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Upper range gone after laryngitis

hi all,
in my early 40s, choral singer and part-time teacher of young children. I got laryngitis 2 weeks ago completely lost my voice. Doctor said viral and to rest so I cancelled classes and more or less stayed in bed for a few days, didn't go to choir and speaking voice returned though was shaky for another week. I also suffer from asthma which only occurs in winter and is aggravated by viral infections which unfortunately I seem to get a lot of. So I am coughing a lot now (it's cough variant asthma) and taking steroid inhaler twice daily and ventolin when I need it, could be around 6-8 puffs a day.
My problem is that while my speaking voice is more or less back to normal my singing voice is shot and I cannot sing above C5. Any advice as to what I can do to speed up the healing process? I still have to teach but only 2 hours a week and I am trying very hard to mind my voice when teaching.
Thanks in advance!
Replies (20): Threaded | Chronological
on November 5, 2015 5:03am
HI Ciara:
I would highly recommend getting to an ENT who specializes in professional voice users - someone who understands the demands of using your voice int he way you do. You have so many things going on that could be causing this that it would be difficutl to pinpoint which is the primary cause of your loss of high notes, and in combination, it is creating an unfortunate "perfect storm."  They will scope you and take a look to see what is going on.  You did all the right things - but the voice is a delicate instrument!  
Good luck!
Applauded by an audience of 4
on November 5, 2015 5:48am
Perhaps the inhaler is drying you out? That would definitely interfere with the high notes. But really, it would be best to check in with a good ENT!
Applauded by an audience of 1
on November 5, 2015 5:49am
Since you have complicating factors, You would probably be best off starting with an ENT specialist. Once you know what's really going on in there you'll be able to make decisions about voice therapy or any other services that might help.
My biggest regret is that I didn't get medical input sooner, my biggest blessing is that through the ENT eval I found a plan that helped me restore (in part) what I'd lost.
Assumng that you're steaming and hydrating, right?
Applauded by an audience of 2
on November 5, 2015 7:10am
Everything you are describing about your asthma and now the dryer air of winter makes it harder for your vocal folds to heal.  One of the best things you can start is using a humidifier, talk with your doctor about other options to the steroids to counteract their drying effects.  Make sure that when you are teaching that you aren't trying to push through any vocal fatigue, that will only prolong the healing process.  Don't forget that when you speak you need to use the same support (probably extra breath support so that your voice isn't doing the grunt work, but your breath is) and speak in your healthy vocal range.
You could start with gentle humming.  Stay in a very comfortable range at first, support the hum, make sure there is lots of vertical space in the sound.  Gradually add notes as your chords regain their strength and flexibility.  If you are only getting to a C5 it sounds like your voice is not wanting to move into head voice.   As you find your voice healing you could add gentle decending sighs from your head voice into your chest voice.  As much as possible see if you can support through the vocal 'break' between head and chest.  
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on November 5, 2015 10:19am
Too soon to rerally worry about it. Give it time and rush things/be in a hurry to get back to full throttle.
on November 11, 2015 3:17am
Thanks for all the replies. Working on trying to get the asthma under control first as I think that is the root of all other problems. Also, trying to consciously mind my voice while teaching. The upper range is coming back, but slowly. I might consider an ENT if things don't progress or I get hit with another virus. Unfortunately where I am located, an appointment to see an ENT could have you waiting 3-4 months. In the meantime I am going to take some advice from today's choral blog and Wash My Hands!
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on November 11, 2015 9:49am
Try to make an ENT appointment anyway. If you get to it a couple of months down the road, and feel you don't need it, someone else will be very happy if you cancel!
