I have a gift...apparently

In the next two weeks, I would have presented four presentations worth significant portions of my class grades based on research I have done. One will be on a term paper I’ve written, and the others are in place of a term paper. I would be more worried about this, but I recently received a wonderful compliment from a very knowledgeable professor in the SLP field on my presentation skills that has calmed my fears, to a certain extent. (To be honest, I’m still a bit brain-blurry at receiving such a glowing review of my work. Coming from the field of music and being that “girl with the nice voice but with problems,” I’m not very used to receiving professional compliments. I’m just taking it as a sign I’m heading in the right direction.)

A few weeks ago, I gave a 10 minute presentation on an assigned research article as part of one of my classes.  Recently, the professor said that I had a real gift for teaching.  I had a great comfort level talking to the class, I was well-spoken, and she was thoroughly impressed.  She recommended I really consider getting a PhD in speech pathology to be a professor, which was something I was already considering, so it was very nice to have someone else suggest it unsolicited. 

Now, I don’t feel like I have some sort of “gift” for speaking in front of people.  In fact, from my perspective, I felt like I might have been giving too much info at some times and not going into enough detail at other times, but my classmates all said it was a very good presentation.  So now, I have a friend of mine who doesn’t feel she’s very good at presenting asking me for tips.  This got me thinking of why I was able to present that day so well, and I decided it’s directly related to my experiences as a singer. 

Obviously, I’ve become very comfortable standing in front of audiences, and I’ve cultivated the coveted demeanor of not looking nervous when I am nervous.  Those things came with time and a lot of performance experience, so that’s not going to help my friend out much at all.  But the thing that I decided was the biggest help is that I am very used to being judged on my performances.  The ability to stand and deliver, even when I know I’m being evaluated, judged, and graded based on what I say, has come directly from my training as a singer.  It’s really lovely to know that the years I spent training to be a professional performer are not wasted at all.  But something else from my experience in preparing presentations this semester crosses over to singing as well:  Preparation.

I was VERY prepared for that presentation.  I wanted to make sure I was standing up in front of the class as an “expert” on my topic rather than as a peer.  I knew if I could stand up there as an expert, I could make the experience informative and interesting for my classmates.  Maybe I got this from my training as a singer, but I think it’s more likely I got this from my desire to do well in my new field and the passion I feel for it.  But, as a singer, and especially as a professional, you MUST prepare just as well.  You must prepare so well for your list of arias, opera role, or recital, that you feel you are the expert on all of that music.  At least, that is what professionals do. 

This is one of the things I took as a sign that continuing on to be a professional opera singer, as was my original goal in life, was perhaps not the right path for me.  I remember sitting in the chorus at the local “big name” opera house where I live and realizing that I simply did not share the same level of passion for the nuances of the Italian language that our chorus master did.  Now, I did my job and made all the adjustments he requested, but I realized that the “big name” soloists singing the leads in this opera probably not only knew of those nuances, but had mastered them for their roles.  (Okay, maybe not the tenor, but the soprano I could believe absolutely had done her work!...and I’m sure it was just that one “bad apple” of a tenor, so no offense other tenors out there intended.)  This was right around the time that I was considering going to school for SLP, and this was one of the moments that made me realize I should go and do it.  I love singing.  I absolutely love singing!  But I love singing on MY terms.  (Honestly, this is what has empowered me to seek out a new career, while still working toward a polished, professional quality of singing I can do in my community…on my terms.  I get to pick the venue, the repertoire, and the terms of my performance.  And I really like it that way.)

So now, my friend has taken my advice to heart and recently felt "over prepared" for her presentation, and she did really well.  She began to realize the importance of preparing for your "performance," and the comfort level that preparation gives you in spite of your nerves.  But realizing that I’m finally going far enough with my preparation, that I'm going far enough with the "nuances" of my new field, that I feel so driven to being the expert in my field, and that I keep hungering to go further and further with the science and research brings this all back to this one thought:  I’m heading in the right direction.  And that feeling is so worth the effort. 

Personal note:  I might not be able to post too much in next two weeks due to it being “finals time” at my university, but I will be posting more on neuroscience, neural plasticity, basic physics I believe singers should know, and what the big deal with vocal fold efficiency is.  Thank you all for reading so far and for the great compliments.  I’ll try to get more posts up as the semester officially winds down. 

Neuroscience, I think I love you

I promise to get back to my singing journey, but as my semester is winding down, I've just got to say I freakin' love neuroanatomy and physiology!  If I could go back in time, I would totally be a neuroscientist of some sort right now.  (And why do we say "winding down" in reference to semesters?  Anyone who's ever been in college knows it should be "winding up" given all the projects, performances, term papers, and exams you have to do in a two-week time frame.)  But this post will be about singing...and neuroanatomy!  Woo hoo!

Currently in my anatomy and physiology of speech class, we are studying the most basic of neuroanatomy. As this is technically an undergraduate course in the speech pathology field, it really is more basic than a full-on neuro course.  Nonetheless, I am loving it!  How could you not see the way the brain communicates with itself and other parts of the body as fascinating?  And if you don't, maybe I can help bring it home to singing.

