Villazón’s surgery was a success and he exuberantly expresses his happiness in this video, from his website.  Watch it all the way through for the full effect!  Happy New Year to all!

A Well-Oiled Machine
* Drink plenty of water.  Also hydrate before and during extended periods of vocal use, which make you more prone to damage and fatigue.  Sip water throughout the day if at all possible.
* Limit alcohol and caffeine intake–both increase urination and can dry out your vocal folds.  They can also exacerbate reflux which can severely irritates your larynx.
* Include ‘wet foods’ in your diet–soup, fruit and decaffeinated beverages.
* Use a humidifier during the winter or in dry climates. The National Institute of Health recommends 30% humidity.
* Know your Rx’s side-effects–some medications, such as antihistamines, may dry out the throat.  If you are unsure, check this list of the 200 most frequently prescribed medicines and their effects on the voice available at the website for the National Center for Voice and Speech. Also, ask your physician about the drying effects of your medications.

You (and Your Voice) are What You Eat
* Don’t eat 3-4 hours before bed–besides helping control your weight, this will reduce the potential for heartburn or reflux.
* Eat whole grains, fruits and vegetables–these contain vitamins A, E and C to help keep the mucus membranes of the throat healthy.
* Avoid spicy and acidic foods if you have a problem with reflux.
* Limit oily foods and dairy products, especially just prior to heavy voice use. These foods, such as mayonnaise, increase the tendency to clear your throat, which can contribute to vocal cord damage.
* Reflux that affects the voice is called Laryngopharyngeal Reflux (LPR). People with LPR frequently do not experience heartburn or other classic symptoms of Gastroesophageal Reflux Disease (GERD). If your voice is worse in the morning, if spicy, acidic, or fatty foods make your voice worse, if you belch a lot, or if your throat is chronically sore, see a laryngologist. If LPR is diagnosed, follow recommendations even when you feel better and discontinue medications based on your physician’s recommendation.  

Support Your Voice
* Practice good breathing techniques–use deep, relaxed breaths from the diaphragm. As you speak or sing, your abdominal muscles should be engaged (but not rock hard!) and should move inward. To take a breath, relax your abdomen; it will move in an outward direction and breath will come into your body easily.  
* Talking “from the throat” puts a great strain on the voice.  When you speak, you should feel no sensation in your throat. 

All Natural
* Use your natural tone–good voices are “placed” in the face and emphasize facial resonance. Practice saying “mm hmm”. Note the vibration in your face and the ease in your throat. That’s your natural tone. Don’t drop your voice to your throat to achieve a more authoritative tone or a lower pitch.  There are much better ways to do this!

Know When Enough is Enough
* Avoid hyperfunctional overuse–screaming, speaking too loudly or using a telephone too often (we often speak louder on the phone). Avoid noisy places where you will have to strain your voice to be heard.
* Recognize when your voice needs a rest and take it.
* At the podium–When making a presentation to a large group or in a difficult acoustic environment, use a microphone if available.  Project your voice in a healthy way.

Cleanliness is Next to Tonality
* Limit throat-clearing –When you clear your throat, your vocal cords squeeze together and air is pushed through.  This can result in irritation and damage. Try swallowing, humming, taking a deep breath, yawning, or taking a drink of water instead.
* Wash your hands to prevent the spread of colds and flu.
* Gargle–a solution of a teaspoon of salt and a teaspoon of baking soda dissolved in a cup of warm water washes away phlegm, allergens, and other irritants. Avoid mouthwash that contains alcohol. If your mouthwash use is for persistent bad breath (halitosis), you should see a health care professional as halitosis may be a sign of low grade infection or gastric reflux.
* Use a Neti Pot for sinus health. Though it may seem strange to flush water (warm salt water, actually)  through your nose, it is gaining popularity because of its effectiveness and ease. You can get a Neti Pot at drug stores, health food stores, or online.
* Don’t smoke–breathing in toxins of any kind is damaging. Avoid smoky, dusty and chemical-laden places.

