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Piano Man
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So....I was diagnosed with a vocal nodule over a month ago.

Recently, about two weeks ago, the doc said it was gone and that I could continue singing as normal.

Since I am recording an album, I began singing again but it still caused pain among my chords. It hurts to talk loud also. and it feels like there's a lump in my throat. I hope the node didn't come back. Right now I'm just sitting it out, wondering how long it is going to take before my voice is finally back to normal.

Is there something specific I should be doing to recover faster? How long is it going to take? I've got an album to finish recording.

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Hi,

Before I get going, I'd just like to clarify for the record that the 'Dr' bit in my name refers to a PhD - I'm not a medical doctor! So I'm coming at this from a vocal coach perspective, not a medical one. There are plenty of guys on the site who will be able to give you the science bit though :-)

There's quite a bit to address here. First off, this doesn't make sense to me - the diagnosis was about 4 weeks ago, then the doc said it had gone within the next two weeks? Unlikely. (Possible, I guess, but I've never seen this problem clear up that quickly before - I'd be interested to hear from others on that).

Secondly, nodules usually occur in pairs, whereas polyps usually occur singly. Did you see an ENT consultant? Or only your GP? This kind of thing really wants the old camera-down-the-throat exam so that the experts can really see what's going on.

Thirdlly, the problem of the pain coming back: I'd have to disagree with the person who told you it was OK to 'carry on singing as normal', for the simple reason that if it was technique that caused the problem (and I don't know if it was, or if it was overwork, or whatever), then carrying on singing with that same technique will cause the same problem to occur again. It certainly sounds like there's still a problem, as it's not 'normal' for the voice to hurt when talking loudly (or indeed at all)!

There are many exercises and regimes that can be followed to assist you in rehabilitating the voice, but you really need to be working face-to-face with a seriously experienced vocal coach and potentially also a speech therapist. Whereabouts in the world are you?

There is good news - it is usually possible to rehabilitate a voice by addressing the underlying technique and working through the right regime. However, it takes time - if you have indeed got nodules, then it could be at least several weeks and more probably months before the voice is fully recovered (I have known severe cases take up to a year, less severe cases 2 - 3 months). I know several professional singers who are rehabilitating the voice whilst continuing with their gigging / recording schedule. It's far from the ideal way to do it, but when you have to pay the bills...........

I think I've just flagged up more questions rather than giving answers - sorry! But it doesn't sound as though you've been entirely properly advised. Are you able to get a second opinion through another doctor?

Regards,

Ria Keen

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I agree with Ria. You can do serious harm. Whatever gave you the node has to be addressed. Nodes come from a behavior that is harmful to your cords. You are only going to remediate it by taking action. That means changing your technique under the supervision of a good voice teacher or voice therapist. Do not let it slide.

Best,

Roberta

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Speech therapist talkin' here:

Pain and "lump in throat" symptoms are not typical for nodules. More often they come from acid reflux irritation, but there may be other causes.

The doctor who examined you does not sound very knowledgeable about voice & singing. ENTs vary in their specialties. You need to be seen by a true laryngologist, preferably with a videostroboscopy exam. I'm not sure your initial diagnosis was correct.

Partial vocal rest ("half as much, half as loud"), whole-body relaxation, good nutrition/exercises/sleep (wellness) should be your first agenda, along with logistic problem-solving if you have singing commitments in the next month or 2. Even if you can get through them, you'll be reinforcing bad technique—the misuse that caused the problem and/or the layers of subtle compensation required now to sound your best.

Maybe there are some gigs you don't feel you can change [some venues or agents you really can't risk disappointing], but there are probably some that are negotiable, you can find a substitute, etc.. Take mental & vocal pressure OFF as much as you can.

Whatever the true diagnosis is, I don't know of any (involving pain) that resolve overnight or even in 2 weeks. A few months is a more reasonable expectation.

