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Chronic voice strain
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Chronic voice strain

Hi,

I hope someone can help me. I am at my wits end. I have had a problem with voice strain for about 4 years now. I first went to see an ENT after a period of using my voice very badly (long story!) and developing vocal nodules. I since stopped that bad vocal use, and even went for speech therapy to make sure that I am speaking and breathing correctly -- I am. The vocal nodules have completely cleared up. However, I am still having a problem with a very hoarse, strained, weak voice. I have been to a number of ENT's, including a specialist at Duke, but none have been able to help. Each of the ENT's have looked at my vocal chords with a scope, and report that my throat and vocal chords are red and swollen. The obvious answer was "reflux", but after a great deal of treatment for this, I have seen hardly any improvement. I have been on various doses of different anti-reflux meds (including as much as 80mg of Omeprazole (sp?) per day), but none have helped. I even had a "laparascopic nissan fundoplication" (sp?), but if anything, that has made the situation worse, as now, after eating, I have a tendency to belch more, which -- if the problem IS reflux relate -- could be causing further vocal irritation. All things considered, the problem is as bad now as it has ever been.

I really would appreciate some advice as to what I can do next. I'm out of ideas, and I dread going to another ENT just to have to repeat the same tests I've gone through with the other three.

Thank you in advance!

Kind Regards,
Greg
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12 Comments Post a Comment
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125112_tn?1217277462
"Each of the ENT's have looked at my vocal chords with a scope, and report that my throat and vocal chords are red and swollen. The obvious answer was "reflux", but after a great deal of treatment for this, I have seen hardly any improvement."

Based on this, I can see why they are focusing on this. Obviously, your cords are irritated. Did you have a CT scan of your sinuses?
Do you have a-lot of post nasal drip? If so (or suspected) try a nasal decongestant (note, not recommended for those suffering from high bp) for about 2-4 weeks and see if that helps.

"However, I am still having a problem with a very hoarse, strained, weak voice."

If after the trying the above (and considering visits to the ENT)...the last option, would be to seek counsel with a Neurologist.

Just in case there is more than one condition existing.

Best.


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Avatar_n_tn
Hi Greg,  I too am dealing with a very hoarse, strained weak voice, though not as long as you.  Mine started Feb '07 for no aparent reason.  I have been to the ENT doctor 2x, I've been on a steroid pac, antibiotics, Nexium, as well as a CAT scan of the sinuses. It is recommended that I try speech therapy next.

I agree this is very frustrating and I can't imagine going through 4 years of this...ugh!  My thinking now is allergies.  Have you been tested for them? It's something I've been thinking of as of late, though I'm not sure if an allergy would cause these symptoms.  Let me know if you come up with any other help and I will do the same.

Laura



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Avatar_m_tn
I'm noting that this is about 2 years later for you guys, but I was wondering if either of you have come up with any solution since?  I'm having similar problems.  Chronic weak voice with red and swollen vocal chords; and nothing seems to resolve the problem.  It started when I was teaching in Korea, but I've been back for 6 weeks with ample rest from speaking and Korea's pollution... Yet nothing has changed and the doctors are running out of ideas.  My life has been on hold for 5 months because of this...

Hope you can help!
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Avatar_n_tn
I wish I could say it has all cleared up, but it hasn't. That being said, it's not really bothering me as much these days. Part of the reason, I think, is that I have been learning to speak with more "focus" to my voice. I don't know if that makes sense, but I'll try to explain. Growing up, I used to speak almost from my throat, and I wasn't using any sort of natural vocal resonance. I used to be painfully shy and quiet, and I think I just never really learned how to project my voice properly. Now that I have, though my voice is still weak, I'm able to compensate by projecting it better. I've basically reconciled myself to living with the issues as best as I can. [But hopefully you can get your issue fully sorted out. We're all different, and there may be a different root cause for you.]

I do take 80mg of Omeprazole daily (40 morning; 40 night), and I find that helps quite a bit. If I don't take it, I notice reflux being more of an issue.

A few tips for voice care. These have helped me (when I make a point of doing them):
- Drink lots of water! [I don't drink nearly enough, unfortunately.]
- Don't eat within a few hours of going to bed (3 hours?).
- Avoid fatty foods.

[The last two tips are reflux related. Don't know if that's the cause of your issue, but if it is, it might help.]

Also, I'd encourage you to not put your life on hold over this. Focus on moving forward as best you can. Hopefully the issue can be sorted out in due course. Hang in there.

Greg
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Avatar_m_tn
have u been shouting if u have stop my voice is back to normal after not shouting a lot just stop for about 5 weeks
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Avatar_m_tn
Hey Guys, I just found this forum, I have had chronic vocal strain for 6 months now. It started as laryngitis, I took pain killers and started talking for business all day which was a no no. Now for 6 months I have had raw, sore vocals. I had a camera look at it and they said no nodules, just redness and swollen vocals...I have tried talkiing less and not at all for a few days at a time, I am taking all kine throat sprays, tea, inhaling steam. It just isn't getting better!!

