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Are You Losing Your Voice?

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Your voice helps to define your personality, mood, and health. In this episode, speech-language pathologist Jessica Schwartz explains what can impact your voice (and how you can take care of it!).

Darshan

Hey, everyone. Aas you guys know, my podcast is generally about the life sciences and what impacts on life sciences. And this podcast, specifically, is going to be talking about life science leaders and mistakes we make as leaders, and what can we do about it specifically in the context of, of voice and speech and speech pathologies. And if you're any kind of leader that a lot of talks and mostly there's, I know, I know, lined up doing a bunch of talks. This is a conversation we probably end up having to do sooner rather than later. And we have Jessica Schwartz with us, who is a voice pathologist, how would you What's your title, Jessica?

Jessica

So I'm a speech language pathologist, but I specialize in voice.

Darshan

There you go. And Jessica is going to be talking to us about a lot of this stuff, and I apologize that my dog has decided to join us in the background. But, but this is DarshanTalks, and I am Darshan Kulkarni. So welcome, Jessica. First of all, thank you for coming on. Just want to give us a is a little bit more about yourself, tell us a little bit about what you do, who comes to join you and listen to you.

Jessica

So as mentioned, I'm a speech language pathologist and I have a virtual voice practice that I have a telepractice. So I can see people who are voice professionals, I can see teachers, executives, anyone who needs some training and voice either from a preventative standpoint, or from a rehabilitative standpoint, I also do speech therapy and other non voice related but sort of laryngeal related. So chronic cough or chronic throat clearing, which can often affect your voice, pretty, pretty big impact there, as well as swallowing and some other breathing issues. But overall, I focus on voice. And so it could be anyone from children to adults that I work with.

Darshan

So for you talk about me, I have several questions that jumped out right off there. But you talked about having a virtual voice practice, what does that actually mean?

Jessica

Yeah, that's a great question. And in this pandemic, it's definitely been a trend to move to virtual. So I feel pretty fortunate that I'm able to give voice therapy and, and work with people via the computer here, kind of like we're doing right now. So I use Google meet or FaceTime or whatever. platform is appropriate, hopefully, HIPAA, HIPAA compliant, but so basically, just, we would do conversation just like this, I would give assessment and therapy over the internet instead. So it can be a little challenging at times, just because of technical difficulties. But overall, there's actually been studies that show that voice therapy is just as effective in person as it is virtually

Darshan

no. Talk about the comparison, we move towards virtual therapy. Well, you already doing this before COVID? Or is this a new thing for you?

Jessica

It's a great question. Um, this is pretty new. I started doing this because of COVID. Some people did already do this, it wasn't totally new. It definitely has become more prevalent.

Darshan

So what have you found to be challenges in shifting over? Because I can, I can tell you that when I was when I when I talked to my therapist, for example, my therapist wanted to go virtual and I struggled with that, um, did you find that initial struggle when you were switching your your patients over?

Jessica

Definitely, there was a big learning curve, especially because a lot of my patients were older individuals, some didn't have the equipment or wasn't really sure or used certain, you know, applications that they weren't familiar with. So that was a challenge. But also, for me, personally, one of the biggest challenges was the assessment. So luckily, in voice, it's so much of it is perceptual. So it's really all about my ear. And of course, most of the time, it works fine when when it's choppy, or there's a lag or something going on, it can be a little challenging. But also our measurements, we do have some acoustic evaluation measurements. So that gets a little tricky measuring pitch or sustained foundation because a lot of our technology platforms will mute or reduce background noise, and we want to hear that background noise. So I've gotten a little bit around that with a really cool software called loopback, where it actually kind of patches one application through to another voice analysis application I have from, you know, directly from Chrome, or whatever I'm using. So it can be helpful, but that that's been challenging for me, just because I'm not the most tech savvy person. But it's been working so good.

Darshan

You're now dealing with a virtual practice, your patients you mentioned, a lot of them tend to be on the older side. And they struggle with that. Here's my question, what platform do they line up using? I'm visualizing my mom who's going, I don't even want to learn how to use WhatsApp. She refuses to get on the phone. She lives in India, and I live here and she'll come back and forth and all that good stuff. But my point being, she refuses to learn how to use What's up, how do you convince your your patient that they need to be on there, and they need to sort of join whatever tool you recommend.

