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Vocal ProblemsDate: March 30, 2010
I am a high school choral director and have been in the classroom for over 20 years. Within the past 10 years, I have been experiencing problems with my speaking and singing voice. Specifically, my speaking voice is raspy at times, and my singing voice has become unreliable and unpredictable. While I used to be able to sing a high C, I now can only reach an F (on a good day). When I vocalize, the sound just stops - there isn't even a squeak or twirp that comes out - just no sound at all.
I have been to an ENT several years ago, thinking that perhaps my issues stemmed from having had GERD and major post-nasal drip. She assured me that "nothing was wrong with my voice". Before I seek the help of an otolaryngologist, I'd like some input from fellow singers/teachers, who might have had or still have similar problems (or someone with suggestions!). In addition to the GERD (which is now under control), I also probably suffer from sleep apnea, which I should have diagnosed and treated. I'm sure that my daily talking in the classroom isn't helping either. I also still have the problems with post-nasal drip and have several sinus infections each winter.
Does anyone have similar problems? Does anyone have any suggestions as to whether the GERD and/or post-nasal drip and/or sleep apnea could be the cause of losing the notes at the top of my range?
I really miss being able to sing, and would like to be able to give aural examples of proper singing to my students!!!
Thank you in advance for your help! Replies (29): Threaded | Chronological
Stephen Stomps on March 30, 2010 9:56am
First, get to a doc who has worked with singers. Since you are in Wisconson, you should contact the U of W voice faculty and enquire of them. There might even be a voice clinic on campus catering to the many voices.
Losing an entire P5 from your range is certainly reason to have done this before now. If GERD has been involved to this extent, there may well be much more and continuing damage. All of the things you have mentioned feed into your vocal difficulties. The damage from GERD takes 4-6 weeks to heal but if there is contining damage, there may never be sufficient healing. Add sleep apnia to this and whatever is causing the post nasal drip and continuous damage done by forcing the voice to do things it can't and you have a terrible situation with no easy solution. But every minute you sing under these conditions, you continue to damage your instrument. By this time, you cannot simply sing yourself out of this.
I went through several months of uncharacteristic vocal difficulties due to GERD and thrush on my vocal chords before my GP told me of a new ENT (or whatever) practice in town. I went to the practice and was seen by one of the docs but when he heard that I was a singer, he referred me to his partner who also had a voice clinic at Ithaca College. This first doc said that if I had had node (and not been a singer) he would have sent me to the hosp and simply STRIP THE VOCAL CHORDS!
Luckily, especially after the thrush was gone (several months)--talk about fuzzy tone!--and the GERD damage was diminished by Aciphex and a modified diet (I would burn just holding an unopened can of tomato sauce), I felt secure after a year of not singing very much. But this is one contributing factor of my retirement.
The birdy does not sing if the birdy is not happy and I was deeply unhappy.
There must be a singer's ENT to help you in Chicago or Minneapolis. I will mention Dr Peak Woo in NYC but this is very far afield. Perhaps our Philadelphia collegues can remind me of the clinic in that city. (Callahan?) google singers clinics in Phil.
There is no more "before I see an otolaryngologist". I urge you to do this YESTERDAY!
Holding your hand from a great distance,
S
Ghislaine Stewart on April 3, 2010 6:14am
I am having some vocal problems myself and was wondering if you could give me the name of the doctor who also had a voice clinic in Ithaca , if he is still available. I am in the Binghamton, NY area.
Stephen Stomps on April 3, 2010 8:11am
Ghislaine,
I see Dr Robert Strominger in his Auburn Office. Here is his info:
http://www.cayugaent.com/Physicians/RobertNStromingerMD/tabid/238/Default.aspx
Good Luck
S
on March 30, 2010 11:04am
Hi. Sally.
You should go to the doctor who specializes the voice/vocal cords for your problems.
But, anyway... How is your voice in middle and low register? Is it normal as before? How often the raspyness occours? Can you sing long notes?
As far as I know, the voice problems can be classified into two categories, one is that vocal cords are phsically damaged or alterd (like polys), and the other is that nerve is hyper or hypo active and it prevents the vocal cords (and related mascles) to work correctly.