Let's start with the basic regions of the brain.  We all know, in one way or another, about our prefrontal cortex.  This is the area located right behind your forehead.  This is the seat of your decision making, personality, reasoning, and what philosophers call "qualia."  Qualia is the "what it's like to you" character of mental states.  It's the way YOU see the color red, smell a rose, etc.  The idea behind qualia is that every experience you have had is unique and individual to you, even if someone else was there.  It's undefinable...which would be why philosophers like it so much.  (Well, it's still pretty cool to the rest of us too.)  The frontal cortex is pretty much the "boss" of who we are.  It also sends signals out to the motor cortex when we cognitively command our body to do something, like dance, yoga, running, speaking, or singing.

As you can see up there in the brain image I posted, still in the frontal lobe of the brain is the primary motor cortex (called the "somamotor cortex" above).  This pretty much does what it's named for:  it sends the motor-coordination signals out from the brain (via a lot of different nerves) to the rest of your body.  Okay, just to set up my next point here's a quick little brain-fact:  the cortex is the upper "layer" of brain tissue that deals in higher functions.  The cortex is made up of six layers of different neurons with different jobs to do.  So, these layers vary in thickness throughout the cortex depending on what area is in charge of what.  In the primary motor cortex, the layer of neurons associated with projecting signals to motor centers beyond the cerebrum is at its thickest throughout the cortex.  Just as in the primary sensory cortex, the neurons associated with receiving information from other areas is at its thickest.  Pretty cool stuff, huh?  Also interesting in the motor cortex is the fact that larger regions of the cortex itself is in charge of fine-motor movements, such as the production of voice, and smaller regions do the gross motor movements, like moving your quadriceps.  Yup, even though your quadriceps are the larger muscles, the motor cortex assigns more space to finer movements of smaller muscles.  In light of that, here are a few cool facts for ya:  A single motor neuron triggers fewer than 10 muscle fibers in the muscles controlling eye movement. A single motor neuron for the calf muscle triggers 1000-2000 muscle fibers, but for the laryngeal motor unit, there are 2-3 muscle fibers per one single motor neuron.  That means there are more neurons devoted to moving the laryngeal muscles than your calf muscle and eye muscles.  (Did that blow your mind a little bit?  It did mine, but I'm a huge geek, so it's hard for me to tell if that's a normal response or not.)

In contrast, the primary sensory cortex doesn't have much space devoted to receiving sensory information from the larynx in comparison to some other areas of the body.  So if you're getting all frustrated because you can't "feel" what's happening in there, it's cause your brain has decided it didn't really need to know that much.  It didn't devote much space to receiving impulses from there.  But...your primary auditory cortex does send sensory information about the sounds it hears.  (Just my theory, but I think that's why it's so hard to "stop listening" to yourself as a singer.  You're entire speech system is governed by the information received from the auditory cortex.  It's known as the feedback loop, and it's very important in speech production.  For example, this is why it is very difficult for profoundly deaf people to speak intelligibly:  they are getting no information from the auditory to sensory cortex loop to inform the motor cortex of the proper motor planning for speech.)

So where am I going with all of this?  Now, this is so much more of a theory than actual researched fact, but I believe this is why "imagery" teaching works so well for some and so poorly for others.  It is why teachers who teach well with those techniques can alter their images student to student and why some students can thrive with one "imagery" teacher where others crash and burn.  So much of the imagery we use is dependent on our qualia of that image.  All our personal experiences and concepts are poured into the image.  Due to that, who knows what muscle coordination pattern is being sent to our motor cortex when we command our body to sing off of that image?  (For that matter, it's probably why one image works great for a little while and then stops working.  Our qualia of that image has shifted due to it's usage, and so the "command center" is sending a different command in relation to it.)  I also believe this is why imagery can be such a powerful teaching tool, when in the right hands.  The right image can really command the right coordination so much more quickly than trying to "sense" the right coordination.  Our frontal cortex is a direct link to our motor planning.  Our sensory cortex, which is already a little more "out of it" on the laryngeal side of things, sends it's information to the frontal cortex ,which then process it and sends out motor planning in response.  Truth is, even if your image is a scientific one, it's still an image that's working from frontal cortex to motor down to larynx and back up to your sensory/auditory cortex where to process repeats over and over again.  I'm personally having a lot of luck with having my high school students imagine the tilting of the thyroid cartilage as their cricothyroid contracts as they go into their higher range.  (The thought is not to think "vertically" and send the wrong vertical motor response which I think might have something to do with too much laryngeal elevation.)  But, this is still an image, right?  Who actually senses their cricothyroid while it contracts?  I know I don't.  I can also always back up any image I give with a scientific explanation of what I'm trying to get at.  That way, I can work with that student to figure out what image will work with their qualia and yield the muscle response I'm after in our lesson.

So next time a teacher or coach gives you an image that just ain't working, consult with your qualia, talk with your teacher, and see if you can find something that will work for you.  (And yes, I'm sure I will geek out a lot more about this neuroscience stuff along my new study path since I plan on making it part of my specialty.)

It IS a confidence issue

Let’s talk about the psychological effects of a vocal injury…or at least, the ones I experienced.  The more I teach, the more I realize that how you feel or think psychologically about singing really is 90% of the battle of learning how to sing.  And I know that about 99% of getting back into singing post-injury for me was a total mental game.

