Dear Doctor Jahn,
When I have a bad cough and sore throat, I know I shouldn’t sing, but what if I have a gig I can’t get out of? What can I do to minimize harm to my voice?
-Steve
Dear Steve,
While there are many potential causes for a sore throat and another bunch of causes for a cough, when the two occur together, you most likely have an infection. The ideal treatment of rest, hydration and not singing may not be an option if you have an important gig. So here are some things you can do to minimize harming yourself.
Let me preface this by saying that you should not make performing with an infection a habit: you need to give your body the chance to fight that infection and recover, whenever possible. You need to do three things: treat the infection, minimize the symptoms, and adjust the parameters of your performance, all with the idea of lessening the impact of the additional strain on your body.
Dealing with the infection: if you have a bacterial infection, manifested by a red and swollen throat, tender neck glands, a cough productive of colored sputum – take antibiotics. Remember to stop alcohol while you are on antibiotics. Additionally, start Vitamin C, 1000 mg four times a day. Increase your water intake, to loosen the phlegm and make your cough more effective. Other herbal-type remedies, such as garlic, can be added at your discretion.
To address your symptoms, take medications to relieve the pain and fever. Aspirin and ibuprofen are better than acetaminophen, provided there are no contraindications (such as a history of bleeding or stomach ulcers).
Relieve the sore throat by gargling with warm salt water, or drinking hot ginger tea. You can even keep a mug of this beside you on stage – audiences are used to performers sipping between songs. You should take a cough suppressant only when needed, keeping in mind that these are often a bit drying, and also that, apart from when you’re singing or sleeping, that cough may not be bad thing: it clears your chest of infection.
Next – adjust your set to reflect the temporary impairment of your condition. If you have the option of shortening the set, taking out songs that are especially demanding, tweaking the sound system, or adding more instrumental bits – anything to reduce the amount of high-strain singing – that would be great.
Finally, once your gig is over, take a break! Your immune system is working hard to get you better, and you should not sabotage that effort by pretending that everything is fine.
-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.
Dr. Jahn is an internationally renowned otolaryngologist based in Manhattan with a sub-specialty interest in the professional voice. His practice includes classical and popular singers. He holds academic appointments at Mount Sinai School of Medicine and Westminster Choir College in Princeton. He is Medical Director at Jazz at Lincoln Center, and former Director of Medical Services at the Metropolitan Opera in New York. Dr. Jahn has published several books for vocalists, including “Vocal Heath for Singers” (Singdaptive) and “The Singer’s Guide to Complete Health” (Oxford University Press).