Frankie Goes to the Masseuse…and to the Trainer
* Relax–tension in your upper body compresses the airwaves causing hoarseness and other damage.
* Do a vocal warm up–there are many exercises that can help you warm up and develop your voice, but nothing works for everyone. Try lip trills (brrrrrr) and gentle upward and downward pitch glides on ooh as in “too” and on mmmmm (a hum). Nothing you do with your voice should hurt.
* Work with a voice professional, such as a speech pathologist who specializes in voice, a voice teacher or voice coach.
* Don’t cradle the phone between the head and shoulder–this can cause muscle tension in the neck after extended periods.
* Exercise–increases stamina, muscle tone and overall well-being. Helps provide good posture. Allow your body to breathe naturally.

Additional information:

Self Help for Vocal Heath from the National Center for Voice and Speech

Vocal Warm-Ups  from NY Eye and Ear Infirmary

Taking Care of Your Voice from National Institute on Deafness and Other Communication Disorders

Learn more about World Voice Day, including its history and purpose, and link to exercises and information about the voice.  Click here, and turn on your speakers to hear the word “voice” spoken in many of the world’s languages.

World Voice Day is approaching on April 16th, and we continue our posts about voice disorders.  If you have any questions or comments, please feel free to leave them below.  The voice is an amazing instrument.  How is yours working for you?   

Normal human vocal cords (or vocal folds) consist of two infoldings of tissue situated horizontally across the larynx, or voice box, at the top of the windpipe. Vibrations, caused by air from the lungs moving past adducted vocal cords, produce the sound of the voice. The sound of each individual voice is determined by the size and shape of a person’s vocal cords, throat, nose and mouth, as well as environmental, behavioral, emotional, psychological and other physiological factors.

Voice disorders range widely in their vocal impairment, severity, causes and treatments. Nerve damage, acid reflux, smoking, an over- or under-active thyroid, stress and a person’s psychiatric and physical health can all create or worsen a voice disorder. Some voice disorders are caused simply by vocal misuse, like speaking or singing with poor technique, and overuse, such as excessive singing, talking, coughing or yelling.

Some common disorders appear below. See a laryngologist if you experience vocal discomfort or unexplained loss of voice that lasts longer than two weeks.
 
Laryngopharyngeal Reflux–inflammation of the larynx caused by gastric acid.
Symptoms: Decreased vocal performance, increased effort upon voicing;  may or may not include “heartburn” or indigestion.   Lifestyle changes are recommended, such as avoiding spicy and acidic foods, especially late in the day.  Medications that decrease acid production or level are a common treatment.
Causes: Reflux, specifically a back flow of stomach contents through the esophagus which spills over into the larynx and pharynx (i.e. throat)  that results in swelling and irritation of the laryngeal and pharyngeal tissue.

Vocal Fold Bowing–a small gap in the middle of the vocal folds develops and causes incomplete vocal fold closure, commonly seen in older adults. May improve through strength and flexibility exercises.
Symptoms: Less than optimal voice, weakness, breathiness, hoarseness, or a strained voice.  Treatment options include voice therapy to strengthen the voice and injections into the vocal folds to “bulk them up”. 
Causes: Age and atrophy of the larynx, inactivity of the vocal folds.

Vocal Fold Cyst–a fluid-filled lesion that can occur at any location on the vocal folds, and which interferes with vibration and fold closure at times. Usually appears on one side, but may cause swelling on the opposite side due to irritation.
Two types of cysts: 1. Mucus retention cysts occur when a glandular duct is blocked and unable to secrete; 2. Epidermoid cysts result from congenital defects or trauma.
Symptoms: diplophonia, a voice quality in which the vocal cords produce multiple tones at the same time; dysphonia an impaired quality of voice typically involving hoarseness or a breathy sound. Treatment involves voice therapy and medical interventions including surgery if necessary.
Causes: An upper-respiratory infection combined with vocal overuse, or trauma, which makes tissue prone to developing cysts. Females are more likely than males to be effected.

