My Voice Has ‘Deserted’ Me…

Cartoon doctor with a choir

Hello Dr. Jahn:

I’ve just moved to the desert and my singing voice is not the same. I’m assuming that my allergies are responsible for my constant mucus. When I hit a high note, it sounds awful. Furthermore, my left ear is always clogged up. Various remedies such as honey, water, neti pot etc. do not seem to work –and I have a gig next week. Help!

– Eve

Dear Eve:

You’re most likely dealing with an overly dry climate. The vocal folds work best if the larynx is hydrated, both internally (the deeper tissues), and on the surface. When the vocal folds vibrate, especially at higher frequencies, there needs to be a thin layer of fluid covering them. In effect, the contact between the two vocal folds is this cushion of thin fluid. 

You can compare it to ice skating: the reason your skates glide easily on ice is because the blades slide on a thin layer of water, which is generated by heat, which is generated by the weight of the skater. The actual sliding (or vocalizing) takes place on a fluid-covered surface; If the fluid is not there then, in the case of the vocal folds, the voice sounds thin and rough. Trying to produce your normal sound only leads to excessive squeezing and further rubbing together of two dry vocal fold edges.

Sooo – you need to hydrate! Drinking water is helpful, especially if it’s hot outside, and even more so if you exercise. I would suggest at least 60 ounces, spread over the course of the day. Keep your nose hydrated as well, with frequent sprays of saline. This is one situation where a small squeeze bottle of saline used frequently is actually more useful than a Neti pot. If you can obtain a saline nasal gel (marketed in the US under the brand name NaSal) this is even better, since the gel adheres to the nasal lining and keeps it moist longer. Once your nose is wet, please remember to breathe through your nose (rather than you mouth) as much as you can; this humidifies the inhaled air, and reduces laryngeal dryness.

Another issue may be allergies. The flora indigenous to deserts is usually not very allergenic, but we have imported a lot of non-indigenous plants to these areas (this is certainly true in areas of the US like Arizona), and with these plants come allergies. The dry desert wind carries pollen more easily and for greater distances. Once the pollen is inhaled into a respiratory tract which is dry (i.e. under hydrated), it is more easily carried down to the larynx and the bronchial tubes. So allergies are also a consideration- the dilemma here is, should you take a drying antihistamine to combat this? Look either to non-drying medications like Singulair (a leukotriene inhibitor, not an antihistamine), or natural anti-allergy remedies such as stinging nettle tea or capsules. Longer term allergy relief may be aided by eating local honey, which gently exposes your body to pollen- sort of like taking anti-allergy shots!

And finally, what is the elevation of this desert? Singing at higher altitudes actually adds to the misery, because the air is thinner, and makes it more difficult to support the voice. The body does get used to this thinner air over time, but initially you definitely need to use more muscle effort to get the voice out.

-Anthony F. Jahn, MD, FACS, FRCS(C)

This discussion is for general information and not to be construed as specific medical advice that you should obtain from your own physician.

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