You are a vocal athlete on the disabled list. No shame, no blame, but also no one who can solve the problem/advocate for care, besides you.

Please check out my website, www.voiceofyourlife.com ,self-care book www.tinyurl.com/cazden-book, and resources I've listed on the site, for lots more info on getting your voice healthy & staying that way.

Feel free to contact me off-list if I can be further help.

take care - Joanna

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Thank you all for your responses. Now that I think of it, the time it took me to heal was an entire month not two weeks. Maybe a tad bit more than a month. But I did go see an ENT, the best in town. A fellow musician recommended me to him. Unfortunately, the ENT knows nothing about singing so he's given me no ideas of recovery. After a month, he stuck the scope down my throat and said I was healed. There were no signs of a nodule and my throat lacked the previous redness that I had seen previously on the stethoscope. I believed him, other than my voice just didn't feel right.

Now, it's back to hurting again. Not as bad as when I had a nodule but something is bothering me. I live in Redding, California so i don't have access to professional voice coaches as far as I can tell. I did some vocal therapy exercises but it only seemed to bring on the pain even more so i stopped. I was humming "m" and it irritated my voice. He's checking back in on me in a couple weeks. Other than that, I've been trying whatever else information I can find and I'll sure put your guys' info to good use. Thanks again.

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  • 3 weeks later...

Hi,

I have had vocal problems myself twice. The first was hipotense vocal folds, that was point out by my first vocal teacher as soon as we started lessons ("your voice sounds a little weird, go to a Laringologist and LOOK at your folds") and the second one was really small nodes, that came 2 years after the first problem, because of overwork.

In my experience AS A PATIENT the first step is to be sure that your diagnose is correct, look at pics on how folds with nodes look like and compare them to the pics of your folds (if you can't find some or are not sure let me know and I send you a couple, I don't know how to paste them here).

Second step: rest your voice... try talking about 30% less a day then what you usually do, spare words. Do not talk to loud, and do not whisper either. Use your regular speaking voice. Avoid more damage....If you smoke, don't. Also avoid smoky places and being around smokers. Keep your folds humid, drink water or teas (I find ginger tea is the best... camomille is also good... it's better if you prepare it from stratch... so start boiling!)

Third step: You need to be sure of what you have, because a specific problem has a specific treatment... for example the treatments for the 2 problems I've had oppose. I had a first bad diagnose on the hipotense folds telling me it was nodes, the MD only looked at my folds with the small mirror instead of the camera down my throat. The voice therapist I saw was the one that ordered A VIDEO OF MY LARINX to look at it and she detected the wrong diagnose. Try to find a voice therapist, usually what's on the internet is not reliable, be really careful with what you find.

YOU HAVE TO TELL YOUR MD AND YOUR THERAPIST YOU'RE A SINGER. My therapist didn't find anything wrong with my speaking voice, but she did find some things I wasn't doing good with my singing voice (like glottal attack and breathing too much thru my mouth). You have also to consider that, most of the times, the therapist is not a singer and they specialize on speaking voice... so they only talk on the medical point of view, and not everything applies to the singing voice (like the "NEVER EVER" breath thru your mouth... in singing sometimes you just don't have enough time to breath thru your nose).

I know this post is REALLY long... but well I tried to learn from my bad experiences so I don't make the same mistakes EVER again.

If you need to know anything else just let me know and I'll help you with whatever I can. Remember this is from the PATIENT point of view.

Ursula

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  • 3 weeks later...

Hi Piano man,

In my case, I told the MD right away I'm a singer and asked him for an aggressive treatment. I had to take pills for about 2 weeks ...9 days of corticosteroids (I'm google-ling the translations... my main language is spanish, I'm sorry if some word is not the right one), 15 days of antihistamins and I also got vaccined against the flu and getting my inmune system stronger.

