Are you psyched for voice fatigue? Join Lindsey and Julie Grower, SLP for a great discussion on how to prevent and alleviate voice fatigue. Whether you are in a brick and mortar or virtual setting, Julie has some great tips. Coffee lovers, did you know that a hot cup of Joe may not be the best antidote for a sore throat? Breath in and carry on to find out how you can maximize your therapy sessions without straining your voice in the process.

Lindsey:

Good morning, Facebook, and welcome to another episode of SPEDtalk. I’m your host, Lindsay Kucich, Counseling and School Psychologist Coordinator with Global Teletherapy. And I have a special message from all of us at GT, because our hearts, thoughts, and prayers go out to those affected by the wildfires in California and Oregon. We hope that they can be brought under control and the homes and forests are rebuilt quickly. We are thinking of you and anyone among the affected. So, we are praying for you.

Lindsey:

And I am excited about today’s show as we talk about vocal fatigue. Before I introduce you to our guest today, please take a minute and share this video so that we can reach as many people as possible. And don’t forget to comment and tell me where you’re watching from. If you’re watching the replay, also comment with #teamreplay. I am ecstatic to announce that our watch community is growing because we hit over 1,000 members on our Facebook group, The Therapist Hub.

Lindsey:

So to celebrate, we’re going to do a drawing. And taadaa, one lucky winner is going to get a Be Happy book. Yay. So, drum roll, please. God, this is fabulous. Oh my gosh, there’s so many names in here, right? Like who are we going to have? Anticipation is killing me. Okay. The winner, an SLP, Jamie Hudson-Smith. Yay, congratulations. Our amazing Olivia will be reaching out to you via Facebook Messenger to make arrangements so that you can get your very own copy of Be Happy.

Lindsey:

So, if you are not a member of our Facebook group, then you are missing out on some amazing resources. So, you want to get added to the group. In fact, you want to get added to all of our social media accounts so that you can get access to everything that we offer. You want to find us on Instagram, LinkedIn, Twitter, and of course, subscribe to our YouTube channel. Then you can watch all of our past SPEDtalk shows. Just search for Global Teletherapy. And then you’ll get access to all of our content, which includes resources, blogs, and our vlog.

Lindsey:

So, well, let’s welcome our guests today, Julie Grower. She is originally from the New York Metro area, and now Julie lives in Nashville, Tennessee. Her undergrad studies were music and media arts, including studies in classical voice. She became a speech and language pathologist in 2007 after being in the communications and media industry for 15 years. Julie retired from Tennessee public schools this past spring, and then she joined the Global Teletherapy family in August. She has a lot of knowledge and training in the area of voice and is here today to help us learn how to protect our voice. So, welcome Julie.

Julie:

Hi, I’m so excited to be with you today, Lindsey. Good morning.

Lindsey:

We’re so excited to learn from you because we are in this wonderful age of video conferencing where all we do is talk, talk, talk. So, tell me, what is vocal fatigue, and then what causes it?

Julie:

Well, okay. I’m not going to do a big biology lesson here, but we have a mechanism called our larynx, which is where our voice box sits right here in our throat. It’s surrounded by a bunch of muscles. We have right in the middle, right within it, our vocal chords, and they kind of look a little bit like this. Can you see my hand? You might not be able to.

Lindsey:

I think we actually have a slide where we can show and show our audience what that looks like.

Julie:

Yeah. Good. So, these are two slides. And the one to the right on the bottom is actually what your vocal cords look like when you’re looking down on them. And they are actually two chords and they vibrate together. They open and shut with the force of the air that comes up from your lungs. And when too much force forces them open and shut, and when they’re not opening and shutting and the vibration doesn’t have a lot of efficiency, that is when we can develop vocal fatigue. And we might even develop like small irritations or nodules created by that situation. So, it can definitely happen. And yeah, I hope that that helped explain it a little bit.

Lindsey:

Yes, that’s a great explanation. I can see the mechanics behind it. I’m definitely not in the medical field. So, why does it happen when we’re in Zoom meetings? I feel like when I was in the schools, this didn’t happen, but I’m assuming that could probably happen in person, too, right?

Julie:

Yes. It can definitely happen in person. In fact, at the beginning of the school year when I was working for Metro public schools, I used to provide all of my teachers in general ed, special ed, all throughout the school with a handout, giving them advice on how to treat their voices because they’re in large classrooms, they’re having to project out to a lot of students, and they may also have to project over noise.

Julie:

Now, in the special circumstances of a Zoom meeting, I think what’s interesting is that we have a little bit less ability, I think, to gauge how well our client is hearing us. So, we may overcompensate if we are not used to being in that setting or even if we are used to being in that setting. We have to figure out whether they can hear us or not really just by asking them. And we’re not dealing with a room or a distance. We’re dealing with something that’s a little bit more technical, which is the sound waves coming over our electronics.

