VOCAL HEALTH PRODUCTS

The best form of hydration for the larynx is water; however, symptoms may be severe enough that additional products are needed for immediate temporary relief. Here are some products that may help offset the feeling of dryness in the larynx. This list is not meant to be exhaustive but should provide you with some direction about useful products that are readily available. These products do not contain alcohol, menthol, or eucalyptus (ingredients that are known to contribute to dryness and irritation). Ingredients that can be soothing and that provide relief for dryness include glycerin, slippery elm, and pectin. Keep in mind that what works for one person may not work for another. And remember, these products do not treat the underlying problem; they only provide temporary relief of symptoms, so it is essential to continue to follow your doctor’s advice to improve the health and well-being of your voice.

Most of these products are available at several local retailers, including Walgreens, Target, Harris Teeter, CVS, Food Lion, Kroger, WalMart, and Rite Aid. For those products that are harder to find, purchasing information is provided as part of the product information.

THROAT LOZENGES

Luden’s
ludens.com
Recommended flavors: Cherry, Berry Assortment

Halls Breezers
(also in sugar-free) gethalls.com

Grether’s Pastilles
pastillesforless.com
Available online

Thayers Slippery Elm Lozenges
thayers.com
Available at Whole Foods

HUMIDIFIERS & STEAMERS

Vicks Warm Mist Humidifier (V745A)
vicks.com/products/humidifiers
1-gallon capacity, operates 12 hours
per filling, automatic shutoff
* DO NOT use the recommended medicine cups

Vicks Steam Guard Vaporizer (V150SG)
vicks.com/products/vaporizers
1.5-gallon capacity, operates 18-24 hours
per filling, automatic shutoff
* DO NOT use the recommended medicine cups

SINUS RINSE
Sinus Rinse Nasal Wash
neilmed.com

Sinus Rinse Nasal
Wash— Pediatric
neilmed.com

DISCLAIMER

The Vocal Plan provides this document for the benefit of our clients. We do not guarantee these products nor assume any responsibility for their usage. We do not receive any financial compensation nor have any financial arrangements with these companies.

VOCAL MISUSE & VOCAL OVERUSE

Vocal misuse is using the voice in a way that causes it to be injured. These behaviors can lead to vocal fold lesions (bumps or calluses on the vocal folds), and in some cases, can cause permanent damage to the voice.

Examples of vocal misuse include:

1. Yelling, screaming, and hollering (including cheerleading)
2. ƒThroat clearing and coughing
3. Loud talking
4. Talking in noisy situations (sporting events, restaurants, bars, parties, social gatherings, industrial settings)
5. ƒWhispering
6. Singing without warming up the voice or without singing training

Vocal overuse is using the voice too much so that it gets overly tired. This can lead to an increased risk of vocal fold injury. If your voice feels tired or gives out easily, you may be overusing your voice.

The vocal folds are made up of layers of delicate tissue. When you use your voice to make a sound, the vocal folds vibrate or come together. If they vibrate in an easy, gentle way, the voice works well, but if the vocal folds come together in a hard or forceful way, they can be injured. It’s like clapping your hands: if you clap them softly, you make a sound and your hands don’t hurt. If you clap your hands together hard, they will start to tingle, and then hurt, and will become red and irritated. If you continue this hard clapping, you might get blisters on your hands. Yelling, screaming, throat clearing, coughing, and even loud talking can all bring the vocal folds together in a hard and forceful way and can cause vocal fold injury.

Talking a lot can also hurt your vocal folds. Your vocal folds come together about 100-200 times per second when you are talking. That can add up to millions of times per day if you are talking for many hours! All of that contact can cause wear and tear on your vocal cords. If they don’t get a chance to rest and recover, they can become injured over time.

Many styles of singing bring the vocal folds together in a forceful way, too. Athletes and dancers carefully warm up their muscles to avoid injuring themselves, and they receive lots of training to learn to use their bodies without injuring themselves. Singing is the “athleticism” of voice use. Warming up your voice before singing and getting training in how to sing well can help you avoid injuring your voice.

HOW CAN I AVOID MISUSING OR OVERUSING MY VOICE?

1. Use a noise maker or gesture to gain someone’s attention instead of yelling or screaming.
2. ƒWalk over to the person you want to talk to or have them come to you instead of yelling across the room or from another room.
3. ƒUse easy, gentle throat-clearing.
4. Avoid talking in noisy situations.

If you are in a noisy situation:

1. Get close to the person you want to speak to.
2. Put an earplug in one ear so that you can monitor how loud your voice is.
3. ƒUse a microphone if you have to speak in a large room or in front of an audience or class.
4. ƒIf your job or social setting requires you to use your voice a lot, give yourself voice breaks or times when you don’t use your voice for a while to let your voice rest.
5. ƒUse a hands-free device or hold the receiver in your hand when you speak on the telephone instead of propping it between your ear and shoulder.
6. ƒAvoid speaking in stressful situations or when you are overly tense.
   ƒAvoid whispering.

THROAT CLEARING

Throat clearing is traumatic to the vocal folds and can contribute to a vocal injury. Oftentimes, people feel the need to clear their throat because of the feeling of too much mucus, when actually the mucus is just too thick. Increasing your intake of water should gradually improve this problem. Inform your doctor if you have any drainage from your nose or any burning sensation in your throat. Some medical conditions may also contribute to a problem with thick mucus. If your doctor recommends a medication to thin the mucus (i.e., Mucinex), drink plenty of water (six to eight glasses per day) so the medication will work properly.

