Arterias Mahmoud Posted April 20, 2011 Share Posted April 20, 2011 Okay, I posted a topic regarding an upcoming septoplasty surgery...no responses. Oh well. :\ It was successful! Surgery went very well...first few days were absolutely miserable, but by day 4/5, I was feeling good, and gradually, all the pain has subsided, leaving my breathing far better than it's ever been! The difference truly is night and day, and things like TMJ and poor sleep quality, or waking in the morning with a dry throat from poor mouth breathing are quickly becoming a thing of the past. Plus, better sleep = better rest for the body as a whole, including joints, ligaments, mind, spirit, AND the vocal cords, which is HUGE! I have made huge lifestyle changes, and am continuing to adjust in order to best serve my vocal health. One major problem still remains... ***PRE NODULES!!!! HOW LONG DO THEY TAKE TO GET RID OF!!?!?!?? Is full, strict vocal rest really necessary? I've had them for 1-3 years. Nuts, I know, but the ENT has assured me that with enough rest, they'll vanish. Vocal teachers everywhere tell me they detect no deterioration in vocal quality, but I can feel the strain and lack of endurance, as well as a serious pitch ceiling. Who else has dealt with pre-nodules, and can you offer any advice? I really need some help!!! Link to comment Share on other sites More sharing options...
Arterias Mahmoud Posted April 20, 2011 Author Share Posted April 20, 2011 Has anyone successful taken anywhere from 4-12 weeks of FULL vocal rest before? And what is the boundary between pre-nodules (soft, early-stage callouses that my doctor assures me he sees), vs full blown nodules? Can you have full blown nodules without serious hoarness or cracking of the voice, issues in register transitions, etc? Any advice from speech therapists or experienced sources would be greatly appreciated! Link to comment Share on other sites More sharing options...
Guest Posted April 20, 2011 Share Posted April 20, 2011 Congrats on the surgery, glad to hear the big improvement. I have read pre-nodules subside after a few months of rest. I may have them. Ent found mucus gathering on two spots on the vocal folds. This is a sign they may be forming. Do you feel direct pain from your pre-nodules? I went to the ent because of a sharp burning pain when I sing, but read that nodules don't usually hurt. He thinks I may have two things going on, pre-nodules and acid reflux which is actually causing the pain. I've been on semi voice rest, ~90% reduction for a few months but waiting until my followup to see if it works. The voice therapist in the office mentioned that doing light slides and bubbles are actually better than complete vocal rest, but I'm not sure what to do in my situation. Link to comment Share on other sites More sharing options...
Arterias Mahmoud Posted April 23, 2011 Author Share Posted April 23, 2011 d1hard, This is correct. That may be a sign of pre-nodules forming. When my pre-nodules were in their early stages, I began to have incredible amounts of phlegm and mucus build-up. In my ignorance I thought it was the recent change in living environment, and that it was a dust/air-quality factor. In fact, it was the cleanest environment I had ever been in, I was simply abusing my cords more than I ever had. Also looking back, I can tie the heaviest amount of initial abuse to the onset of pain, irritation, and cord dysfunction, so yes, pain can be associated. The intricate muscles in the larynx and surrounding physiology in the neck/throat are just as susceptible to being strained, pulled, or wrongfully exerted. When the vocal mechanism tires, this is when extrinsic exertion in and/around the cords begins to happen. The problems snowball from this point onward...neck, jaw, tongue tension, upper-chest muscles, all of these are places where the body may try to compensate for any vocal dysfunction or shortcoming. I suffered from a severe feeling of burning in the throat; this was a combination of factors: both the pre-nodules, and the severe acid reflux that I had at the time. However, though my reflux has subsided, the presence of pre-nodules makes me that much more susceptible to that burning feeling on any day where I have significant heartburn. My advice is, even in the subside of your reflux (if you have it), maintain the medication for at least a couple months to make sure that it is not keeping your cords vulnerable to that irritation. Reflux is also tied to inflammation of the sinuses. The combination of added sinus inflammation and pressure, coupled with the drying and acid burn on the cords will put you in a rough vocal situation very quickly, especially if pre-nodules are already in the works. --- Nodules can have pain associated with them. Is this the majority? Quite the opposite. But the laryngeal pain that I deal with is a dead give-away that my pre-nodules have not gone away, even when other vocalists