Jessica

So luckily, you know, things like Google, a lot of people have Gmail already, or FaceTime, which is already on their iPhone, or they, especially if they're an older person, they might have a child or someone in their family that has the ability to set them up. So it can be really helpful. But but it is a bit of a challenge. And sometimes it really helps that there might be a doctor telling them that they need to do this or the convenience of not leaving their house and not having to plan on you know, scheduling a ride or maybe having childcare, whoever they may be, but but it can be part of the convenience factor his motivation. And just really me sitting on the phone and walking them through it can be really a big part of that.

Darshan

Okay. So, you talk about having the specialized, um, what do you call it a tools, tools that you ran, for example, to Chrome? Is this something that's really available to everyone? Or is it the fact that you have certain expertise? And if I tried to download that, for example, I'd be completely lost? How does that work work out for you.

Jessica

So I'm really lucky that I have a great resource and a family member who understands audio. And he's the one that actually hooked me up with this software and sort of explained it to me, it is something that you can purchase. So it's it's not super complicated, though. So I'm sure there are tutorials and things like that. But again, me being kind of not super tech savvy, it was very helpful that I had someone who did have expertise to help me

Darshan

out. I'm mainly talking about BS. This idea of going virtual because COVID sort of forced that on a lot of people might my question for you is one of the one of the issues we end up dealing with is the idea of telemedicine, which this would obviously fall into. And there has been a whole push of well, is reimbursement the same and how you handle reimbursement from Medicare, Medicaid, etc. Have you ever struggled with that?

Jessica

Initially, with with COVID, it was a big struggle, because while they were expanding a lot of the reimbursement for doctors and other professionals and providers, they took quite a while to expand to speech pathologists, especially in Medicare, and things like that. So it was a bit of a struggle at first, they opened it up and now there's kind of that question mark of is it going to last so it's kind of up in the air at this point, as far as I know,

Darshan

I ended the state by state dependent or does it not matter because you know, virtual and could do this for some time sitting at the base of I don't know, Machu Picchu right now.

Jessica

Well, actually, I'm because I'm licensed in Pennsylvania, I'm only able to treat people in Pennsylvania so I actually don't have an interstate compact yet. That's something that our organization is working on. And I'm looking forward to that but um, so as far as I know only just Pennsylvania it does I think vary state by state because honor organization, they had a updates for state by state, but for me, it's mostly just Pennsylvania related.

Darshan

Okay, so you've got a situation where you, you got speech pathologists. Now I'll be honest, when you called me just for the first time, I was struggling a little bit with this idea of what exactly does a voice pathologist a speech pathologist do? And do I need their help and you want through that little bit you can you explain what what are the types of problems you're solving?

Jessica

Absolutely. So there's two sort of realms of this, I'll start with the rehabilitative realm, because that's what most people think of when they think of, you know, medical or voice therapy. So thinking about someone who goes to see an ear, nose and throat professional, because they've had hoarseness for more than two weeks, or chronic cough or something of that nature. So for voice therapy, what can happen is someone who talks a lot, so whether you are a professional voice user, like a teacher or executive, let's just say you get laryngitis, and you get a typical cold, and you lose your voice a bit, and you talk through that cold, because it's your job, it's your livelihood, and you know, your voice doesn't really get better, it gets worse, maybe or it doesn't change, and it continues being forced. So they might go see an ear, nose, and throat professional. And that can be a lot of different things, you can have pathology that might happen to the voice from overuse or misuse. So something like vocal nodules, or vocal polyp or a scarring, anything that can happen, inflammation or other laryngitis. So they would send you to a voice therapist, to help retrain your voice to not be so tight or tense. So muscle tension dysphonia is a big, it's a very frequent disorder that we work with. And that is a functional disorder. So there's the structural, which might be, let's say, swelling or vocal nodules, because you've been misusing your voice. And then from that, when you strain through that voice, you develop muscle tension and muscle tension patterns and behaviors that you might even be doing subconsciously, that actually makes your voice worse down the line. And so that person would need to see a voice specialist, for example, to help retrain their breath support their how they're using the airflow with their voice, to retrain their resonance, where they're placing their voice to make sure that it's not in a place that would be harmful. So from a more preventive standpoint, we might be working with someone who is a voice professional, who essentially needs to learn technique, because if they don't, they might overstrain and over misuse their voice. So someone who has a lot of glottal fry, for example, which is, which is this kind of sound in your voice, like, a lot of times, it happens towards the end of your sentences, we might start up here, and then we kind of drop into this place, right? So I'm exaggerating it, but vocal fry is, is becoming more and more common, and it can be a really straining behavior. So knowing behaviors that are positive and negative for your voice to prevent thinking about vocal hygiene, which is healthy behaviors, so hydration and chronic throat clearing and all sorts of strategies that we give a person based on evidence to make sure that they don't strain or harm their voice.

