Dear Doctor Jahn,
Is it okay to keep singing even when I’ve got a cough and sore throat? On the one hand I don’t want to by a hypochondriac afraid to stretch myself, but on the other hand I don’t want to do any damage which will affect the gigs I have after I get over my cold.
In general, when you have a cold or a sore throat, it is better not to sing. But not everyone has the luxury of cancelling gigs when they get sick; for many reasons – professional, financial, personal, the show may need to go on. While opera singers often have the stage manager make an announcement before the opera, hoping for a more forgiving and supportive audience, this is not the custom with popular music. So if you do need to perform with a cold or a sore throat, first, do whatever you can to minimize stress on your throat.
Some suggestions are, reducing the number of songs in the set, eliminating songs that are particularly high and “belty,” substituting songs that are more limited in range and dynamics, transposing down (if you have time and opportunity), amplifying more aggressively, and absolutely avoiding social voice use between sets.
Once you have adjusted all of these “environmental” factors, treat your specific symptoms aggressively. For a sore throat, take analgesics (aspirin or ibuprofen) to control the pain. Hot ginger tea is great for sore throat, and warm saline gargle can also reduce the discomfort.
For nasal congestion, take Sudafed (pseudoephedrine); this will decongest and open your passages, and is less drying than antihistamines. I generally recommend staying away from proprietary compounds such as DayQuil, since they often have more ingredients than you need (like a cough suppressant), and tend to be quite drying. A decongestant nasal spray such as Otrivine or Neosynephrine is also useful. Drink plenty of water throughout the show – just have that water bottle up there beside you on stage; this has now become an accepted convention, so ask for it before you start your performance.
Remember, when you sing with a cold, your voice will not sound normal, and how you produce that voice will also be impaired. Don’t try to produce your “normal” voice. Based on your auditory memory, your laryngeal agility, resonance and projection will be altered by the infection, and trying to achieve your normal sound may lead to excessive strain on the vocal tract, which may need voice therapy later on to undo. You will know this is the case if your voice continues to sound abnormal after the infection has cleared, or if you continue to experience throat pain or excessive strain during singing.
-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).