The End of Therapy

My last therapy session was about two and a half months after I started.  I had been coming every other week for the last three sessions, and I came back for the last session three weeks after my penultimate session.  My SLP took more measurements of my voice and the difference was a follows:

Vocal Range:  I had regained an extra third to the top of my voice (from high Eb at the start of therapy to the G above.)  I believe I had lost those notes due to excess tension from compensation rather than from the paresis (explanation here,) but it was nice to get those notes back nonetheless.  (I had been singing Queen of the Night on year prior to my diagnosis, so I was quite disturbed when my high F had progressively become very strained and hard to hit!) 

Vocal duration:  This is where she would have me take a big breath and phonate on /a/, /i/, and /u/ for as long as I could while she timed me.  At the start of therapy, this was my worst measurement at 15 seconds, due to incomplete fold closure. (Normal measurements for adult females are around 22 to 25 seconds (and that’s not professional voice users either, that’s just regular old folks…As you can imagine, it was pretty traumatic seeing my original measurement being about 10 seconds below normal.)  At the end of therapy, this measurement was around 30-35 seconds.  Awesome, huge improvement in my mind!  I was above normal, just where an opera singer would want to be!  Hurrah!

Habitual pitch:  Re-pitching worked, and I was regularly speaking around Bb to middle C…and my voice felt a whole lot better because of it.  (And I felt more resonant speaking in that range.)

Voice clarity and resonance:  As this is a perceptual measurement, it was much improved.  My voice was clear with no use of vocal fry when I read passages.

One interesting physical thing I had noticed was during the vocal massages we would always do in the session.  At the start of therapy, I noticed my right sternocleitomastoid (pictures and explanation here) was always very, very tight to the point of the massage hurting on that side.  Also, I noticed an asymmetry in that little notch between my hyoid and thyroid cartilage where the thyrohyoid membrane is located.  (You can feel that place if you palpate the sides of your larynx and move upward were it feels like it “ends”…if you keep moving up from there you’ll feel your hyoid bone.)  When I felt that notch at the beginning of therapy, the space on my left side was noticeably larger than my right side.  In fact, I could hardly feel any space between the thyroid and hyoid on my right side.  Throughout therapy, I began to feel space on the right side.  It wasn’t completely balanced by my last therapy session, but about six or so months later, it was totally balanced on both sides and my sternocleitomastoid on my right side felt the same as my left when I massaged.  Now, since this is just my personal observation, I’m not 100% sure why there was such a dramatic asymmetry there.  I can only assume it was related to long-term compensation for this long-standing injury.  Whatever the reason, it was additional proof of my injury and recovery that I could literally feel with my hand!

By the time of my last therapy session, I had not been experiencing any fatigue at work, and I could speak at a loud restaurant without fatiguing or shouting and be heard.  Everything was just feeling so much better!  But, I missed singing terribly.

I had not been singing at all throughout the process.  After my diagnosis I decided to postpone any auditions I had lined up and not take on any performances anywhere.  I also took a hiatus from singing in my church choir as well.  I had decided to go “all in” on the vocal healing process without encouraging any old, bad habits of compensation by still singing throughout.  The therapeutic exercises did keep my voice in good shape and I did start to add in some easy singing vocalizations per my SLPs instruction during these two months, but I did not sing any arias, take any voice lessons, and certainly no coachings during this time.  This break and therapy was an investment in my singing future, and I was not going to take any chances of delaying healing by doing too much too soon or getting too far ahead of myself.  It was definitely an exercise in patience!...which was never really my strong-suit.

But giving up singing wasn't easy, especially not through feeling slightly hopeless about my situation in the month between my diagnosis and seeing my SLP.  I remember walking through my church one day and hearing a soloist rehearse with the organist in the chapel.  The soloist was someone I knew from graduate school, and she sounded great that day…but just the act of hearing one my peers singing brought a lump up in my throat.  I just wanted to cry.  I missed singing so very much.  I missed being able to just sing whenever I felt like it.  I missed my practice time.  I basically felt the way every singer feels when they have some laryngitis or something they have to rest through, but I felt like it might never end.  I was really, really glad to be wrong.

One of the things I appreciated the most from my SLP was that she did not consider me healed until she saw my vocal measurements go well above normal.  As a professional singer, that felt so very, very good for me to hear, and it really helped me to feel like I was in very good hands.  I progressed through therapy pretty fast thanks to diligence and her excellent guidance.  I will be eternally grateful for my experience with her.