I went the day after I got diagnosed to a speech therapist and started treatment. No singing... try not to talk too much... stop using the cellphone that much... and so on... PLUS therapy excersizes. Exactly one month after I got diagnosed I had a second look a my folds and the nodes where almost gone... the MD said I was able to continue with my normal life. Instead I decided to take it easy for a while, but started to sing again... and gradually went back to my regular singing/speaking habits.

Next check 2 month later... back to normal!

So... that's my story. I hope it helps you.

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  • 2 months later...

Hi to 'Piano Man,' Ursula, Joanna, riakeen, and Roberta Prada,

Just got done 'Reading' all of your "comments" as to this 'Problem' regarding 'The Voice and

Vocal Cords, and specifically "NODULES."

I have had 2 Operations on my 'Vocal Cords' many years ago and in my opinion "Nodules" are developed from "Incorrect and, or, Abusive use of the 'Voice.'" First, I was working with a 'Rock Band' and I'm sure not 'Placing my voice correctly, Smoking, and doing a lot of "Yelling" was the cause of my "NODULES" the first time. The 'Doctor' instructed me to 'NOT SPEAK AT ALL' for at least 2 or more months, (as I recall), after the "First Operation." Unfortunately, I continued to 'Smoke' and returned to singing with my 'Rock Band' after only about 2 months and also continued the 'YELLING!"..............The 'NODULES' GREW RIGHT BACK!!! When I "requested" my Doctor to do a 'Second Operation' he "Flatly Refused!" So I sought out another 'Doctor' who 'DID THE OPERATION AGAIN!'..........I don't know what he did but he 'DAMAGED MY VOICE SO BAD I SPOKE LIKE A 'FROG' FOR ABOUT 3 YEARS!' So needless to say the "Singing Career" was put on hold for quite a while. Thankfully to God my voice finally did return to normal and I was able to 'QUIT THE SMOKING' about 5 years ago.' I've been through hell and back again so I 'can not' stress my opinion strongly enough when I say if anyone is suffering any kind of problems with their 'voice/vocal cords' they should definitely take it very seriously and do everything that's necessary to avoid damaging their voice any further. :o

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The contrast in stories here shows the wide range of knowledge among doctors. If you have to travel to see an ENT who knows singers & does video-strobe exams, weigh that against the money you'll save by getting the right diagnosis & treatment, NOT getting butchered by unnecessary surgery, & getting back to great voice & great gigs sooner.

And thanks, Ursula, for finding value in speech therapy!

FYI I am now offering voice therapy over SKYPE. TMV members get 20% discount. Contact me directly for details.

and PLEASE please take care to avoid damage! Much as I enjoy my work with singers-in-trouble, it is SO much better for YOUR body/mind/spirit to prevent problems, than to have to fix them!

best wishes -

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  • 5 months later...

I also had nodes, and after 4 weeks of not singing and speaking softly (I susally speak very loudly, which may explain why I got the nodes in the first place), I got to the voal coach for 4sessions and to the speach therpist for about 6 sessions. It was awesome!! The therapist recorded me talking, and I heard myself do all kinds of byzare sounds when talking, like finishing off my sentences in a weird rumbly sound. I was also asked to record how I was using my voice each day for a few weeks (ie, reharsed for 2 hours, then spoke for 1 hour... etc. ). I was made to understand my voice has a finite capacity for optimal use each day, and I had to use it wisely. Stop talking when I don,t have to, speak close to the people I am speaking to and refrain from shouting across the house...

The vocal coaching was a great reminder of technique, nd I can apply it to speaking as well. After several months of completely changing my habits (drinking so much more water, sleeping more,a nd everything mentioned above), I went back to the hospital (stobe light in the throat), and lo and behold, GONE!

Pain indicated that something is wrong, so don,t sing if in pain, that,s for sure. 1 month is really fast recovery and doesn,t sound likely, unless you were completely silent during that month, and in which case maybe.

Nodes can definitely go away, but not sort of by themselves without a complete change in the way you use your throat.

keep on keeping on!

karine in Montreal

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