>>She assured me that "nothing was wrong with my voice"
Did she say that after laryngoscopy?
on March 30, 2010 11:28am
The ENT took swabs to assure that there was no infection, checked for nodes (which she didn't find), and gave me her stamp of approval.
I admit that I have been remiss in not dealing with this sooner, but I really thought it was the natural progression of age. I am more and more convinced that it is not!
My middle and lower registers are "OK", but I think there is enough wrong that what I consider my voice now, is not what my voice used to be! I don't know if that makes sense, but I have just gotten used to how my voice sounds over time. I can sing long notes, but the fuzziness and raspyness are there, along with the unreliability.
In response ot Stephen, I WILL be pursuing treatment. Though I may be too late to have my voice completely recover, I would like to do what I can so I will be able to sing again (with confidence and enjoyment). It's been far too long since I've been able to do that....
Thank you both -
Sally
on March 30, 2010 1:43pm
Mmm... So, the doctor didn't check vocal cords paralysis or any other things...
I am no doctor, but since there seems to be no mucus problems, it seems that that is not a problem infection. If there is no polyps, or muscle injuries, I would guess the problem is more on the nerve, paralysis, bowed vocal cords and so on.
By the way, in general, I would guess the vocal problems as follows.
1. Whether there is noise in the voice --- vocal cords are not fully closed... polyps or paralysis? 2. One cannot sing a long note --- maybe spasmodic dysphonia? 3. Voice cracks in higher note or there is a break or a multiple-sound in the higher register--- polyps? 4. Voice cracks in lower notes, but it gets better in higher range --- paralysis?
What you described does not exactly fit in my usual guessing categories. But, since your voice "stops" in the higher range, it might be a problem of surrounding muscles (or the nerve controls them) which controls the vocal cords tension or length.
Since you seem to be able to do all of the normal activities related to the phonation (normal for non-singers), I would think only the specialists can find your problems. So, look for laryngologist now.... Of course, there is aging factor, but everyone should feel comfortable with his/her voice no matter how old s/he is.
on March 30, 2010 12:56pm
Sally,
The best throat Dr. in the Chicagoland area is Robert Bastian. He is located in Downers Grove, a suburb west of Chicago. My husband is a general ENT, with an interest in care of the professional voice and if he has something out of the ordinary, sends them to Bob. He has a partner as well--can't remember his name--but this is a very holistic practice for singers (and those with swallowing disorders)with a vocal therapist on staff.
If you weren't scoped--what did they do to "check for nodes"?-- how can they tell if you have nodes and did you see your chords (actually, they are vocal bands)? Chuck has a video camera hooked up to his scope and will allow the patient to see their chords--it's reassuring to see what is what becasue a picture is worth a thousand words.
The natural process of aging of the female voice is not losing range such as you describe. I still have a nice, reliable high B flat and my high C shows her face every once in a while. My oldest son is 30, so......I can relate. So, sister-soprano, get thee to an ENT!
Marie
on March 30, 2010 6:09pm
Sally, everything Stephen said is right on, but let me ask a simpler question "just in case." Are you teaching in a room with a fan-driven heating/cooling unit of the kind they've been putting in schools forever (or at least since they did away with hot water or steam radiators)?
I ask because my mom moved to a new high school (new back around 1960, that is), and immediately started having problems because without realizing it she was forcing her speaking voice to be heard over one of those fans. And she taught foreign languages, so she spoke a LOT in class. It can happen, and eventually lead to real problems including nodes.
As to ENTs, YES! find one who works with singers. When the usual one talks about "your voice," they are familiar only with the speaking voice, and usually have no special understanding of the demands and problems that come with the singing voice. (Same thing with audiologists, who worry about and test you for speech recognition but have no idea what a musician needs to be able to hear.)