Spasmodic Dysphonia–inovoluntary movement of the vocal folds during speech resulting in irregular voice breaks and interruptions of phonation (sound). Most common in females between the ages of 20 and 50.
Depending on type of SD, the vocal folds may slam together and stiffen cutting off words or making it difficult to start; or spasms can cause the vocal folds to open allowing air to escape from the lungs during speech. A mix of these types may also be present.  Injecting Botox into the spasming laryngeal muscles causes temporary paralysis of those muscles and usually results in improved voice.
Symptoms: Tight/strained voice; choppy voice similar to stuttering; strained or strangled and full of effort; weak, quiet and breathy or whispery voice. Spasms are usually absent during activities such as laughing or singing.
Causes: Believed to be neurologic in nature with stress and other environmental factors exacerbating symptoms.

Muscle Tension Dysphonia–(sometimes referred to as muscle misuse dysphonia or vocal hyperfunction) a cluster of abnormal patterns of vocal muscle activation, most commonly excessive or unequal muscle tension due to inappropriate use while speaking or singing. Ranges from mild to severe.
Symptoms: In severe cases, voice is extremely breathy or tight/strangled and high-pitched. Treatment involves abdominal-diaphragmatic breathing, relaxation, muscle control, and voice placement exercises guided by a speech pathologist.
Causes: Theories point to incomplete relaxation of the muscle responsible for opening the vocal folds, excessive contraction of certain muscle groups, and incoordination of laryngeal muscle contraction with air pressure and airflow timing. 

View part I.

Voice disorders range widely in their vocal impairment, severity, causes and treatments. Causes can vary from trauma, inflammation or structural changes to immunological, neurological or behavioral factors that result in less-than-ideal voice production.

Some conditions heal on their own, but others require voice therapy and medical management. Nerve damage, acid reflux, smoking, an over- or under-active thyroid, stress and a person’s psychiatric and physical health can all create or worsen a voice disorder. Some voice disorders are caused simply by vocal misuse, like speaking or singing with poor technique, and overuse, such as excessive singing, talking, coughing or yelling.

The tissue of the vocal folds, or vocal cords, sometimes become swollen or injured due to illness, heavy use, exposure to irritants, etc. Sometimes the muscles of the larynx, or voice box, do not work properly due to nerve damage, behavior patterns, or other problems. Common disorders include the development of growths such as nodules or polyps, swelling as in laryngitis, laryngopharyngeal reflux and vocal cord paralysis. 

Laryngitis–inflammation of the vocal cords.
Symptoms: Raspy, hoarse voice. May be low- or high-pitched, depending on how the vocal cords are affected in terms of mass and mobility.
Causes: Excessive use of voice, infections, inhaled irritants, acute laryngopharyngeal reflux.

Vocal Nodules or Nodes–small, callous-like benign growths on vocal cords, which usually occur in pairs and can be a problem for professional voice users. Typically can be reduced or eliminated with proper voice care.
Symptoms: Hoarse, low and breathy voice. Vocal fatigue.
Causes: Vocal misuse and overuse.  Also, dehydration, smoking, drinking alcohol, certain medications, drug use,  laryngopharygeal reflux and environmental factors can precipitate and aggravate the condition. 

Vocal Polyps–soft, blister-like benign growth on a vocal cord, which usually occur unilaterally (on one vocal cord).
Symptoms: Hoarse, low and breathy voice. Vocal fatigue. Severity depends on location and size of lesion.
Causes: As with vocal fold nodules, polyps are associated with heavy voice use, and may be precipitated or aggravated by dehydration, environmental factors, hormones, medications, drug use and allergies.

