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sore throat

If you’ve heard a saying a million times, consider for a moment that it might be true. A perfect example: An ounce of prevention is worth a pound of cure.

If there is one thing I would want every singer to understand it is that the earlier you get plugged into good vocal hygiene and care, the less likely you are to have an injury or need surgery. If you are injured, the chances of effective resolution are much higher.

If you ignore this, and wait until an injury happens, you will never do as well with treatment as you would’ve done had you just been proactive in the first place.
Voice medicine is a minefield. There is a wide spectrum in the quality of care provided, and this includes the person who sees the celebrities or the person your friend swears is the best. This is for many reasons:

  1. It’s sexy to take care of singers so everyone wants to do it. This means even people without appropriate training and qualifications do it. You’re looking for (in the US) a fellowship trained laryngologist (not voice doctor, not an ENT). This means ENT training followed by an extra year of training in just voice medicine. In the UK, there may not be a fellowship but you still want the best exam for a singer. This is called videostroboscopy and involves placing a rigid scope in your mouth using a strobe light. This exam is recorded and played back for you to see. You will see your vocal folds vibrating, not just moving in and out. In sum, four major concepts: 1. Fellowship-trained 2. Laryngologist 3. Scope in mouth. 4. Strobe light with recording.
  2. Voice medicine has advanced a lot in the past 10 years. It takes active interest to keep on top of all the changes. This means your practice really has to be exclusively voice (rather than sinus, or other areas of ENT). This applies to very few people.
  3. Okay, it seems there are only two reasons voice care can be so bad in some places. Everyone wants to take care of singers because it’s “cool.” Most haven’t been trained to or kept on top of medical and surgical care of the voice.

Once you find a laryngologist you trust, who has shown you your videostroboscopy, don’t be afraid. Go in as soon as you find this person. Do it before you have a problem so that you can get a picture of your vocal folds and understand your voice.

The baseline (healthy) exam is extremely important because it puts everything else in the future in context. If the baseline exam shows any health issues (allergies, reflux, etc), get those things treated immediately. It will prevent injury. The only thing that is just as important as this is working with a qualified vocal therapist for voice analysis and technique assessment.

Transition to a vocal coach after that and keep on studying voice. Do not stop. Voice coaching is the key to early detection of injury and will ensure you have good technique (when you find the right coach… minefield number 2).
If your laryngologist is someone you trust, try to ignore the mythology about voice and listen to them. Not blindly. Do your research and do not take casual chances with vocal surgery. But if they are advising you to do something, or to take care of something, you should seriously consider it, despite what your friend’s friend told you. You can get a second opinion (from another fellowship-trained laryngologist who does rigid videostroboscopy) but don’t be so afraid of vocal surgery that you allow an injury to get worse.

The best time to deal with an injury is yesterday. Prevention and early intervention are the keys to a long and healthy voice career.

Reena Gupta (Guest Author)
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