All the best,
John
on March 30, 2010 7:27pm
John,
In medical school, young med students are taught, "when you hear hoof beats, think horse and not zebra"....some times, we all think "zebra" and not "horse". A very simple explanation is probably the reason for Sally's vocal problems. Finding a good voice doc, like Stephen did, will really help. They've seen plenty of "zebras" but mostly see "horses" someone else thinks are "zebras"!
I used to do something not so good---especially for a soprano---I forced my voice to sound more "professional" by speaking in a lower register then is good for me. I stopped doing that about 20 years ago and it made a world of difference in my vocal quality and range. I also wear a Minnie Mouse wristwatch now to most of my rehearsals to remind me to speak in my own register----I embrace my inner Minnie.
I can see how your mother could have problems by trying to be heard over the heating system---Sally lives in Wisconsin, for goodness sake!
Marie
on March 30, 2010 7:22pm
Sally,
There are other issues other than polyps or paralysis that can cuse hoarseness and raspyness. I had found out from one ENT that I had something called Rienke's edema (I could be wrong on that spelling) about 15 years ago and it took FOREVER to figure out what it was. It's basically fluid collecting on the vocal folds. The medical term for swelling is edema.I had laser surgery to ( in layman's terms) "pop" a small hole on the outside edges of each fold (not where they vibrate together, but opposite from that) and drain the fluid. After that I was much better, but still a little raspy. I then went to the best singer's ENT in the Dallas-Fort Worth area Wayne Kirkham. He diagnosed a weakness in the anterior part of my vocal folds that caused a little gap allowing air to escape as I sang or spoke. He said it was probably hereditary and was like an adolescent female voice where the gap (mutational chink) never closed. End result - my voice is always a little raspy, but I know why now. I never would have gotten to the final answer without a scope - actually several scopes. Any doctor who does not scope you and gives a diagnosis is not worth seeing again. Find a doctor who knows singers and insist on a scope.
Mary Jane Phillips
on March 31, 2010 6:57am
Sally,
I am a success story and I just turned 65. I had severe vocal problems since 2002--I not only could not sing but also could barely speak. But first of all, I repeat as others have said: you really need a scope for a diagnosis. They are not fun, and after my first few I felt as if I had swallowed a polaroid camera, but my laryngologist numbs my nose first so now I do just fine with a scope. My initial problem was nodes so my ENT sent me for speech therapy, which worked in 8 weeks. Didn't anyone mention speech therapy? It is wonderful. The problem returned so I did the exercises on my own and solved it again.
The problem kept returning and got worse and worse. I tried speech therapy again but she said the problem was more serious so sent me to a laryngologist--Indiana has only one and fortunately she is here in Indy. She thought it was a polyp but soon found it was a cyst, so I had surgery on Jan. 5, 2009. I was told not to talk at all for 8 days and I obeyed! I even attended a spiritual retreat for my new job and didn't say a word. (I filled 3 legal pads!)
She also put me on Nexium for GERD. Now this is what I do to maintain my voice: most important, I don't talk at all in the morning until I have done my vocal exercises, from the speech therapist. I drink water all day long--you must"hydrate your vocal cords, or folds." I make an effort to not talk too loud or too much, which is most difficult since I am a "talker."
When I am really scrupulous about this, I do just fine, and I am a full-time music director in a large Catholic Church so must use my voice a lot.
Nodes do not require surgery; polyps sometimes do, and cysts do. Mine was large.
So in addition to advising a scope with a real laryngologist, I advise speech therapy. You will learn proper ways to use your voice. Are you aware of "easy onset" for vowels? Incidentally, I use some of my exercises from my speech therapist to warm up my choirs, and they work! Insurance will pay usually for 8 weeks of speech therapy if it is prescribed by the ENT or laryngologist.
Incidentlly, after I do my speech therapy exercises every day (which take less than 10 minutes) I always sing a song or two. That helps.
It is strange, but because of these problems, my husband (of 38 years) and I never talk at breakfast anymore. But we have survived. My roughest time of the week is Sunday when I must play 7:30 AM Mass. It is difficult to do my vocal ex. earlier. As my doctor explained, when we lie down all night, the vocal cords swell, and it takes a few hours being vertical for them to calm down so I can do my vocal exercises.
