Dr. Anthony Jahn Answers Your Questions


Dear Dr. Jahn,
Thank you for your valuable contribution to Classical Singer. The information is extremely relevant to my own performing but more importantly, to my teaching. I took a course on the subject of vocal fatigue through the speech pathology department at the University of Minnesota while completing my D.M.A. in vocal performance. The issue of the whisper was discussed and it was noted that this is one of the most fatiguing uses of the voice in that it engages (contracts) the largest number of internal laryngeal muscles. If you agree with this, here is my question: Is breathy singing more fatiguing than singing that is not breathy to the listener’s ears? Is there less approximation of the glottis in breathy singing (as I’ve been told is common in adolescent female singing) and is this “breathing singing” in any way similar in function to the fatiguing affects of the whisper?

As you know, the vocal folds do not only approximate with phonation or singing. They also come together with whistling, pushing and whispering, and generally move back and forth dutring normal respiration. There are two kinds of whisper, the voiced and unvoiced. The unvoiced whisper is barely audible and is not generally used. It involves almost unrestricted airflow through the larynx. The voiced whisper does involve some vibration of the vocal folds or other laryngeal structures, and can be soft, stronger (like a stage whisper), and even a whisper-like singing voice, as you mentioned. In these cases the vocal folds are held firmly by the laryngeal muscles, although they do not completely approximate, at least not along their entire length. In terms of muscle effort, this sort of whisper is definitely more tiring than well supported singing or speaking. Breathy singing usually involves strong muscular effort pushing the vocal folds together, but leaving a gap, usually posteriorly. This is very effortful, involves high laryngeal tension, and may in the long run lead to nodules.

Dear Dr. Jahn,
I have a problem where I am always clearing my throat. I always have mucus on my vocal chords. I don’t have any allergies that I know of. Any suggestions?

I have several thoughts. Do you drink enough water? You need 8-10 glasses a day (two with each meal, two between each meal), in addition to any coffee, tea or other drinks. Try to avoid milk products for a few weeks. Irrigate your nose twice daily with salt water to reduce any post-drip. Try to avoid any drying medications, such as antihistamines, antidepressants or decongestants. And finally, if you have any heartburn or gastroesophageal reflux, have it treated.

Dear Dr. Jahn,
I am a 53-year-old light lyric coloratura. I began singing lessons at age 9 and have studied and performed for 40 years. Even at this age, people think I’m a teenager when I answer the phone. However, I am developing a widening vibrato, kind of a shake in the voice. Also, I have put on a great deal of weight since age 45 and I am in menopause. Should I take hormone replacement? Will TSH effect the singing voice negatively? Does weight effect vibrato? Will medications to assist in weight loss effect the voice? I want to save the delicacy I’m known for, or perhaps I should say get it back. Please advise me on what to do.

I don’t know if there is a simple solution to your problem. Normally a widening vibrato is a sign of muscular fatigue. I don’t know your repertoire or performance history, but we often see this in voices that are wearing out, not necessarily from age. Certainly, if your estrogen level is low (as it might be postmenopausally), you should consider hormone replacement, if there are no specific contraindications. Thyroid medication does not normally cause the voice to wobble. I’m assuming that you would be taking this to correct low thyroid output (hypothyroidism), and in appropriate amounts. I the thyroid is low, you may get a huskiness to the voice, and if it is overactive, you may develop a tremor, but not a widening vibrato. Certainly, loss of excess weight is a good thing, particularly if it makes you prone to acid reflux. You may, however, need also to consider reworking your technique to try to address the wobble.

DISCLAIMER: The suggestions given by Dr. Jahn in these columns are for general information only, and not to be construed as specific medical advice, or advocating specific treatment, which should be obtained only following a visit and consultation with your own physician.

Anthony Jahn, M.D.

Dr. Anthony F. Jahn is a New York-based ear, nose, and throat physician with special expertise in ear and voice disorders. He has a 40-year association with the Metropolitan Opera and is medical consultant to several music schools in the tristate area. Dr. Jahn is professor of clinical otolaryngology at Mount Sinai School of Medicine and the author of over 100 publications, including The Singer’s Guide to Complete Health. He lectures internationally on ear and voice related disorders.