VOCAL CORD DISORDERS
By Slawomir Gromadzki, MPH
RISK FACTORS
Abusing vocal cords by improper speaking or singing technique, deficiency of vitamins, minerals and antioxidants, pro-inflammatory diet, gluten, consumption of refined oils, margarines, dairy, meat, drinking cold fluids, eating cold food, weak immunity caused by deficiency of vit. D, C, zinc, lack of antioxidants, refined diet high in sugar and white flour products, cheese, pizza, stimulants, lack of sleep, psychological stress, sedentary lifestyle, hypoxia (lack of oxygen in the body), use of antibiotics and meds, insufficient number of good probiotic bacteria in the colon, alcohol, smoking.
TREATMENT
– The most important aspect of successful treatment is lifestyle and diet according to the recommendations listed in the HEALTH RECOVERY PLAN > Please study it carefully and do your best to use the remedies and implement all the principles. If you manage to do it you will recover from this problem.
REMEDIES
– Often spray your throat with Propolis > Apart from having powerful anti-inflammatory, antiviral and antibacterial properties it can help regenerate damaged vocal cords when used externally in the form of a spray.
– Avoid cold foods and drinks. During the day drink plenty of hot water and hot herbal teas (licorice, mint, ginger, chamomile, sage, etc.).
– Suck Charcoal tablets many times during the day. Drink 3 times a day at least 2-3 glasses of very warm water (including herbal teas) between meals.
– Hot steam inhalations for relieving congestion.
– N-acetyl cysteine (300-500 mg 2 x daily) is good for chronic cough to help reduce the viscosity of phlegm.
– Astragalus (500-1000 mg 2-3x daily) is one of the strongest immune system busters and fight off any underlying infection. A 2012 study displayed its ability to control T-helper cells 1 and 2, essentially regulating the body’s immune responses. As a result of taking astragalus extract the macrophages and the natural killer cells of the immune system have a markedly enhanced ability to fight intruders, including viruses, five- to six-fold!. It looks like no other herb can be more effective immune system stimulator than astragalus.According to Dr. Randy Horwitz, Medical Director at the University of Arizona Center for Integrative Medicine, “Astragalus has been found to have both antiviral and immune-enhancing properties. Research shows that the 50 or so different compounds in astragalus work by stimulating immune cells, such as T-cells, phagocytes, and macrophages, to fight off disease. In Asia, it’s even given to cancer patients.” Astragalus – Like zinc, selenium, and vitamin D does not only makes immune system stronger but it also modulate immunity helping prevent leukocytes from attacking own body and reducing symptoms of inflammation as well as various autoimmune diseases.
– Zinc: 30 to 50mg a day after breakfast (should be with Selenium and Copper). Zinc required for strong immune system. Deficiency can cause gastrointestinal system to malfunction (for example, without zinc proteins can’t be properly digested), so foods aren’t completely digested. These food particles can then be absorbed into bloodstream where body misidentifies them as antigens and then produces antibodies against them weakening immune system. Zinc inhibits influenza & cold viruses; Taking Zinc at the start of a cold or flu helps minimise duration and severity of symptoms. In 2014 meta-analysis of 67 studies researchers have found that zinc is the best supplement for warding off colds and flu! According to the 2013 study, “Zinc (lozenges) administered within 24 hours of onset of symptoms reduces the duration of symptoms.”
– Vitamin D3 >: 50,000 IU after breakfast every day until recovery. After that 10,000 IU a day. (Must be with Magnesium as if you are deficient in this mineral Vitamin D is useless. In addition Vitamin D will lead to magnesium deficiency, sleep problems, etc.). Recently researchers investigated and compared data from 25 studies on vitamin D that involved 10,000 people to explore the effect of vitamin D in preventing cold, flu, bronchitis and pneumonia. Their conclusion suggests vitamin D supplementation was very beneficial in preventing respiratory tract infections.
– The best oil to use in the kitchen is raw coconut oil.
– Avoid foods with refined sugar as it makes leukocytes behave like drunken soldiers. Also white flour products weaken immune system because they are quickly converted to sugar.
– Avoid or significantly reduce consumption of cheese & dairy. They weaken immune system and are mucus producing making symptoms worse.
– Eat more raw vegetables, cabbage family vegetables, carrots, etc.
– It is very important to control stress and think positive.