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on November 29, 2015 6:37pm
Yes - make the ENT appointment now. I have had a similar problem for the last few years and wish I had seen an ENT much earlier, particularly one who specializes in voice issues. I was referred to a voice pathologist as well, and we ironed out a few vocal problems that years of teaching and singing with poor acoustics in church had let seep in. Also, the sooner you get scoped, the better, because then down the road you can compare and see if things are improving or getting worse.
on November 12, 2015 4:09am
Hallo Clara, 
    As a fellow asthma sufferer and singer, I hear you loud and clear. I've had the same kinds of problems many times, and you are very right to think that the asthma may at the root of things. You are using two inhalers quite a few times a day, so I think you realize that your lung capacity is not optimal at the moment. Of course, you know that lack of sufficient air is going to cause all sorts of problems, not the least of which is exhaustion. We asthmatics often slide down so gradually that we don't realize how much air we're not getting. Can you go up the stairs energetically? That's a good check. 
    If you have an allergy or lung specialist, you can ask if for an inhaler that will control the asthma while irritating your vocal folds as little as possible. There are alternatives. You can also ask him to measure your present lung capacity and recommend a small apparatus, which you can use to check it at home. On days when you know your lung capacity is down, it's a little easier to be forgiving of your vocal abilities. 
   For the rest, the other advice here is excellent. I would add that if your singing range doesn't return as hoped, an experienced speech pathologist is also a good person to consult. 
Applauded by an audience of 1
on November 12, 2015 9:19am
I also have chronic asthma. I got stuck on the 2 inhalers cycle quite a few years ago, just for maintenance. If I got sick, I had no where to go because I was already maxed out on the inhaler doses. When Singulair came out, it turned my life around. I take it once daily, every day, year round. Sometimes I go 10 months or more without needing an inhaler. If I use the inhaler for more than 2 days running, I go the the doctor because I know there's something more going on. Singulair generic now, so it's not even expensive. I'm not being paid to advertise, it's just the only oral asthma med I'm familiar with. There are probably other oral meds out by now, so check with your doctor. The inhaler is hard on your whole system, not just your voice.
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on November 12, 2015 12:06pm
After almost a year of vocal therapy prescribed by my doctor, I've changed a lot of bad habits brought on partially by losing my voice and trying to continue talking and singing through it. When the vocal therapy ended and my voice had returned (all but the highest notes), I began voice lessons with an instructor who is connected with the voice pathology treatment plan and continues to remind me of using my speaking voice correctly in order to keep my singing voice in shape.  My manner of speaking was damaging my singing voice. It took a lot of practice to remedy that, and it is an ongoing project for me.  I use a BoomVox from Griffin Labs to amplify my voice during large group rehearsals. It allows me to speak quietly and sound BIG.   Speaking over children or choirs or over your choir singing or over you piano playing or over an amplified recording.....if you do any of that on a regular basis, it will be hard to recover your voice.  Using a personal amplification system can help rest your voice.  The vocal pathologist recommended this for me.  It had the side benefit of keeping the attention of those in my rehearsals because they can hear me very clearly, even the hard of hearing church choir members. The wireless speaker is portable and the size of a cereal box, so I can put it behind those guys.  I use a small headset with a battery pack connected with a cord, but no cord to the speaker.  
I suggest you see an otolaryngologist who has many singers as patients;ask for a referral from your primary care, maybe after you talk to some professional singers who have specific recommendations for someone in your area.  You might also ask for recommendations from the best local voice teachers or college professors in your area.   If there is a voice center at a hospital or medical school nearby, that might be the place to go.   You may be recommended for vocal therapy with a voice pathologist who specializes in singers rather a speech pathologist.  Although I don't have asthma, I was given an inhaler when I had bronchitis, and it was the first thing the voice pathologist suggested I stop using.  Coughing was aggravated by reflux, so daily use of something for reflux was encouraged.  I started my vocal sessions weekly in August and finished them the following June.  It was not easy to re-train my speaking habits, and like I said, I'm still a work in progress a year later, but I'm a much more aware work in progress.  I will always have to be careful with how I use my voice, speaking and singing, but I feel I have the tools now to manage it better.  Voice lessons once or twice a month (none in December and around Easter for this church musician) Sep-May keep me honest.  Mentally, the expense goes into the self category with my hair and nails - this is money spent on me.  Professionally, it is also essential to maintain my voice.  
