Taking Care of Your Voice: A Whole-Patient Approach to Vocal Health

For opera singers, Broadway performers and public speakers, the voice is a professional asset, comparable to a surgeon’s hands or a pilot’s vision. But most of us tend to take our voices for granted—unless something goes wrong.

During the long months of the pandemic, some people have developed vocal problems related to the heavy use of Zoom and other remote meeting platforms. “It turns out that Zoom is a challenging acoustic environment,” says Dr. Lucian Sulica, Director of the Sean Parker Institute for the Voice at Weill Cornell Medicine and Sean Parker Professor of Laryngology. “In an effort to be heard, people have a natural tendency to overproduce their voices on Zoom.” In other words, we push our voices beyond their natural limits, resulting in hoarseness, laryngitis or more serious issues.

There’s a lot you can do to counter that tendency, Dr. Sulica says:

• Stay hydrated. Keep a bottle of water by your desk or work area at home or in the office.
• Use a microphone to amplify the sound of your voice.
• Try headphones as well. These will allow you to hear well and modulate your voice accordingly.

He also points to another vocal stressor: stress! The larynx, or voice-box, is an organ that responds to emotion, he says, and so is its “product”: the voice itself. Therefore, he advises, do what you can to manage your stress.

The basics of self-care

Vocal health is inextricably interwoven with overall health. You can make improvements to both, says Dr. Sulica, by exercising regularly, limiting alcohol and refraining from smoking.

He also recommends budgeting the use of the voice—especially if you work in a field that requires you to use it for hours on end such as sales, public speaking or teaching. But Dr. Sulica’s advice also applies to everyone: “Limit your vocal use outside of work hours. It’s also important not to push through any vocal discomfort or pain.

“If you develop hoarseness,” he adds, “and if it doesn’t clear up within a few weeks after standard measures like voice rest or reflux or allergy medication, consider seeing an otolaryngologist who can evaluate your vocal cords.”

Triggers

For some people, heavy vocal use can irritate the vocal cords, he says. Allergies and frequent upper respiratory infections also can cause inflammation and even injury. Acid reflux—the regurgitation of stomach acid into the esophagus—can be a trigger as well. And don’t forget your work environment, which can be a source of inhaled irritants such as dust or mold.

...and remedies

Acid reflux sufferers sometimes try to avoid acidic foods such as citrus, tomatoes, coffee and chocolate. But Dr. Sulica advocates moderation as opposed to eliminating these from your diet. Try an over-the-counter medication to control reflux.

Another important tip: Avoid eating a big meal close to bedtime. “Gravity alone will exacerbate reflux,” he says. Better to have a lighter meal earlier in the evening, giving your body more time to take care of the business of digestion.

Finally, Dr. Sulica sees the concept of a vocal “cache”—a kind of savings account—as a useful way to think about our day-to-day vocal use. How much voice is left in the “bank” at the end of a meeting? A day at work? An evening at home? “The idea of a ‘cache’ can help people become more aware of how they use their voices and how much vocal energy they have left at the end of the day,” he says.

If we have a good idea of our vocal cache along with our wellness patterns, we can take better care of ourselves. For example, he says, “if a patient knows that they usually throw off an upper respiratory infection in four or five days but their voice isn’t bouncing back and they don’t have their usual cache, they may well decide to visit the Sean Parker Institute at Weill Cornell Medicine for an evaluation. Reach out to the Institute by phone at (646) 962-SING.

“We need to examine the patient’s instrument”—yes, the voice is an instrument!—“and we need to do that in person,” Dr. Sulica says. That goes for the professionals among us and for anyone concerned about their vocal health.