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Silence is not always golden especially while dealing with a voice disorder

Director of voice therapy at the Louisville Center for Voice Care, Lisanne Craven is using videostroboscopy to evaluate Dr. Katherine Calcamuggio Donner's vocal folds.
Cheri Lawson
Director of voice therapy at the Louisville Center for Voice Care, Lisanne Craven is using videostroboscopy to evaluate Dr. Katherine Calcamuggio Donner's vocal folds.

Silence is not always golden, especially when singers and teachers are the silent ones.

There is help for those with a voice disorder.

Teacher and singer, Dr. Katherine Calcamuggio Donner is demonstrating vocal warm-ups she typically does with her private students. Earlier this year the Assistant Professor of Voice at the University of Louisville learned she was dealing with a vocal fold bleed.” I had a vocal fold hemorrhage that we discovered in January. And the issue, we don’t know why it occurred,” said Donner.

She sought care from her colleagues at University of Louisville Physicians, Louisville Center for Voice Care. She stopped in for a quick check of her vocal cords. Donner sits in the white examination chair. Speech, language pathologist, and director of voice therapy at the center, Lisanne Craven is evaluating Donner’s vocal folds with videostroboscopy, to get a detailed image of the vocal cords. Craven uses a rigid scope. It looks like a silver metal wand. She places it on top of Donner’s tongue and asks Donner to do her best to make the ‘e’ sound

Craven’s job at the center is to assist with diagnosing and treating voice disorders. She said while teachers make up approximately four percent of the workforce, they are about 20 percent of a voice care center’s population and some studies show that as many as half of all teachers can develop a voice problem during their careers.

“Teachers have a very high vocal demand, not only in the intensity that they often need to use day to day but also the duration of voice,” explained Craven.

But teachers are not the only people who seek treatment for voice disorders. Craven sees people from a variety of professions.

“ Many, many singers, actors, performers but also day to day people that use their voice in factories and call centers. We see a lot of sales representatives, many clergy members, choir directors, attorneys,” reported Craven.

The voice therapist treats patients with various voice disorders from general hoarseness that lasts more than two weeks to a lesion on a vocal fold.

“So, anything that affects how your voice sounds or how it feels may warrant your attention,” explained Craven.

In Lexington, people with voice issues might see Dr. Vrushali Angadi, co-director of the laryngeal and speech dynamics lab at the University of Kentucky. She and Craven both pay close attention to how a disorder affects the patients’ quality of life.

“If a singer told me that they can’t hit their high notes anymore or they can’t perform at that three-hour concert but they have a completely so-called normal speaking voice, that’s still a voice disorder because that affects their profession. If my teacher patient told me, I can teach all day but when I go home, I really can’t speak to my kids because my voice is so tired, that’s a voice disorder,” explained Angadi.

Treatment for a voice disorder usually includes vocal function exercises that are specifically designed for the muscles used for voice. Lisanne Craven understands why some people might refer to her as a physical therapist for the larynx but there’s more to it than that.

“Voice is many subsystems working together. The power for voice comes from breath. And many times, we spend time on breath as powering, energizing that voice to create the best outcome.” said Craven.

Before Katherine Donner was evaluated at the Louisville Center for Voice Care and discovered a vocal fold bleed, she was able to sing and teach but she knew something wasn’t quite right.

“As a singer, you learn how to adapt. You learn that there will be different things that you have to do in order to hit a note in a certain way or ‘oh, that I have a little bit of nasal drainage so if I just do this, that will help out. When you start to say I’m adapting more than normal for what’s happening in everyday life, that’s when you start to say, I think I need to go see a clinician,” said Donner.

After having the vocal ford hemorrhage in January, Donner worked with Lisanne Craven for a few weeks. After some vocal rest, Craven walked Donner through a specific exercise where she used a straw.

Voice therapist Craven takes Katherine Donner through a vocal exercise using a straw.
Cheri Lawson
Voice therapist Craven takes Katherine Donner through a vocal exercise using a straw.

Donner is doing well and said along with voice exercises an amplification system has been a big help. The mezzo-soprano continues her busy schedule of classroom teaching, singing at recitals, in operas, with symphonies, and giving private voice lessons like one she captured on tape.

When it comes to the voice, specialists like Lisanne Craven recommend staying hydrated and using caffeine only in moderation.

Cheri is a broadcast producer, anchor, reporter, announcer and talk show host with over 25 years of experience. For three years, she was the local host of Morning Edition on WMUB-FM at Miami University in Oxford, Ohio. Cheri produced and hosted local talk shows and news stories for the station for nine years. Prior to that, she produced and co-hosted a local talk show on WVXU, Cincinnati for nearly 15 years. Cheri has won numerous awards from the Public Radio News Directors Association, the Ohio and Kentucky Associated Press, and both the Cincinnati and Ohio chapters of the Society for Professional Journalists.
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