Life on the road is rough, you tend to eat on the run and whatever is put in front of you, if anything. You might also be drinking alcohol on your breaks. There are some natural steps you can take to stay healthy on the road to maintain your energy levels and take care of your voice. You may be hurting your voice and developing polyps on your vocal chords. These articles are for information purposes, they are not a prescription or diagnosis. As always, see a physician at the first sign of illness or soreness of your vocal chords. 

Articles were collected from natural health organizations, on the web, and stuff accumulated from www.peaceandharmony.org.

Vocal Health

BOGART-BACALL SYNDROME

Many people with low-pitched speaking voices, who complain of vocal fatigue (worsening of the voice with "prolonged" usage), odynophonia (soreness or pain in the throat with "prolonged" vocal usage), and dysphonia (hoarseness), suffer from "Bogart-Bacall Syndrome". The condition is most common in professional voice users such as singers, actors, and radio or television personalities. Such people often employ a habitual speaking fundamental frequency (habitual pitch) that is too low and therefore very inefficient, thus producing a kind of muscle tension dysphonia. And this is why the condition is called "Bogart-Bacall" syndrome (BBS); both of those great actors had noticeably low-pitched voices. (not to imply that either Bogart or Bacall had voice disorders as a result). For most people, to maintain a very low-pitched speaking voice (particularly when one uses the lowest pitch of one's pitch range), considerable effort is required. Most people with this condition are unaware of the effort required, at least until trouble develops.

In contemporary society, a low-pitched speaking voice is generally considered to be authoritative, worldly, and sophisticated. Until the last few years, a low-pitched resonant voice was almost a prerequisite to become a radio or television news person.

Although some people consciously choose to employ a very low-pitched speaking fundamental frequency (SFF), usually the selection of one's habitual conversational pitch is unconsciously determined. Perhaps, Bogart-Bacall Syndrome, which is more common in women, is to some extent, the result of social pressure on professional women to compete with men in the business arena. In actuality, however, no one knows why people get Bogart-Bacall syndrome (BBS).The pattern of muscle tension seen is termed "MTD III"

A low-pitched SFF is not the only feature of the BBS. Also usually present is poor breath support for speech
and apparent muscle tension in the larynx.
"Poor breath support" refers to inefficient regulation of the air stream that drives the vocal folds. This problem is common in many types of voice disorders. Interestingly, when BBS occurs in singers, MTD III is not present during singing. For some reason, perhaps due to vocal training, good breath support is exhibited during singing, but not during ordinary conversational speech. Ironically, singers with BBS may complain only of problems with the singing voice. It may be that the increased vocal demands of singing unmasks the tension and fatigue that results from the muscle tension of chronic inefficient speaking.

Preventing Vocal Chord Nodules

Repeated hoarseness, breathy or "husky" tone (especially in the middle register), difficulty singing in the upper register (especially the inability to sing high notes), the need to use greater-than-normal breath pressure to sustain the voice, thereby increasing the overall effort of singing -- these are danger signals that indicate the possibility of nodules on the vocal cords.

Normal vocal cords have smooth, white mucosal surfaces without any irregularities on the vibrating borders. Excessive tension or force used when singing or speaking often "overloads" the vibration of the vocal cords, resulting in too much friction. A bruise on the vibrating edge develops. Fibrous tissue replaces the bruise, becomes larger, and eventually appears as a soft or hard white nodule.

Treatment of Nodules

Once vocal nodules have been diagnosed, treatment usually begins with complete vocal rest followed by a careful regimen of speech therapy and/or appropriate singing exercises. If the nodules are large, surgical removal may be necessary. However, regardless of how the nodules are treated, it is imperative that destructive singing or speaking patterns be corrected. If the singer returns to his or her old habits of voice production, the nodules will return.

Prevention

Proper vocal technique and a sensible lifestyle, which includes necessary rest and relaxation, aerobic exercise, and a healthy diet, are sufficient to prevent vocal nodules.  Recent studies of the laryngeal biomechanics of singers at the Center For Voice Disorders have shown that excessive muscle tension patterns in the larynx are greatly reduced in singers with vocal training, as compared to singers who have never studied voice.