Speech therapists will also advise you about diet. Naturally smoking is forbidden, but I never smoked so that was not a problem. And as is true for just about any ailment, the usual substances are to be avoided: coffee, alcohol, spicy foods, etc. The speech therapist wll give you a list of foods to avoid. The only food that troubled me was chocolate. I can't live without chocolate.
Also, if you should get a cold or sinus infection, strictly limit the use of your voice. When it is hard to talk, don't talk!
It is now almost 10 AM and I have not done my vocal ex. yet so I'm silent. Partly because of this problem, I go into work late, and then work at night.
My voice was in such dreadful shape that I figure if I can recover, just about anyhone can. One more thing: speech therapists will tell you that when you have vocal problems, the phone becomes your enemy. We all speak louder and more intensely on the phone. Therefore, I really limit my phone use. E-mail is now my preferred method of communication, even though I admit a phone call is often easier and quicker. But it saves my voice!
Good luck. Incicdentally, I am from Wisconsin, and so is my laryngologist!
Susan Raccoli, Indianapolis
on April 2, 2010 1:54pm
Susan - That was most interesting. Could you share a couple of the vocal excercises from the speech therapist that you use to warm up your choirs? I run a community choir which starts at 9.30 am (!!) and we all start very gently.
All best,
Jane
on April 2, 2010 2:49pm
Susan and Jane,
I would also be interested in the exercises. One of my choirs is early in the morning, so that would be helpful. I do a lot of vowel work, so would be interested in the "early onset vowel" exercises. In addition, I would like to try some of them myself.
Thank you ~
Sally
on April 1, 2010 12:14pm
Thank you to everyone who has replied to me either in this forum or personally. I really appreciate knowing that a) I'm not the only one out there suffering like this and b) there may be something that can be done.
That being said, I have made an appointment to see a laryngologist who specializes in singers. I got his name from someone on the vocal faculty at UW - Milwaukee (my alma mater). I'm actually looking forward to going and hoping to find that there is a diagnosis, and that the symptoms that I've been experienced can be "fixed" or at the very least improved.
I started to research some of the things that were suggested as possible causes for the symptoms I'm having. I've found some very interesting correlations with some of the possible diagnoses.
John - The building I'm teaching in doesn't have forced heat, as it is brand new. So, that shouldn't be the cause, although we've been in four different buildings while our school was being fundraised and built, so it is possible the problem started elsewhere.
Following just a little research since I posted this earlier this week, I have a "feeling" that perhaps when I had one of my sinus infections or in response to reflux, I began to compensate for the problems it was causing, and have been using my voice incorrectly for years. I have felt this for some time, but being a vocal instructor thought I would know if I was! Having to "talk through" or "talk over" the infection/reflux residue may have caused even greater stress on my vocal cords, and I'm just finally done waiting.
So, Marie, I am "getting me to an ENT". My appointment is on April 13th. I may even have a scope that day, so once I have found anything out, I'll repost here to let you all know what I find out.
Again, THANK YOU. Your response has pushed me to do what my husband has been telling me for a few years now, and that is to "go to the doctor"!
Sally
on April 13, 2010 11:32am
I have just returned from the doctor. He was most helpful and reassuring! My vocal cords are fine - no nodes or polyps, and are working properly, though they are a bit rigid, and don't close all of the way. So, that is a relief!
The diagnosis is muscle tension dysphonia, which had been suggested by an anonymous contributor. The prognosis is good with speech therapy and physical therapy. Interestingly, my doctor has seen many cases of women with fibromyalgia who have this problem, and my symptoms correlate completely with theirs.
Since fibromyalgia is a muscle disorder, I have a lot of tension in my neck and upper back, which is also a symptom of muscle tension dysphonia. The physical therapy is myofascial, because the tension has created a loss of range and motion. The therapy should help to stretch those muscles out again. That tension in neck and shoulders is exacerbating the tension in the larynx and throat. When the doctor and speech therapist showed me the scope, I could see the rigidity of the muscles and vocal cords. I could also see the small opening when the cords were supposed to be closed all of the way. This could be part of the cause of the raspyness.
