The Dr. Is In: On the Road and Singing

Touring and traveling for singing can be fraught with problems for singers’ health. Read on for tips and tricks for staying healthy on the road.

 

Whether you are a singer or an instrumentalist, traveling for work is a task you are likely to face. Whether you travel to study or are on tour as part of a company, you have put yourself on a different schedule while you are away from your normal and comfortable environment. 

This past summer, I had a little personal insight into what such an undertaking involves. In early July, my colleague Dr. Jenny Cho and I accompanied the Metropolitan Opera orchestra and several singer soloists on their tour to Europe, a tightly scheduled affair that visited three countries in 10 days with performances on most evenings. While we had done tours with the Met years ago to Japan, this recent experience gave us a renewed understanding of what singing (and playing) on tour involves.

One issue common to all intercontinental musical travelers is jet lag. Depending on your schedule, you might have a couple of days to adjust to the new time, or you may need to perform sooner. Jet lag affects some more than others and is worse when traveling east (when you lose time) than west (when you gain it). Also (spoiler alert!) it seems to last longer as we get older. Jet lag is more than sleep deprivation: our hormones are also on a diurnal cycle and need to recalibrate for complete adjustment to the new time. Headaches, reflux, and difficulty concentrating are just some of the symptoms that can accompany jet lag.

If you suffer from jet lag, there are several steps you can take. First, a day or two before you leave, try to get on your new time. For example, if you are going from the U.S. to Europe, try both going to bed earlier and getting up earlier. Once you arrive, you should spend as much time in the sunlight as possible—sunlight affects your melatonin production and regulates your wake-sleep cycle. A brief catch-up nap can be helpful, but force yourself into the local day-night schedule as soon as possible. 

Know that the ambient noise level on the airplane can hit 80 or more decibels. And the best way to conserve your voice and avoid laryngeal strain is to not talk while flying. If you travel frequently, investing in noise-cancellation headphones is a good idea: just being exposed to higher environmental noise can reflexively raise the tension in the vocal muscles.

And, speaking of muscle tension, consider what you’re packing. While carrying everything with you may avoid lost luggage, the excess weight of a heavy backpack or overloaded carry-on will increase tension in your neck and upper back. For singers, this can translate into raised muscle tension in the vocal apparatus. If you absolutely have to overpack and avoid checked luggage, consider getting a massage at your destination to relieve residual tension prior to singing.

Hydration is always important for singers, and especially when traveling. Airplanes are dry—and especially when your travel also includes off-the-path destinations, trains, and buses, where to get your next bottle of potable water is potentially an issue. Inadequate hydration not only impacts your voice but generally impairs your body’s ability to clear toxins. Travel in an increasingly warmer world is a sweaty business, so be aware of additionally replacing your discernable water loss. Collapsible water containers (they look like plastic IV bags) take up less room in your backpack and are worth considering.

Good nutrition when touring is a significant topic. While most of us like to try new foods and restaurants, be sure that you get enough fresh fruits and vegetables, ideally washed in clean water. Most singers prefer to not eat before performing, but eating opportunities after the performance may be limited. For example, in London, hotel restaurants close by 9:30 p.m. and outside eateries stop serving food by 10:30 p.m.—which, in our case, was before we left the theatre. 

Fresh food options may be generally limited, and backstage snacks (usually cookies and chips) followed by alcoholic drinks after the show are not the ideal diet. So, bringing some food with you as you travel is recommended. An apple or an orange, or even a sandwich you make at breakfast or lunch, take up little room in your backpack. Your stomach and not the clock should be your guide, so healthy snacking is the answer. When it comes to planning your next meal, you should always have a plan B.

A somewhat neglected aspect of traveling is your bathroom routine. With jet lag and a restrictive schedule, you may not have the option to “go” according to your usual habit. While traveler’s diarrhea gets lots of press, with advice such as avoiding street food and dubious drinking water, traveler’s constipation can also be a problem. Irregular eating times, inadequate hydration, and living on low-bulk fast foods and snacks can also contribute. In this regard, eating adequate roughage, drinking lots of clean water, and taking time to use the bathroom is advisable—and if there is concern about the purity of local water, remember to also avoid ice cubes in your drinks.

Traveling to a significantly different time zone is also a stress to the immune system, leaving you more prone to airborne infections. While the COVID emergency is now officially over, sitting next to potentially infected strangers is still a concern. Even if fully vaccinated, you may catch the virus, although your symptoms will be much milder. Wearing a mask when traveling has become a personal choice, but you should seriously consider doing so—especially on a bus or plane or while waiting in line at the airport. You may also consider packing a COVID test kit in your luggage, since even a mild infection puts your fellow performers at risk. 

Along the same lines, you should always bring your personal medications in your carry-on bag, along with a supply of OTC meds for possible reflux, colds, etc. I will often give patients a week’s supply of antibiotics to take on the trip, “just in case.” Remember, your home doctor cannot call in medications for you when you are in France or Japan!

Much of what has been covered here is old news to the seasoned traveler, but if you travel to perform only occasionally, it is good to know how to prepare. Simply put, to function optimally in any new environment, you need to be as “self-contained” (i.e., self-sufficient) as possible.

 

Dr. Anthony F. Jahn is a New York-based ear, nose, and throat physician with special expertise in ear and voice disorders. He has a 40-year association with the Metropolitan Opera and is medical consultant to several music schools in the tristate area. Dr. Jahn is professor of clinical otolaryngology at Mount Sinai School of Medicine and the author of over 100 publications, including The Singer’s Guide to Complete Health. He lectures internationally on ear- and voice-related disorders.

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.