Patient Testimonials : Lisa Paige Wheeler

Lisa Paige Wheeler

I have had issues with my voice since college and even before then, but didn’t realize it was an issue when I was younger. Throughout my life I was a cheerleader, singer, actress and just loved to talk! If I ever overused my voice I would lose it and it would become raspy or my throat would hurt, but it would always go back to my normal Minnie Mouse, high-pitched sounding voice after a day or so.

Then I went to college and my social life transitioned to drinking alcohol and being in loud, smoky environments like bars, clubs, house parties, sorority functions, etc. I was also training to be a teacher and had to use my voice more than usual. On top of it all, I had developed a liking for spicy foods around my senior year. All of these factors I didn’t realize could affect my voice; although I was noticing my voice getting deeper but I assumed that was due to growing older.

After graduation I became a substitute teacher. Within a few months of subbing I remember a student saying, “Wow, Ms. Wheeler, your voice sounds different!” I couldn’t believe that the student noticed the change in my voice after a few months of not being in college and not partaking in as many social gatherings; however, being a substitute still caused me to use my voice more often than usual. I then became a preschool teacher and later a faculty member for FSU under the Florida Center for Reading Research (FCRR). At FCRR I would write curriculums for elementary school children and had to test them out in classrooms with students that were not my full-time students. All of those teaching environments were not conducive for helping me to preserve my voice, let’s just say.

It wasn’t until someone pointed out to me that I would always clear my throat all the time that maybe there was a real issue with my throat region. When I consulted my speech pathology friends about it they said that maybe I was producing mucus in my throat as a result of eating certain foods or consuming certain beverages and how constantly clearing my throat could be harmful to my vocal cords. They also pointed out that it was not good for my vocal cords to lose my voice all the time and to sound as raspy as I did. They expressed that I could potentially have polyps or nodules. I went from sounding like Minnie Mouse to sounding like Lindsay Lohan or for the older generation, Joan Rivers overtime. Yet I still didn’t see a professional at this time.

I left the teaching world when I moved back to South Florida and joined the corporate business world. Many times, employers assumed I was partying every night because of my raspy voice; it was very frustrating, especially when that wasn’t the case. My speech pathology friends continued to remind me that it wasn’t normal to constantly have a raspy voice and they made a point that I needed to see a doctor. I had also read an article about Adele, the famous singer who needed vocal cord surgery because she had developed a polyp (http://www.cbsnews.com/news/adele-opens-up-about-vocal-cord-surgery/). The article made me think twice about the condition of my voice and how I should seriously think about getting my vocal cords checked out.

I decided to do some research online about vocal cord doctors and vocal therapy. I came across an article on the UHealth website about a doctor helping a patient get their voice back (http://med.miami.edu/news/on-world-voice-day-patient-celebrates-his-voice-and-the-um-doctor-who-resto). At the time I didn’t think that was possible. I was starting to get into acting again and really wanted to repair my singing and speaking voice. I am also a partner now in my marketing and events company and have to go to a lot of loud, social settings again. My voice was getting to the point where it was painful to talk most of the time, so I decided to seek treatment and made an appointment with Dr. Rosow.

Diagnosis

During my initial appointment I felt very reassured that I was in safe hands because there was a vocal therapist present, Dr. Rosow and also three med students. They were all very nice and answered all of my questions. Dr. Rosow diagnosed me with Silent Reflux (LPR) and he noticed that the one side of my vocal cords had scar tissue forming as well. All of which I learned can cause serious damage to my vocal cords and the quality of my voice; therefore, he gave me a list of foods and beverages to eat and to avoid on the “Reflux Treatment Plan”, prescribed me Omeprazole and Tums/Antacids and referred me to vocal therapy.

