Adele, shown here at the 2011 MTV Video Music Awards, has canceled her tour… (Matt Sayles / Associated…)
Vocal hemorrhaging appears to have put the kibosh on singer Adele's tour; the UK singer posted a long, heartfelt explanation on her website about her voice problems.
"Guys," she writes, "im heartbroken and worried to tell you that yet again im experiencing problems with my voice. its ridiculous i know! i cant believe it myself. i follow all the advice im given and stick to regimes, rules and practices to the best of my ability but it seems to simply not be enough."
Bad punctuation aside, Adele's voice problems are fairly common among singers, says Dr. Lee Akst, a laryngologist and director of the Johns Hopkins Voice Center in Baltimore.
"A vocal hemorrhage would stop anyone in their tracks," he said, adding that singers are considered a high-risk group because they use their voices so much.
A hemorrhage, he added, is the result of phonal trauma.
"Every time we use our vocal cords to sing or speak, one vocal cord vibrates against another, and that leads to collisions between them," Akst said. Lots of collisions can cause blood vessels to break, leading to bleeding in the vibrating layer of the vocal cord, which in turn causes the area to bruise. The inability of the vocal cords to vibrate is what causes hoarseness, the main symptom of vocal hemorrhages.
"The louder you use your voice the more violent the collisions, and the higher the pitch the more frequent the collisions," Akst said. "That's why singers are at high risk."
Generally, a vocal hemorrhage is not painful, unless a blood vessel pops, and then there may be pain at the time, like stubbing your toe, Akst said.
Taking aspirin or other medications that thin the blood may make someone more prone to a vocal hemorrhage, said Dr. Martin Hopp, an otolaryngologist and medical director of the Sinus Center at Cedars-Sinai Medical Center in Los Angeles.
The best remedy, Hopp says, is rest. Steam heat, via a humidifier, can help as well.
"When you have a black and blue mark," he says, "it usually takes a good week or so to resorb. You have to be very careful -- you don't want it to come back because you'll have to go through the healing process again."
Remedies people typically use for sore throats such as gargling with salt water or drinking hot tea with honey won't work in this instance, since they won't affect the vocal cords.
In some cases there may be an underlying vocal malformation causing the hemorrhaging, Akst says. Polyps or dilated blood vessels, for example, may be treated in some cases with surgery. Singer Steven Tyler of Aerosmith underwent surgery in 2006 for what was reportedly a popped blood vessel.
But if it's just a case of bruising, then the prognosis is probably good.
"If the vocal cords look good," said Akst, "then someone should be able to use them again."