sive friction related to overuse, such as yelling and improper use of the speaking voice. A polyp is a swelling anywhere along the vibrating edge of a vocal cord. Polyps are typically filled with blood or gelatinous fluid. Hoarseness and pain are the most common symptoms of nodules and polyps, and should said symptoms continue to occur aſter attempts at vocal rest, the best course of action is to visit a specialist who can examine the cords via video-scoping. Vocal cord bowing occurs when the vocal folds adduct on the posterior (back of larynx) and anterior (front of larynx) parts of the folds. Te most common symptom associated with bowing is breathiness (hypo-phonation) in the vocal tone. As in the case of polyps and nodules, recurrent symptoms should be addressed by a physician.
A personal story
For the last few years I have been pondering my own vocal health and finally, in the fall of 2017 I consulted with Dr. Rachael Gates, professor of voice at Grand Valley State Uni- versity (I referenced her excellent book above), and began not only a series of visits to an ear/nose/throat specialist and a speech language pathologist (SLP), but also twice weekly voice lessons/therapy (with Dr. Gates). Visits to the doctor and SLP revealed that my vocal cords were under a great deal of stress with extreme reflux disease and a congenital deformation on both vocal cords known as a sulcus. Both of these disorders are organic and can only be confirmed by a physician.
Te reflux disease is caused by excessive acid in the stom- ach, which bubbles out of the esophagus and spills over into the vocal cords (the larynx and esophagus are literally next door neighbors in the throat). Treatment is typically made with a prescription of Prilosec or similar medication to reduce production of stomach acid, but in my case I had already been taking the medicine for years, so aſter a visit to a gastroenterologist (stomach specialist), my dosage was doubled. Of course, there were other recommendations, such as raising the headboard on my bed to aid in keeping acid from coming up while I sleep and to watch my diet for foods that could increase acid production in my stomach. Te other condition, the sulcuses, was quite a surprise.
A sulcus forms when the many upper layers of the vocal folds start to fuse together, causing indentations in the vocal folds. Tese indentations make it very difficult for the vocal folds to fully adduct and result in a husky, airy speaking tone. I had also been experiencing a great deal of vocal fatigue when singing because I was working very hard to produce a clear tone—I was literally willing my vocal cords to fully adduct. Te diagnosis of bilateral (both vocal cords) sulcuses explained why I was loosing my voice so frequently in choral rehearsals. Moreover, this condition explained
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why I experienced difficulty maintaining longer phrase lengths when singing (my vocal cords were literally leaking air). Two solutions were presented: 1) bimonthly injections in the vocal cords to build up bulk to facilitate full closure of the vocal folds and 2) regular voice therapy. Te injections would prove to be quite costly and the only medical facility offering such a treatment is in Ann Arbor, quite a distance from my home and work in west Michigan. Since my voice teacher is an expert on voice disorders, the SLP suggested that my work with Dr. Gates would be quite beneficial.
A plan of action to remediate vocal distress
My recent vocal lessons have been a combination of tradi- tional technical instruction and therapeutic massaging of the vocal cords. Te first order of business was to adequately hydrate my body by drinking in ounces one-half of my body weight: I weigh approximately 190 pounds so I was required to drink 95 ounces of water (three quarts!) each day, in addition to other liquids I chose to ingest, such as coffee and soda. Yes, there were many trips to the bathroom at first, but over time my body learned to make good use of the liquid and the bathroom annoyance dissipated. Aſter discussion with my physician, I also realized that my sleeping habits were not conducive to healthy vocal production. I have tried to establish regular times for going to sleep and awakening, with a minimum of seven hours nightly.
Next, Dr. Gates prescribed a morning vocal regimen that I had never undertaken, but now utilize almost every day. Soon aſter awakening, and before I speak a single word, I vocalize on an “ng” to a sol, fa, mi, re, do pattern, starting with C3 (octave below middle C) as the “do” and moving as high as G3 as the “do”. I move up and down by half steps, repeating the vocalization for five to ten minutes. Following the “ng” vocalizations, I change to “mee”, using the same pitch pattern and continue for another five minutes or so, working up and down chromatically. Due to the constraints of a written article, it is difficult to describe the sensations that I aspire to achieve in this process, but needless to say, I’ve experienced somewhat of a miracle in that this morning warm-up provides me with more stamina than I’ve experi- enced in two decades.
In addition to the warm up regimen, I was encouraged to be mindful of continuous healthy use of my voice; therefore, I raised my speaking pitch and became conscious of breath- ing more deliberately when I speak, since I tend to finish sentences with very little air. Over time, I have increased my stamina to the point that I can enjoy a full day of work without losing my voice. Of course, the brief discussion that I have provided doesn’t provide the complete picture; therefore, I have embarked on a line of inquiry involving auto-ethnography. With the help of a colleague (an anthro-
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