Sunday, August 12, 2018

Bilateral vocal cord nodules

To maintain a normal and pleasant voice adhere to the following instructions:

1. Do not neglect any kind of throat infection or irritation.  Get immediate advice from your ENT doctor.  Speak sparingly during a cold and sore throat.

2. Do not misuse your voice by shouting, talking constantly for hours together or speaking in whispers (children should be checked particularly for howling and shouting while playing).  Do not lecture for more than 45 minutes approx. at a stretch.

3. Do not take very hot and very cold drinks simultaneously.

4. Avoid liberal use of condiments and spices in your food.

5. Avoid smoking, chewing of tobacco, betel etc.

6. Avoid, if possible, dusty and smoky environment like busy traffic intersections, bus terminals, fairs etc.

7. Use a moist duster to rub the blackboard.  Teachers should avoid speaking and writing simultaneously on the blackboard with a chalk. A wet chalk is better to write with.

8. Do not allow your throat to get dried up while speaking at a stretch, take a sip of water in between to moisten your throat.

9. Do not clear throat all the time by coughing, grunting or hawking.

10. For any type of throat infection or irritation do warm saline gargles in the morning and at bedtime.

11. Keep your head and neck erect while speaking.  Do not extend the neck or tilt your head in a backward position while speaking.

12. Do not strain to speak loudly.  Observe in the mirror that your neck muscles are not tensed up and that your veins do not become prominent.

13. Do the following exercise to keep yourself relaxed while speaking:
 (i)  Head and neck exercise: Rotate your head slowly towards your left and right shoulders alternately about 15 - 20 times daily
 (ii)  Breathing exercises:
      (a)    In order to breathe in and breathe out freely, hold the head straight, the shoulders thrown back without stiffness and chest forward, raise the chest by a slow and regular movement and draw in the stomach and then release the breathe gradually.
      (b)    Assume an easy standing position without any support, weight on the feet, chin in, chest up though not held rigid.  Place the hands across the stomach with fingertips touching at the centre. Breathe easily and quietly feeling the expansion of the chest remains passive and relaxed.
      (c)    Sit erect in a chair, place your hands on the sides of your chest at the lower edge, with fingers towards the front and thumbs towards the back.  Blow out as much air as possible, squeezing inwards with your hands as you do.  Now inhale rapidly, taking in as much air as possible and expanding your chest as you take in it.  Then exhale slowly, forcing the air out with steady contraction.  Follow this movement with your hands.  Remember to expand when you inhale and contract when you exhale.  Repeat 10-12 times without stopping.
 (iii)  Select out any passage from the book and read it in front of a mirror (keep pt. no. 12 in mind).  If you feel tension in your throat, you are not producing your voice properly.  Try to speak in such a way that you do not feel any strain in the throat.  Read for 15 min. a day.
 (iv)  Blow in a foot ball bladder to fill it up with air.  Repeat this 10 times every day.

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