COLUMBIA —There's an important statistic many people aren't talking about.
Voice disorders affect up to 10 percent of the United States population, according to the American Speech-Language-Hearing Association, and the risk increases for those who use their voice professionally.
Matthew Page sees between 80 and 100 patients per month at the MU Voice, Swallow and Airway Center. He treats common disorders related to misuse or overuse, voice infections and nodules.
"You need your voice your whole life," Page said. "It's our identity."
Most of Page's patients are young or middle-aged. During MU's sorority fall recruitment, Page sees more women from sororities. His middle-aged patients include MU professors, performers, smokers and teachers.
The No. 1 problem Page sees is reflux laryngitis.
"Stomach reflux problems have voice consequences. It causes laryngitis," Page said. "Often, it occurs in people who don't have traditional symptoms of heartburn."
Not everyone needs medical help with voice problems, many of which can be prevented with education. Protecting the human voice was the focus of the MU Voice Symposium and Vocal Arts Festival, held Sept. 29 at the Missouri Theatre , which Page helped organize.
Using a flexible laryngoscope, or video camera for the throat, and a willing volunteer, Page used a projector to show images of the vocal cords as he fed the tiny camera through the nasal cavity.
The symposium was designed to raise awareness about the consequences of improper use of the voice and provide tips on care and prevention. Several physicians and professors talked about the mechanics of the human voice and ways to keep it healthy.
Emily Riesen helped Ann Harrell, associate professor of the MU School of Music, demonstrate proper posture for singing.
Riesen took private voice lessons in her younger years and participated in musicals, festivals and vocal contests. She majored in music business at Southern Illinois University and began performing once a week after she moved to Nashville. After Riesen increased performances to three or four times a week, the routine began taking a toll on her voice.
"When I slowed down a bit, I became aware of how raspy my voice was and I couldn't hit higher notes," Riesen said.
Riesen recently moved to Columbia to start her own music therapy business, Bluebird Music Therapy Services, which opened in July. She limits vocal performances to once a week and has noticed a change in her voice during the past year.
"If I hadn't become conscientious of my voice, I would have ended up in a doctor's office," Riesen said. "The voice needs exercise. It's kind of like stretching. If you don't do proper warmups, you'll injure it."
Teachers, vocalists, broadcasters and other public speakers are more at risk of developing voice problems.
Voice overuse is a problem, especially for Lorie Francis. She teaches five classes and directs two choirs at Missouri University of Science and Technology in Rolla. She notices her voice gets hoarse often.
"It's just gone at the end of the day," Francis said.
Francis plans to share what she learned at the symposium with students in the two choirs she directs.
"I think they'll like it," Francis said. "They're looking for ways to get better."
She persuaded her husband, John Francis, to tag along for the event in Columbia. John Francis hosts the National Public Radio's "All Things Considered" at KMST Public Radio in Rolla. During the station's fundraising week, John Francis talks almost all day.
"I don't drink enough water and talk too much," John Francis said.
Since the symposium, John Francis said he's been drinking more water and less coffee.
Darren Facen, director of music at New Dimensional Christian Ministry in Rolla, plans to use the information he learned at the symposium to teach better vocal techniques, especially for the praise and worship team he directs.
"It's a huge help in terms of ministry," Facen said.
There are plans to make the symposium an annual event, Page said. The feedback from an estimated 125 participants was positive.
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- Drink lots of water. Hydration keeps the vocal cords lubricated. Drinking eight 8-ounce glasses each day is recommended. Avoid caffeinated or alcoholic beverages, as these can dry out vocal cords. If caffeine is a must, drink extra water throughout the day.
- Avoid yelling, screaming or talking loudly in noisy situations such as sporting events and parties. It can strain the lining of the vocal cords.
- Use your voice less when you're sick. If it takes extra effort to use the voice during sickness, give it a rest and use only as necessary. Pushing the voice can cause straining.
- Use technological assistance. Talking with a microphone during speeches and presentations decreases strains on the voice.
- Use proper breath support and warm-up techniques. Vocalists, teachers and others who use their voice regularly need to warm up their voice before singing or speaking for an extended period of time. Warm-ups include lip and tongue drills and moving from low to high notes. Tall posture and deep breathing can increase breath power and support the voice.
- Keep coughing/throat clearing to a minimum. It can cause stress on the vocal fold tissue. Instead, trying taking a sip of water.
- Don't smoke. Smoking increases cancer risks, can cause inflammation and vocal polyps and also can make the voice sound husky or weak.
Sources: MU Voice and Swallow Pathologist Laura Powell and the American Academy of Otolaryngology website.