I had zero confidence in my singing at the time of my diagnosis.  I was never able to trust my voice, and it had betrayed me to a unforgivable point at the Met competition.  I pretty much wanted nothing to do with it.  But after therapy, my voice mended its ways and I had to begin to trust it.  Building that trust took a whole lot of time, and I still don’t trust it 100% of the time two years later.  I had to remind myself over and over that my voice WAS healthy, my voice COULD be trusted.  Thank God for a positive and encouraging teacher!  Positive encouragement isn’t just blowing smoke up the butts of those of us with injury.  It’s a vital part of our recovery!

About five months after my injury, I found I was constantly getting down on myself for still not getting my technique right.  My main problem I kept thinking was, “I know my voice was healthy, so it just should work, right?”  Getting my larynx in the right position was a struggle.  Keeping my pharyngeal space “open” was a struggle (still kinda is sometimes).  I failed over and over again to get things right for years, and now that my fundamental problem was healed, I was expecting to not fail at all.  Yet there I was, still “placing my sound” by tweaking my throat into funny ways.  My tongue was still bunching, and my jaw was still tight.  My confidence when performing was shot, because I knew my technique wouldn’t be perfect.  Ten years of always hitting a developmental wall had made me extremely impatient to get to a good place with my singing and my technique…never mind that almost no one sings with perfect technique all of the time and that it takes most people years to get close enough to “perfect” to be world class.

Some singers have great little mottos they say to themselves before they sing such as:  “This performance is going to be so fun” or “Please let my performance touch someone out there.”  And other singers have so much confidence or experience that they don’t even need silly little mottos.  They just do it.  Know what I would think before a performance?  “Please, just let my voice work!”  That’s what I would think.  You know how you’re not supposed to think about technique when you perform?  How it’s supposed to be on auto-pilot so that you can think about your character, emotions, musicality…?  Yeah, well, that still wasn’t happening for me.  It wasn’t happening because I didn’t know how to trust my voice.  I still expected it to be a traitor.  It also wasn’t happening because I still felt like a failure for not being able to figure out the right way to sing, even though my voice was better.  Never mind that it takes most people a few years to figure it out anyway.  Never mind that I was basically starting at square one after the injury, so it would take time.  I wanted my voice to work now!

You know what helped with my confidence?  Improving and solidifying my technique.  That allowed me to trust my voice because good technique made it reliable.  I really think that's one thing the "close to natural" talents out there in the operatic world have over those of us who struggle:  They have trust in a voice that is 100% reliable.  That takes a lot of the worry off the table.  I never realized how much pressure it is to sing with an unreliable voice until my voice became reliable.  It's such a revelation!  And the exhilaration of being able to finally, finally truly make music with my voice was so completely worth the struggle...I cannot even being to tell you!

Know what kept me going so that I would finally feel like I could use my voice to make music?  Positive encouragement from my teacher.  So, so vital to healing the psychological hurt I had experienced with my injury.  Being reminded of how far I had come and being reminded to be patient were such gifts during this time.  I was so used to being that girl with “a nice voice with problems” that I would fall back into that crippling mental state of always being that girl with the vocal issues.  And you simply cannot learn how to sing well if you’re crippled by negative labels and doubts, especially when those labels don’t apply to you anymore.

Another vital thing I did was change my moto before singing.  Instead of “I hope my voice works,” I started to say “My voice does work and will work, even if my technique is not perfect just yet.”  That really helped me when it came down to actually performing on my not-so-perfect technique with my healed-up voice.  I still got nervous as heck, but if it didn’t go perfectly, I was at least able to laugh it off as a fluke rather than as a sign of my incompetence.  Might seem like a little thing, but it was a big step in the right direction.

*Voice teachers, don’t babysit your singers or coddle them, but for your student's sake try to learn when they need some encouragement.  Students who sang on an injury, even if for a short amount of time, are going to need a lot of encouragement to get through the trauma.  And if encouragement doesn't seem to be cutting it, send us to a counselor.  The psychological impacts of vocal injury really should not be ignored or belittled.  But some of us were just put in the wrong “box” as a young singer, and we need someone to take the lid off for us before we can make any progress.

Laryngopharyngeal reflux is nobody’s friend

My last post discussed my own issue with LPR that I faced just last week, so I thought I’d write a little more on the topic since it is such a prevalent problem. 

Many, many singers, and just people in the general population, suffer from this condition.  As a singer, though, I know I was personally very quick to blame my “symptoms” on something else instead of facing up to the fact I have LPR.  The first thing that put me in denial was the fact that I never experienced heartburn (unless I ate greasy Chinese food…but who doesn’t get heartburn in that situation.)  The other more insidious issue is that I suffer from allergies.  I have always had allergies which were no small problem back on the east coast where I grew up.  I always attributed any excess mucus in the morning and/or irritated feeling in my throat to my allergies rather than reflux.  How did I climb out of this area of total denial?  My voice teacher took the time to ask thorough questions that led her to suspect reflux.  While I was still questioning her conclusion, I went through a few up and down vocal days that led me to think she was probably right.

