This post may come across as rather self-indulgent, but I thought, since this is a choral music blog, that it might be helpful to my readers to learn about my long and frustrating experiences with trying to get a handle on my voice/throat issues. You may recognize some of your own symptoms in mine and get some ideas for dealing with them. If you find yourself nodding off in the middle of my fascinating story, then I guess that’ll be a hint that you don’t need the information!
I’ll begin with the fact that I have always had incredibly tight/stiff neck, jaw, and shoulder muscles. When I was a speech major in college and taking a class called “Voice and Diction,” our teacher gave us an exercise in which you were supposed to take hold of your chin and move the lower jaw freely from side to side. I could never, ever do that. I can consciously move my jaw/chin in that way, but I can’t get it to hang loose. Part of the problem is that I have fairly severe TMJ issues and my jaw pops in and out if I try to do that movement. I also have some mild scoliosis in my upper spine. I was later able to get some physical therapy in which the therapist worked on the sides of my neck and even (this sounds gross, but it worked) went inside my mouth to work on the tense muscles along the sides of my jaw. I don’t know of anyone now, though, who does that sort of thing. I should at least wear my rather uncomfortable retainer at night to help with my teeth-grinding problem. (Honestly—I don’t consider myself to be that tense! My life is great!) It’s also helpful for me to consciously relax my shoulders and not sit hunched over my computer. I did that just now as I sat typing these words.
I’ve also had chronic allergy problems since my teenage years. (So 50+ years altogether.) While I originally had classic seasonal “hay fever,” with itching eyes and sneezing, eventually my problems seemed to coalesce at the back of my throat/roof of my mouth and become chronic, creating a tight, scratchy feeling that really interfered with singing. I consulted with a whole series of doctors over many years trying to get a handle on this problem; most doctors professed complete befuddlement as to what I was talking about. One ENT specialist even had me tested for gastric reflux with my having to wear a monitor for 24 hours with a wire that went up my nose and down my throat. Boy, was that weird! And of course I didn’t have reflux. The symptoms were in the wrong place.
When we moved to the Denver area in 2009 I went in to a respected ENT/allergist and was given the standard prick-test panel, with the usual suspects showing up: grasses, mold, dust, pollen, and cats. (I have three cats.) I was put on a regimen of allergy drops, a new-ish allergy therapy that replaces the old allergy shots. You don’t have to trek into the doctor’s office once a week for your shots but instead just squirt the drops under your tongue once or twice a day. (This isn’t some kind of alternative medicine; it’s scientifically established that you have receptors under your tongue.) I was very faithful with applying the drops and with going in once a year to be re-tested, and I did this for four years. I was also put on a regimen of two prescription nasal sprays. What was the result? A big, fat nothing. I saw no noticeable improvement at all. (However, just to be fair, let me mention that many if not most people find the drop regimen to be very helpful.) I’ve wondered since if I’m sensitive/allergic to something that doesn’t show up on the standard test panel. They can’t test for everything, after all. My symptoms don’t seem to track with the seasons or direct contact with an allergen. I can pick up a cat and bury my face in its fur without any reaction at all. So my working hypothesis is that I’m unique!
During all of this time I was also experiencing pain/pressure in my ears. Eventually I realized that I must have some kind of sinus infection or blockage in addition to my allergies. After I basically pitched a fit at the allergist’s office I was scheduled for a CT scan. Guess what? The sinuses behind my nose, the sphenoid and ethmoid ones, were completely blocked. Ah-ha! Vindication! So I had surgery to ream them out, then 28 days of heavy-duty antibiotics to clear out the infection, and that problem was solved. I’ve had a couple of sinus infections since, but now I know what symptoms to look for and that a short course of antibiotics will shoot it down. (To be clear, I’m not a fan of gulping down antibiotics–but I think my chronic issues in this area make a drug treatment justified.)
But the scratchy-throat issue remained. I had stopped the allergy drops and the heavy-duty nasal sprays and switched to non-prescription steroidal sprays such as Nasacort, Flonase or their generic equivalents, and they helped some. At some point I also started using the nasal irrigation thinga-ma-doopsy (using a squeeze bottle and not a Neti pot) and found that, 1) my throat/sinuses/nose felt really great after I used it, but 2) it was messy and drippy. No matter how much I tried to drain every single drop out of my nose and sinuses afterwards, putting my head down to my knees, blowing my nose repeatedly, and turning my head from side to side, I’d still end up with unexpected errant drips later on. Some of the solution was lingering in my sinuses despite all of my efforts, and the heavy-duty nose-blowing I was doing isn’t recommended. Also, and this is very important: You’re not supposed to use a Neti pot or its alternatives with anything but sterile, distilled, or boiled water. And you need to be sure to clean it well after every use. What a pain! So I tried a nasal spray, finding it to be quite effective although it doesn’t get up into the sinuses. The product I’ve used, Snoot!, is billed as the best “blend of acidifiers, carbonates and salts.” It has really gone up in price since the last time I bought it, though, and they seem to have some supply issues, so fair warning. You can visit their website here. (Don’t waste your money on colloidial silver sprays, btw.) You may find that using the nasal irrigator for severe allergy symptoms and a spray on days when things aren’t so bad can work well for you. I’d advise you that do some experimentation. My sinuses are probably just weird and you won’t have the delayed drippiness problem if you do the irrigation. (But it will still be a pain.)
Although the throat scratchiness problem was helped by my efforts, it wasn’t completely solved until I finally realized that I could get the steroidal sprays to the affected part of my upper throat if I lay down flat after spritzing my nose. The spray would run/drip to the back of my throat that way. I’d lie there briefly to let it settle and then be free to get up and go about my business. This technique has worked surprisingly well, and I just use the spray on an as-needed basis. If I had one recommendation for anyone experiencing upper-throat raspiness, this would be it. I’ve never seen this piece of advice anywhere else. Ta-da! I’ll take the credit.
It’s hard for me to believe that I went around for years feeling kind of . . . horrible. I basically just tried to ignore my symptoms. Since I started doing the lie-down method of nasal steroidal sprays I haven’t had the throat issues much at all, and if it recurs I know exactly what to do. The sinus problems are also treatable if they recur.
Here’s a clear but stylized diagram of the sinuses behind the nose:
Hope all of the foregoing isn’t TMI but instead of some practical use. I’d love to read any feedback in the comments section.
