Music Moves

Perspectives & Insights from a Local Music Therapist

Hey there! Thanks for dropping by Theme Preview! Take a look around
and grab the RSS feed to stay updated. See you around!

As promised last post, we’re going to take a look this week at an experience I’ve embarked on many a time before due to my personal intuition, but never before been medically mandated to do until 3 weeks ago: vocal rest.

There are two main kinds of vocal rest – partial and complete.  I’m dealing with the former, under which I am required to abstain from singing and limit the use of my speaking voice, though when I do speak I’ve been instructed to speak in my normal tone (whispering actually strains your vocal chords more than just speaking).  If I were on total vocal rest I would have to be completely silent, and believe me, partial rest is hard enough, thank you very much!  My prescription (yes, I actually have a prescription from my doctor with “partial vocal rest” and a list of restrictions on it) lasts for 8 weeks, which puts us into mid-September – a long time for this singer to go without singing!

Now, I mentioned that in the past I’ve put myself on vocal rest just intuitively – as a voice student in college, I was trained to know my limits vocally,  so if I felt my throat was sore, or my voice wasn’t performing the way I was used to, I would stop and cancel a few sessions (or modify what I was doing or eating – alcohol and caffeine can dry your throat out) to try and let things work themselves out.  Usually that would help – but in the case of my issues this summer, no matter what I did, the soreness and difficulty singing that I experienced on and off after a cold in May just seemed to come back no  matter how long I tried.  I actually had myself on vocal rest for 6 weeks before my regular doctor referred me to an Ear Nose & Throat specialist who stuck a camera up my nose (and ultimately, down my throat) to figure out what was going on.

Below is an image of what your vocal chords (which are located in your larynx, a part of your throat) do when you’re breathing vs. when you’re projecting sound, like speech or singing.

A simple graphic of what your vocal chords look like while breathing or making sound.

As you can see, your chords remain open for receiving air and then come together for projection of sound.  Sustained sounds (like singing) will actually cause the chords to vibrate against each other.  Now picture a gardener shoveling dirt – if they do a lot of shoveling in one day, they might get some irritated skin or blisters from where their hands make contact with the shovel, and if they continue working hard over time those blisters may turn into callouses.  The same thing can happen to your vocal chords – the folds that make them up can become irritated and swell, as mine have, and over time, if untreated, they can harden into callouses called nodules. Remember the singer Adele, and the surgery she had to have to fix her voice? She was out of commission for over 6 months – those were vocal nodules.  And she was one of the lucky ones to recover so well after surgery – ever wonder why Julie Andrews doesn’t sing anymore? She had surgery for vocal nodules and her chords ended up damaged in the process.  She’ll never sing like she used to again.

Now, like I said, what I have is swelling on my vocal chords that can be a precursor to vocal nodules, so they’re not nodules yet, I just have to make some major modifications to ensure they don’t become them!  In addition to 8 weeks of vocal rest, I’ve also been prescribed medication for acid reflux (Surprise! Stomach acid can erode your vocal chords!) and made some lifestyle adjustments, like cutting out caffeine and dairy products (caffeine I figured, but I used to drink milk when I had a sore throat because it coated my throat and felt good going down, who knew it could actually exacerbate acid reflux symptoms!). I’m also experimenting with raising the head of my bed a few inches so acid doesn’t creep up while I sleep.  That adjustment I actually like! Been pretty good for my back, actually… after my 8 weeks are up, I’ll see my ENT and his little camera again, and hopefully then he’ll give me the go-ahead to start seeing my voice teacher again and gradually progress back into singing once more.

Here’s how my weeks of vocal rest of gone so far:

 

WEEK 1: I had already scheduled the week off after my Braille Music Institute at the ND School for the Blind, so there was one week where it was really easy to be quiet – I didn’t even listen to music, the temptation to hum along (or just feel depressed that I couldn’t) was too great. When speaking to my husband or close friends, I cut out unnecessary words like “Hello,” “Goodbye,” “Yes,”  “No,”  “Maybe,” and sounds like “Mm-hmm” where my meaning could just as easily be construed with a gesture.  For those friends that knew a little Sign Language I used that as well, and used whistling to announce my entrance into rooms of crowded people, like the birthday party we had one night that week for a friend.