Now the bad part. My insurance, through my husband's work, approves this therapy, but it is put toward our deductible, which is $5000. So, I will have to find out how much each session costs and how many sessions they recommend. One would think that there should be a special allowance made because my profession demands I be able to speak and sing, but there is none! So, it becomes a matter of me finding a summer job to pay for the therapy - which I want to be able to do!!!
Any suggestions for someone who can't be on her feet all day? I would love to find a job that I could do at home, but not all to sure that there's really anything out there.
Once again, thank you to all of you who commented and showed your concern by offering suggestions. I finally felt that people understood the frustration of not having a singing or speaking voice that could be depended upon. I hope that within a few months my voice will start to improve and I'll be able to SING again.
Sally
on April 14, 2010 8:00am
Sally said, "Now the bad part. My insurance, through my husband's work, approves this therapy, but it is put toward our deductible, which is $5000. So, I will have to find out how much each session costs and how many sessions they recommend. One would think that there should be a special allowance made because my profession demands I be able to speak and sing, but there is none! So, it becomes a matter of me finding a summer job to pay for the therapy - which I want to be able to do!!!"
You've said that your condition is related to, caused by, or exacerbated by your work. So, check with your employer to see if workers' compensation insurance might provide coverage. Stress is a recognized occupational injury. All sorts of physical and occupational therapy to help you recover from (and prevent future) occupational injury may be covered by your employer's workers' compensation policy. If you need a healthy voice in order to do your job, then your employer and your employer's insurer may be obligated to assist. And it is in their interest to help you heal and to help you learn how to prevent further injury ($$). Be assertive. Your new-found doctor, or his/her staff, will be familiar with what needs to be done. Don't be willig to accept "no" until you are absolutely sure that there are no other options.
Also, since you are experiening muscular tension and discomfort which is creating or exacerbating the vocal tension, ask for an ergnomic evaluation of your work area. Your employer's insurance carrier can probably provide this service. Small adjustments -- to your office set-up, piano/bench combo, podium/music stand, automobile, etc. -- can make a huge difference. Most workers' comp insurers have staff ergonomists who visit workplaces and work directly with employees to keep them comfortable and productive.
(When I'm not singing, I'm a research consultant serving the property-casualty industry, specializing in risk management and occupational safety issues.)
Good luck!
Sarah Hager Johnston, BMus, MLS http://quodlibet-sarah.blogspot.com/ Grace Notes www.grace-notes.com Program annotations, research, and writing services for classical musical ensembles and the professionals who serve them Peregrine Information Consultants www.peregrineinfo.com Research and writing for insurance, risk management, safety & health, business, and medical professionals
on April 14, 2010 5:08pm
Sarah,
Since I'm part-time at my work, worker's comp will be of no help to me. However, once I've met with the speech therapist and physical therapist and found out what the recommended length of treatment is, I may discuss some of the things you mention with my employer.
Thanks for your input and suggestions. I'm excited to see what the speech and physical therapists have to say!
Sally
on April 14, 2010 6:31pm
Sally, I don't think that your part-time employment status affects your employer's obligations for workers' comp coverage. When I mentioned workers' compensation, I'm not talking about your own health insurance, I'm talking about commercial insurance that employers purchase to insure themselves for the costs of treating occupational injuries and illnesses. Most employees do not ever know the details of their employers' policies unless they need to make a claim. Talk to your human resources person, or your doctor. This is NOT the same as your health insurance.
Sarah
on April 13, 2010 1:30pm
Sally,
That is good news. I was afraid that you were going to make all of us come to your house and take you to the doctor.
S
on April 13, 2010 4:47pm
Stephen,
I guess asking "you all" for help got me really wanting to find out what could be done. I really had given up any hope of ever having my singing voice back, or my speaking voice back to normal. So, I'm thrilled there's nothing "serious" wrong (nodes, polyps, etc.), however, it's not over yet! I will be calling the speech therapist tomorrow to see how long the treatment will be.