– One of the most powerful remedies against upper respiratory diseases is Hot Foot Bath. Before bed keep your feet in hot water plus very cold compress on forehead and neck and a lot of water to drink as you should sweat a lot. VIDEO >
– Vitamin B2. Take about 50mg of Vitamin B2 (or B Complex) until recovery. The most common B2 deficiency symptoms may include sore throat, cracks in the lips and corners of the mouth, swollen tongue, scaly skin, tiredness, weakness, redness of the lining of the mouth, etc.
– Chlorella > and Spirulina > are very beneficial in AIDS and HIV infections and are effective in treating other viral infections such as hepatitis C. Scientists treated patients who suffered from chronic hepatitis C with Chlorella. After 3 months of treating patients with relatively small doses of Chlorella researchers discovered that the condition of 70% of the patients significantly improved.
– Selenium boosts immunity and helps defend viral and bacterial infections, autoimmune diseases and allergies. For instance, in people who already contracted HIV, selenium has been shown to also be able to slow down the progression of the disease into AIDS. It was discovered that 200 micrograms of Selenium per day helps prevent viruses from replicating.
– Take quality Probiotic formula such as ImmuProbio for to 2-4 months, or eat raw home-made sauerkraut every day, as inflammations, weakness of the immune system and autoimmune diseases are linked to the deficiency of the probiotic bacteria in the gut.
– Vitamin B12: 1,000 to 2,000 mcg a day under the tongue (must be sublingual Methylcobalamin!). This vitamin is involved in the production of white blood cells which are responsible to deal with viral infections and many people with inflammations, weak immune system and autoimmune diseases have low levels of this most important vitamin. Read a fascinating article on B12 >
– Boost Glutathione levels which is a most powerful of all antioxidants and strengthens the immune system and is one of the most effective remedies against inflammations . It boosts body’s ability to modulate and regulate the immune system. It is also important to provide body with ingredients that increase glutathione production in the liver by taking turmeric, milk thistle, L-cysteine or NAC (N-acetyl cysteine), Alpha Lipoic Acid, bilberry, vitamin C, asparagus, broccoli, peaches, avocado, spinach, garlic, squash, grapefruit.
NUTRITIONAL AND LIFESTYLE RECOMMENDATIONS
– Don’t use stimulants such as smoking, caffeine products or alcohol.
– Learn to control stress and always think positive! Never think negative and get rid of anxiety and fear as all negative feelings have very bad effect on immune system and increase chances of developing diseases triggered by viral infections! In the beautiful book „Ministry of Healing” Ellen G. White wrote that, “The sick, shut within four walls, look out on houses and pavements, with perhaps not even a glimpse of blue sky or sunshine, of grass or flower or tree. Shut up in this way, they brood over their suffering and sorrow, and become a prey to their own sad thoughts. The pure air, the glad sunshine, the flowers and trees, and outdoor exercise amid these surroundings, are health- and life-giving. Outdoor life is the only remedy that many need. It has a wonderful power to heal diseases caused by the excitements and excesses of fashionable life, a life that weakens and destroys the powers of body, mind, and soul. How glad would they be to sit in the open air, rejoice in the sunshine, and breathe the fragrance of tree and flower! There are life-giving properties in the balsam of the pine, in the fragrance of the cedar and the fir, and other trees also have properties that are health restoring. In nature may always be found something to divert the attention of the sick from themselves and direct their thoughts to God. The beauty of nature leads them to think of the heavenly home, where there will be nothing to mar the loveliness, nothing to taint or destroy, nothing to cause disease or death.”
– Increase Serotonin! We know that serotonin is very important in fighting depression, fatigue, or insomnia. Serotonin is the “feel good” hormone and neurotransmitter which helps us regulate moods and use good judgement. Unfortunately, the older we get the less serotonin we tend to produce. Dr. Carolyn Meltzer’s research has demonstrated that with age serotonin receptors decrease by over 50%. People who struggle with overweight, obesity, and depression, those who commit serious crime as well as people who commit suicide have very low level of this extremely important hormone. Unfortunately, if you don’t have enough of serotonin or when the number of serotonin receptors is low then it leads to depression. Serotonin deficiency can be caused by sedentary lifestyle (lack of physical activity), insufficient light during the day, refined and low in nutrients diet, use of stimulants (alcohol, nicotine, coffee, tea, cola drinks, chocolate and other caffeine products), or insufficient amount of sleep.
– Exercise in the morning outside to boost serotonin!
– Light therapy. Expose your body to sunlight whenever it is possible or use strong light imitating sunlight.
– Go to sleep as early as possible. Try to sleep at least seven or eight hours a day.
– Avoid foods with refined sugar as it makes leukocytes behave like drunken soldiers. Also white flour products weaken immune system because they are quickly converted to sugar. Instead of sugar and other harmful sweeteners you can use xylitol, erythritol, stevia or organic raw honey in moderation.
