Nodules after three weeks of coughing?

[Maudlynne]

I'm a professional singer - which is to say I make my extremely meager living exclusively through singing. I'm half of a lute song duo, so the singing I do is very quiet. A month ago, I picked up a particularly nasty flu/cold thing, which had me coughing hard, day and night, for three weeks. NOTHING stopped it - I couldn't sleep; it was a nightmare. Better now, no fever for a week, getting stronger every day. Except that my voice is not recovering, and is very, very painful. I've lost about a fifth off the top of my range, and what's left is weak and unpredictable.

Obviously, I've dealt with occasional colds, flus, and even strep over the course of a long career, and I have never had to stop singing for any length of time. Never turned down a gig or had an illness significantly affect the music until now. We're nearly finished with our 8th recording, and we've had to cancel several studio sessions. This thing has plowed straight through the Easter season, and the income from my church gig has been cut in half. I'm supposed to be singing a solo quartet for the service Sunday, and I'm looking for a replacement. Again. Got three more studio sessions scheduled for next week, and I honestly can't imagine being ready to sing.

Apparently I've done some real damage, and I'm terrified. I've never had any trouble with my voice before. We live off the grid in a very remote little cabin in the woods - a very quiet life with no shouting, on or offstage. No trouble with acid. Whatever's going on is definitely the sole result of three weeks of hard coughing.

Unfortunately, since I'm a professional musician in the US, seeing a specialist is completely out of the question. I went for a simple throat culture a few years ago when I had strep, and it took us the better part of a year to pay for that one visit. I've been gargling with hot salt water three times a day, followed by a spoonful of honey. I don't usually go for pharmaceuticals, but I'm finding that the maximum strength Mucinex seems to thin the mucus that's still in my chest, which in turn lessens the lingering hacking somewhat. But singing and speaking are still very painful. So is the state of our checkbook.

Is it possible to have developed nodules or pre-nodules so quickly?

[random1destiny]

If you go the cold a month ago and coughed for 3 weeks, then I'm assuming you've had about 1-2 weeks of the post-cold symptoms. Given that you still have lingering cold symptoms, and your main complaint is pain, my (non-expert) guess is you don't need to jump to the nodes conclusion yet. It sounds like you have lots of swelling and rawness, which would be expected from that much coughing. Most sites say to see the ent after 2 weeks, so you're still under that. I would definitely try keep any talking and singing to an absolute minimum and drink lots of water, inhale steam. Ginger has some anti-inflammatory properties, so ginger tea or even sucking on a piece of ginger may be very soothing (not to mention great for colds).

[Joanna]

It is very possible to get nodules from a few weeks of serious coughing; I have two such patients on my caseload right now at the voice clinic.

If money is extremely tight, definitely try your best to help cords recover with general good care (rest from talking as well as singing; steam; and do a tiny bit of singing --very relaxed in throat and very resonant in front-placement, tolerating other rough aspects of the sound -- like, 5 minutes every few hours. This gives the cords a little stretch & may have some intracellular healing effects.)

Use your time otherwise for non-vocal breathing exercises, mental practice of repertoire, work on mailing lists, etc. = lots of ways to keep career & artistry moving ahead during extreme conservative use/maximum rest... If all goes well, you will hear some recovery as weeks go by.

If however you are seriously pampering the cords, and in a few weeks there is absolutely NO change, then it is possible the problem is not nodules. Little Cysts can form under the surface from acute trauma such as coughing; they will not go away by themselves.

So the bigger picture for everyone is that no matter your budget, if voice is the tool of your trade you MUST set aside money for medical care. There are laryngologists who work with singers & understand the financial as well as artistic pressures, may have a low cash-price if you ask for it. Better is to set aside $5/week when you're healthy just like any other kind of insurance, so that when your voice is in trouble you can get good help.

Also check out my "Visualizations for Singers" program on Amazon, you can download the Healing -Damaged-Voice meditation (MP3 format) for very little if you don't want to order the whole CD.

best wishes, feel free to contact me off-list if I can be of further help.