portsmouth the second time, and asked why. Apparently she went to the doctor a couple of times and was told to stop singing and she ignored the advice.

Be warned!!

Anne Croucher


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Subject: RE: Swollen Vocal Chords
From: GUEST,Laurie Wallenstein
Date: 29 Sep 11 - 11:32 AM

I have a problem with my voice for about 5 years. I have been to every doctor and one took a picture of my vocal cords and told me that they are very swollen and red.He did not know what to do with me. I am always trying to clear my throat.I have children and adults ask me why my voice sounds like that.I have a 90 year old mother that is deaf with hearing aids.I know that is a very big strain on me. If I don't talk loudly she doesn't hear and this is going on since she was 40.I try to tell her when I repeat something that it hurts in my chest.
When I am on the telephone giving people my name or anything else they don't understand me.They ask me to repeat it again.When I am in bed sometimes I hearing a weird sound like a very small wistle.any advice would be helpful.I don't think that it would help me to rest my voice, I think I need something else.
Any advice would be wonderful.


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Subject: RE: Swollen Vocal Chords
From: Don Firth
Date: 29 Sep 11 - 02:52 PM

Laurie, number 1 on your agenda should be to get to an otolaryingologist (ear, nose, and throat specialist) immediately if not yesterday. Then, follow their advice.

I can't stress that strongly enough.

Don Firth (as noted above, been there, done that--and still singing at the age of 80, WITH a clear, strong voice!)


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Subject: RE: Swollen Vocal Chords
From: Don Firth
Date: 29 Sep 11 - 02:55 PM

Laurie, I just re-read your above post and apparenly missed the part where you said that you'd already been to a doctor and he said he didn't know what to do!

Find another doctor.

Don Firth


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Subject: RE: Swollen Vocal Chords
From: dick greenhaus
Date: 29 Sep 11 - 03:14 PM

Laryngopharyngeal Reflux Disease and Recommendations to Prevent Acid Reflux

What is Laryngopharyngeal Reflux Disease (LPRD)?
When we eat something, the food reaches the stomach by traveling down a muscular tube called the esophagus. Once food reaches the stomach, the stomach adds acid and pepsin (a digestive enzyme) so that the food can be digested. The esophagus has two sphincters (bands of muscle fibers that close off the tube) that help keep the contents of the stomach where they belong. One sphincter is at the top of the esophagus (at the junction with the upper throat) and one is at the bottom of the esophagus (at the junction with the stomach). The term REFLUX means "a backward or return flow," and it usually refers to the backward flow of the stomach contents up through the sphincters and into the esophagus or throat.

What is the difference between GERD and LPRD?
Some people have an abnormal amount of reflux of stomach acid up through the lower sphincters and into the esophagus. This is referred to as GERD, or Gastroesophageal Reflux Disease. If the reflux makes it all the way up through the upper sphincter and into the back of the throat, it is called LPRD, or Laryngopharyngeal Reflux Disease. The structures in the throat (pharynx, larynx and lungs) are much more sensitive to stomach acid and digestive enzymes, so smaller amounts of the reflux into this area can result in more damage.

Why don't I have heartburn or stomach problems?
This question is often asked by patients with LPRD. The fact is that very few patients with LPRD experience significant heartburn. Heartburn occurs when the tissue in the esophagus becomes irritated. Most of the reflux events that can damage the throat happen without the patient ever knowing that they are occurring.

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 morning)
Asthma-like symptoms
Referred ear pain
Post-nasal drip
Singing: Difficulty with high notes
Diagnosis of LPRD:
The following signs seen by the physician are strong indicators of LPRD:

1. Red, irritated arytenoids (structures at the back of the vocal folds)
2. Red, irritated larynx
3. Small laryngeal ulcers
4. Swelling of the vocal folds
5. Granulomas in the larynx
6. Evidence of hiatal hernia (May or may not be associated with reflux)
7. Significant laryngeal pathology of any type
Definitive diagnostic for LPRD:
The 24-hour Pharyngo-Esophageal pH monitoring is the goal standard for monitoring reflux events associated with LPRD. A small tube is passed through the nose into the esophagus in order to monitor the amount and type of reflux during a typical day. One of the biggest advantages is that it allows the testing of the patient's system while performing his/her daily routine. In LPRD patients, it is important that the upper channel is placed at the level of the laryngeal (voice box) inlet.

Treatment for LPRD:
1. Stress: Take significant steps to reduce stress. Make time in your schedule to do activities that lower your stress level. Even moderate stress can dramatically increase the amount of reflux.

2. Foods: You should pay close attention to how your system reacts to various foods. Each person will discover which foods cause an increase in reflux. The following foods have been shown to cause reflux in many people. It may be necessary to avoid or minimize some of the following foods:

Spicy, acidic and tomato-based foods like Mexican or Italian food.
Acidic fruit juices such as orange juice, grapefruit juice, cranberry juice, etc..
Fast foods and other fatty foods.
Caffeinated beverages (coffee, tea, soft drinks) and chocolate.
3. Mealtime:
Do not gorge yourself at mealtime
Eat sensibly (moderate amount of food)
Eat meals several hours before bedtime
Avoid bedtime snacks
Do not exercise immediately after eating
4. Body Weight: Try to maintain a healthy body weight. Being overweight can dramatically increase reflux.

5. Nighttime Reflux: If the 24-hour pH monitoring demonstrates nocturnal reflux, elevate the head of your bed 4-6 inches with books, bricks or a block of wood to achieve a 10 degree slant.

Do not prop the body up with extra pillows. This may increase reflux by kinking the stomach. Recent studies have shown that reflux occurs much more often during the day when upright. Therefore, this suggestion may be much less important than once believes.

6. Tight Clothing: Avoid tight belts and other restrictive clothing.

7. Smoking: IF YOU SMOKE, STOP!! This dramatically causes reflux and many other evils to your body.

Medications for LPRD:
Take one dose (as recommended on the label) at meals and at bedtime of an over the counter antacid such as Tums ®, Gaviscon® or Mylanta®. Tums has the added benefit of containing calcium.

Medications such as H2Blockers (Axid®, Pepcid®, Tagament®, Zantac®), Proton pump inhibitors (Prilosec®, Prevacid®), or motility agents (Propulsid) may be prescribed by your physician.


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Mudcat time: 25 June 6:44 AM EDT

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