A Singer Diagnosed With “Vocal Cord Dysfunction”

Recently a singing student of a colleague received a diagnosis of “Vocal Cord Dysfunction” from an ENT. The voice teacher asked on a forum what that meant. Those of us who work with injured singing voices responded that Vocal Cord Dysfunction wasn’t a diagnosis.

Any vocal fold injury or pathology creates “vocal cord dysfunction.” Right?? That is perfectly logical.

Evidently, in the medical community “Vocal Fold Dysfunction” is another name for “PDFM”–Paradoxical Vocal Fold Movement.

And, evidently, ‘Vocal Cord Dysfunction’ is not categorized the same as ‘Vocal Fold Injury.’ However, both affect movements of the vocal folds and the larynx.

PVFM doesn’t refer to one specific vocal fold injury diagnosis. It’s anything that causes “an episodic unintentional adduction of the vocal folds on inspiration.”  Which means the vocal folds are working backwards—they close when the patient tries to inhale. Normally the vocal folds open upon inhalation.

Can you imagine how awful that would feel? However, Kerrie Obert, a Clinical Voice Specialist at The Ohio State University and Dept. of Otolayrngology and co-author of The Owner’s Manual to the Voice: A Guide for Singer’s and Other Professional Voice Users, says

While scary, one of the things to know is that oxygen levels remain normal during an attack. People with this disorder feel they are not getting enough air but they actually are. It is one of the things that distinguishes it from asthma or other respiratory disease. It is basically a behavioral problem and generally remedied with just a few sessions with an SLP.

This voice disorder ALSO has other alias’, such as laryngeal dyskinesia, inspiratory adduction, periodic occurrence of laryngeal obstruction, Munchausen’s stridor, hysterical croup and irritable larynx syndrome….just to name a few!

Kristine Pietch, SLP at Johns’ Hopkins’ Dept. of Neck and Head in Baltimore and Bethesda, Maryland and a fine singer, noted that

We don’t like the term ‘vocal cord dysfunction’ in our clinic for the reasons you describe (very non specific!) but it is the one that most pulmonologists use and that our patients hear first! I see a number of these patients every week and on my handout have to write “vocal cord dysfunction AKA paradoxical vocal fold motion” and NOW I’m probably going to have to add yet another…ILO aka inducible laryngeal obstruction which has been taking off (especially outside of the US). Too many terms…..very very confusing….

Paradoxical Vocal Fold Movement is misdiagnosed frequently as asthma because the symptoms are:

  • Noisy or wheezy inhale
  • A feeling of not inhaling enough air when playing sports or singing but recovers quickly, within 5 minutes.
  • Asthma or allergy medications don’t help with breathing problems
  • Has a history or symptoms of acid reflux
  • Patient points to the throat more than the chest to indicate the area of tension

This condition seems to be most common in young females 11-13 who are competitive athletes and quite driven academically. It occurs more in females than in males. It’s really imperative that the student get a correct diagnosis (asthma or PVFM) and specialized therapy from a voice care clinic and an experienced Speech-Language-Pathologist.

Sometimes asthma and PVFM occur at the same time too.

The speaking and breathing need to be addressed before the singing voice.

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Please view my services as an Independent Singing Voice Rehabilitation Specialist and my qualifications:

I. Individual Singing Voice Rehabilitation

For individual singers after diagnosis from your doctor.

II. Cate’s Collegial Consults

For experienced voice teachers and their student together, for those who live in areas without access to the resources they need.

A Singer Diagnosed with Bi-Lateral Vocal Fold Paresis

It’s time to SHATTER the imbedded pedagogical view that “singing with the wrong vocal technique” causes vocal fold injury. That is true in many cases, but in equally as many cases it is not.

Please listen to my interview on the VocalFri podcast. We get into cool stuff every singer and voice teacher needs to hear.

Thanks for your precious attention and time!

Singing Through Change: Who We are Writing For

If menopause symptoms were due solely to hormonal changes then the menopausal experience would be more homogenous.

In “Singing Through Change: Women’s Voices in Midlife, Menopause and Beyond, Nancy Bos, Joanne Bozeman and I are writing for a wide variety of singers who:

–Have sung all their lives but don’t understand that singing through the lifespan is like being active in sports. You need to tend things along the way or you can’t play.

