Starting Point:

Alexandra, primarily a dancer, was referred to me by her agency, several months in advance of a professional Spamalot production she was auditioning for.

There was some rasp in her speaking voice, and more in her singing voice. She reported having been to ENTs numerous times while in previous shows, and always being free of any lesions on her vocal folds, each time.

When singing up from chest voice into higher mix/belt range, Alexandra’s voice got raspier and louder, before cracking into a breathy head tone, around A4. Her folds sounded puffy to me, and not able to easily access mix coordination, maybe due to a combination of vocal health and technique.

I asked her to get our local ENT (a voice-specialized ENT doctor*) to do a new scope/assessment of her vocal folds and get medical clearance to sing before we did any work, which she did.

The ENT ruled out lesions but noted some inflammation. He cleared her to sing, adding she should self-monitor and be cautious. The ENT also prescribed reflux medication (reflux is aeresolized acid from the gut getting into airway and irritating or even burning the folds) as the tentative diagnosis, and also referred Alexandra to a singer-specialized speech language pathologist (SLP) we worked with.

Process:

When working with a singer with reduced vocal health, it’s important to have a care team in place.

A care team consists of:

• a laryngologist

• a singing voice specialized (SVS) speech language pathologist (SVS—SLP—so many acronyms, I know…)

• a singing teacher who has familiarity with pathology, treatment, and rehabilitation of vocal health issues.

When working with a voice care team, the singing teacher must work within any advice or parameters of the laryngologist and SLP.

In Alexandra’s case, her condition was not severe and the main guideline was ‘self monitor and be careful.’ So we carefully explored improving her voice. Specifically:

• We broadened her range via gentle exercises that took her through both chest and head voice, going for gradually cleaner tone in both registers.

• We explored ‘mix voice’ sounds that would help her maintain clean, commercial sound, but avoid the heavier, limited-range chest-belt she was used to.

• We checked in each week about potential heath factors and monitored what seemed to make things better or worse. Between Alexandra’s reflux medication and other lifestyle tweaks, her vocal health steadily improved.

Results:

Alexandra’s vocal folds improved in health and function, and she learned how to sing higher, with a strong but healthy mix tone. She booked the Spamalot role, and later another role with the same company for In the Heights.

*Re Laryngolosts and ENTs: If you have a potential vocal health issue, it’s important that you get a referral for a Laryngologist—ideally a professional voice-sub-specialized laryngologist, not just a regular ENT (ear, nose, and throat doctor), as ENTs and even regular laryngologists may not have enough expertise to diagnose and treat singers best, especially for subtler issues.

A laryngologist possesses additional years of fellowship training in vocal fold pathology and treatment. A pro-voice sub-specialized laryngologist invests time and effort to develop their practise, over time, to focus increasingly on just professional voice users, as opposed to e.g. people with swallowing disorders or Parkinson’s and other areas of laryngology.