Here’s a pretty generic list of the symptoms of LPR:

• Continual throat clearing
• Chronic throat irritation
• Chronic cough
• Hoarseness
• Excessive phlegm the throat
• Constant sensation of something in the throat
• Post nasal drainage
• Weak voice
• Cracking voice

Now, prior to the talk with my voice teacher, I had seen lists like this before.  I never connected it to reflux, however, because so many of the things on this list match up with the symptom list for allergies, asthma, or any number of other things.  So here’s what solidified the reflux issue for me:  I had very distinct “good” voice days and “bad” voice days.  In fact, singing would feel great for one day and then the very next day I would find myself thinking something like, “What’s going on with my voice today?  Yesterday was great and today feels like complete crap.  I just can’t seem to clear it up!”  Or I would have so much “junk” in there it would take me a couple of hours after waking up to feel like my throat had cleared enough to sing and warming up on those days took at least 30 minutes, which is much longer than it should take.  Also, singing itself would bring on more and more mucus to the point where I would be clearing my throat excessively either after a performance or during lessons.   Although this could have been caused by allergies, my allergies never struck that badly over the course of one day unless I had done some spring cleaning that caused me to inhale a lot of dust the day before.  And I did not have asthma at all.  So the fact that my “bad voice days” would come on so suddenly seemingly without cause and the mucus production was so excessive were a big red flag that something else beyond allergies was going on.

I will admit that the prevalence of reflux for me was MUCH more obvious after I was treated for my paresis, but this up and down pattern was there even before the paresis diagnosis.  The biggest trigger for there being something wrong was the presence of excessive mucus in my throat that got much worse on the days where my voice was burned.  Now, excessive mucus alone is not a diagnostic factor of anything, but vocally speaking, excessive mucus is just a sign that the tissue of the larynx is irritated.  And if you experience excessive mucus during or after singing, it is either a sign that singing on that irritation increased the level of irritation or that the act of excessive voice use is bringing about irritation.  (The later is more common in cases where there is an asymmetry on the vocal folds, usually due to excess pressure being called upon in an attempt to “clarify” the sound.)  So I had a double-whammy of mucosal production on those days when I had some burning from my reflux that made singing on those days a nearly impossible task. 

I did go on Nexium for a while which worked very well, but due to financial constraints I was unable to continue on that.  Since then, I have elevated the head of my bed at least five inches, I don’t eat anything four hours before bed, I monitor my dinners very carefully for anything that might cause reflux, and I take an OTC proton pump inhibitor for a couple of weeks before a singing gig to ensure I don’t have reflux prior to the event.  (Obviously, getting the stomach flu a week before a singing gig didn’t let me stick to this lovely schedule of PPIs I have invented for myself.)

The main take-home message for anyone out there who suspects they, or their student, might be suffering from LPR:  Go to the doctor.  They are the only ones who can really diagnosis this issue and treat it effectively if it is too severe to be controlled by OTC medication.  But truly, anytime there is any sign of excess irritation in the larynx via mucosal production that cannot be explained, a trip to the doctor is warranted, especially if the issue seems to be chronic.

Acid Reflux: The clingy, possessive boyfriend who won’t go away

Here’s a little something from what’s going on currently in my singing life.  Acid reflux.  Still a giant pain in my butt sometimes…like this week.  Two weeks ago, I was singing great.  Then, I got the stomach flu.  Lovely.  Even lovelier was that I had two concerts this week to sing which I hadn’t gotten enough practice time thanks to midterms, so I was stuck listening to the pieces on youtube over and over while lip singing through them since my voice was toast from the stomach acid.  I was finally better on Saturday, as in finally able to eat solid food again, but my LPR had kicked up thanks to this little stomach bug and has fried my voice.  Just lovely. 

Since starting my SLP undergraduate courses this year, I haven’t really had a lot of time to devote to practicing or singing, and I rarely get to perform much at all.  (It seems that when you emerge yourself into a non-music field, fitting music in becomes a bit of a difficulty.  Who knew?  I didn’t.  I had never NOT been emerged in music before. )   Anyway, it just would figure that my dirty little friend would pop up this week.  But, I thought to myself, I should write something about it.  And so I shall!

First, let’s start with a bit of science…since it’s what I love so well.  Notice I called my reflux LPR up there and not GERD.  GERD is the common medical term for gastroesophagial reflux disease.  GERD tends to come with the traditional heartburn and such we all associate with acid reflux.  But some of us have laryngopharyngeal reflux (LPR), which is usually silent, meaning it doesn’t have any of the heartburn-like symptoms of GERD.  Ever wondered why it can be so silent like that?  How does stomach acid manage to burn our vocal folds without us noticing?  Wouldn’t we at least taste it in our mouth or have bad breath or something?  Well, the answer lies with our anatomy, of course.  Check it out:

The opening to the esophagus is located posterior, or behind, the opening to our larynx.  This is a rather unfortunate position for the singer who has LPR.  It means the acid doesn’t have to go too far up to “splash” over into our larynx.  It doesn’t have to get to the tongue or the soft palate, and the epiglottis isn’t much help either.  (The job of the epiglottis is to help close off the larynx during swallowing, not to protect it when stomach contents come up due to esophageal sphincter malfunctions.)  We all think of LPR as something that happens over night, but in truth, if it’s bad enough, it could spill over even during the day.