or coaches suggest otherwise, based on the auditory info they get when I'm singing or speaking. You are your best first opinion when it comes to your body, and your voice. Be careful! If I could go back and take care of it like I was supposed to, I would. I'm looking at 4-6 weeks strict vocal rest in about a month here when I finish school for the semester (an aspiring vocal performance major with nodules...good grief). --- Another thing... If you're recovering from pre-nodules, no vocal activity is the best for you...work on your breathing and support, do not become slack in your speech habits, as this is the worst thing you can do for your voice. I've made drastic adjustments to my speech habits in the last month. They may be more a cause for my pre-nodules than I originally anticipated. I will say this: When you are coming off of vocal rest, begin easy: start with light humming, buzzing, or lip trills, sirens in your upper-low to mid rage, and monitor that time very carefully. Begin with ten to fifteen minutes each day with light vocal exercise. Do not jump right back into full singing or vocalizing...that is the quickest way you can cause a sudden vocal trauma, and wind up in a worse position than you began. I wish you the best! Root for me too...vocal rest is just around the corner from me. I've never taken any sort of sabbatical before, but this sure is going to feel like one. Vocal rest is a challenge, but if you can endure, it can be an incredible time of inner work and reflection, as well as an opportunity to examine and develop aspects of your artistry that you may have neglected, or perhaps just overlooked. All of the above applies to me, of course, and I've done my homework, which is why I'm comfortable offering these suggestions. I think your case is a mild one, but do not be any less cautious! Avoid nodules AT ALL COST! P.S. ...props to your doctor for not dismissing you, though the calloused spots on your cords have not formed yet...for him to caution you even at the sign of mucus localizing at two points of your cords is a compliment on his professionalism. Link to comment Share on other sites More sharing options...
Joanna Posted April 25, 2011 Share Posted April 25, 2011 speech therapist here -- just a few comments If there is a strict definition of nodules vs pre-nodule swelling, I think it would exist under a microscope, like the distinction between soft nodules & small polyp. Cells are different but MDs just looking at them will disagree, and for treatment purposes it doesn't matter. UNLESS the nodules are long-standing, hard& fibrous & penetrating into deeper layers. Vocal rest takes immediate pressure off of the vocal fold edges, for healing of all such minor lesions. Yes there is speculation that small amounts of light vocalizing is better than 100% rest, just to keep circulation/metabolic processes going for cell healing. A couple minutes every hour or 2 is better than 30 minutes all at once. BUT prolonged periods of absolute rest (weeks/months) bring other problems & are not recommended by any MDs I know, unless there's a severe situation like repeated surgeries. Problems are (1) high risk of psychological backlash, subconscious fear of voicing, with new kinds of tension in the throat that make it harder to start again with good technique (2) highly inconvenient unless one lives in a monastery; social consequences are just not worth it (3) That time is NOT being spent learning new technique, & solving the problems of usage/technique/lifestyle that created the nodules. So they will come right back, & the inconvenience/sacrifice is somewhat wasted. Best recommendation from modern voice clinics is for significant amounts of rest, plus strategic vocalizing and serious retraining of how one talks as well as sings. Yes folks that's the hardest thing & also most important! It can be hard to find good teachers/therapists where you are, but some of us do work online ... be careful out there. Link to comment Share on other sites More sharing options...
Guest Posted April 26, 2011 Share Posted April 26, 2011 Thank you for your advice, Joanna. It really does feel like walking a narrow line between rest and re-training. I found your visualization exercise mp3s to be helpful with the psychological impact, and giving me a sense of continual improvement even while not vocalizing. Arterias, thank you for sharing your experience. Glad to hear you will be able to get some downtime. Best of luck with your recovery! Link to comment Share on other sites More sharing options...
Arterias Mahmoud Posted April 27, 2011 Author Share Posted April 27, 2011 No worries d1hard, best of luck to you too. Thank you for the encouragement. Joanna, thank YOU very much! Your quick response is really appreciated. I will check out your website, as advised. Link to comment Share on other sites More sharing options...
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