It was actually kind of funny when the doctor asked if I had shoulder and neck tension in addition to the other symptoms. My whole life revolves around tension, so to have the doctor put all of the things that I've experienced for the past 10 years and put them all together in one dianosis was pretty amazing. Now, I just have to follow through with both the physical and speech therapy. He said that doing both will net the best results.
Thank you for your encouragement and concern!
I'm so excited I could sing! ?
on April 14, 2010 11:20am
I suspect that spasmodic dysphonia and muscle tension diysphonia a related but different. But the snippet below, or even a note to Ms Rehm could well be worth the effort. Certainly seek out the Nightline archive.
1998, Rehm’s career nearly ended because of spasmodic dysphonia, a neurological voice disorder that causes strained, difficult speech. Rehm sought treatment, returned to the show, and called attention to the condition. The National Council on Communicative Disorders recognized her work with a Communication Award, and ABC’s Nightline devoted an entire program to a conversation with Rehm about her disorder.
S
on April 14, 2010 5:15pm
Stephen,
They are different, according to some online research I've done. Spasmodic dysphonia is a brain function issue, while muscle tension dysphonia is purely muscular. However, the physical symptoms are very similar. I will take a look at the Nightline archive for information.
I'm going to the speech therapist on Friday at 3:00. I'm excited to hear what she has to say. She has a vocal degree and specializes in treating singers.
Thanks for your continued interest....
Sally
on April 16, 2010 9:26pm
Saw the speech therapist today. Very interesting!!!
First, she thinks I have some nerve damage in one vocal cord, which could be causing the sensation of the "glob" in the back of my throat, as well as some difficulty swallowing.
Second, she thinks that it is likely that she can help me regain some of my range, and certainly get my voice back into better condition. I am optimistic! Third, she gave me permission to have a can of Diet Mt. Dew a day! (I don't drink coffee, so this is great news for me!)
I was able to view the computer analyzation of the vocal test she did on my voice. Apparently I have very little resonance in my voice, I have very little power behind my voice, and though my range extends relatively far down, I only could vocalize up to an E flat today. She showed me several visualizations of different aspects of my voice - it was fascinating.
The main thing that I came away from this session with, is that this problem is not a result of something I'm doing wrong. It is not my fault. Clearly there is something wrong, and I have to let people (my students) know that. I really needed to hear that! Tears came to my eyes, and I realized that I had been blaming myself and feeling pretty ashamed that I, a choral/voice teacher, couldn't "control" my own voice. I was truly feeling shame that I wasn't able to model positive vocal skills for my students. The therapist reassured me that it wasn't my fault, and that the good news is that she feels strongly that she can help me!
So...other than the $5000 deductable, I feel much better about things. Again, I thank you all for the prodding and pushing that finally got me to go in and find out what was going on.
on September 21, 2010 6:39pm
Saw the speech therapist today. Very interesting!!!
First, she thinks I have some nerve damage in one vocal cord, which could be causing the sensation of the "glob" in the back of my throat, as well as some difficulty swallowing.
Second, she thinks that it is likely that she can help me regain some of my range, and certainly get my voice back into better condition. I am optimistic!
Third, she gave me permission to have a can of Diet Mt. Dew a day! (I don't drink coffee, so this is great news for me!)
on April 17, 2010 8:16am
Better news and, yes, facinating.
I'm am not an insurance guy nor do a play one on choralnet or any place yes BUT my insurance says that I have $x.00 deductable but I am not actually paying the first $x.00. For instance, my insurance plan is not the best available and it is probably more complicated than this. I pay 20% for my perscriptions up to, say, a deductible of $2000 a year after which all my perscriptions are free. Insurance is billed, however, the entire cost of the drug. Thus, I am only paying 20% the company is placing the full cost of that drug against the deductible. So, I would believe that you will pay 20% of that $5,000 to fulfill the plan.