So that stomach virus of mine last week really kicked my reflux up in a bad, bad way.  My voice felt gravely, sounded slightly hoarse, and my mean speaking pitch was lower than usual.  And singing in head voice was a nearly impossible task.  I didn’t sing all week, but my voice wasn’t completely healed up by the concert, either.  See, another issue with having your vocal tissue burned by stomach acid is a pretty big decrease in your threshold of vocal fatigue.   So the rehearsal the night before the concert was fatiguing.  Singing the first concert was fatiguing, and singing the rehearsal and second concert were fatiguing as well.  I proceeded to rest my voice each night, and it did feel better the next morning every time.  However, once I started to sing, I could tell it just wasn’t right yet.  I had simply not given it enough time to heal up well enough to function optimally.

I did manage to make it through the concert, and it did go pretty well…although I wasn’t able to get enough “chiaro” in my sound thanks to my vocal condition.  So here’s the take-home for fellow LPR suffers, or anyone who suspects they might have LPR, your voice is going to take a few days before it’s really, truly healed…depending on severity of the burn.  Think about when you accidently burn your finger on a pot on the stove.  It might be a small, red spot that will take a couple of days to heal up, or if your reflexes didn’t kick in right away, it might be a blister that will take several days to heal.  Laryngeal tissue simply is not composed in such a way as to withstand stomach acid, so a burn there will take at least a couple of days to heal up.  Constant burning of the vocal folds can cause some pretty serious damage, though, so do try to treat your reflux if you have it so it gets under control. 

And if you have to sing on a concert in spite of  those burns, just be wise with your technique, forgive your voice for not being able to function optimally, and move on…(instead of getting all frustrated and complainy-under-the-breath for your condition…like I did.  Sorry to my colleagues from that day.)  

Obtaining a clean onset: Ah…good times…

Might seem a pretty obvious thing after reading my earlier post about just how asymmetrical my laryngeal musculature had become thanks to paresis, but it really took me about two to three months post-therapy to realize I needed to rebalance my voice.  It’s not like I had an adolescent voice…quite far from it in fact…but I don’t think I fully realized just how atrophied my right vocalis had become.  Therapy really had healed up my voice, meaning I had full glottal (which is the term for the space between the vocal folds) closure when speaking.  That’s the only way I was able to successfully achieve those measurements my SLP took at my last session.  But my laryngeal cartilage still didn’t feel totally symmetrical when I did my massages.  It was getting better slowly, but it really took a good six months before it felt normal again.  It seems perfectly reasonable to me now that I needed to re-balance…or maybe finally actually balance…my laryngeal musculature when it came to singing.  I had to get that right fold up to speed, so to speak.

As any pedagogy-guru would tell you, you need adequate fold closure at the onset of phonation, or else the whole darn phrase just ain’t gonna go very well.  (Paraphrasing from the great academics out there…but you get the idea.)  This is why I set out with some onset exercises as my main vocalization about two months post-therapy.  I had never had a clean onset before.  Prior to healing up, I had so much “adjusting” that I made before the onset of every sound.  Onset was more of a process of manipulation than the ideal balance of air flow and fold closure that it should have been.  And without all that manipulating, then my voice would just be breathy at the onset and breathy throughout the phrase.  (Of course, that manipulation was really pressing too much, but what else are you going to do with a ‘gimpy’ fold, right?)  My head and chest registers were healthy and strong, and I could transition into whistle register just fine, but my onset was still a sloppy mess and my middle voice just couldn’t figure out the right balance between chest and head voice.  While the later issue would take more time and a few more lessons to sort out, the first issue I decided to tackle on my own…with some help from Richard Miller and my teacher, of course. 

I started out doing the onset exercises, five pulses on /a/ followed with legato 5-3-1 and eventually 5-4-3-2-1 down quickly (simplified for myself in the beginning to just the pulses), without any thought to resonance placement, solely in my middle voice.  First, I’d do the classic pulse-the-air-out-from-your-belly on a count of five.  Then, when that felt fairly automatic, I would start the onset exercises, just on /a/.   The main key for me was to not actually think about the exercise at all.  I did not allow myself to analyze if it was good or bad, right or wrong, breathy or clean…anything.  No analysis, no manipulation to make it better, just pulse my breath out and add voice to the air movement.  This is one part of my great paradigm shift:  Not over-thinking every sound that came out of my throat.  But, since I was such a chronic over-thinker, I had to start out by blanking out my mind completely and letting my body figure it out without the help of my higher cognitive functioning.  This turned out to be a pretty good idea.  My laryngeal musculature and my air flow started up a nice little relationship without that pesky cognitive analyzing getting in the way.  (As with any relationship, this one would take time to refine and mature, but a good healthy start to this balance was worth its weight in gold to me.)

After about two weeks of this, I was able to gradually increase my range on this exercise, and my onset was starting to get all clean and shinny.  What a revelation it was to just be able to start a clean sound without a lot of fuss!  No wonder so many singers out there actually enjoy singing!  When you don’t have to analyze every second of every sound, or spend ridiculous amounts of time thinking about how to start your sound, singing really does start to get rather fun! 