Julie:

The other thing is, as you all know, sometimes there can be lots of other things going on in the room while our students are participating. They may have siblings. And we sometimes wind up having to speak over what else is going on in the space. So, those are some reasons why we might overuse our voices. And also we are talking a lot of the day, session after session. So, we might want to take a break in between if we possibly can.

Lindsey:

Well, that makes sense. I can definitely see teachers in person struggling with this. And then I guess we just never really thought about it really happening to us in our therapy sessions, especially with the Zoom features that we’re using. And you make a really good point. We’re not trying to fill the room and project our voice, but it really has to do with gauging whether or not we could over talk whatever their background noise is and making sure that we’re being heard through our computer. But we know that this happens to teachers, probably happens to these therapists now that we’re running these back-to-back sessions. But do students suffer from this as well?

Julie:

Absolutely. I know, especially in a busy household where they might be competing with other siblings to be heard, it can be common for them to overuse their voice. Kids have a lot to say, and they want to be heard. And staying hydrated is an important thing for children. And also there are online a lot of the day and having to participate in classes. So, obviously depending on their schedule, depending on the situation and the environment of the student, it may or may not affect their voices, but it is definitely something for parents and teachers to look out for.

Lindsey:

Well, that’s good to know that it really can affect all of us.

Julie:

Absolutely.

Lindsey:

So, what are some of the symptoms of vocal fatigue? You mentioned that we should look out for it. So, what should we be looking out for?

Julie:

Okay, well, you might experience pain deep in your throat. You might experience hoarseness. Your pitch might get a little lower. Also, you may experience dryness in your throat. So, those are really the main symptoms to look for and to notice.

Lindsey:

Makes sense. And I’m curious to know, have any of our therapists have been seeing this vocal fatigue? Have you guys had dryness? I know, I see Elana, you’ve joined us. We’ve got Rebecca. Your guys are on here. Anybody else that’s watching, put in the comments, are you guys experiencing vocal fatigue? Is this a strain on your voice doing all of these sessions back to back? I want to hear from you guys and see what other things that we can do to help you. And so, while you guys are commenting, we’ll have Julie tell us what are some ways that we can prevent this vocal fatigue. I’m sure all of you are like, “Oh my gosh, I’ve been dying. Help me.” So, what should we be doing to prevent this?

Julie:

Okay, well, number one, stay hydrated. Keep some water on your desk. I have a beautiful little cup that I love to have around. Something that you enjoy, something maybe with a top so that you don’t have to worry about spills, but something that you can easily just reach for that’s there all the time. I would avoid drinking overly cold water. You might not want to put ice in it, just regular room temperature water. Avoid drinks that are acidic like coffee and Cokes. Those will irritate your throat. I love a good cup of coffee just like anybody does. But if it’s a day that I’m going to be either singing or talking a lot, I will avoid it that morning. Alcohol can also irritate your voice. And anything that’s just overly cold or overly hot. You want something kind of in between. And above all, just keep that water close by so you can reach for it all day long.

Julie:

The other things are when you’re on an antihistamine, it can definitely dry your throat more. So, make sure you stay extra hydrated if you’re on any allergy medication or decongestants. Try to let your voice rest about maybe 10 minutes every hour or so. Try to give yourself little breaks when you’re not talking at all. Also, coughing and clearing your throat are two things that can irritate your voice. So as you find yourself doing that a lot, maybe you get a cough drop or something to avoid doing that.

Julie:

Now, another really big topic is acid reflux. I don’t know how many of us suffer from acid reflux, but it’s a form of indigestion. And when you have acid reflux, what’s happening is that those assets are coming back up into your throat and they’re irritating your vocal chords. So, you want to try to treat that either with medication or sometimes diet. For me, for example, I had acid reflux for many years, and it was really painful for me and uncomfortable and it irritated my voice. So, I was on prescription antacids for a very long time. And I finally tried to go off of them because there were some side effects. And what I discovered was the only way I felt better is by taking gluten out of my diet. And I am not one of these gluten-free freaks. It just happened to be my personal biology didn’t let me digest wheat. So, there are people that certain foods will exacerbate your reflux. And if you can, maybe by a process of elimination, figure out what those foods are, that can really help.

Julie:

And then finally, your posture and your workstation should be ergonomically comfortable for you so that you can maintain your posture and have support for your breath, because the efficiency of your breath is definitely going to help your voice stay healthy.

Lindsey:

You make some really, really good points. So, a lot of people, I know so many people who just love ice cold water. And that is like, they’re like, “Oh no,” or they love hot tea or hot whatever. And they feel like it’s very soothing on their throat. So, when you say that we really shouldn’t have those extreme temperatures, can you talk a little bit more about as to why, or why in our brain do we think that this is soothing, but it actually is not?

