HEALTH CORNER
The election fever reaches the homestretch today as millions of Filipinos troop to the polls. During the past many months, we’ve been exposed to the din of sundry sound bites – from political rhetoric, to potshot exchanges, to frenzied debates not only from the candidates for national offices but also from the general public.
We have been witness to a slew of voice abuse or the use of our voice in a prolonged period of time in high volume or frequency. Many of us engage with this type of activity without realizing about its damaging effects on our health. It happens when we commit excessive talking, speak or sing too loudly or at an abnormally high or low pitch, frequent throat clearing, coughing, inhaling irritants, smoking, shouting or screaming.
These activities are considered abnormal because they cause stress or injury to our vocal folds. They result in the trauma of the larynx and vocal folds. Prolonged vocal abuse or misuse can cause lasting or permanent damage to our vocal function, voice quality and, possibly, loss of voice. This is because the excessive activity of the muscles involving the larynx (intrinsic) and neck (extrinsic) affects our vocal function and is considered a contributory factor to a spectrum of symptoms which leads to the diagnoses of Muscle Tension Dysphonia (MTD).
MTD is the technical term for stressful or strenuous overuse of the voice which results to vocal dysfunction. Over time, untreated MTD results in worsening of symptoms, including loss of vocal range and pain when talking, singing or performing. It can also manifest through a rough or hoarse voice, deepening of the voice, difficulty projecting, throat pain with voice use especially while performing, vocal fatigue, sudden change in voice pitch, sense of strained or effortful voice and voice quality that worsens with use but recovers with rest
To determine if you are suffering from MTD, you should see an expert laryngologist. A laryngologist is a medical subspecialty specialist who has training and education in the branch of medicine concerning the larynx, pharynx, and fauces after he/she has obtained the otolaryngology (ENT) course. Only a laryngologist possesses the specialized and focused training that is critical for the comprehensive evaluation of vocal pathology.
During your evaluation for your laryngologist, he will use cutting edge technology including stroboscopy and flexible laryngoscopy to visualize the function of your laryngeal muscles and vocal folds. These diagnostics allow your skilled specialist to effectively observe any dysfunction or abnormality that may be present in generating your voice. The diagnosis is ruled in after finding no evidence of mucosal disease of the larynx.
MTD is caused by many factors including psychological/ personality factors, technical misuse of the vocal apparatus that tends to push the voice beyond its limit, learned adaptation following an upper respiratory tract infection or trying to whisper, and, compensation for underlying disease like paralysis of one’s vocal cord. The symptoms include hoarseness of voice which is progressively worsening after prolonged vocal activity (towards the end of the day), pain over the anterior neck area, and strained, strangled, or tensed vocal quality. If untreated, it can lead to laryngitis, vocal nodules, vocal polyps, and contact ulcers.
Management of MTD includes voice therapy which has two types of intervention: the voice hygiene intervention and the voice production work. In voice hygiene intervention, the patient is taught to take care of his/her vocal fold tissue. People who use their voice for their profession like the singers, announcers, call center agents, teachers, trainers, coaches and others will find it important to know the components of voice hygiene.
Some of the practical voice hygiene tips that we can easily observe are: (1) maintaining the vitality of the vocal folds by proper hydration which is through drinking of water in small frequent sips; (2) avoiding trauma to the vocal folds by refraining from extreme vocal activity such as yelling and talking with glottal attack, (3) treating the muscle of the vocal mechanism like any athletic mechanismmaking use of vocal exercises for teachers and other professional voice users, vocalization for singers, doing vocal cool downs after strenuous vocal activity, (4) voice conservation by avoiding unnecessary voice use.
Voice production work teaches a patient how to use vocal mechanism in a way that produces the best possible sound to helps reverse the injury. The sensitivity of the larynx to stress, emotions, and other psychological situation is addressed with this type of intervention. Voice-facilitation techniques are also designed to relieve tension in the laryngeal area. Manual reposition of the larynx can also be undertaken through kneading the circumlaryngeal area reducing tension in the neck muscles.
The simplest Do-It-Yourself remedies for many of our vocal health problems can be done by taking note of the following: (1) turn the TV or radio down instead of talking over the top of them, (2) give up smoking, (3) drink plenty of water especially when talking or singing and, if possible, always bringing a bottle of water in our work area, (4) taking a fresh air breaks especially when we work in smoky or noxious environments, (5) resting our voice especially after lots of singing or talking, (6) pacing our voice by not using it too much, too often and having a rest breaks in between periods of use, (7) trying to whistle instead of are yelling when we want our team to know of our support, (8) swallowing instead of clearing our throat all the time as this reduces the abrasion, (9) avoiding too much stress, (10) keeping whispering to a minimum as it is quick to cause vocal fatigue, (11) maintaining a good posture that is in an upright, balanced posture which is very helpful in reducing stress on the body and promoting optimum vocal tone, and (12) avoiding drying out medications like cold cures and antihistamines.
Vocal health is very important for everybody of us and not just for teaches, singers and those who use our voices a lot and as our way of living. It is of utmost importance that we are aware of and be well-informed about the means by which we can keep good our vocal health because our voice is our primary tool for communication. For more information about vocal health and conditions, please call the St. Luke’s Medical Center Voice Swallowing & Sinus Disorder Service Center at 723-0101/0301 ext. 4715/4716 (Quezon City) or 789-7700 ext. 2055/2056 (Global City).