Another little perk from this was the beginning of developing a belt voice for me.  I had never belted before, but like I said, I did nothing to adjust my sound into anything at all, so I end up sounding a lot like a musical theater belter.  That was what my middle voice onset sounded like about two weeks into using this exercise.  But the onset was clean!  Oh glorious day!  Who cares if I don’t sound like an opera singer just yet?  I can work on resonance and vocal quality later as long as the foundation was finally good!  I was able to just open my mouth and sing.  That was a feat worth celebrating.

Practice can make a real mess of things…when you're doing it wrong

When I first started singing again after the injury, I pretty much just attacked it like I always had before.  I had a new voice and everything was just going to click for me.  I just knew it!  So I ran on this idea for the first month or two when I came back.  I started to practice just the same way I had before the injury.  I had a list of arias I wanted to learn, competitions and auditions I wanted to do…I was really going to go for it in a big way.  I was sure I’d be some amazing, world-class singer in no time!  And oh boy!   Was that a stupid thought!  What I really should have done was learn how to practice effectively to promote new muscular coordination.  I should have retained the patience I had during therapy.  I had a lot to learn!

Let me explain a little bit about me and practicing.  I had always been very good at practicing.  I was diligent, meticulous, disciplined, set goals for my practice sessions, and often wouldn’t stop until I felt those goals were met.  Yeah well, turns out, I wasn’t as good as I thought…

Once I started with my teacher, the one who sent me to the ENT in the first place, she would quite often remind me at nearly every lesson that I should NOT be singing for over an hour at a time.  My teacher would always say just to stick to the 30 minute practice sessions broken up throughout the day.  However, my work schedule simply did not permit that, so I often just practiced in the evenings when I got home until I felt too fatigued to go on further.  Mistake number one.  I would also spend so much of my practice time thinking, conceptualizing, analyzing, and manipulating what I learned in my lesson from every possible angle at every single practice.  Mistake number two.   I always wanted to leave a practice session feeling I’d accomplished something technical…that a light-bulb of some sort had gone on.  Mistake number three.

The other day, I was speaking to one of my friends’ who is also struggling with vocal injuries; he has long-standing superior nerve paresis and also a vocal hemorrhage caused by the compensation (thanks to an eager teacher telling him to “sing through” the hoarseness in his voice.  Oy.)  I told him he probably should only be vocalizing for ten to fifteen minutes at a time until he’s healed up he said, “Oh…that’s good to know.  I usually just vocalize until I feel like I’ve accomplished something.”  This just solidified one of the problems with someone recuperating from an illness:  we (and I’m sure many others out there) over-practice all the time!  It’s because to us, learning to singing has been a war we’ve been fighting for so long that we tend to think of practicing as just another battle.  This isn’t a process of learning and training.  It’s not a journey we take with wisdom and patience.  This is Sparta!  This is Fight Club, people!  We tend to just keep going in our practice until we feel we’ve conquered something, or won the battle of the day in some way.  Basically, we don’t stop until we feel we’ve landed a strong right-hook on our voice that’s put it down and out for the count.  I realized I was doing that all the time, and it was time to change.  My voice teacher was constantly telling me to practice in short bursts of time, no more than 30 minutes at a time.  And I kept doing that for a little while, but then would slowly start “accidently” practicing for much longer.  Why did I keep doing that?  So I could accomplish something, darn it! 

Now, about a year before I found out about my injury, I started doing yoga pretty regularly.  If you’ve ever taken a yoga class for all levels, then you know you’ll end up being next to that advance yogi who’s comfortably bending into pretzels with a smile on her face while you’re just trying to hold your down-dog without slipping off your mat, right?  Well, after practicing yoga for a little over a year, I began to realize just how much of a process doing yoga is.  I slowly was able to make my way into poses I never thought I’d be able to do.  As my strength and flexibility increased, I was able to do more and more with considerable ease I had not expected.  It was a process of constant repetition.  As long as I stay focused on my alignment every yoga session, it became more and more natural for my body to get into and out of the poses with ease.  What all that conscious repetition was doing was training up those neural pathways that solidified those yoga postures in my body.  It became so familiar that it is nearly automatic now, so much so that I now can meditate on other things while flowing in and out of poses during practice.  And, I have such a good technical base of alignment, strength, and flexibility that I can approach a new pose with patience and the wisdom to know that if it’s not perfect today, it will become better with time.   Yoga has become fun and invigorating, where it once was exhausting.

Singing and learning to sing should be the same way.  Or, as I explained it to my runner-friend, singing, as well as vocal recuperation from injury, is a bit like training for a marathon:  You’re not going to just go out and run the full 26 miles your first day of training, you’re going to start in small increments and then build your body up to the 26 mile run slowly and purposefully.  This is what helped me to realize that this is what learning to sing really should be like.  It should be a constant process of progression where you slowly but surely develop the technique needed to sing difficult arias and operatic roles with ease that you never thought you’d be able to do (just like those advanced yoga poses).  So in reconciling myself to this progress, I began to be very meticulous in the way I sang. 

