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KEEPING FIT : Clearing Up Some Common Misconceptions About Laryngitis : All the throat-clearing and coughing in the world won't help, and may even exacerbate the problem, experts at Fullerton's Voice Institute say.

January 08, 1991|JAN HOFMANN | SPECIAL TO THE TIMES

You open your mouth, you try to talk, but nothing comes out. Or the sounds you do make are hardly the ones you--or anyone else--expected to hear.

You try clearing your throat; that doesn't help. You cough a few times and try again, but the problem is still the same.

It might have been that big game last night, the one where you cheered on the team at the top of your lungs. Or that party you went to, where you had a bit too much to drink but proved to everyone--quite loudly--that you did TOO know all the words to "American Pie." It could have been that shouting match you had with your teen-age son. Or simply the lingering effects of that cold you caught three weeks ago that still hasn't gone away.

Whatever the cause, you've got laryngitis, and all the throat-clearing and coughing in the world isn't going to help. In fact, both those things only make the problem worse, says Lori Peirson, director of the Voice Institute at St. Jude Hospital and Rehabilitation Center in Fullerton.

"I tell a lot of people, 'Never clear your throat,' " Peirson says. "That's tantamount to slamming your vocal cords together."

And try as much as possible not to cough, for the same reason, she says.

Instead, sip some water or other liquid, or, if the problem is serious enough, use cough medicine, she says.

Many of the classic folk remedies your mother may have recommended aren't much help with laryngitis, says Dr. Norman J. Harris, an otolaryngology (ear, nose and throat) specialist at St. Jude. But some do make a difference.

"Most of the folk remedies your mother taught you came from the physicians of a few generations before," Harris says. Problem was, doctors back then weren't even sure how the vocal cords worked.

Drinking hot tea, for example, or hot water mixed with lemon and honey. "Nothing you eat or drink is going to get anywhere near the vocal cords," he says. "But it does add water to your diet, and you need that.

"Gargling doesn't even get past the back teeth, not even to your tonsils," he says.

Throat lozenges can help a little because they stimulate mucus flow, and the steam from a hot bath or shower can help counteract the effects of dry air, Harris says.

Unfortunately, it doesn't do much good to "rest" your voice, either, because that's impossible, even when you're not talking.

"The voice box, or larynx, is a part that keeps moving all the time," Harris says. "It moves every time you swallow, so there's no resting it. It does help not to scream and shout and carry on."

Even though the voice box can't be completely rested, it's best to avoid talking when you have severe laryngitis, Peirson says. Write notes or whisper, and try to use only your breath when you do, instead of simply trying to speak more softly.

The most common cause of laryngitis is infection, such as those caused by the colds and flu that tend to circulate this time of year. The problem is compounded in Southern California, Harris says, because "we live in a desert. We tend to dry the larynx out, either because we're not drinking enough water or there's not enough moisture in the air."

Because the voice box is used not only for making sounds but also for breathing and swallowing, other problems can affect it as well. "The valves that hold the acid in the stomach can leak, and that's another source of irritation that might not be obvious to people," Harris says. "If you have a big meal and then go to bed and lie down, or if you're overweight, you can have a leak that not only causes heartburn but also can irritate the voice box."

Smoking, of course, also can make laryngitis more likely or aggravate an existing problem. And drinking alcohol can make things worse because it acts as an anesthetic, causing some people to overextend their voices without realizing it until the next morning.

What's happening physiologically when your voice doesn't sound normal--or when you can hardly make a sound--is that "something is keeping the vocal cords from coming together evenly," Harris says. "Their shape has changed; they're swollen, usually."

Some specialists now have equipment in their offices, such as the unified video stroboscope, with which they can visualize the vocal cords as they move. But with laryngitis, "it's a very subtle change. And since the problem usually clears up after a short time, the expense of using the equipment isn't justified in those cases," Harris says.

We use our muscles to pull and hold the vocal cords together, and then as we exhale, they are blown apart, vibrating in response to the passing air, Harris explains. Doctors once believed the cords vibrated on their own, he says, "but now we know they don't actively do anything."

As you might expect, the people who seem most likely to develop vocal cord problems such as laryngitis are the extroverts, Peirson says.

"They tend to be the life of the party," she says. "They use their voices to yell. They're often the center of attention."

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