WEEk 2: After one week of vocal rest my throat was finally starting to lose it’s constant ache, so I returned to working just at my office at School for the Blind, but even that I’ll admit was an adjustment.  I emailed everyone in advance of my return that I would be limiting my speaking and preferring email over phone correspondence, but I ended up additionally having to shut the office door I usually leave open so folks knew I was in, just because I found it made it less awkward to have people greeting me from the hallway and expecting a reply when I couldn’t project loudly enough.  That way if anyone needed to find me, they had to come in or send me an email.  Phone conversations have been difficult because in trying to limit my speech output, it can be easy to misunderstand me or assume meanings that I haven’t meant to imply with my silence, so that’s been an adjustment as well (especially with my parents, who don’t text, out of town for two weeks and calling every so often to check in!) I even wrote up a note that reads “I have a vocal chord injury and canny talk.” for particularly loud environments, like the rock concert a friend and I went to my second week of vocal rest.  We’d purchased the tickets a month ago, so I didn’t want to pass them up, but I have to admit I was worried about being in such a noisy setting and not being able to speak for myself. I ended up having a wonderful time, albeit feeling a little sad whenever the lead singer would say “I wanna hear you scream” and all I could do was clap more loudly and do a little dance in my chair!

WEEK 3: I’m now starting to return to some of the sessions I’d struggled to lead or dropped back in May after my cold.  I’m finding new ways to conduct my sessions and make music that don’t involve my voice.  That may seem like a “no duh!” moment to the average individual, perhaps even to most other Music Therapists, but my voice has always been such a central part of my sessions – I even have clients that greet me by yelling “singing!” It’s going to be a major adjustment for me to operate full sessions without doing so.  My free children’s group is one that I don’t think I can manage without being able to sing, so that group will remain on hiatus until I get the go ahead in September, though I’m welcome to suggestions on non-singing activities any of you readers use out there! I’m finding great comfort in reaching out to my musical community during this time – we have lots to share and lots to give! I hope to share more of what I’ve learned over the next few weeks, hopefully culminating in a Week 8 post that reads “Huzzah, I can sing again!”

 

You can leave a response, or trackback from your own site.

4 Responses to “Lessons in Vocal Care (from an MT on Vocal Rest)”

  1. Maxx! says:

    wow! thankyou so muchfor sharing this! I willtry vocal rest…soooooo hard tonot be able to sing though….mythroat feels constricted….but due if it’s allergy/asthma symptoms or due to vocal overuse causing imflamation….frightened I could be developing permanent problem… so your comments are truely very helpful they reaffirm that I mayreally need VR !
    thanks
    Maxx!

    • You’re very welcome! One thing I’ve definitely learned is it’s always better safe than sorry with vocal rest – you can find creative ways to still do what you need in a session while using your voice less or otherwise giving it the space to rest when you’re feeling tired or strained. Glad my posts on the subject have been useful!

  2. Jordan says:

    Thanks for this! I can’t go on complete rest either, so I’ve eliminated singing and try to talk as minimal as I have to (which can still be a decent amount, but I make sure not to tire myself out or shout in bars etc), while doing some light lip rolls and humming to see where my progress is at.

    So far, I’ve gone two weeks, and there’s been improvement but there is still much more to be done. Seeing how you had an 8 week prescription, that makes me feel better about how long it could take.

    I had some bad acid reflux, but not eating before bed seemed to fix it as I at least now don’t have any noticeable sensations of reflux. Hopefully in the next few weeks I’ll get a job and then see an ENT just to be sure.

    • Hi Jordan! I’m just realizing I never replied to this, but hope you are doing well! I regularly “checked up” on myself with light lip rolls and humming during my rest as well, found it helped ease my mind to at least know I could still make sound if I wanted to periodically :-) My acid reflux has definitely been on ongoing problem though – I’m still on Prilosec to this day (a year and a half post vocal rest!) and I haven’t been able to go back to eating dairy, but I’m singing more healthily than ever and been able to go back to eating the occasional spicy dish to boot, so life, despite the modifications I’ve had to make, are good! Best of wishes to you and your vocal journey!

Leave a Reply