Don’t know much about their bodies or biological cycles other than what they hear in media or what their doctors tell them.

–Work with singers through midlife and aging: coaches, teachers, performers, choral conductors, music directors and medical personal.

–Are colleagues, students and medical professionals. We are writing the book we wish we’d had as we moved through our changes.

A very T-A-L-L order? Yes.

That’s why there are three of us writing in collaboration. We are really excited about the very unique way of co-authoring we’ve created! It takes longer than if we each write a chapter, but it’ll be worth it!

Sign up for our mailing list to receive regular publication updates & fun peeks

or

Join us on our Facebook Group Page for insights, information and some great conversations.

or Follow us on Instagram if you are off of Facebook. You’ll need to download the Instagram app to your phone, create an account, and then just look for “Singing Through Change” and Follow.

Singing and Teaching From an Undivided Self

We have more academically-educated singers and voice teachers now than at any time in the history of vocal expression, and dare I say it? Very little teaching from an Undivided Self, which means very little useful and true wisdom.

Learning to get to this place this requires TIME.

It’s a sort of alchemical process to find personal, musical and pedagogical ah ha’s! amid the deafening noise of information, data, and a cult of personality. These things don’t work well with singing. Because singing is about first finding silence of stillness and then becoming a channel for bio-electric energy, all human expression and divine connection.

I think many teachers ‘head’ know this–but they don’t FEEL it or EMBODY it.

There is a crying need for a 1:1 Experiential Learning Program outside of academia to allow teachers and singers the time they need to create this alchemical process. To learn to teach WHO they ARE as well as WHAT they KNOW.

I’ve put together what may be the first program of its kind, “The Alchemy of Teaching Singing,” to fill a hole in the Continuing Education of Singing Teachers.

We’ll work with practical and useful steps towards integrating your singing, passions, pedagogical foundations, teaching interests and needs to create your undivided Self.

I’ll also help you honor every facet of your life experience, which creates a space of immense coherence and strength to hold student, learning, and your Self.

THAT’s where the magic happens.

Special thanks to Palmer Parker and his brilliant book “The Courage to Teach.”

Evidence-Based Vocal Pedagogy and Other Mystifications Part I

I’m developing a 5-month digestible program for singing teachers who haven’t had the opportunity to develop a hands-on understanding of what “evidence-based” teaching of singing means in the 21st century.

Dr. Kari Ragan has written her thoughts on this topic in a Journal of Singing article. You do have to be a NATS member to access it on line. However, you can always contact Kari, tell her you are interested in her work, and ask if she will forward you her article.

I’ve been able to work privately with many masters-in-pedagogy and performance graduates, in classical, jazz and contemporary genres, after they graduate with their degrees. I’m seeing a strange trend that has developed over the past 10-15 years, of voice teachers not understanding what to do with the information they have learned. They aren’t sure how to make it useful or fit it in with their world of experience. So the next summer, they go to another pedagogy intensive, hoping to learn what they still do not understand.

There are many fine voice pedagogues who teach in useful ways, and are able to distinguish between voice science, vocal pedagogy, what is true and what is useful. But if you want to be the best teacher you can be, and are not in their programs, how to you begin to make the same distinctions?

That’s what my program is for. I am collaborating with Dr. Patrick L’Espoir Decosta (Australian National University School of Business) to lay the infrastructure for the course.

In Part II I give you a little quiz on what you might think “evidence-based” means in the field of Adult Learning. Especially interesting if you teach adults!

Menopause and Singing: Shifting the Conversation

As some of you know, I am co-authoring a book with Nancy Bos and Joanne Hayes Bozeman on the topic of women singing through midlife biological changes and menopause.

Research has been pretty fascinating and we are digging into areas not usually associated with The Change. (ooooo, suspense!) Our interviews include 52 female singers during 1) various stages of peri-menopause and menopause, 2) a large variety of genres and musical styles 3) many skill levels and cultural experiences.

We are speaking with colleagues and experts in a wide variety of disciplines and will reference many top-notch resources. We are grateful for those who’ve researched and written about hormonal effects on the female singing voice.