– Avoid all artificial sweeteners! Artificial sweeteners can usually be identified by many different names such as sucralose, saccharin, or aspartame (Splenda, Equal, Sweet n Low). There are almost a hundred side effects listed by the FDA, including depression, anxiety, schizophrenia, memory loss, nerve cell damage, Alzheimer’s, migraines, reproductive disorders, brain lesions, weight gain, food cravings, seizures and more.”
– Avoid high glucose/fructose syrup (HFCS).
– Switch to a well-balanced plant-based and unrefined diet with plenty of raw vegetable juices and raw vegetable salads.
– Avoid or significantly reduce consumption of cheese, pizza meat, bad fats & dairy. They weaken immune system and are mucus producing making symptoms worse.
SPIRITUAL ASPECT OF TREATMENT
– Learn to control stress, depression and anxiety by positive thinking, frequent smiling and laughter exercises, taking care of others, helping people in need, going for a walk, enjoying life and the beauty of nature. In this way you will boost good hormones, program cells to live longer, build new strong neural pathways, greatly reduce the number of free radicals, and greatly boost your immune system. As a result those smart and intelligent tiny soldiers (leukocytes) will protect and fight for you with HIV like Kamikazes.
Unfortunately, from experience we know that for most of us it is very difficult and often even impossible to control stress, overcome fear, anxiety and depression, or to become a positive thinking person simply because those negative emotions and fears are so deeply rooted and even seem to be a part of our nature. Sometimes we even feel like slaves of those negative attitudes and bad emotions.
And that is the very reason I included on my website a very special, unique and even most important section called EMPOWERMENT >. So please read it carefully and then study also another article – the GOSPEL OF FREEDOM >, which is even more significant as it reveals the secret of finding the only source of true inward peace which according to Apostle Paul “surpasses all knowledge” and which can “guard (protect) our hearts and minds (emotions)”. Combined with true strong faith this message will lead you to freedom from negative emotions such as anxiety or existential fears (one of the key source of deadly free radicals). It will also empower you with moral strength necessary to overcome long-cultivated bad habits or addictions, often impossible for us to defeat on our own. Finally, this unique and most wonderful Good News of the Gospel will also give you a new strength and a powerful motivation to not only practice but also enjoy the new and very healthy way of life.
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VOCAL CORD DISORDERS
What Is It?
The vocal cords are two bands of elastic muscle tissue. They are located side by side in the voice box (larynx) just above the windpipe (trachea). Like other tissues in the body, vocal cords can be strained and damaged. Vocal cords are also subject to infections, tumors and trauma.
When you are silent, the cords remain open. They create an airway through which you breathe.
When you speak, the air you exhale from your lungs is forced through the closed vocal cords. This causes them to vibrate. They vibrate faster for higher-pitched sounds, slower for lower-pitched sounds.
Strained vocal cords generally aren’t noticed until the problem becomes severe. People who use their voices for a living or who shout or scream frequently are at particular risk. People who work in noisy environments that require shouting to communicate are also at risk.
Common vocal cord disorders include:
- Vocal cord nodules. These are small, hard, callus-like growths caused by vocal abuse. They occur in pairs, with one nodule on each vocal cord at the site of greatest irritation. They sometimes are called singer’s, screamer’s or teacher’s nodules.
- Vocal cord polyps. Polyps are small, soft growths that usually appear alone on a vocal cord. They are caused most often by vocal abuse or long-term exposure to irritants, such as chemical fumes or cigarette smoke.
- Contact ulcers. This is a less common disorder. Contact ulcers are erosions and sores on the vocal cords. They tend to occur in people who consistently use great force when beginning to speak, instead of gradually increasing force and loudness. For example, contact ulcers may affect people who work as public speakers. Ulcers also can be caused by gastroesophageal reflux disease (GERD), or heartburn. Reflux is when acidic stomach contents flow back up the esophagus and irritate the larynx.
- Laryngitis. This is a swelling of the vocal cords caused by inflammation or infection. Swollen vocal cords vibrate differently than usual, changing the typical sound of your voice. You can lose your voice if the inflammation is so severe that you can’t make a sound.
Laryngitis can be caused by:
- Vocal abuse
- Allergies
- Viral infection
- Reflux of stomach acids
- Exposure to irritating substances, such as cigarette smoke or too much alcohol
- Vocal cord tumors. Tumors can be cancerous or noncancerous. Noncancerous tumors can be caused by a virus. Or they may be unusual growths of body tissue that cause voice problems. Cancerous tumors are most likely to occur in smokers and people who drink too much alcohol. Cancerous tumors are life threatening if not caught and treated early.