Good luck!  
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on November 13, 2015 4:28am
Hi Clarae
sorry to hear you are suffering this - I had the same experience over the advent season last year, my full range didn't return for seven and a half weeks! Eventually, the relief of a clean bill of health from the laryngoscope procedure seemed to unlock my anxiety. 
The he factors seemed to be
- fatigue, due to heavy workload
- high caffeine intake
- the air conditioning in the college where I was teaching half of the week
patience is difficult under the circumstances (I had ten 3-hour solo/band engagements to fulfil during the period), but the ENT specialist's advice was that steaming was the most valuable management strategy. 
Wishing you you a safe and patient recovery. 
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on November 13, 2015 9:34am
I'm a lifelong asthmatic with constant allergies.In addition to all the other good advice (including seeing an ENT and using a humidifier), it's never a bad thing to revisit the medication regimen with a specialist -- especially if you're hitting the rescue inhaler a lot. As others have said, the two inhaler usage per day may be due for a change; With so many puffs per day, be sure to drink something so the excess can be rinsed off your folds. You might also see if you can get approved for a nebulizer for home usage. I do home treatments when my asthma gets out of control. Good luck.
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on November 14, 2015 12:08pm
Listen, Clara.  An ENT is good, but better is best.  The best advice is to immediately go to an ENT who specializes in treating singers.  You do not indicate where you live whatsoever, but you MUST go to an ENT who specializes in singers' problems.  Call the opera company in the area where you live.  Get the recommendations of some of their singers.  I live the DC metro area.  I have a list of nine such ENTs. The advice of some well-intentioned people, even though based upon some experience, is not the soundest advice.  I am also an asthmatic who has bouts with bronchitis.  Those conditions kept me from a career in opera.  Dr. Barbara Doscher, a leader among the members of NATS and internationally renowned professor of vocal pedagogy, at every turn, always said, "But above all else, never, never damage the voice."  You have one voice.  It is YOUR decision.  My advice has been given.  All the best!
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on November 14, 2015 7:28pm
Even if you have to wait a long time to get an appointment, you should probably get it on the calendar. Call your local conservatory and find out who all the singers see!
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on November 15, 2015 9:00am
A lot of the experience chronicled here is similar to mine; I concur that an ENT who is very familiar with singer-actor's issues will be best.
I would add that steroid sprays can affect the vocal muscle, because of drainage toward the vocal folds.  Just as they artifically inflate an athlete's arm muscle, they can "mess with" us.
Personally, I was put on steroid spray years ago (by a doctor who was neither an  ENT nor particularly singer-experienced) and had a very unfortunate experience.  For the next 6 months, I could only squeak or wobble.   My normal sound (I was in grad school getting my Master's in Vocal Performance) was/basically still is, a clear, light lyric-coloratura.  One day, after about 6 -7 months of being off the steroid spray, I woke up and could sing normally again.  Another student in the same area had the same experience.  We both had to postpone recitals, but were fine after eliminating the steroid for 6 months.
Some will tell you that different types of steroids will have different effect.  Perhaps this is true, but our theory/experience was affirmed by a few medical professionals.
I also know of cases where caffeine is/was a factor, as Johnny McGeown wisely mentions.  I am personally lowering my intake, toward maximum vocal health.  Salmon, and similar high-protein foods,  can give energy.  (And  no red-cup issues.... smile.)
If steroids are the only option, (which is doubtful...ibuprofen can shrink swelling) I recommend that you inquire about the tapered dose-pak.