I hope that I am correct but only your policy and insurance rep can really clear this up. Certainly, persue other options but, at least in NY, you may be limited to the therapist of COMP's choice, not yours.
s
on April 22, 2010 6:41am
Stephen,
I'm still waiting to hear from the doctor's office as to what my coverage for speech and physical therapy will be. All I have had to pay so far is a co-payment when I saw the ENT/otolaryngologist. (And of course, he is a specialist, so the co-pay is higher!) I have looked at my claim for that doctor visit online, and there is the "full charge" for the doctor's services, the "insurance company discount", and the remainder that I pay is the $50 co-pay. If this hold true for the therapy sessions, there should be a"full charge", a "discount" and then the remainder that I will have to pay.
I still think I will have to pay that amount, not 20% of that, however, perhaps what they will have me pay will be 20% of the "full charge". However, it will all still be applied to my $5000 deductible. I am not absolutely sure about this, but my husband and I understand this to the be the way it will work. Once the doctor's office has called with the results of the "pre-authorization" request, I'll be asking them to check so I know exactly what I'll have to pay!
I'm just praying that it will not be cost-prohibitive, because I am really excited about the prospect of being able to sing again! Even if it is fairly costly, I hope we can find a way to make it work. (I'm seeing a summer job in my future!)
I also have an appointment to see the Physical Therapist to find out how many sessions they recommend - that will play a part in all of this as well.
Thanks for your perspecitive on insurance - I hope ours works out like that!
Sally
on April 30, 2010 9:19am
Well...
I'm not quite as excited about all of the therapy as I was before, as I've received the EOB for ONE doctor visit. So far, I owe over $400, and that doesn't even include the first speech therapy session. There is a $50 co-pay for seeing the doctor, because he's a specialist. The other charge received says that it is for "Treatment or Observation Room", so I think it's just for use of the room where they did the scope, when I went to the doctor! Fortunately, they are "giving" me a discount (!) and only charging the "allowable" amount. I haven't even gotten any EOB for the speech therapy yet. I asked their office how much EACH session was, because I was going to have to budget to be able to afford the 4-6 sessions that have been recommended, and was told it was $396 per session. Now, if that doesn't include the "room fee", I'm sunk!
I will be calling the insurance company today to find out what their coverage of the speech therapy sessions will be, and I'll also be calling the hospital/medical college where I see the therapist and doctor, to find out about the Treatment or Observation Room fee. That's just ridiculous, because I'm guessing that doesn't include the technician's time nor the time of whomever "read" the results of the test.
And let's add on to that my appointment next Tuesday with the Physical Therapist. Then I can see how that all plays out; how many sessions they recommend and how much each one will cost.
I absolutely hate that this sounds like it's all about money, but when I've spent my life teaching part-time (currently) at a private school, where the pay is below public school pay, I just don't have the resources to afford this. It means the world to me to regain my vocal ability and confidence, but the cost may be too high. If so, I'll have to take the few exercises the speech therapist gave me, and work with them on my own. However, I'm not a speech therapist, nor do I play one on ChoralNet!!! If I were, I probably wouldn't be in this predicament with my voice!
Stay tuned - I'll keep you posted on what the physical therapist says, and what the hospital/medical college says, and what the insurance company says. Lots of things to do - and I have a son graduating from high school at the end of May! Plus, concerts, exams, chapels, church choir singing, playing organ for church, Fine Arts awards night, etc., etc., etc........ NO WONDER I HAVE MUSCLE TENSION!
Thanks to all for your concern ~ Sally
on May 7, 2010 12:05pm
Now that I've had the assessment session of physical therapy, I feel that I would benefit more from theraputic massage. I already go for massages once every two weeks, and feel more relaxed when I'm done with that than I did after the PT. And, the cost isn't even comparable! I will use some of the exercises the therapist gave me, but feel I would be wasting my money. (And even though we do have a medical reimbursement plan, we'd go through the money in the account very quickly.)
So, the insurance company took off their "discount" for the speech therapy, and each session will cost $288. With 4-6 sessions, that will be a good chunk of change, but I think it will be well worth it. Just have to find a place for it in the budget.....
The "treatment of observation room" fee was for the scope itself, so that is understandable.
So, I guess until I experience some results from the therapy, this is the end of this thread for the time being.
Thank you all for your concern!
Sally
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