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Voice Problems from Ulcers

Since my senior year of high school I have been having problems with my singing voice.  Originally, it was that my tonsils were causing me pain to sing then I got them out and they found ulcers on my vocal chords.  I went through about 6 months of vocal therapy and several reflux medications till the otolaryngologist said I was fine to sing again.  I am now in my junior year of a music education program and my voice professor gets frustrated with me because I can’t sing above a high A on a good day and I am a soprano.  I have worked and tried every exercise I can find and have been taught to sing these notes but my voice just cracks out or stops completely when I get high A.  My teacher has told me that she won’t accept that I cannot sing those notes because there’s no reason I should not be able to.  Does anyone have any advice on how I might be able to build up those notes?  I have been back to the otolaryngologist and they have said that there are not any problems. 
Any advice will be greatly appreciated.
Replies (7): Threaded | Chronological
on January 26, 2013 12:33pm
this is hard to address via email, but I'll offer some methods or approaches in case you or your teacher haven't tried them.
1.  Do you know what pitches you are singing as you ascend?  If so, you may be dealing with a phobia about the high A and tensing up, resulting in a clutched sound.
2.  Does this happen with every vowel sound?  Are you keeping a forward, nasally-resonant timbre?
3.  Have you tried downward glissandos on "ooh" and "ee" vowels, phonating lightly and aiming for pitches higher than the A?  In other words, have you tried coming to the A from above rather than below?
good luck,
on January 26, 2013 1:39pm
Jessica:  As Ben says, impossible to diagnose via email, BUT I'm pretty sure you will be getting much the same advice from a number of people.  You need to be referred to either a voice therapist or a different ENT WHO SPECIALIZES IN THE SINGING VOICE and not just the speaking voice.  Preferably one who is a singer him- or herself.  You also need to find a different voice teacher who knows enough about the physiology of the voice to recognize a problem and knows better than to try to force your voice into doing something it isn't ready to do!!!!  But once you start working with one teacher in college it can be kind of hard to break away without leaving hard feelings.
And did you really mean "ulcers," which are open sores, or vocal nodes, which are actually more like calluses and result from misuse of the vocal folds?  Two very different medical problems.
We assume that by "high A" your mean A5, first ledger line above the treble staff, right?  (For someone in musical theater a "high A" might be an octave lower!!)  If you're a real soprano you should be bridging at around an F5 just below that, so it sounds as if you're already pushing your midrange head voice up higher than it should be going, and that simply isn't very healthy.  Yes, you should be working down from ABOVE that with a falsetto vocal fold action, but if your voice won't do that DO NOT FORCE IT!  Be a second soprano for a while.  It won't make you a bad person!!
Let us know where you're located, and someone might have a more concrete recommendation about whom to see.  You only have one voice, original equipment on all models, so it's important for you to take care of it and get the best medical advice you possibly can.  And most ENTs simply do not understand the demands of the singing voice.
All the best,
Applauded by an audience of 1
on January 27, 2013 4:39am
Jessica, I suggest that a second opinion is in order: the opinion of another voice teacher. (Patience is the most important quality of a teacher of any kind.) Find someone who speciallzes in fixing problems. A teacher who is a deconstructionist will teach you to recognize the tensions that are holding you back, if, indeed, your vocal apparatus is healthy.
You may not be opening your pharynx completely.  Maybe you have not been taught to correctly support. (I haven't met all that many teachers who actually have studied and understand the anatomy of the pulmonary tract.) It could also be that you supply the air, but have not been taught that you can let the vocal folds go and trust that the air flow coupled with the low larynx will make those notes happen. Does your teacher teach a low larynx technique? It is difficult to tense the vocal cords with the larynx in a low position. 
Right now, it sounds as if your instructor needs to concentrate on teaching you proper phonation and let forward resonance take a back seat for a bit. I can tell you from personal experience that the "ping" won't serve you if you can't properly phonate. 
on January 27, 2013 12:46pm
Hi Jessica,
Your difficulty could be coming from so many different things!  I'd suggest consulting
- an ENT who specializes in treating singers
- a voice teacher who has good training in anatomy/physiology and disorders.  
- If you can find one, a "Singing Voice Specialist" who works as part of a voice team with the aforementioned ENT.
My feeling is that the right voice teacher for you right now will not say, "I won't put up with this," but instead, "Let's figure out what's going on and get you some tools to address it."  Likewise, a really good ENT will go beyond just looking at the tissues and tell you what is happening with your technique by having you sing while you are being scoped (fiber-optically, through the nose), preferably while making a video fo the exam.
My organization (the McClosky Institute of Voice) trains people to work with things like this, and I know some good ENTs in Boston who could probably tell you what doctor to see in your area.  If any of this is of interest, feel free to send me a message.  Good luck!
on January 27, 2013 7:02pm
It comes down to logic. You have some pretty good advice here, about as good as you can get by email.
One can not learn to sing by email any more that one can learn to ride a bicycle by reading instructions.
What makes it harder is that you can't see the action. You need a teacher with an ear for phonation.
Some do not recognize it when they hear it.
Get a second and third opinion from someone not associated with your institution.  Try Oberlin.
on January 28, 2013 3:54am
Hi Jessica,
"Knee jerk" reaction..... it's time to switch teachers. It is time to find a teacher that values you, your well being and your vocal health more than  notes above high A. 
Good luck.
on January 28, 2013 7:14am
I don't know where you are located, but if you are in or near Chicago, I can recommend an ENT and speech pathologist/singing teacher who helped me a lot.  Have you had the test where they put a scope into your vocal cords to see exactly what's happening when you're singing?  Once they know that, you can go to a speech pathologist who can correct the problem.  The one I went to was wonderful because she is also a voice teacher. 
You mentioned reflux medication.  It is possible that no reflux medication will help you because the valve between your esophagus and stomach may have loosened.  This can happen for any number of reasons, and once it does, stomach acid will come into your throat and possibly, your vocal cords, regardless of how little acid is produced.  (Your stomach has to make SOME acid or you won't be able to digest your food.)  There are many different kinds of reflux meds, and you may need an H2 blocker instead of a proton pump inhibitor-- but you may have tried all of those already, and if you still have reflux, the problem most likely DOES have to do with a weak valve. 
There is a book about how to control reflux that I found helpful.  It's called "Dropping Acid."  (There is a subtitle, as well, but I don't remember what it is.  You can check on Amazon.)  It is both a scientific explanation of reflux and a cookbook.  There are certain foods you should avoid-- more than you will want to-- to minimize your reflux, if reflux is part of your problem.  There are other lifestyle changes you can make, as well, all described in the book and on the Internet.  I won't go into details because it's possible you don't even have reflux at all.
There are lots of other medical conditions than can affect one's voice, including myofascial trigger points and post-nasal drip.  That's why all the above recommendations to see an ENT are spot on.  I think you should do that ASAP.
Good luck,
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