About two months after I got back into singing, where I was trying to practice as I always had before, I decided to take a step back and just do 15 minute chunks of simple exercises from my lessons.  I alternated between the massages, voice therapy exercises, and lesson exercises.  After about a week of just doing that, I would progress into singing through a song or aria for the next week.  Then, I felt I was ready to head back to my lessons and get a new set of exercises and bump the technique up a little more.  I didn’t set any goal other than getting the extrinsic musculature to shut up and get out of the way.  I didn’t set out to learn arias or art songs.  I didn’t practice getting my coloratura dead-on accurate.  I didn’t even work on resonance placement…at least not just yet.  (This made me sound a lot more like a mixed belter in my middle voice, but since free phonation was my goal, I was fine with that for the time being.)  I just did some mindless “workouts” with my voice everyday for a short period of time.  I got out of my body’s way and just let it learn how to balance breath with onset all on its own, using Miller’s onset exercises as a guide.  If I only made it 15 minutes before I felt tension creep back in, I stopped at 15 minutes.  By the end of each week, that time would usually double so I could make it at least 30 minutes before fatigue would cause me to revert to the old muscle memory.  Just doing those simple exercises, massages, and stretches for 15 minutes a day for a week or so really helped not only build my voice back to full strength, it helped to reset those pathways so I could get more release during phonation.  I still got stuck on the “pendulum” swing of going too “dark” or falling “back in my throat” and then going too “bright” or too “forward,” but I could always get back on track with this type of practice.  I had discovered a process by which I could slowly and methodically build my technique in, and a process that kept my neural pathways agile.  They became so agile that making a change to my technique, or to my concept of singing, in a month or so became so normal that it has gotten to the point where I can now make those shifts in a week or two.

Good thing I found this process though, because just a few more months down the road, I would slip into typical bad singer-habits.  Returning to this process would always be, and probably will always be, my vocal saving-grace. 

A note for other singers out there:  Sure, you might not have the time to spend only 15 minutes a day if you're already a pro singer or a student at a university, but if you split up practicing into short chunks throughout the day, you'll actually make much faster progress than if you go at it for a whole hour at a time.  It's the repetition that infuses the correct coordination and sets the neural pathways, not the length of time.  Once the musculature slips back into it's old ways, stop, take a break, and come back to it later.  Really, you'll be surprised at your progress, and you won't be nearly as frustrated at your vocal mechanism as you would be if you "push through" the slip back to the old ways.

All scopes are not created equal

I actually meant to post this sooner, but life got the better of me.  This is a reply to a question I had on a classical singer forum, so I thought it would be nice to have it up for others to read.


So the question basically was:  If I had gone to one ENT who didn't find anything, why did the next guy I see find the paresis?  What the heck was up with that first ENT anyway?


First, about that first ENT I saw:  In all truth, he was being very nice to a singer without any insurance and tried to save me money by not turning on the camera to really see my folds in action.  He mainly just looked at the folds themselves, saw the nice, whitish-color to them while I was breathing, and said I was good.  He hardly had me phonate at all and when I went to the next guy, the paresis really only showed up after a bit of phonation.  The next guy was expensive, but thanks to a crappy day-job, I had insurance when I saw him.)

Well, unfortunately for us professional-voice-users, not all ENTs are equal and a laryngoscope is not equal to a videostroboscope of the folds. Now, the laryngoscope gives one a nice view of the folds themselves, but to really see the folds and muscosal lining during phonation in detail, you really need the strobe light effect with the stroboscopy. The reason is that the folds vibrate simply too fast to see the subtle movements of the lamina propria and fold vibration without the strobe light breaking up the image enough to make it seem like it's in "slow motion." As I said above, the first ENT did not ask for any extensive phonation. However, my folds always were healthy and "normal" looking themselves since I hadn't had any secondary pathologies like hemorrhages or nodes, and my muscosal wave was always good as well. It was the muscle action during phonation that showed the effects of the paresis. The second ENT I went to looked at an HD video of my folds during silent breathing, onset attacks, sustained phonation, and pitch changes (basically a glide up and down the pitch range) usually all on /i/...(I'm not sure why, but I assume it has something to do with keeping the tongue in an advanced, or forward, position so it doesn't interfere with the camera in your throat.)  The video was displayed on a big flat-screen TV behind me while his assistant handled the camera.  This allowed him to see a lot of detail from this examination that the other ENT hadn't been able to see. I suspect another different in the two ENTs I saw was the assumption made that my voice would be healthy based on my speaking voice.  The second ENT stated, after the diagnosis, that he was a bit shocked to see the paresis since he couldn't hear it much in my speaking voice at all.  I wonder if the first ENT made a similar assumption and just figured there wasn't going to be much to see in there.  Guess I'll never actually know... From what I've heard from some SLPs in my area, the videostroboscope is what is necessary to accurately diagnosis muscle tension dysphonia and spasmodic dysphonia as well as paresis (since it's not full-on paralysis). It just allows a much clearer picture...sort of like the difference between watching a movie on VHS on a hand-held screen compared to watching it on blue-ray on a big-screen. (I actually observed a session with a lady who the SLP suspected had spasmodic dysphonia,http://en.wikipedia.org/wiki/Spasmodic_dysphonia, but since this SLP works through a hospital and uses their ENT, she had to work on getting the woman referred out to one of the three ENTs in my area that have the videostroboscopy technology so the SLP could get an accurate diagnosis to treat.)  So my main advice to anyone thinking they need to see a doctor:  go to one who regularly works with professional (high-level if possible) singers and who has the latest equipment.  Those ENTs should take more time and care with your diagnosis and the videolarngostroboscopy will allow a more accurate picture of your laryngeal function than the regular laryngoscope will.  Unfortunately for those of us without insurance, the newest technology does come with an increase in cost, but if you can afford it, it can save you a lot of time and headache wondering why the heck your voice just doesn't work right.