Vocal Cord Paresis or Paralysis–weakness or immobility of one or both vocal folds causing them to not open or close properly. Cases range from relatively mild to life threatening as paralysis can allow food or liquid to enter the lungs. May require therapy or surgery, although no action may be necessary.
Symptoms: Depending on the exact location of the insult and the position of the immobile vocal fold, the voice may be weak and breathy; there can be stridor during inhalation; and swallowing and coughing can be difficult.
Causes: Mechanical trauma (e.g., head/neck/chest surgery or injury), tumor, certain disease processes, viral infections, hereditary neoplasms and idiopathic.

Voice therapy involves collaborating with your laryngologist (one can be recommended), identifying your vocal demands and habits, and working with you to develop a way of speaking that is optimal for you. The goal is a voice that has endurance and meets your needs.

We don’t normally think of our voice as needing maintenance or special attention, though a healthy and effective voice is a vital asset. Your voice is one of your most valuable tools in your personal and professional life, especially with an increasing emphasis on voicemail, teleconferencing and face-to-face communication. Your voice contributes as strongly toward making a good impression as your appearance or handshake.

That’s why the theme for this year’s World Voice Day is “Invest in your Voice”. Investing in your voice means treating it right by avoiding smoking, limiting heavy screaming or shouting, and by staying hydrated and recognizing when your voice needs a break.

You should also warm up your voice, like you would other muscles, before periods of extended use. Warm-ups are not just for vocal professionals, but also benefit teachers, public speakers, or preachers, to name a few.

If you think you have a voice disorder or you want to improve your voice projection or quality, don’t wait to seek help.  Speak to a speech pathologist who has expertise in the vocal mechanism.  See a laryngologist if a disorder is suspected.  Different diagnoses require very different care, so it is important to be seen by a highly qualified professional.  

The Sound Center will feature information about the importance of your voice and tips on how to keep it in peak condition as part of its count down to WVD 2009.

World Voice Day began in Brazil in 1999 as a day of awareness, recognition, and celebration of the human voice, and is now commemorated worldwide each year on April 16. WVD strives to inform people of the importance of the human voice and the need for preventative care.

• VOICE:  Would you like to know something about how your voice works?  What people prefer to hear in a voice?  Voices people dislike?  Can a voice be changed?
• ACCENT:  Perhaps you want to know something about accents, like what is the American accent?  Why are some accents harder to understand than others?  Is it discriminatory to require an employee to receive accent modification training?
• PRESENTATION:  How about presentation in the business world?  How much should a person use gestures?  Should a presentation incorporate visual aids like PowerPoint?

These are just a few ideas.  Use them or brainstorm your own and ask.  I love this stuff!

One of the services we provide at The Sound Center is accent modification for foreign and regional accents.  Clients work on pronunciation, intonation, speaking rate, style of presentation, and tone of voice, among other areas.  The accent we teach is American English, as spoken by most broadcasters in the US.

Some see this work as fundamentally racist.  They claim that the group in power dictates the correct way of speaking, and the less powerful are forced to change.  Who has the right to say which way of speaking is correct?

I can see their point, especially when people are dismissed or demeaned for the way they speak.  However, in my opinion, communication is the goal.  If people have ideas to share but their audience cannot understand them, it is to their benefit to make some changes in the way they speak.

I have simplified this debate considerably, but I am curious to find out what you think.  Is accent modification a racist goal?

This group is near and dear to my heart.  They sing innovative programs and have extremely high musical standards.  I serve on the Board, and The Sound Center is a sponsor of the upcoming Black and Red Ball on May 22nd.  I would like to extend a warm invitation to this event.  If you would like to taste the vocal arts and delicious cuisine, join us at Park West.

If you can’t attend, please give yourself the opportunity to hear them!  Sample their sound here or buy a CD.  Download their music at itunes.  Catch a performance in the ‘08-’09 season.  They perform in Chicago, Oak Park, Evanston, and Naperville.

You can also buy some raffle tickets and be entered to win a Desert Resort and Spa Getaway for Two!  Check it out!