Appropriate voice classification is essential; singing out of range is asking for vocal trouble. Likewise, singers should use care in developing the extremes of their range, and should avoid singing too many high (or low) notes during a practice period. Singers should also be aware that the "correct technique" applies not only to their singing voice, but also to their speaking voice. Misuse of the speaking voice, usually by forcing it to a lower pitch, causes problems for singers, including the possibility of developing nodules.

It remains the responsibility of the singer to maintain optimal vocal performance through a sensible regimen of daily practice, including a careful warm-up before all rehearsals and performances. No athlete would attempt to compete without warming-up, yet singers frequently neglect to prepare themselves adequately for the physical intricacies of singing!

Certain types of singing are much more prone to the development of vocal nodules: rock, jazz, gospel, and most popular styles, for example, in which the technique resembles shouting or screaming, greatly "overload" vocal cord vibration. Performing for long hours in the smoky, dusty, and noisy environment of nightclubs further aggravates a tendency toward vocal abuse. The prevalence of nodules among popular singers is often evidenced by the typical "husky," or "breathy" tone quality -- a characteristic sound that can become a personal "vocal trademark." Many singers diagnosed with nodes do not wish to treat them, for fear of losing their "persona". Continued vocal abuse (singing with nodules), combined with smoking, alcohol, or drug abuse can lead to serious laryngeal disease, including cancer. The fact that many popular singers are untrained also increases their chances of vocal disorders.

Regardless of the style of singing, rest and relaxation are essential antidotes to the rigors of extensive vocal use, nervous tension, and performance stress. Proper diet is important, especially since many voice disorders result from gastroesophageal reflux disease, in which stomach acid backs up into the larynx, causing irritation of the vocal cords. Overuse of alcohol adversely affects the voice through its drying effect on the tissues of the vocal tract. The damaging effects of cigarette smoke, including "secondhand smoke," obviously should be avoided by singers. Any drug that is inhaled, swallowed or injected may affect the muscles of vocal production. Commonly used drugs, such as antihistamines, can irritate the vocal cords through over-drying of the mucosa, and aspirin can increase the tendency to hemorrhage. A routine of aerobic exercise, yoga, and/or meditation, can greatly help to relieve stress and tension, thereby enhancing the singer's overall well-being.

Common Problems of Professional Vocalists

  • Upper respiratory tract infection (URI, "cold," laryngitis)

  • Gastroesophageal reflux-related voice abnormalities

  • Overuse syndromes ("decompensation")

  • Vocal abuse syndrome

  • Misuse of the speaking voice

  • Environmental factors

  • Singing out of range

  • Substance abuse

  • Medications

    Unique Problems of Professional Vocalists
    Vocal Overuse
    • Heroic schedule
    • Inappropriate time management
    Vocal Misuse/Abuse
    • Singing out of range
    • Inappropriate role selection
    • Use of certain character voices
    • Vocal-fold hemorrhage
    • Yelling/Screaming
    • Vocal nodules
    Environmental Risk Factors
    • Noise pollution
    • dryness
    • Inadequate amplification
    • Dehydration
    • Air travel
    • Poor diet
    Anxiety/Panic
    • Bulimia/Anorexia
    • Substance abuse
    Reflux Laryngitis
    • Substance Abuse
      • Tobacco
      • Alcohol
    • Drugs
      • Cocaine
      • Marijuana
      • Beta-blockers
      • Stimulants
    • Medications
      • Antihistamines
      • Corticosteroids
      • Anti-inflammatory drugs
      • Throat sprays
    Suboptimal Medical Care
    • Inappropriate surgery
    • Inappropriate medicine
    • Inappropriate advice

Taking Care of Your Voice

-Avoid excessive throat clearing.
-Keep the speaking voice at a low intensity.
-Avoid talking and singing over loud noises.
-Blow away tension before talking or singing.
-Rest the larynx when not using it.
-Reduce vocal demads.
-Avoid smoking and second hand smoke.
-Avoid using an unhealthy voice.
-Avoid mucosal-drying agents such as caffeine and alcohol.
-Maintain mental health and manage stress. 

Vocal management includes:

-Reduce quantity of singing; fewer lessons, more use of instrumental arrangements,
 feature other memebers of the group.
-Use monitor speakers facing the stage.
-Discuss vocal needs with the sound technician.
-Avoid use of chest voice at high pitch levels.
-Rest the voice on performance days.
-Rest between sets or scenes.
-Arrange the music to suit your voice; change keys if necessary.
-Pace your practicing.
-Reduce choral/choir singing.

