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Keeping Your Voice Healthy

John, age 72, had worked as a naturalist and ranger at a nature preserve for more than 30 years. One of his favorite duties was lecturing to the buses of school children on field trips about wildlife in the park and other important environmental issues. For six months, he noticed he was having difficulty projecting his voice loudly enough to be heard by the children, and by the end of a busy day his voice was hoarse and tired. As the months passed, his symptoms of voice fatigue and hoarseness increased and became such a problem that John was considering retirement—something he did not want to do.

John’s voice problem is one shared by almost 10 percent of children and adults in the U.S. Voice disorders exist when the quality, pitch, and loudness of the voice differ from those of similar age, gender, cultural background, or geographic location, or when changes in the voice make it difficult or impossible to carry out daily activities of communication.

Causes of voice disorders
Voice disorders may arise from a wide variety of causes that can affect individuals in many ways, ranging from a mild annoyance to a threat to one’s career or livelihood. Some of these causes may be the result of other medical conditions, such as acid reflux, allergies, rheumatoid arthritis, or heart or lung disease, that can affect the tissues and muscles of the vocal cords. Other causes include emotional stress and tension, which can interrupt the normal functioning of voice production.

By far, the most common cause of voice disorders is voice misuse and abuse caused by speaking too loudly, shouting, singing too much or out of range, smoking, poor hydration, or simple overuse. Because of their heavy vocal demands, teachers, telemarketers, singers, and actors are at greater risk and suffer with voice problems more so than other occupations. Homemakers also have a high rate of voice disorders because of increased vocal activities with their children.

Consult a specialist
John experienced hoarseness and voice fatigue for six months before he sought the opinion of his family physician. Because persistent hoarseness is the first sign of throat cancer, he was immediately referred to an ear, nose, and throat specialist (otolaryngologist) for a complete examination, and was identified as having a weakness of the vocal cord muscles, not uncommon in John’s age group. He was referred to a speech-language pathologist who specializes in voice disorders and received voice therapy, which consists of specialized vocal muscle exercises, restoring the strength and quality of his voice. John continues working today.

The University of Kentucky Academic Medical Center, through the UK College of Medicine Department of Otolaryngology and the UK College of Health Sciences Division of Communication Sciences and Disorders, provides the only integrated team of voice specialists in the state. The team consists of otolaryngologists, speech-language pathologists, singing voice specialists, and voice scientists who are dedicated to evaluating, treating, and preventing voice disorders. They also conduct clinical research to improve the vocal health of Kentuckians. For more information on the UK HealthCare Ear, Nose and Throat Clinic, call (859) 257-5405 or go to


• Drink at least 64 ounces of water each day

• Avoid yelling, shouting, loud talking, and talking over noise

• Avoid singing or excessive talking in the car

• Do not use a cell phone in noisy environments

• Eliminate throat clearing and coughing; use a hard swallow instead

• Stop using all tobacco products

• Stop all recreational drug use

• Avoid chemicals, dust, and other harmful inhalants

• Never whisper

• Don’t push your voice to its physiological limitations

• Don’t overuse your voice

• Take “vocal naps” throughout the day

• If your voice starts to feel tired, don’t push it

• Avoid cough drops with menthol, as they may be drying to the throat; use a piece of sugar-free hard candy or an herbal drop instead

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