On the Road Again : Six Tips for Caring for the Voice on the Road


A couple of years ago my wife and I visited Santa Fe, and naturally went to the opera. We saw a production of Don Giovanni at Santa Fe Opera’s spectacular outdoor theater, which sits in the middle of the New Mexican desert. As a music lover, I enjoyed a first-class performance. As a laryngologist, however, I could not help but sympathize with the singers. First, the location was dry and geographically at significant elevation. The lack of moisture and oxygen significantly impaired the singers’ ability to sing slowly and to sustain long lines. Second, the performance couldn’t begin until after sunset–9 p.m. local time. With the three-hour time change from New York, cast members who had flown in from the East Coast were in fact starting Don Giovanni, not the shortest opera by any means, at 12 midnight by their biological clocks!

Summer festivals are a boon to musicians of every kind, as they provide employment in the off-season and often provide an opportunity to try unusual repertoire, work with different ensembles and directors, and even to give a young singer a first break into the professional milieu. But precisely because you are away from your usual environment, you need to prepare for the expedition.

#1 The time change may be a more significant stress to the body than you think. If you are crossing more than one time zone, be sure to arrive a day or two before you need to perform. The ideal rule of thumb (alas, usually not possible) is to be there one day for each hour of time change before your performance. While most New York singers cannot arrive in Europe five days before their first performance, you nonetheless need to take time change seriously. Your biological clock (mostly referring to the ebb and flow of various hormones) needs to reset. As soon as you arrive, force yourself to follow local time. Spend a lot of time out in sunny weather, since this resets your pineal gland and adjusts the secretion of melatonin.

#2 Elevation is another important factor. Oxygen is thin at higher elevations, and you may not get enough to function normally. This can cause headaches, fatigue, palpitations, and vocal difficulties. The problem is compounded if you are slightly anemic–not a rare situation among women with heavy periods or on iron-poor fad diets. If you have a tendency toward anemia, work on this with your physician. You may need to take an iron supplement or change your diet.

#3 Being away from home also means being away from your physician. I have had several patients who have been over-treated by well-meaning local doctors for apparent abnormalities of the larynx. One of my patients, a basso, received treatment for an “inflamed larynx,” since the local doctor did not appreciate that a basso’s vocal folds are not uncommonly a bit pink. It would be useful to carry a photograph depicting your vocal folds in their normal state, which your local emergency physician can look at for convenience. You should also carry your own laryngologist’s phone number with you so that he or she may be consulted in an emergency.

#4 If there is no reliable local medical help available, an emergency medical kit may be useful. Before you leave on your trip, ask your laryngologist to give you a prescription for emergency medications (antibiotics, antihistamines, steroids, etc.), and take these medications with you. You should always call the doctor before you take anything, but at least you won’t have to waste time and money looking for a local clinic or pharmacy.

#5 Be aware that different climates may mean different allergies, either to foods or inhalants. The flora is quite different in Florida vs. New York, and your latent allergies or asthma may kick in. If things are blooming, you may consider spending more time in an air-conditioned hotel room and less time jogging through the woods. Allergens are worse in dry, windy weather, when pollen is blown far and wide. Saline nasal spray is a useful way to wash away allergens, and you should use this frequently.

#6 Finally, keep your diet constant. If you sample local delicacies, try to determine what they contain. This can be difficult–two years ago, on the Met tour to Japan, several people became ill from the high salt and MSG contents of Japanese restaurant fare. Fresh meats and fish, lots of fruits, salads, and vegetables are often safer (although more boring) than exotic spices and sauces. Drink lots of water to keep hydrated and to dilute any potentially harmful substances you may have ingested.

Now, if you can keep all this in mind and still sing “La ci darem la mano,” you’re off to a great summer adventure.

Anthony Jahn, M.D.

Anthony Jahn M.D. is an otolaryngologist with a subspecialty interest in ear diseases, disorders of hearing and balance, and disorders of the voice. He is a professor of clinical otolaryngology at Mount Sinai School of Medicine and is the noted author of Care of the Professional Voice. For more resources, go to his website www.earandvoicedoctor.com.