Julie:

It’s a really good point, Lindsey. Yeah, there are other things that make our throat feel better temporarily, and it’s kind of an analgesic in that it will make you make you feel better temporarily, but it’s not actually improving the situation. It’s just like if you put something on a cut just to make it feel better temporarily, and it feels better, but it’s not actually healing it if that makes any sense.

Lindsey:

No, that does make sense. And do you think that if someone is drinking their ice, ice cold water or really their hot, hot tea. Go to Starbucks and we get that extra hot. Does that cause damage if they do it repeatedly, or is it just not going to help with vocal fatigue?

Julie:

Well, If you have any irritation, what it’s going to do is make the irritation a little worse. The cold can sometimes numb you out so you don’t even feel. For example, a lot of cough drops have menthol in them, and what that does is it kind of numbs you out so you’re not feeling the pain, but the fatigue is still there. And so, I try to avoid the mentholated cough drops. Because if I’m tired and my throat is bothering me, what I want to do is try to do something to make it better in general, not just take away the pain temporarily. So yeah.

Lindsey:

For that too, for sure. And I know any of our therapists that are watching, you guys absolutely love to have your hot, hot or cold, cold drink with you. Is that something that this is going to be hard for you to give up? I mean, going back to like room temperature? It’s not bad, I promise. That’s typically how I drink all my water.

Julie:

Room temperature.

Lindsey:

Room temperature. And you mentioned no alcohol. You mean when we’re with our students that we shouldn’t be… How are you expecting me to get through the day? Just kidding.

Julie:

A glass of wine with dinner should not be a problem.

Lindsey:

That’s not an issue. All right. I mean, you know what kind of world we’re living in right now. I understand what people… not a proponent of alcohol. Okay. But no, those are really good things that we need to do to prevent us from experiencing this. And hydration is so, so key. I know that we’ve talked about hydration before and some people just are not used to just sipping water throughout the day. They’re like, “Oh no, I’d rather just chug it.” So, definitely that sipping and staying hydrated throughout the day is important. Making sure that it is room temperature or not to one of the extremes, also people noting that as well. Because we want to help protect our voice where we’re going to be there.

Lindsey:

The one thing that I’m going to have a hard time with is, you mentioned I have to stop talking for like 10 minutes. Do you not know me? You want me to stop talking for that long to rest my voice? Oh my goodness. So no, but what you bring up is a really important point of how our therapists really should be structuring our days where we need to build in that 10 to 15-minute block every hour. And whether you want to do back-to-back, that’s fine. But that allows you to do like maybe documentation, billing, checking emails, work that time in there so that way we can really protect our voice. It’s really a scheduling issue.

Lindsey:

And I think like when we’re in the brick and mortar setting, we just get up and we walk out of our room and we run to the bathroom. We’re not engaging and it’s not so back to back. But I feel like now that we’re all working from home and that we’re doing these Zoom meetings that we’re just like, nope, back to back to back to back, and we’re not taking that time. So again, that falls into that self-care piece. And self-care, this is falling into self-care with your voice as well.

Lindsey:

And then you did mention posture, sitting up straight, making sure we have room and making sure we’re not slouched over and have a comfortable chair. I know we’ve had a couple of our OTs on the talk about our ergonomics and making sure our workstation is set up. So, all of this just overlaps and plays with one another to where you want to make sure that you have your elevated computer, you have a very nice comfortable chair, you’re going to be in there. So, all of these things really do overlap for taking care of the whole body and not forgetting about the voice.

Lindsey:

So, let’s say we have these fabulous techniques that you have given us. I’m super excited about them. I will do my best to implement all of them. But what happens if we didn’t, and now we’re suffering from vocal fatigue? So, what do we do? How do we recover? How do we protect our voice? I don’t want to cause permanent damage. Did I mess up? Can I make it better? I did not stop talking, clearly, for 10 minutes.

Julie:

So, the first thing I would say is if you’re experiencing vocal fatigue and pain for more than two weeks and you’re not getting relief from it, definitely visit your laryngologist or general practitioner or ENT. And I have a cat that may actually walk in, but hopefully that’ll be fun. But here is a fun exercise you can do during your 10-minute break that can relieve strain on your voice by stretching your vocal chords and opening that space. You take a straw, and this is called a phonation exercise or straw phonation exercise. You want to put the straw in your mouth and you’re going to hum. And as you hum, you don’t want any air to escape around the outside of the straw around your mouth. You want all the air to come straight through the middle. And what you’re going to do is you’re going to start from the lowest end of your voice and just slide on up to the highest and then slide back down like this. And just do that a few times.

Lindsey:

I feel like this is one of those slideshow whistles I had when I was a kid growing up and I would annoy my mother.

Julie:

Exactly.

Lindsey:

“Children, where are you? Let’s do this.”

