Vocal Rehabilitation FAQ
© 2008 Lori Joachim Fredrics

I have voice problems, what should I do?

Any difficulties with your voice or changes to your voice should be discussed with your GP

My GP's suggestions didn't solve my vocal problem. I have been experiencing ongoing difficulty with my singing but my doctor is not taking my complaints seriously. What now?

Very slight problems with the vocal cords might not interfere with everyday activities and speech but can be devastating to ability to sing well. Now is the time for specialist attention.

You may attend a consultation with Lori Fredrics, a singing teacher with experience in rehabilitation of the singing voice. While Lori cannot diagnose disease of the Larynx she can diagnose problems with the function of the voice as she puts a singer through a series of exercises. By listening to the voice while also watching for visual signs that a singer is straining the voice, she can make an educated guess as to the both the nature and the cause of the problem. It is then possible to give instruction in singing technique that sometimes results in instant (although only momentary) elimination of the problem. If the singer experiences no vocal problem when he or she sings correctly it is unlikely that actual damage from voice misuse has occurred, However it may take a number of months for a singer to eliminate habits that cause vocal dysfunction, but it is an encouraging sign.

Occasionally Lori Fredrics encounters signs that indicate the probability or the possibility of problems that should be brought to the attention of specialist doctors.   One of the problems is vocal nodules.

What are Nodules?

Vocal nodules or nodes are non-cancerous growths on the vocal folds (cords) caused by vocal abuse. The nodules are small and callous-like and appear as symmetric swellings on either side of the vocal folds The nodules usually form on the areas of the vocal cords that receive the most pressure when the cords come together to produce sound. Size can vary from a tiny pinpoint to a pea.

What problems do Vocal nodes cause?

With correct singing technique, the vocal cords should press firmly together and the closure of the glottis is complete. When a singer has nodules, the cords cannot close completely. Therefore, extra air escapes causing a breathy voice.

Other problems include raspy or hoarse quality, delayed vocal onset, reduction in range, reduction in the ability to sing softly especially when singing high.

What causes nodules ?

There are many causes including faulty singing technique excessive voice use, habitually speaking too low or too high screaming or yelling, or using the voice excessively while sick.   Party Girl Vocal Syndrome a condition named by Lori Fredrics is one of the causes of hoarseness.   This occurs when an individual becomes intoxicated and over uses the voice, perhaps while sick with an upper respiratory infection in the presence of loud music and smoke.   This continual behavioral pattern causes vocal nodules much more often than singing. It is found more often in women because due to the tiny size of female vocal cords and the female endocrine system. If you want an example of Party Girl Vocal Syndrome just listen to Demi Moore. This situation is further complicated if the young man or woman also uses his or her voice to attempt to sing rock music, as was the case with Demi. It is quite similar to Cheer Leaders Vocal Destruction and US Army Humiliators Voice both caused by excessive yelling. There is of course an overlap in these syndromes.

I went to an otolaryngologist who saw vocal nodules on my cords, why did he send me to have singing lessons?

When a specialist voice doctor finds vocal nodes he may suggest vocal rest, medical treatment, a new singing technique, speech therapy and possibly surgery.

If you are a singer with a faulty technique the vocal nodules may go away with a change in your singing technique. Even if you have the vocal nodes surgically removed they are likely to return if you do not learn how to sing properly.

I went to a doctor who diagnosed nodes and he/she wants to operate right away, what should I do?

Run do not walk to a second medical opinion. Many times nodes go away simply with vocal rest. Other times they disappear with retraining surgery should be a last resort. While the advances in vocal surgery have been significant and have helped many singers, other singers including some famous ones, have lost the ability to sing after surgery.

My doctor found vocal nodes caused by the way I sing, but I do not want to change the way I sing. I am a rock singer with a rough voice; I do not need a big range or resonant clear sound. Should I have surgery?

If you have been diagnosed with benign vocal nodules and are still able to do what you want with your voice, consider not having surgery. Since the nodes will likely return if you continue to sing with your present technique why have the surgery, many well know rock singers live happily with their vocal nodules. One even told Lori that he named each one because they were worth about a million dollars each!