Try to get a good gentle, theraputic warm-up from a knowledgeable voice teacher, and use it consistently, building gently.  Try to stay calm, and not stress the neck/jaw/throat area; these muscles refer/connect to the voice.  Always be aware of breathing support,open- relaxed posture for breath to connect, including neck/head position.  (Many of us inadvertently jut our head/chin a bit forward as we relate to students, drive, use a computer, etc.)  Take your breath easily and slowly.  The non-sugar cough drops, for short periods, may help, so that continued coughing/wheezing does not aggravate your vocal folds.
Many of us have been where you are; I feel that all the posters here, and many other singer-teachers are sending cyber moral support! (Smile)
We hope that you are better in a timely manner, without having to compromise your health by rushing anything.  Meanwhile, find some situations (a familiar warm-up or song)where your best students can lead for you, vocally.  They may surprise you.  Also, leading with recordings at a low volume might allow you to hear things you wish to address.
Feel free to messge me for further help.
Best Wishes,
on November 27, 2015 3:57pm
This is going to sound WIERD, but I have been trying something my chiropractor recommended for sinus congestion and have been having great all around results. I have also been doing some research and this VERY ancient treatment has been known to do wonders for asthma, while causing NO HARM.
it is called Oil Pulling. At least once a day (preferrably in the morning, before you eat and before you brush your teach), swish  2-3 teaspoons of liquid oil in your mouth for 15-20 minutes (same as rinsing the ttothpaste after brushing). Any oil will do, but coconut oil is especially beneficial (you will have to melt it  in the microwave). After you are done (I use the time to put up coffee, feed the cats, get my breakfast ready), spit it out in the trash amd rinse your mouth with water. For severe problems, you can do it 2-3x a day or more.
I found within a day I had sinus drainage, after 4 days the chronic pain I have been living with for years started to improve, after a week my breathing is clearer than it has been in years and I am able to discontinue allergy pills. 2 weeks out I feel an increase of energy and well being day to day (I deal with some cheonic health issues)
Again, I know it sounds strange (and not a little yucky), but what do you have to lose? You can try it while waiting for your ENT appointment, and, who knows, maybe you won't need it by the time it arrives :-) (PS some side beneifts - my teeth are whiter, my breath is fresher and my skin looks AMAZING!)
on November 28, 2015 6:31am
Lots of Great Suggestions above, the Most Important of which is securing an appointment with an ENT Voice Specialist - a necessity- not an option, but while you wait, perhaps try Warm Tea with Honey, especially first thing in morning. Follow-up with Water instead of Clearing Throat/Coughing throughout the day, warm water or tea when possible.  I also have Vocal Warm-ups that helped me recover my voice after 31 years of teaching &  I just sang in my 4th Opera - Barber of Seville since retiring with the best range of my life:). After using these warm-ups multiple times each day during a 2-1/2 month Middle School Choral Interim position last spring  was in fantastic voice for my ALO Audition in June:)!
I ost it again after several days of teaching band and chorus on a Friday (fortunately Costume Fitting) night  as we went into production week, and recovered it in 2 days to sing a solo that Sunday and sitzprobe that evening. 
David C. Woodard, Jr

Music Education Consultants, Inc.

Fairview, NC 28730

828-628-9550 ph.
on November 30, 2015 6:59am
I am a singer, singing teacher and speech-language pathologist/voice specialist. I hope you have seen a laryngologist/ENT, as that will be the only way to know what is going on with your vocal folds. You may need the help of a voice care team- laryngologist, speech-language pathologist and/or singing voice specialist. Please consult the voice team locator here if you are having trouble finding a qualified specialist.
Karen Wicklund, DM, MHS CCC-SLP, SVS
Florida Center for Professional Voice
Applauded by an audience of 2
on November 30, 2015 10:06am
Steam 2 -3 times daily.  Drink hot water all day.  Take a hot bath.  Keep neck warm - go to bed with warm towel on neck or warm/hot water bottle on neck.  Be kind to yourself while teaching - gentle, gentle, gentle!  Peace!  Love!  And, get to ENT if no better!  :-)
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