Darshan

Oh, interesting. So I'm putting some disclaimers on there as a lawyer I feel bad if I don't put those on. So this is not clinical advice for anyone who's looking. Um, here's another question for you. I remember taking some music classes, and I wanted to learn how to train my voice. And I remember my teacher talking to me about using the my lungs and sort of placing the boys there. Is that similar to the types of things you do or is it Do they have a different goals therefore the result is a very different result.

Jessica

There's a lot of crossover with singing and you know, I do work with singers as well there's, you know, basic singing, voice rehabilitation so definitely the the same processes that we use to sing and oftentimes can be really helpful to teach speaking as well. You know, the, the process is the same you use your your diaphragm to support or use your ad muscles to support the diaphragm to help increase the pressure up into the the larynx, where it goes through the vocal cords and causes the vibrations and the voice. So basically are using that same kind of breath support and airflow to create the voice for singing. You're using the same kind of resonance so you're taught oftentimes to promote voice out in front of your face to project right so we use techniques and strategies to help train resonance. So it's oftentimes the same thing you're just applying it to speaking voice instead of singing voice. And, and it makes such a difference in how you sound whether you sound more professional or sound. You know To the listener pleasing to the listener. So it can be really important for the vocal health and stamina of how much you're talking or if you're projecting things like that.

Darshan

So the question I have is, this is something I thought off after we first spoke, I am semi addicted to Mountain Dew, and I love my mountain here. That's, that's my equivalent of whatever addictive substance you have. What I found myself at some point doing was I'd have so many of them that my voice would just go dry. And I couldn't speak. And essentially, I had to just stop it. Because if I didn't, I couldn't talk, or I would just start coughing. Is that a pathology or is that a stop drinking so much coffee there.

Jessica

So that would probably fell under the vocal hygiene part of the counseling that I do. So it's more of you know, caffeine, for example, can be dehydrating. If you're drinking more caffeine related drinks and not clear fluids and water, it can definitely cause you to have that dryness and the issues there. But the important thing to know is if you are chronically dry, and you're talking all the time, that can then lead to potential pathology down the road because your vocal cords vibrate together at least 100 times per second, on average. And it's a lot of friction in those tissues. And so if you're not well lubricated from, you know, drinking water and things like that, or you're depleted of that hydration, it can actually cause some of that really fast rubbing to cause more inflammation, and then it can lead to things like vocal nodules. You know, this is, of course, really kind of, you know, not to say you definitely will, but it's something that can happen if you're not careful. So if that answered your question.

Darshan

So here's a question for you. So, if you are a executive in any industry, but I'm going to become farmer, because that's what I'm talking about? Um, what are some good voice hygiene tips you give up?

Jessica

Definitely, um, hydration, let's start there is important thinking about drinking half your body weight and water, and ounces of water.

Say that again?

Darshan

What does that mean drinking half your body weight and water.

Jessica

So So of course, everyone knows the eight cups a day is that recommended dose, but what they really have started saying is, everybody is a different shape, everybody's a different size, different activity level, maybe you live in a different location and altitude. So making sure that you're adjusting your hydration to what you need. So when you take your body weight, you know, let's say a person weighs 100 pounds, you have that. So 50 ounces is what you'd want to drink. So it means drinking half of what you weigh in your body in ounces of water. In

Darshan

my case,

Jessica

you can do over the day, it doesn't have to be you know, all at once. So, okay. Hydration. Yeah.

