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Question About Medications....

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Buzz
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Hi everyone!

I received some great feedback on another post and thought I would post again :)

I have done some research on some of the medications I am on and how they may have an effect on my vocal chords. Background...I have a disc extrusion in my lower back. The VA had me on a boatload of medications, most of which I stopped taking long ago...in particular Percocet. I chose to get a PT consult through a private agency and am working more with strengthening as opposed to being medicated. There is a lot online about NSAID's and the effect they can have on vocal chords and I really minimize the use of those (e.g. Meloxicam). However, one medication Neurontin (Gabapentin) seems to have contradictory information online. Some sites say that the drug can have an adverse effect on the vocal chords...others claim that the drug can be beneficial in some cases.

Is there anyone out there who can give me a more solid opinion about Neurontin? The benefit I get from taking it is really minor and, if it can have a negative impact on my singing, I would like to work with my physician to wean off of it in favor of continued PT methods (e.g. heat and exercises).

Any opinions are most welcome.

Thanks in advance!

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hi Buzz:

Sounds like you are doing a great job of prioritising treatment components and balancing voice needs with other medical stuff. Not easy to do, especially given how little most MDs really understand singing & larnyx. I'm impressed with your attitude.

Best reference on voice & medications is at National Centers for Voice and Speech. http://www.ncvs.org/e-learning/rx2.html It's note on

Neurotonin: "may have a drying effect on the body, including vocal fold tissues, which can lead to hoarseness, soreness, voice changes or laryngitis. Additionally, dry vocal tissues may be more prone to injuries such as nodules."

My assumption is that any medication that has a side effect of dry-mouth can be assumed to do the same to the mucous membranes that cover vocal cords.

(NSAIDS are a different problem...they make cords more vulnerable to hemorrhage, and prolonged use can increase risk of acid reflux.)

hope this helps --

BUT as you work through these challenges I would also be very mindful of how back problems themselves can affect the mechanics of voice. If breathing is impaired by muscle stiffness or decreased range-of-motion, OR if one restricts breathing in middle or low back areas in order to avoid pain, that 'guarding' can affect singing indirectly. I've see this a lot in my speech pathology (voice rehab) practice. Breathing "into & through" painful or stiff areas may be important to explore, gently & with gobs of self-compassion of course.

The jaw can also tighten up as one attempts to balance posture or cope with pain. I've had to be mindful of this as my arthritic neck "matures." So many little things can affect the voice... but that also means that improvements in any area of health are likely to help the voice!

keep at it --

best wishes,

Joanna

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hi Buzz:

Sounds like you are doing a great job of prioritising treatment components and balancing voice needs with other medical stuff. Not easy to do, especially given how little most MDs really understand singing & larnyx. I'm impressed with your attitude.

Best reference on voice & medications is at National Centers for Voice and Speech. http://www.ncvs.org/e-learning/rx2.html It's note on

Neurotonin: "may have a drying effect on the body, including vocal fold tissues, which can lead to hoarseness, soreness, voice changes or laryngitis. Additionally, dry vocal tissues may be more prone to injuries such as nodules."

My assumption is that any medication that has a side effect of dry-mouth can be assumed to do the same to the mucous membranes that cover vocal cords.

(NSAIDS are a different problem...they make cords more vulnerable to hemorrhage, and prolonged use can increase risk of acid reflux.)

hope this helps --

BUT as you work through these challenges I would also be very mindful of how back problems themselves can affect the mechanics of voice. If breathing is impaired by muscle stiffness or decreased range-of-motion, OR if one restricts breathing in middle or low back areas in order to avoid pain, that 'guarding' can affect singing indirectly. I've see this a lot in my speech pathology (voice rehab) practice. Breathing "into & through" painful or stiff areas may be important to explore, gently & with gobs of self-compassion of course.

The jaw can also tighten up as one attempts to balance posture or cope with pain. I've had to be mindful of this as my arthritic neck "matures." So many little things can affect the voice... but that also means that improvements in any area of health are likely to help the voice!

keep at it --

best wishes,

Joanna

What a great post, Joanna! This is so helpful in many ways.

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This gives me something to think about, as well. I have a high tolerance for pain. I can hurt like anyone else, I just have the ability to put up with it forever. For example, when I get a tooth extracted, the doc usually gives me a scrip for vicodin. I still have some left over from 2009. Even then, I take half of one right after the procedure and another half of one later, at night. By the next day, vicodin (actually, I get the generic equivalent hydrocodone acap aka Lortab, a mix of codeine and tylenol) is too much and I might take a Motrin. But I never thought about NSAIDs causing drying. I might watch for this in the future. I have a knot in my back and my lower back has zero degrees of arc. So, sometimes, I have some back pain that is alleviated with one or two Motrin at 200 mg per tablet. Usually, just that dose in the morning. But I bet I watch out for that in the future.

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Buzz - I'm not sure about Neurontin, but I'm not a fan of NSAIDs at all (I know neurontin isn't one). What I would suggest is a totally natural and highly effective supplement based on enzymes. One brand which is outstanding is Wobenzym. There are others too. Bromelain is one of the great enzymes used. It helps you repair your body from injury - speeding up recovery like you wouldn't beleive. When the East German Olympic team got busted for using Steriods in the 70's they researched and started secretely importing tons of this stuff.

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