Christine Livingston,

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Your chief vocal organ: your larynx or voice box, is much like any other organ in your body – your heart, your liver or your eyes.  It can become diseased or it can be harmed by strain or misuse.  When you become hoarse, that is a sign that there is something wrong with your larynx.  Often the hoarseness is temporary and you know the reason for it.  Perhaps you had a cold that settled in your throat or you were at a baseball game and yelled too much.  But if : 1) the hoarseness persists for an unusually long time, as 3 or 4 weeks, for example…or 2) the hoarseness comes on for no reason that you can think of, or…3) if you have always been hoarse, then you should go to a doctor who specializes in throat conditions – a laryngologist or an ear, nose and throat (ENT) specialist.

As in many other things, however, prevention is more important than the cure and it is wise to know some of the conditions that can bring on voice problems and to know and practice the habits and precautions that will keep your voice strong and healthy.

The following suggestions will be found helpful:

  1. Misuse/abuse of the voice is one of the most common causes of voice problems. The misuse can take many forms.  Here are a few:
    1. Yelling excessively, loud talking. If this has a harmful effect on the voice, try to participate in quieter activities, find other ways to show enthusiasm, etc.
    2. "Unnatural” uses of the voice as in imitating tractors, machines, animal noises, high squeaks, squeals, screams seem to be found among people who develop voice problems.  Such activities place an unusual strain on the voice, and may result in hoarseness.
    3. Taking part in public performances, singing, cheering can produce strain that will be harmful to the voice and hence should be minimized or proper training to do these activities is recommended.
    4. All vocal activities, including talking, must be reduced to a bare minimum or
      discontinued (NO whispering) if you have a sore throat or are already hoarse from a cold or excessive use of the voice.
  2. Good physical health is essential to a sound, healthy voice.  Following are some conditions that may result in, or contribute to, voice problems:
    1. All upper respiratory infections or inflammations, such as a runny nose,
      “sinus trouble”, colds, sore throats or bronchitis, especially if these occur
      often or have become chronic.  IF you have repeated colds or if they fail
      to clear up promptly, the cause should be looked into.
    2. Coughing, especially if severe or prolonged, places a great strain on the
      larynx, as does repeated clearing of the throat. A special threat to a strong, healthy voice is an allergic reaction to any substance such as pollen, foods, dust, etc.  If you show signs of being allergic in any way, it would be wise to have a thorough examination by a doctor specializing in allergies, or at least bring the problem to the attention of your doctor.  Allergic reactions tend to weaken the tissues of the larynx, making them more suspectible to damage from use, or misuse of the voice.
    3. The tonsils may be at the seat of the trouble if there have been repeat
      bouts of tonsillitis.  The infection may spread to the larynx.
    4. A generally weak and “run down” physical condition, whether from
      illness, excessive fatigue, improper nutrition, etc. can, and often does
      contribute to a weakened vocal mechanism that tends to “give out” if
      subjected to any strenuous use.  A healthy voice needs a strong, healthy
  3. Emotional factors may be important also, in bringing on voice problems.  If you are generally tense, anxious, or feel insecure, even normal talking and other uses of the voice may result in hoarseness because of the added strain on the vocal folds when you talk.  Some of the factors and conditions that may produce tensions and strain are:
    1. Excessive family competition, distress, etc. creates a certain amount of tension.
    2. Certain other environmental influences affect feelings of stability and security.   For example: Family or friends who often quarrel or argue over issues; excessive criticism or nagging; inconsistent upsetting behavior by people in your life; lack of respect and attention and the opportunity to be heard.

Why some people are exposed to the very same situations and suffer no apparent ill effects and why others do develop vocal nodules or thickened vocal folds has never been fully explained.  Apparently people differ in the ruggedness of their vocal
mechanisms.  One might think of this as a “weak” larynx or predisposition, in the same way that some individuals have weak hearts, lungs, or poor digestion.  Such people may lead happy, useful lives so long as they recognize their limitations and learn to live with them.  Similarly, individuals whose voice mechanism may not be so rugged will need to curb their yelling, loud and excessive talking and take better care of their voices to avoid hoarseness, discomfort, and possible damage to the larynx.  Vocally, they may have to learn to “take it easy” perhaps all of their lives.  If they do, they may never have any trouble.