Darshan

Is that the only one you also said, Get rid of caffeinated drinks.

Jessica

So yeah, so that kind of falls under hydration is just limiting your caffeine or or being conscious of alcohol, those kinds of things that can be dehydrating. But as far as vocal hygiene goes, there's a lot more and especially for an executive or someone who talks a lot. Vocal pacing or having this concept of a vocal budget, which we often use for singers can apply in the same in the same space. So thinking about how you're using your voice throughout the day, how much you're using it, pacing your voice, so that you have naps throughout the day, we call them vocal naps. So like 10 minute breaks of every hour of voice use, you know, just give yourself that time to just stop and to rest your voice or to pace your voice. So being creative in ways that you can offload the voice use that you are having throughout the day, whether it's sending emails instead of calling everyone or pre recording bits or things like that. But also that vocal budget idea being that you want to save your voice so that you can spend it later. So you know, maybe don't have a social lunch hour if you have a big presentation later in the day. So that you're making sure that you're you're resting your voice to have that stamina and have that power for later. Another big thing for professionals is if you are a public speaker or you're speaking to a group, even as small as 10 people, amplifying Your voice is super important wearing an amplifier an amplification, either a personal amplifier or using a PA system or something to just Make sure that you're not putting that extra effort on your voice to project across the room. And even if you can, this is a big one, because a lot of people say, Well, my voice is booming, it's loud, I don't need a microphone. Even if you can, it allows you to not put that extra load on your voice, which can save you so much effort and strain later on. So amplifying Your voice is another big hygiene. And also this idea of chronic throat clearing, this is a big one. So, of course volume, and excessive behaviors like shouting and yelling and things like that are important to minimize.

But

throat clearing is something that we do habitually A lot of times, or it may be something when we have allergies or whatever's going on. And we're you know, constantly, it becomes a habit and it actually is I liken it to a mosquito bite. When you get bitten by a mosquito bite and you scratch the itch, it just kind of facilitates a vicious cycle of more itchiness, right, more swelling. So when we clear our throat or have chronic cough, we're doing the same thing in our throat, we're facilitating every time this sort of slamming of the vocal cords. And this can be really, really impactful for your voice and for hoarseness, strain, vocal nodules or lesions down the road. So being really self aware of that, or you know, seeing someone like me and getting some strategies to reduce the or eliminate the chronic throat clearing. That's a big one too.

Darshan

Okay, so I'm going to sort of recap what we spoke about, we spoke about the fact that you've got a virtual voice practice, we talked about some of the the advantages of a virtual voice practice, we talked about some challenges associated with it, we then went into some of the tools that someone like you would have to to help people. We then spoke about how the type of advice you'd give, whether it's preventative or treatment, whether it's functional structural, depends on on the needs of the individual, and they can range of these individuals that can range anywhere from a teacher to a child to an executive. And you told me not as big as what Matthew did, he gave us some some voice hygiene tips. Everything from had I thought so my favorite ones were vocal maps and a vocal budget. I thought those were really interesting. Um, anything I've missed that you think I should have reiterated or I missed?

Jessica

I'm really just, you know, thinking about being proactive about your voice and just, you know, the voice is something that we tend to take for granted so often. And it's so so important to not only your livelihood potentially but but socially and emotionally and you know, people that I work with who who have lost that ability or regaining that ability it can be very cumbersome and and it can be a bit of a you know, hard work to get back to that place so being proactive and being preventive can be so so important in just the care of your voice and in vocal health.

Darshan

I'm just gonna where can people reach you

Jessica

so my my practice is called resonate voice and speech and you resonate voice and speech services and you can find me at ResonateVoiceAndSpeech.com. I have links to social media on there, I have my email address, which is Jessica at resonate voice and speech calm and phone number.

Darshan

Perfect. And you can find me at DarshanTalks.com or you can find me on Twitter at DarshanTalks. And Jessica and I are both eager to hear from you. So thank you so much. This was DarshanTalks, and Jessica, please come back soon.

Jessica

Thank you so much for having me.

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