Can anyone help? How long can this last? Can it turn into something worse? do I need to stop talking compltely for months?
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Avatar_n_tn
Hi there.
Im waiting to see the ENT and Im worried sick.  Ive had a sore raw throat for 6 weeks.  Im finding it an effort to talk as it hurts.  I have just left a call centre job and this started about 2 weeks later and if anything is getting worse.  Doctor thinks its Voice strain but its odd its happenned now Ive left the job.  I did struggle with my voice in the job though.
Have you seen any improvement yet?
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Avatar_f_tn
I been through the same as you.
Two years ago, I started with a very bad sore throat. My primary doctor gave me an antibiotic. Then my sore throat went away for three days. After that, I coughed alot and had alot of phlegm stick in my throat! I have very bad hoarseness! It wasn't easy to clear my throat so I had to drink water to clear my throat! I went to ENT doctor to check it out. He said my vocal cord (throat) is little swollen because it's from the exposure of acid and I have alot of phlegm in my throat! He also said that I have acid reflux. Also it is because I used to overeat heavy meals (dinner) often. He gave me prescription pills called Omeprazole bi carb (PPI) medication. It gave me very painful headaches as side effects and I stopped taking them. Then he gave me different pills called Protonix (PPI) medication.

One year later, the symptoms haven’t gone away. I still have bad hoarseness and the phlem or saliva sticks in my throat! It worried me so I had to go to a new ENT doctor. She said my right vocal cord is little sluggish. She suggested I go to throat specialist, I went there, he checked it out, he said I have scar on my left side of my vocal cord! He couldn't do anything to reduce my hoarseness. Then I went to new Gastro doctor and had an endoscopy, he said my esophagus was little irritated from the acid reflux. He advised me to take 2 Protonix (80mg) a day.

Four months ago, I still have some hoarseness and my voice cracks all day everytime I talk! My voice gets more hoarseness after I eat lunch and dinner! I felt a lot of phlegm or saliva sticks in my throat. It also felt like post-nasal dripping and it sometimes tickled in my throat and I had to cough! When I cough, I felt my hoarseness get worst! I had to go to another new ENT doctor to check it out recently, he said my vocal cord seemed fine! He said I should continue taking 2 Protonix.

I’m very depressed because I know something is wrong with my vocal cord and all those ENT doctors kept giving me different diagnoses and did nothing to help me to reduce my hoarseness! They seemed not to concern about me and refusing to give me more tests!
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Avatar_m_tn
I've had the same issues.
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Avatar_m_tn
I've had chronic hoarseness for four years now.  I've been to several ENT's, an allergist, an internist.  I've had several endoscopies.  Everything comes back normal.  The ENT of course said it could be reflux.  I've been on Prilosec and I sleep almost sitting up and the weak hoarse voice has not improved.  I've tried cutting caffein out of my diet and that hasn't helped.  

Nothing i've tried in four years has helped whatsoever.  I've started to get a hopeless/desperate feeling come over me.  The doctors i've seen have no real interest in ruling out the possible causes of this problem.  The treat me like it's an frivolous annoyance when the exact opposite is true.

I feel that this issue with my voice is destroying my quality of life.


If anyone has any ideas as to what this could be, I am all ears.
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Avatar_m_tn
Oh I understand you all. I have had voice problems over a year now, it's so frustrating. I have muscle tension dysphonia and it always hurts when I talk.
What have I learned is
-drink as much water as possible( minimum 2 to 3 litres of water a day )
-don't eat before going to bed(2-3 hours)
-work out, sport keeps ALL muscles in shape
-eat healthy(very important) proteins like-eggs, meat, milk, peanuts, bananas and so on.
-warm up your voice gently every morning before school, work etc. Start warming up your voice with diaphragm warm ups(write in  youtube---''Eric Arceneaux diaphragm warm ups'' he is really good) then go for humming exercises.
-sleep sleep sleep, sleep a lot!
-yawn sign( i found this exercise on the internet and it sometimes really helps to relax muscle/neck/throat tension:
First, you start out by yawing as wide as you can; imagine the wide-open mouth of a lion roaring. Follow your big yawn with a loud and open sigh. You should drop your tongue down low in the back of your mouth and let the air flow out easily. Make an "AHH" sound like you do at the doctors' office; it should sound relaxed and open. Repeat this exercise at least five times.
- relax your voice, don't talk if you wanna say something then better write it, don't shout, don't whisper-whispering is more harmful than talking in normal speech.
That's what I know. Hope this helps. Good luck guys:)
P.S. sorry for my english.
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Avatar_m_tn
Oh I understand you all. I have had voice problems over a year now, it's so frustrating. I have muscle tension dysphonia and it always hurts when I talk.
What have I learned is
-drink as much water as possible( minimum 2 to 3 litres of water a day )
-don't eat before going to bed(2-3 hours)
-work out, sport keeps ALL muscles in shape
-eat healthy(very important) proteins like-eggs, meat, milk, peanuts, bananas and so on.
-warm up your voice gently every morning before school, work etc. Start warming up your voice with diaphragm warm ups(write in  youtube---''Eric Arceneaux diaphragm warm ups'' he is really good) then go for humming exercises.
-sleep sleep sleep, sleep a lot!
-yawn sign( i found this exercise on the internet and it sometimes really helps to relax muscle/neck/throat tension:
First, you start out by yawing as wide as you can; imagine the wide-open mouth of a lion roaring. Follow your big yawn with a loud and open sigh. You should drop your tongue down low in the back of your mouth and let the air flow out easily. Make an "AHH" sound like you do at the doctors' office; it should sound relaxed and open. Repeat this exercise at least five times.
- relax your voice, don't talk if you wanna say something then better write it, don't shout, don't whisper-whispering is more harmful than talking in normal speech.
That's what I know. Hope this helps. Good luck guys:)
P.S. sorry for my english.
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