- Vocal cord paresis and vocal cord paralysis. Vocal cord paresis occurs when one or both vocal cords don’t open and close properly, changing voice quality. When one or both vocal cords don’t move at all, this is called vocal cord paralysis. If both vocal cords are paralyzed and remain in the closed position, breathing can be difficult.Vocal cord paresis and paralysis can have several causes, including:
- Surgical trauma, most often from thyroid surgery, but also from any neck or chest surgery
- Head or neck trauma
- Trauma during birth
- A neurological disease (such as Parkinson’s disease or multiple sclerosis)
- Stroke
- A tumor
- A viral infection
- Some debilitating diseases, such as myasthenia gravis
Paresis also can result from weakened vocal cord muscles. Vocal cord muscles can be weakened temporarily as a side effect of inhaled corticosteroid medicine sprays. They may also weaken after extended treatment with an artificial respirator (ventilator) in a hospital.
Symptoms
Symptoms can vary, depending on the vocal cord disorder.
- Vocal cord nodules
- Hoarseness
- Low-pitched voice
- Breathy voice
- Singers may notice a loss of vocal range.
- Vocal cord polyps
- Hoarseness
- Low-pitched voice
- Breathy voice
- Contact ulcers
- Some throat pain while talking
- Possible hoarseness
- A voice that tires easily
- Laryngitis
- A change in the sound of the voice, from hoarseness to croaking or complete loss of voice
- If due to an infection:
- Fever
- Throat pain
- Malaise
- A feeling of having to clear your throat
- Vocal cord tumors
- Hoarseness
- With large tumors, possibly trouble breathing or swallowing
- Vocal cord paresis
- Changes in the voice:
- Hoarse
- Breathy
- Change of pitch
- Unable to get louder
- Discomfort from the strain of trying to move paralyzed cords
- Possible breathing difficulties
- Changes in the voice:
Diagnosis
Your doctor will ask about your medical history. The doctor will listen to the quality of your voice and then inspect your vocal cords. This is usually done by holding a small mirror at the back of your mouth. To get a better view, the doctor may use a small, flexible lighted tube with a camera at the end. The tube is inserted through the nose to the larynx.
You will need to make certain sounds so your doctor can see your vocal cords in action. The examination may be videotaped so your doctor can analyze it later. This is all that is needed to diagnose most cases of laryngitis, vocal cord nodules and polyps.
In some cases, your doctor may recommend an acoustic analysis. This is a series of tests that measure the quality of your voice, including its pitch stability, range and intensity. Often, these tests are used when vocal cords are paralyzed or if a growth must be removed surgically. Using the test results, doctors and voice therapists can judge the amount of improvement after treatment.
Cancer of the larynx can look similar to a noncancerous growth or a contact ulcer. If an abnormality is found on the vocal cords, your doctor may do a biopsy. A biopsy involves removing a tiny sample of the affected vocal cord tissue so it can be examined in a laboratory.
Additional tests, such as computed tomography (CT) scans, may be required in some cases of vocal cord paralysis or cancer.
Expected Duration
- Vocal cord nodules – If you don’t do anything to change your vocal cord abuse, nodules can last a lifetime. They can even come back after they are surgically removed. With proper voice training with a certified therapist, nodules can disappear within six to 12 weeks.
- Vocal cord polyps – With rest, some vocal cord polyps will go away on their own within a few weeks. Most, however, have to be removed surgically.
- Contact ulcers – It can take a long time for contact ulcers to heal. Some doctors recommend resting your voice for a minimum of six weeks. If the ulcers are caused by acid reflux, the reflux problem must be treated to keep your vocal cords healthy.
- Laryngitis – Laryngitis caused by a viral infection usually goes away within one to three weeks. Laryngitis from vocal abuse usually goes away on its own in a few days with voice rest.
- Vocal cord tumors – Noncancerous tumors generally do not go away. They must be removed surgically. Cancerous tumors must be treated immediately to prevent the cancer from spreading. Untreated cancer of the larynx leads to death.
- Vocal cord paresis or paralysis – In some cases, the voice returns on its own within a year. If not, the condition is likely to be permanent. Surgery may be done to try to improve speech.
Prevention
To help prevent disorders caused by vocal abuse (including laryngitis, vocal cord nodes and polyps, and contact ulcers), you need to learn how to talk without straining your vocal cords. A voice therapist can teach you how to do this. Look for a licensed and certified speech-language pathologist who specializes in voice.
