Professional voice users face challenges, and the first step in dealing with these challenges is to take a detailed health and voice use history. Often the voice artist can easily identify what the problem is, but in some cases the complaints and the conditions causing them may not be clearly identified. Sometimes performance anxiety, combined with the stress of the illness, can make the performer reluctant to share their problems openly. The close relationship between the artist and the vocal doctor and vocal coach, and the fact that they know the artist in all aspects, will often be the most important support in overcoming this problem.
Professional voice users benefit greatly from accurate history-taking when trying to overcome acute or chronic voice problems. A voice doctor who has an ongoing relationship with a professional voice user is certainly at an advantage. Information is gathered on the details of the voice problem, the person's vocal training history, the frequency and quality of voice use, vocal warm-up exercises, habits, a detailed review of personal and family health history, and an understanding of the voice risks to which the person has been exposed.
If the voice problem has been present for only a short time, a recent change of voice teacher or the addition of a new song to the repertoire may be the cause of the problem. Other symptoms accompanying the voice problem should also be examined very carefully. For example, in a patient with acute laryngitis, it should be checked whether there is increased nasal mucus, headache, muscle aches and fatigue. Asking an artist who visits the voice doctor because of a voice problem about pharyngitis, nausea, vomiting or diarrhoea may seem pointless. The importance of these questions becomes clear when one considers how important these issues are for the musculoskeletal system that supports the posture required for effective voice production.
Particular attention should be paid to laryngopharyngeal reflux, which means direct contact of stomach contents with the voice-producing mechanisms. Although the common belief is that reflux is only a bitter taste in the mouth, silent reflux in fact affects many individuals. This is seen more often in people who consume spicy foods and use tomato-based sauces. Reflux can be diagnosed without causing the patient any discomfort, using routine voice assessment equipment such as videolaryngoscopy. The effects of reflux on voice quality have also been demonstrated objectively in clinical studies (H. Oğuz, et al. Journal of Voice). Although reflux has many symptoms, the symptoms we particularly see in voice professionals are hoarseness that is more pronounced in the mornings and prolonged voice warm-up times.
Many endocrine problems, especially menstrual cycle abnormalities and pregnancy, can affect a person's voice performance. The effect of oral contraceptives on the voice has been known for many years. Preparations with a high progesterone content have been reported to cause a woman's voice to deepen towards a more masculine tone. Although the oestrogen and progesterone ratios in commonly used oral contraceptives are very balanced, 5% of users still report voice problems. For this reason, this should not be overlooked in female artists.
Similarly, while almost any drug can affect the voice, certain groups of drugs have a much more significant effect on the voice. For example, some types of medication used to treat hypertension can thicken or dry secretions or cause chronic dry cough. Trauma to the vocal cords due to repeated coughing or inadequate secretion can lead to treatment-resistant oedema of the vocal cords.
I wish you a healthy voice.