Over time, throat clearing becomes habitual. The more you clear your throat, the more you will feel the need to do so. Suppressing the urge to clear your throat or clearing your throat very gently can help to break this cycle.

The following strategies will help to distract you from throat clearing and therefore, eliminate habitual throat clearing:

1. ƒDry swallow: Swallowing your saliva closes the vocal folds and can rid them of mucus.
2. ƒTake small sips of water.
3. ƒUse a gentle throat clear without forcing the breath. It will sound like a puff of air produced in the throat.
4. ƒPant lightly or laugh gently then swallow.
5. ƒHum lightly.
   ƒLaugh gently then swallow.
6. ƒTalk through the mucus. The natural vibration of the vocal folds may rid the folds of secretions.
7. ƒSingers may try to vocalize lightly on five-note scales in a comfortable range on “oo,” slide up an octave softly on “oo,” and crescendo (get louder).
8. Remember, the throat clear is automatic, so it will take time, awareness, and practice to eliminate it. The decrease in wear and tear on your vocal cords will make the effort worthwhile!

INTERNAL & EXTERNAL VOCAL HYDRATION

“Vocal hygiene” can be thought of as the care and feeding of the voice. It refers to the things we do to keep the voice healthy. We work on improving how the larynx (voice box) works through voice therapy, but it is also important to take care of the voice by taking care of the body and using the voice well.

HYDRATION: KEEPING THE VOCAL FOLDS MOIST

Keeping the vocal folds moist through good hydration is very important for good vocal health. You can provide moisture to the vocal folds both from the inside (internally) and from the outside (externally).

INTERNAL HYDRATION

To keep the vocal folds moist from the inside, make sure that you drink plenty of water. The vocal folds move best when the body is well-hydrated, and well-hydrated vocal folds may be less likely to get hurt from voice use. Good hydration also makes the mucus that covers the vocal folds thin and slippery, so that they move against each other easily and vibrate smoothly. Think of the mucus coating as being like motor oil in the engine of your car: if it is thin and slippery, the engine runs smoothly; if it is thick and sticky, the engine doesn’t run well and can be damaged.

1. If you are under a doctor’s care for any medical conditions, be sure to check with your doctor before changing the amount of water you drink.
2. We recommend drinking at least eight times eight-ounce servings of water per day (total of 64 ounces). That’s a little less than two liters per day.If you are drinking a lot less than that now, add a few ounces more each day until you get to 64 ounces.
3. Alcohol and caffeine are drying to the entire body. Drinking them makes the vocal folds drier. Cutting back on caffeine and alcohol can help your body stay hydrated.
4. Dry environments are also drying to the entire body. If you know that you are going to be in a dry place (like a dry building or an airplane), drink lots of water to keep your body hydrated.

If you don’t like drinking water:

1. Try flavoring the water with fruit or with sugar-free powdered drink mixes.
   Drink caffeine-free tea.
2. Sometimes changing the temperature of the water makes it more enjoyable to drink.
3. Foods that have a lot of water in them can help with hydration. Examples include cucumbers, melon, grapes, and gelatin.

EXTERNAL HYDRATION

External hydration is getting moisture to the vocal folds from the outside.

Steam inhalation:

Inhaling or breathing steam helps the voice box stay moist and can be very soothing to irritated vocal folds. Breathe the steam through your nose for three to five minutes, two or three times per day.

You can try any of these methods:

1. Breathe shower steam.
2. Breathe steam from a personal steamer. You can buy these at many drugstores.
3. Run hot water into a sink or basin and inhale the steam. You can also boil water, pour it into a sink, and breathe the steam. Never breathe steam standing over a hot stove or boiling water.
4. Run a washcloth under hot water, wring it out, and hold it over your mouth and nose and breathe in.

Room humidification:

1. You can increase the moisture in your home or office by using a room humidifier or hot-water vaporizer. Be sure to use a hot-water vaporizer. Cool-mist vaporizers can cause chemicals and germs to get into the air. With hot-water vaporizers, only water gets into the air you breathe.
2. Room humidity should be between 30-50 percent. You can check the moisture in the air in your home by using a hygrometer, which can be purchased at many electronics or hardware stores.
3. When using room humidifiers or vaporizers, it is very important to carefully follow the cleaning instructions. If you don’t keep the humidifier or vaporizer clean, germs can get into the air that you breathe.
4. If you have mold or mildew allergies, you should not use humidifiers or vaporizers. They increase the moisture in the environment and can cause mold and mildew to grow.

MEDICATIONS AND HYDRATION

Many medications, such as cold and allergy medications, are drying to the body. Try to avoid these medications to help your body stay hydrated. If you need to take these medications, you may need to drink extra water to make up for their drying effect. Of course, never change your medications without consulting your doctor.

Your doctor may recommend a mucolytic medication. This medication can help keep mucus thin and slippery. These medications are available over the counter. The active ingredient is guaifenesin. Brand names include Humibid, Mucinex, and Robitussin. Be sure to get the preparation that does NOT contain decongestants, antihistamines, or cough suppressants. NOTE: Mucolytics are only effective if you are well-hydrated; they are not a substitute for hydration.

Many cough drops and throat lozenges are drying to the mucous membranes of the mouth and throat. This is especially true for products that contain menthol and eucalyptus. The best lozenges for soothing the mouth or throat without drying are glycerin, pectin, or slippery elm lozenges. Brand names include Grether’s Pastilles, Thayers Slippery Elm Lozenges, and Halls Breezers.