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Irish Singer Regains Voice After Damage to Vocal Cords By Pat Cahill The Republican (Springfield, MA) Wednesday, September 8, 2004 Edition: All, Section: LIFESTYLE / ARTS, Page E05 pcahill@repub.com  While sitting in the stands watching the Holyoke Giants recently, Sheila Healy of Chicopee kept worrying that somebody was going to get hurt.
Not one of the players. The announcer. The man's enthusiasm was downright painful to Healy. "He was so hoarse," she said. "He was screaming." Healy knows only too well the damage that can be done to vocal cords. A well-known singer in the Irish-American community, Healy lost her voice, got it back, and is more aware than ever of good vocal hygiene. She had been afflicted by hoarseness for years by the time she developed a polyp, a large fluid-filled sac "that took up 40 percent of my right vocal cord." Two years ago, she underwent surgery at Noble Hospital in Westfield, where voice care specialist Dr. Gregory Gallivan removed the polyp. Gallivan is himself an opera singer. But at the rate Healy was going, there was the possibility that the problem would recur. So she was referred to Margot Greenwald, senior speech-language pathologist at HealthSouth Rehabilitation Hospital in Ludlow. Greenwald and her colleagues use an eight-week intensive therapy called Lessac-Madsen resonant voice therapy. Not only does it prevent hoarseness, but it can also get rid of nodules, or bumps, before they harden. "If there are nodules, the vocal cords can't fully come together when vibrating," Greenwald said. She explained that over-used or abused vocal cords can result in chronic voice fatigue. Unfortunately, people whose lives depend on talking try to compensate by going into a "hyperfunctional" mode. "The weaker their voice gets, the harder they work," Greenwald said. The results can take the form of nodules, polyps, chronic hoarseness, or aphonia, loss of the voice altogether. Some people find that their volume or pitch is altered. Schoolteachers are among the professional speakers who have voice problems. A 2003 article in the American Journal of Speech Language Pathology estimates that 20 to 50 percent of teachers fall into this category. Very vocal sports fans can also damage their voices. Even children who frequently play at making animal noises, growling and roaring, are straining their vocal cords. "They're trying to configure their vocal cords in a way that's not natural," Greenwald said. Not only was Healy singing on Friday nights at Donovan's Irish Pub in Springfield, but for many years she co-hosted a radio show with her husband. She is also mother to five children, a role for which raising the voice is almost a requirement. "She's got a lot of life in her," Greenwald said, "so her natural instinct is to speak 'hard,' or speak loud." In addition to over-use and misuse, other factors that can put the voice at risk include acid reflux (which irritates tissues), spicy foods, not drinking enough water, and having a dry home with forced hot air. "Living in a dry house or not drinking enough water by themselves would not cause the problem," Greenwald said, "but in combination with using the voice a lot and not using it properly, they contribute to voice difficulties." Dehydrating foods like caffeine can also affect the voice. So does smoking. On trips to Ireland, Healy would often perform in smoky pubs. (That country's new workplace smoking ban may alleviate the problem.) Lessac-Madsen resonant voice therapy emphasizes what Greenwald calls a "forward focus," a habit of projecting from the mouth instead of the larynx. This reduces tension in the throat. "Muscles have tension," she said, "and vocal cords are muscles."  Greenwald also has her patients practice diaphragmatic breathing. The diaphragm is the muscle at the base of the lungs. Some people don't breath deeply enough, relying instead on the muscles of the upper chest, which Greenwald calls the "clavicular" area after the bones at the base of the neck.
"If you use the diaphragm, you get the greatest amount of air into the lungs," she said. "You also get the most relaxed breathing. If you use clavicular breathing, you're contracting and stressing all those upper chest muscles and not getting an adequate breath supply." Greenwald also works with people on their resonance, or the vibration of air in the oral and nasal cavities. The therapy involves humming, speaking single words, chanting and, finally, using therapeutic principles in spontaneous conversation. While recovering, Healy did her voice exercises three times a day, at home and in Greenwald's office. "Two years later," Healy said, "I'm still doing them before I sing." To see someone like Greenwald, a patient must first be examined by an otolaryngologist who specializes in ear, nose and throat issues. Among other things, the doctor has to rule out laryngeal cancer. During her ordeal, Healy was haunted by the specter of musical comedy star Julie Andrews, who famously lost her voice several years ago. But after three weeks of seeing Greenwald, Healy was ready to raise her alto voice in song again. "I was thrilled," she said. "I couldn't get enough of singing." Today, she says she can hold notes longer than ever, and her singing voice has a strength and power she thought was gone forever. | ||||||||||||||||||||||||||||||||||