But the REAL experts are the women themselves. Their stories, their solutions, their journeys: sometimes easy and breezing on through, some devastatingly difficult.

Statistics are important but their purpose is not to reveal how individual the mid-life journey is for EACH woman. Data can be used to influence public health policy and obtaining grants for important research. Stories save individuals and pass on wisdom not found in data.

Both are needed!

Western medical science & academic learning must become equal partners with honed intuition, and listening to the Wisdom of the Body to create health, wellness and experience singing in new ways.

This is an “angle” of our book. We are writing for singers and teachers who may not have access to the information that has been gathered over the past 30 years. We are also writing for women who are willing to do the work of rebirthing themselves during these years and need extra support.

I’ll report on our progress so join me here for peeks and perks!

Index of my previous articles

Vocal Warm Ups to Enchant Your Singing

I was inspired to write this blog post by Nikki Loney, a Canadian vocal music educator who runs a popular vocal music education podcast called The Full Voice. She has a three-part series called “Warm Ups from Around the World.”

The warm-ups Nikki includes are suitable for many ages and stages of singers. Part of her mission is to help singers & teachers understand the reasons for the vocal exercises they use, and sing them in a spirit of fun and exploration. While the exercises may be familiar to more experienced teachers, I was thrilled to hear the guest artist/teachers’ explanations for WHY you are using them and HOW to do them.

This matters much more than the actual exercises themselves! So consider heading over to her series and listen.

In the meantime, here’s three vocal warm-ups from CateFNStudios that I use.

I.  Pick a short musical phrase from the music that your student or group is singing. Choose one that can be moved up and down the chromatic scale easily. Limit them one or two measures at the most.

Here’s an example for developing voices of any age or stage: a passage from the end of Linda Ronstadt’s recording of Ray Orbison’s “Blue Bayou.”

Use “Blue—Bay—-Ou—-“

Works for women and men. Roy Orbison recorded it first, but he ends on the upper tonic, not the displaced third. If you aren’t sure what that means, listen to them both. You’ll hear the difference without needing to know the theory.

This helps coordinate chest to head registration smoothly in all styles of music, perhaps after registration work has taken root. It easily syncs with most functional vocal pedagogy models out there that use other names for those registrations/qualities.

It can also help with teaching relationships between intervals and with coordinating sustained singing. You can also use it as a “Messa di Voce” exercise.

Plus you get to introduce young people to Ronstadt and Orbison if they look at you with a blank stare….

For choristers, any pattern that has slow, sustained passages has the benefit of the kind of choral tuning that American choral conductor Robert Shaw used. Church choir directors can’t usually take the time needed for this way of working, but it can be incorporated into 2 minutes with one short passage as part of your choir’s warm-up. Over time this will develop stamina, mental focus, and group bonding.

II. For vocal flexibility and ear training for world music, Indie artists or jazz singers–have them warm up on arpeggiated patterns that are not the traditional major scale 1-3-5-8-5-3-1 pattern.

Eventually move to other arpeggiated blues or harmonic patterns using syllables they choose. Try to guide them to “ahs and ays” on the lower notes and “ees, oos or ohs” on the higher pitches. Scat singers will use their patterns or you can suggest something like “doo-bway-doo,” etc.

PS. I make classical singers do this, too, to wake up their ears.

I recognize that not all singers and teachers can play this warm up in different keys on a keyboard. You can adapt this idea for you and your students in any way that serves them.

III. This general idea is for singers who know their music well and are far enough along that it makes sense to them:

I coached privately many years ago with the late Randolph Maulden, of The Washington Opera. Obviously I warmed up before coachings, but then he often had me sing phrases from whatever I was working on, starting 4 1/2 steps down from its key, and going up two more 1/2 steps beyond the highest note and back down. I experienced this as a real work out. This gave me a chance to move through all the registration minutia, and solidified where high notes in the right key actually existed in my throat, body and psyche (as a whole singer.) This idea also can be adapted, so open to your creativity!

Once you know the HOW and the WHY for a warm-up or exercise, you can always adapt it to be the most useful!

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