Drying Irritants:

  • caffeine
  • chocolate
  • alcohol
  • antihistamines
  • diuretics
  • cocaine
  • cigarette smoke
  • marijuana smoke
You may be able to continue to use some of these items by drinking lots of water to compensate for their drying effects. Before a performance, or strenuous voice use, avoid them altogether. Of course, smoking is highly dangerous both to the health of voice (your lungs and larynx and mouth and throat) and of your body (including your heart). Quitting smoking is strenuously recommended by all voice teachers. As for caffeine, some people have recommended in the past that voice users "avoid brown drinks", which would be a suggestion to avoid coffee, tea, hot chocolate, cola and rootbeer because they tend to have caffeine in them. 

Some irritants are problems because they cause the creation of copious thick mucous. The best way to deal with mucous is to be hyperhydrated so that the mucous remains thin, and can drain away.
Things to watch out for:

  • nuts
  • dairy products
  • hormones
  • allergens & pollutants
  • dust

The next group of things to watch out for tend to create upset stomach, which can cause gastric reflux. In this situation, the acids in the stomach rise up the oesophagus to irritate the tissues of the vocal folds.
Watch out for:

  • spicy foods
  • fad diets

Additional Irritants

  • aspirin and ibuprophen: make it easier to have a hemorrhage on the vocal fold
  • birth control pills: occasionally affect the vocal folds
  • fatigue: when your body is tired, your voice is also

Environment

Many people injure their voices by working too hard - by trying to compete against the sounds of loud machinery, loud music or crowd noise. If that is the case, try to use amplification equipment if it is appropriate. As stated before, you want to avoid drying environments. Some industrial spaces, frequently rented for rehearsal space at low cost, are actually toxic - not just to your voice but to your whole body. They may also have been used for industries that carry lots of allergens. Avoid or use caution in spaces which are:

  • noisy
  • smokey
  • outdoors
  • cold
  • dry
  • dusty
  • industrial

Voice Care: Natural Remedies

You want to rehydrate your voice as best you can. Work in a humidified environment, if possible. Drink lots of water. Inhale steam - there are now portable steam inhalers available on the market, though the old technique still works well (and is great for your skin):

  • boil a pot of water on the stove
  • once boiling, remove the pot from the stove top
  • place your head over the steam
  • place a towel over your head and the pot
  • breathe deeply

D not use an over-the-counter throat spray to stop the pain. Chloroseptic has a spray product out that numbs the feeling, which can lead to your doing even more damage to your voice. 

Lozenges

  • Olbas
  • horehound drops
  • Fisherman's Friends
  • Megazones
  • Slippery Elm
  • Larydol (homeopathic)
  • Zinc lozenges (put under tongue for sore throat, one per day)
  • Red Indians Ginseng throat drops
  • Avoid lozenges with analgesics

Teas & Drinks

Most of these just make you feel better. Warmth helps sooth the pain, lemon is an astringent - so only use it when you feel like you have mucous.

  • Lemon & hot water
  • Herbal Teas
  • Ginger & Ginger Tea
  • Traditional Medicinals "throat tea"
  • Pure Ginseng Tea
The following are herbal/naturopathic medicines - these are not offered as a prescription, just as information for you to choose to try or not, as a natural means of caring for your voice.

Throat Remedy:

  • Collimsonia herbal tincture
  • horehound drops

Cough Remedy:

1 tsp. lobelia leaves
boil in 1 c. water, let simmer
add touch of honey
use in spritz bottle to get to back of throat

Immune System Boosters

  • Echinacea
  • Golden Seal
  • Fenugreek

Essential Oils

  • Eucalyptus
  • Lavender
  • Steam Inhalations
  • Olbas tincture
  • Eucalyptus Essential Oil
  • Frankincense Essential Oil


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References

Articles edited and excerpted for this site
Copyright, Center For Voice Disorders of Wake Forest University
Koufman JA, Blalock PD: Vocal Fatigue and Dysphonia in the Professional Voice User: Bogart-Bacall Syndrome. Laryngoscope 98: 493-498,1988
Koufman JA, Blalock PD: Functional Voice Disorders. Oto Clin N A 24:1059-1073,1991
Blalock PD: Breath Support. The Visible Voice 1:6,April,1992

Teresa Radomski, MM
Minot State University
Roosevelt University
peaceandharmony.org

 

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