SPEECH & VOICE PROBLEMS

Alternative names   

Laryngitis, Hoarseness, Voice Strain; Dysphonia; Loss of Voice 

"It's not what you say, it is the WAY you say it! And HOW you say it!"

Every week or so, I lose my voice - for days to weeks.  Technically, this is called laryngitis. In everyday life, it is called big-time frustration!   It isn't until I try to speak the first time that I know whether I'm going to have voice problems that day or if I'll be able to be heard.

Most people don't understand laryngitis, 

anymore than they understand me when I have laryngitis!

People think I am angry at them or being abrasive when my voice sounds scratchy, irritated, hoarse, rough, etc. I may actually be in a good mood initially - or at least a neutral mood.  *I* was not irritable or irritated before speaking.  But the quality of my voice makes people THINK I am irritated with them!  It's only after this issue arises with the other person that I *do* become irritated -- but not with the other person -- I am irritated that my voice makes me seem like I am irritated or angry, when I was not and am not angry at ANYONE!

People think that I don't pick up on THEM being frustrated with not being able to hear ME. I react to their frustration by trying harder to speak, more clearly, or louder, so that I am heard better. But because my voice sounds so rough and scratchy, anytime I try to speak LOUDER to be heard, my voice is WORSE and sounds even more like I am "mad" or irritated with THEM.  It becomes a vicious cycle. And when I try to speak softer, to do what I need to do to "rest" my voice, the person gets more frustrated that I am not speaking louder. "Speak up!" they say to me, in a not-so-kind voice.  But if I speak up, they only think I'm irritated with them! 

I often sigh after a few words or a sentence. This is more likely after I have tried to FORCE my voice to be louder, by using my chest muscles to force more air out to make my voice to be louder.  This requires me to hold my breath just a little.  I take in a breath, using those muscles around my diaphragm, then speak as loud as I can, and after speaking, that breath is released. This causes a quick deep "sigh" sound, (as I release the breath I was holding to speak louder, and take a new breath to get oxygen). 

The quick, deep sigh is often misinterpreted as me being "irritated" (or worse). 

This article does not focus on causes or treatments.  But generally, laryngitis does not have one specific cause.  Some possible causes are:

viral upper respiratory infection, bronchitis, pneumonia, influenza, pertussis, measles, diptheria, excessive use of the voice, allergic reactions, gastric reflux (gastric fluids coming up the esophagus and irritating the vocal cords, chronic cough (from irritants, from asthma, from gastric reflux), and inhalation of irritating substances (like cigarette smoking), acute or chronic ear infections, sinus drainage, throat surgery for adenoids, thyroid disorders,  throat cancer, chemotherapy to the neck, and some diseases of the elderly and neurological diseases.  (Also temporary causes from tests or medical procedures.)

Laryngitis may be painless or may be accompanied by pain, depending on the cause (see above).

Just as there is no one specific cause, there is also no specific treatment.  Steam, rest for the voice, therapy for underlying causes, treatment of allergies, reduction of irritating substances including environmental allergies or cigarette smoking.  

Depending on the cause, a person may have other symptoms of illness -- and the person could be quite ill.   If the cause is an illness, such as a viral or bacterial infection, they may be irritable, grouchy, tired, fatigued, feverish -- all the things common to having a cold or flu.  If the cause is an inner ear infection (otitis media), the fatigue may be accompanied by dizziness and tinnitus (ringing or swooshing or other sounds in the ear).   With any infection, the person may have anorexia (not eating as they normally would), and be dehydrated (not drinking fluids as they normally would).  A reduction in fluids actually makes sinus drainage worse, because the mucous gets thicker - water, juice, broth, or tea will help thin the mucous. 

Sometimes though, laryngitis may have few other symptoms, especially when the underlying condition is chronic.  Cancer and chemotherapy patients may only have loss of voice.

WHAT CAREGIVERS AND HOME HEALTH AIDES NEED TO KNOW

ABOUT LOSS OF VOICE AND LARYNGITIS

For more information, see these articles:

Medline Plus Medical Encyclopedia

American Cancer Society 
National - 800-ACS-2345 or 800- 227-2345
Canfield Ohio Chapter Office  330-533-0546