A month before L’elisir d’amore staging rehearsals were set to start, first-year master’s student Alize Rozsnyai, 23, was told she would soon need surgery.
Concerned about her health but also about how surgery might affect her ability to rehearse or even perform the role of Adina, Rozsnyai weighed her options. The laparoscopic surgery—also known as minimally invasive surgery because it involves a smaller incision—would remove a 9.5 cm ovarian cyst, but there was a chance of needing to switch to open surgery given the cyst’s size.
She wasn’t experiencing any pain, so one possibility was to wait until her rehearsal, performance, and audition schedule lightened up. But, she says, she is booked pretty consistently until at least the spring, so it is impossible to count on that.
“The risks of waiting are scary to me because what if it were to burst or rupture during an audition or opening night?” Rozsnyai says. “No time for this surgery would be ideal.”
Her surgeon said that to reduce risk of the area hemorrhaging, she would need to avoid abdominal activity, including singing, for about two weeks after surgery.
Rozsnyai sought the advice of peers as well as singing and health professionals. She decided to put her health first and set the surgery for October 3. She caught a cold, and the surgery had to be postponed until October 9, further increasing the likelihood that her recovery period would cut into valuable rehearsal time.
“I’ll do my best to work with it—and, worst case scenario, I will have gotten this role into my voice and learned. Since I am in school, that’s the whole point anyway,” she says.
Preparing for Surgery
Dr. Anthony Jahn, professor of otolaryngology at Columbia University College of Physicians and Surgeons, says the surgeon should be told about the needs of a singer. “Surgeons should be aware of what you do when you sing—not just about your larynx, but also your abdominal and pelvic support needs,” he says.
Communicating with the surgeon and anesthesiologist about those needs could pay off, he says. They may be able to offer alternative surgical or anesthesia methods to accommodate a singer’s needs. “If, in considering their approach, there is a choice between cutting through muscles or retracting them, opt for the less radical method,” he says. “With the anesthesiologist, discuss your concerns about possible trauma to the larynx. If the procedure can be done with local or regional anesthesia, that may be a good option. If general anesthesia is needed, ask about using a laryngeal mask—this covers the larynx and lessens the possibility of trauma to the vocal folds.”
Vocal Surgeries
Chuck Chandler, assistant professor of voice and director of undergraduate pedagogy at Florida State University, has completed levels I and II (of three levels) of Singing Voice Specialist training with Dr. Karen Wicklund.
“SVS training reinforces vocal pedagogy and voice science emphasizing physiology as it relates to disorders, then equips Singing Voice Specialists to help optimize professionals’ voice use in singing,” Chandler says. “Think of it like a voice teacher with a specialty in how voices function when they are irregular.”
Given the specific knowledge and skills an SVS can offer to a post-surgery singer, Chandler says he recommends contacting an SVS.
“Voice professionals undergoing voice-specific surgeries need to have a carefully chosen, highly qualified and caring team to get them through the process,” he says. “An SVS will become a significant part of the post-surgery team, so getting hooked up with an SVS prior to surgery can help establish a baseline and rapport and can equip the voice professional with what to expect from the SVS perspective.”
Recovery time depends on the patient as well as on the specific surgery the singer has undergone but, Jahn says, “After vocal fold surgery, I typically put patients on full voice rest for at least a week and not have them back to full performing capacity for a month.”
Nonvocal Surgeries
Singers undergoing nonvocal surgeries, particularly ones that affect parts of the body involved in vocal production, must take just as much care. Regardless of type of surgery, in fact, Jahn recommends patients who receive general anesthesia “wait a week before vocalizing to allow the edema from intubation or instrumentation of the pharynx (laryngeal mask) to resolve.”
He says singers could speak with their surgeon to see if there are ways to reduce recovery time or to at least keep certain areas of the body from getting out of shape. Specifically, singers could ask about ways to “strengthen your muscles during convalescence to hasten recovery. This also applies to rehabilitation after bariatric surgery: rapid weight loss will diminish your support, and you need to tighten and strengthen abdominal muscles to recover control,” he says. “Kegel exercises are useful to strengthen the pelvic floor, and you may want to discuss this following gynecologic procedures.”
Two chapters in The Singer’s Guide to Complete Health, edited by Dr. Jahn, are about obesity and bariatric surgery. In “Little Black Dress, Part 2: A Singer’s Perspective on Bariatric Surgery,” the chapter’s writer, dramatic soprano Ory Brown, says she “was in the hospital for three days; I was quite sore for about a week but within the week was off all pain medications.
“Initially my energy was somewhat sapped from the surgery,” she writes, “but I was able to go back to the gym within three weeks. I was back to light singing within 10 days.”
Recovery
Fewer than 12 hours after her surgery was completed, Rozsnyai said she was feeling great, considering the circumstances. “The pain is already manageable so far with only Motrin, but I also have Percocet if I need it.”
To test how much singing would work out the abdominal area affected by surgery, Rozsnyai moved her “stomach rapidly like a staccato passage” and also coughed before surgery. The doctor felt the difference between the activities and “said the cough was actually more violent usage” of her muscles. Rozsnyai said her doctor told her she may even be able to get back to singing within a week to 10 days.
The surgeon was able to complete laparoscopic surgery as planned, leaving Rozsnyai with just four small incisions in the lower abdominal area. The largest incision was no longer than 1.5 cm, she said. The anesthesiologist also used the smallest possible tube with a laryngeal mask, Rozsnyai thought, but she couldn’t be sure given her state at that time.
“My voice was all there when I woke up, other than a slight sore throat, and I’ve even hummed since,” she says. At press time she had not gotten back to singing but was hopeful to be recovered in plenty of time to perform Adina during the fourth weekend of November.
For more information about anesthesia, facial plastic surgery, laryngeal surgery, and bariatric surgery and how these affect singers, read The Singer’s Guide to Complete Health (see complete review on p. 58). First and foremost, though, consult with your doctor.