A little nerve goes a long way

Phonating, articulating, and swallowing (the three main things we all do with our laryngeal, pharyngeal, and articulatory musculature) are all incredibly complex motor functions.   It should come as no surprise that the act of speech is just as complex, if not more so, and singing is an extension of the sensory-motor act of speech (the coordination of phonation and articulation).  Did you know you coordinate 30 muscles through 6 cranial nerves over the span of 1.5 seconds to every time you swallow?  It’s also a reflexive act:  i.e. you don’t consciously think about swallowing to coordinate it, it just happens.  That’s some awesome physiology right there!  Now the act of phonating itself should be a bit more like that too:  you don’t have to think that much about it, it just happens to work right when you command it and it takes 2 branches of 1 cranial nerve to enact.  The reason it’s not considered reflexive is that the command comes from higher up in your brain:  i.e. you consciously think about starting up your voice before it happens.  Phonation involves smaller, fine-tuned, movements from smaller muscles, and so it takes less nerve impulse (or “nerve-power,” if you will) to happen than the act of swallowing.  Those palatal, pharyngeal, and laryngeal elevators (along with muscles of the tongue) are involved in gross muscle movement.  They’re larger, stronger, and take more nerve impulses to function than phonation.

An interesting thing about these neural pathways from your brain to your voice and throat, these muscles that control all these lovely fine motor and gross motor movements, is the synaptic pruning that goes on.  Synaptic pruning is when certain synaptic pathways are eliminated in lieu of the ones that are being used.  This is the “use it or lose it” principle we’ve heard of.  Essentially, in this process, the pathway that gets used out of a command and gets reinforced grows stronger and the pathway that isn’t being used starts to die off.  Now, although this happens on a much more significant, large-scale, during prenatal development, childhood, and puberty, it does happen in smaller amounts throughout our life span.  (There are a whole lot of incredibly smart scientists out there currently studying something called neuroplasticity, which in essence, involves the stimulation of either new or damaged neural pathways to reconnect and rehabilitate someone from an injury, such as strokes, traumatic brain injuries, etc., which is based on this discovery.)

So here’s where I propose my theory, which at this time is more like an educated guess:   While a vocal injury like mine was not a stroke or traumatic brain injury (thank God!), having a “dysfunctioning” voice for nearly a decade really set some fairly concrete, albeit hyper-functioning, muscular coordination.  So when we say we’re working out “muscle memory,” we’re really working out “nerve memory.”  Because of my vocal fold asymmetry caused by the paresis, my brain had to actively recruit other muscles to help bring complete closure to the folds.  I had been “yelling” at my voice to not be breathy, and it had responded by calling upon the “big guns” of those more powerful gross movement muscles and pharyngeal muscles to force a clear “resonance” over that air escaping.  This occurred over and over during those 9 or 10 years of my injury.  The result was the creation and strengthening of very well-set pathways to recruit those gross-movers to force my voice to sound like I wanted it to in spite of the injury.  Those bigger muscles were recruited every single time my brain said to my larynx “sing!”  And just like someone compensating for an injured ankle, the effect was basically vocal “limping” that was so engrained as THE singing muscle coordination my body wasn’t just going to let it go when I told to sing again post-therapy. 

So here’s where the neuroplasticity thing differs with an injury like mine (still my theory at this point):  Therapies based in neuroplasticity seeks to activate pathways that either get damaged by stroke, neurodegenerative disease (Parkinson’s, etc.), or that were never there in the first place.  But, rehabilitating my voice to function optimally was NOT the process of re-activating neural pathways, it was the act of getting additional pathways to shut the heck up!  I had to find a way to get those extra muscles to stop firing when my brain said “sing.”  Therapy had retrained my voice quickly and efficiently by not requiring any manipulation or even thought on my part beyond just doing the exercises as I was taught.  My voice was truly healed up.  My lovely recurrent nerve was firing at full-force once again.  But that retraining only really worked on my speaking voice.  It didn’t magically cross-over into my singing voice.  Why?  Well, here’ s more theory on my part until I know more:  I think the coordination process of singing tends to be stored differently in the brain than that for speech.  (I mainly base that off of the fact that people who stutter can sing without stuttering and my own experience.)  My therapy exercises weren’t just a jumping-off point for how I would finally get my singing voice on track, they were the key to a complete shift in how I practice singing, how I view the process of learning to sing, and how I teach voice now.  Paradigm shifts like that don’t take place in a vacuum, but hopefully, I’ll be able to explain the process well enough for you guys out there who want to know.  But yeah, retraining “nerve memory” as I now like to call it ain’t easy, as we all know too well!