To prevent disorders related to acid reflux (including contact ulcers and laryngitis), see your doctor to treat the reflux. Medications can help to control stomach acid. Lifestyle changes also help some people. Changes include:
- Eating smaller meals to avoid overfilling the stomach
- Not eating or snacking three to four hours before sleeping to make sure all food is well digested before you lie flat
- Raising the head of your bed a few inches to keep your head and upper chest higher than your stomach
- Avoiding alcohol, caffeine, fatty foods, chocolate and peppermint, which may trigger heartburn
To help prevent vocal cord disorders caused by irritation (including laryngitis and vocal cord polyps), avoid smoking, drinking or inhaling chemical irritants. To help prevent vocal cord cancer, quit smoking and limit your consumption of alcoholic beverages.
If you use an inhaled corticosteroid medicine to treat asthma or other lung disease, you may be able to prevent vocal cord muscle weakness. Use a spacer device that catches large medicine droplets too heavy to be carried deep into your lung airways. These large droplets can otherwise settle in your throat and trachea, where they can cause side effects.
If you have viral laryngitis, cover your mouth when coughing and wash your hands often to prevent others from getting your infection.
Treatment
For vocal cord disorders resulting from vocal abuse, there are two main treatments:
- For short-term relief, rest your voice. Speak or make sounds only when absolutely necessary. Try not to talk or whisper at all for a couple of days.
- For long-term relief, voice therapy. Learn the proper way to speak to avoid straining your vocal cords.
If rest and therapy don’t resolve the disorder, other treatments are available. They are based on the type of disorder:
- Vocal cord nodules may require surgical removal.
- Most vocal cord polyps require surgical removal.
- A contact ulcer may require surgical removal if it does not go away on its own after a minimum of six weeks of voice rest. You also may need voice therapy and treatment for acid reflux.
- Laryngitis caused by a virus needs rest and fluids. Antibiotics are not helpful to treat routine infections.
- Vocal cord tumors require surgical removal if they are noncancerous. They generally will not return. Treating cancerous tumors depends on the extent of the cancer. In the early stages, radiation, chemotherapy, surgery to remove a portion of the larynx or a combination of treatments may be needed. Some voice will remain after these procedures. In later stages of cancer, the entire larynx, including the vocal cords, must be removed (laryngectomy). You will need to learn a new speech method, using a special valve inserted surgically between the trachea and the esophagus. This allows air to be sent up the esophagus, creating enough vibrations for understandable speech.
- People with vocal cord paresis or paralysis may be able to learn how to speak in different ways through voice therapy. If improvement is not satisfactory, surgery may be recommended to change the position of the affected vocal cord. Surgery can also add bulk by injecting the vocal cord with collagen, body fat or some other substance. These types of procedures are recommended more often when one of the vocal cords is paralyzed. Both techniques bring the paralyzed cord closer to the cord that is not paralyzed. This allows the cords to vibrate enough to make sounds. For people with two paralyzed vocal cords, the goal of treatment is to improve breathing. The most common procedure is a tracheotomy. This procedure creates a hole in the neck below the level of the vocal cords. A breathing tube is placed into the hole.
- Vocal cord muscle weakness due to inhaled corticosteroids may require a change in medicines. That is, if using a spacer device does not prevent symptoms.
Prognosis
- Vocal cord nodules. Nodules can come back if vocal abuse continues. This is true whether they disappear with voice rest and voice therapy or are surgically removed.
- Vocal cord polyps. Polyps may be removed successfully with surgery. But they can return if you don’t have voice therapy and don’t stop inhaling irritating substances.
- Contact ulcers. With rest, treatment of reflux and retraining the voice, most contact ulcers go away without complications in weeks or months.
- Laryngitis. Most cases of laryngitis go away within a few days to a few weeks, depending on their cause.
- Vocal cord tumors. Noncancerous tumors usually do not return after they are surgically removed. You usually regain your normal voice.Cancerous tumors can be very serious. The earlier they are detected and treated, the better the likelihood of survival and cure. Your voice may change dramatically, depending upon the extent of the cancer and the type of treatment.
- Vocal cord paresis. Many instances of vocal cord weakness improve over time. This may take many months.
- Vocal cord paralysis. Some cases go away within a year on their own. But many people require surgery to restore their voice, and many need voice therapy. With proper treatment, most people with one-sided vocal cord paralysis will regain good voice quality and control. People with two-sided vocal cord paralysis must relearn how to use their voices after they have had surgery to assist their breathing.
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