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.)