Julie:

Do that a couple of times. And then you can make little hills with your voice like this. You’re going to start with small hills and then make them bigger and bigger. It’s fun and silly, and it makes me laugh every time I do it. And then finally pick a favorite song and just hum it. I’m just going to pick Mary Had a Little Lamb.

Lindsey:

I can see this being very entertaining, to say the least. So, you would recommend that someone would do this how often and for how long? What’s the duration?

Julie:

If your voice is getting tired and you’ve worked that 10-minute break in, I’d say maybe just do it for three to five minutes. Maybe just a couple of repetitions of each exercise. And what you’ll find is when you start speaking after doing this, you’re going to feel your voice resonating in your face and your head more than you feel it in your voice. And I can feel it right now just from doing that. What you want to do is you want to try to keep that feeling of the resonance in your mask or your face while you’re speaking throughout the day. And that exercise can actually bring that resonance and that vibration back into that position rather than it coming from your throat.

Lindsey:

Excellent.

Julie:

There’s a couple of other things. You can yawn and sigh. And that’s a really nice way to stretch out your voice. I also recommend, especially in the winter time when you have your heating on, using a humidifier at night so that you can keep everything moist, especially if you have a cold or something and you’re breathing through your mouth. A lot of times, I know when we have a cold, we’ll wake up in the morning and our throat will be sore. And that’s because you’re not breathing through your nose. You’re breathing through your mouth and you’re breathing in all that dry air. So, a humidifier is awesome. If you want to feel better gargling with salt water using honey or herbal tea that’s not too hot is great. But again, those things are really just to make you feel better. They don’t actually cure the fatigue.

Julie:

I would try to avoid whispering. Whispering is actually not very good for your voice. Also, when your voice is tired, you might start speaking in a lower tone of voice, and you want to avoid that. And you want to avoid speaking in a monotone voice, which can also be a habit that we run into when our voice is tired. Make sure that you’re modulating up and down as you speak rather than speaking all on one note and, and avoid speaking lower than you normally would. And then again, obviously, you want to go to a doctor if this is something that persists over a long period of time and isn’t getting better.

Lindsey:

Great. And so, since you mentioned the monotone voice, I’m curious to know then, students that are on the spectrum that typically talk in a monotone voice, that is one of the characteristics, then do they often suffer from vocal fatigue? Do we see that this occurs more often with our students that are on the spectrum?

Julie:

Well, it isn’t something that a parent or a teacher has ever brought to my attention, but it would make sense that that might happen. And it’s something that we work on when we work on pragmatics is to show students, for example, the difference between a statement and a question. And how in pragmatics, we can actually work on the intonation of a student’s voice by modeling for them how their voice will change when they’re asking a question as opposed to making a statement. That’s just an example.

Lindsey:

Okay. No, that’s great. I think you brought up a lot of wonderful tips to help us identify what vocal fatigue is, helping us prevent it, and then giving us some strategies to when we recognize we have experienced it, what we can do to overcome that. So, Julie, thank you so much for being on today’s show. Do you have any other closing thoughts that you would love our therapists to walk away with, because I know you have so much experience in this?

Julie:

I guess as a singer I would just say, don’t be afraid to just… if you’re wanting to just sing for fun in the shower, don’t be afraid to just sing whether you think you have a great singing voice or not, because it’s one of the most enjoyable, fun things I know I can do, and I think a lot of people enjoy it. And they’re held back by the fact that they don’t sing pretty or don’t sound professional. Just do it for fun. And also, sometimes it’ll relax your voice just to hum and sing a song if you’re feeling like it. So, that’s all.

Lindsey:

That’s wonderful. If anybody rides in the car with me, they know that I will be singing all the… You don’t want to necessarily hear me sing. But feel free, those in the shower, go ahead, sing. I love that you’re giving us permission so that we don’t have to feel afraid and that it actually is good for us. So, thank you so much, Julie, for coming onto our show. It’s been a pleasure. We’ve learned so much from you

Lindsey:

And everybody, I am excited for our newest segment, for now, a Moment of Positivity. So, of course, I’m going to reference our Be Happy book by Patrick Lindsay for today’s message. And of course, this is what our fabulous winner of our Facebook hub group got and is going to get in the mail. So again, it was to our SLP. So, this is what you’re going to be getting. I’m excited.

Lindsey:

So for today, the message is about starting each day afresh. So, every dawn brings unlimited possibilities. It brings new challenges. It opens new hope. So, don’t be shocked by yesterday. Look ahead with optimism. Create your own future afresh each day. So, what will you do today to make a difference and be happy? In these times, we want to find ways that we can be proactive and search and create our own happiness.

Lindsey:

Thank you everybody for joining. Join us next time, which is going to be next Tuesday, September 29th, 11:15 Eastern Standard Time. And we’ve got a great show on how to transition to teletherapy, which many of us are doing right now. So, thank you so much. We’ll see you next time.