Dr. Jahn answers questions about throat health and the voice.
What’s the Safest Way to Clear My Throat?
Dr. Jahn,
So what’s the deal about clearing an itchy throat? I’ve heard that its “bad” to clear your throat with an “Ahem!” Is that really true? – Allan
Dear Allan,
Occasional throat clearing, used to dislodge mucus from the throat or vocal folds, is not harmful. When throat clearing becomes habitual, however, there is a concern that forcefully grinding the vocal folds together may cause some damage. This damage is usually not on the soft membranous part of the vocal folds (the part that vibrates with singing), but toward the back, where the folds consist of a thin membrane covering firm cartilage. Excessive rubbing here can damage the mucous membrane and expose the cartilage, causing irritation, pain and inflammatory tissue formation.
I would suggest that you try to find out why you need to habitually clear your throat – allergies, reflux, or a nervous habit? Consider food sensitivities – especially a dairy allergy – or excessive sweets. Any of these may cause mucus to thicken and adhere to your vocal folds. Then, by addressing the various possible causes, you may be able to get rid of potentially harmful chronic clearing.
Seeking a Magical Cure for My Throat Infection
Dear Doctor Jahn,
I haven’t been sick for years! I don’t have time to be: I gig 6 nights a week! But here I am with a temperature (102), sore throat, stuck in bed for the second day. I want an instant cure! Short of that, tell me the quickest way I can get through this and back up on stage!! – Janine
Dear Janine,
No matter what great health you enjoy, you will inevitably occasionally get sick. So if you gig six nights a week and haven’t been sick for years, isn’t it time that you were? I mean, you need to cut yourself a bit of slack. Fever is not the illness, but it is your immune system’s response to a bacterial or viral invader. So if you get a fever, especially a brief episode, it is just a sign that your Immune system Is doing a good job – it is raising your body temperature to make the environment too hot for those bugs.
My suggestion is to not ignore or suppress your symptoms just to get back on stage, but rather that you support your body in the war effort by resting, drinking lots of water and taking Vitamin C
– at least 1000 mg a day, which you can increase to 4000 mg a day while you’re sick.
Your illness sounds like an acute bacterial infection, so you may also consider antibiotics if you’re not getting better on your own within 3-4 days.
More importantly, once this episode is gone, consider on-going preventive methods, including regular exercise, vitamins, a healthy diet and adequate rest. Can you get on stage and perform with a raging fever? You could, by dosing up on aspirin and other drugs. But unless you’re doing it to get through an un-cancellable career-defining performance opportunity, why would you? You’re
short-changing your body and undermining your general health by doing so.
Have Throat Germs Travelled Down to my Voice?
Dear Doctor Jahn,
I was diagnosed with strep throat about two weeks ago. The sore throat was gone after about five days on antibiotics, and after one week, I started singing again. I was hoarse from the start. I stopped and tried again one week later. Again, I was hoarse after about 15 minutes.
I’ve always had a very healthy voice. Can strep affect the vocal cords? I’m worried I might have done damage. – Petra
Dear Petra,
Normally strep should not affect the vocal cords. If you had a strep infection of the larynx, you would have much more severe symptoms, so this is not due to the strep. It is however possible that if you were singing with an infected throat, you were straining to phonate and this muscled type of phonation has persisted now that the infection is gone. I would have your larynx examined and then work on singing without tension and with as much support as you can.
How to Treat Freshman’s Flu
Dear Doctor Jahn,
My daughter is studying voice and is a freshman this year. She just got sick and it looks like she has a common cold (sneezing, coughing, and her throat hurts). She went to Health Services on campus. She doesn’t have strep (she had a test done) and the doctor thinks it is a cold. The doctor suggested she take Sudafed and told her she should not take Nyquil or Dayquil as it will affect her vocal cords. Also, he told her that she should not take Echinacea or Airborne, as she is already sick and it will only poison her body. Is he correct? What over-the-counter medication could you recommend in the situation of the common cold? I appreciate your advice very much. – Lisa
Dear Lisa,
I wonder about the medical advice your daughter received. I happen to like Airborne—it is a combination of vitamins and antioxidants that, from personal experience, can shorten a cold. I am particularly puzzled by the doctor’s choice of words: “poisoned” seems rather harsh when you’re talking about Vitamin C!
Here are some of the measures your”daug’ter can take. To avoid a cold, she should take vitamins daily, especially during cold season. This includes a multivitamin and vitamin C, 1,000 mg. a day. She needs to get enough rest, eat well, and in general maintain her immune system. When she feels a cold starting, I suggest increasing vitamin C to 4,000 mg. a day in divided doses, as well as using Zicam nasal swabs. Zinc, as nasal swabs or tablets, has been shown to reduce the duration, severity, and infectivity of rhinoviruses. She of course needs to stay warm and drink plenty of fluids when a cold starts. Rest also is important— you should not exercise in an attempt to drive the cold out.
The only possible problem with Dayquil or Nyquil Is that they contain antihistamines, which are drying to the vocal cords—a temporary and harmless side effect.
Consider also that the strep test does not rule out any of several other bacteria that can cause a throat infection. If she is coughing or blowing out colored mucus, I would consider treatment with antibiotics, regardless of the strep test.