During Treatment

At my first vocal therapy appointment with Justine Allen I really enjoyed Justine’s enthusiasm for treating my voice. We started off with voice exercises and she taught me to use my diaphragm and frontal tone while doing them. We decided that it was best for me to come once a week and Justine called it “vocal therapy boot camp”. I loved that she made vocal therapy fun and that she was very confident that I was going to be able to overcome my voice issues with practice and self-awareness. She sent me home with a few homework assignments, which was to do my voice exercises twice a day and to find the book “Dropping Acid” to help me with my reflux issues. She also encouraged me to continue doing yoga because when people strain their vocal cords they develop tension in their shoulders and neck, which in turn can worsen the quality of their voice.

Every week Justine would ask me how I was doing on the off days. If I didn’t complete my take-home assignments she would help me figure out other creative ways to get the same results. For instance, at first I had a hard time memorizing my voice exercises and that caused me to not do them everyday. When I expressed that to her we came up with a solution, which was to record my session so that I could replay it whenever I practiced at home. I also expressed to her that my boyfriend didn’t understand the point of me going to therapy and assumed it wouldn’t fix my voice issues. He also would laugh every time I did my exercises in front of him and therefore I was embarrassed to do them. Justine suggested that I bring him to a session so that she could teach him about the importance of vocal therapy and he could see that it wasn’t just me making “silly noises”, according to him.

I later admitted that I wasn’t doing my voice exercises twice a day and she helped me to set realistic goals. We decided that if I could do them once a day then that would suffice. Another suggestion she provided was to put a post-it on my computer to remind me everyday to do the voice exercises. Although it definitely helped to bring my boyfriend to a session I was still self-conscious to do the exercises around him, so the post-it idea still didn’t work for me unfortunately. Justine suggested that I try doing them in the shower and that the steam would actually help my voice. Since the idea of using a post-it on my computer didn’t work, she suggested that I write a note on my shampoo bottle and that did the trick.

Once I perfected the voice exercises, Justine pointed out that I was using a Glottal Fry or Vocal Fry voice where I would let my voice drop at the end of a sentence to a lower vocal register. She showed me articles and videos to educate me on the subject and to teach me the harms of using that type of voice. I realized I developed it while growing up in Boca Raton where majority of the women, and even men, would use what they call a “Jappy” voice (“JAP” is short for “Jewish American Princess”), which I noticed mimics the Glottal Fry voice samples in the videos we watched. I was the token Catholic in a sea of Jewish Long Islanders in my schools growing up and therefore I ended up adopting their dialect, which I admired and wanted to emulate. Who knew that using such a voice could cause damage to your vocal cords?

Justine also showed me a Huffington Post article about how the famous Kim Kardashian uses Vocal Fry and how majority of young women in America are using it. The article spoke about how people may look at you as “less competent, less educated and less trustworthy and less hirable”, according to a study conducted by Florida Atlantic University (http://www.huffingtonpost.com/2014/10/31/vocal-fry_n_6082220.html). That really struck home to me because that would happen to me sometimes with previous professors, employers, friends and colleagues throughout my life. I also came to the realization that since college I started to lower my voice while speaking to men because I noticed they didn’t look at me as being too girly and they would open up to me more than other women. I didn’t know that by doing so I was causing serious damage to my vocal cords so I had to find a happy medium.

To correct using Glottal Fry, at first Justine would have me read pamphlets out loud so I could practice using my frontal tone voice. We would record myself reading each week and reflect on the differences. After I perfected reading we moved into acting. To help me be aware of using Glottal Fry while acting and having conversations with others, Justine suggested I wear a hair tie on my wrist and snap it whenever I dropped my voice like Pavlov’s Classical Conditioning method. I had a hard time practicing that method because I would forget to wear it. Justine would always encourage me each week to keep trying to use it on a regular basis. She would even call nurses in to have a conversation with me so that I could practice using my frontal tone voice and the hair tie method at the same time, which really helped.

Justine and I noticed that I would start to use code switching where I would use my Glottal Fry voice with people I was comfortable with and I would use my frontal tone more with strangers. She suggested that I let my friends and family know that I was using the hair tie method and to let them know when I was trying to practice my frontal tone voice on the phone with them so that I could be aware of it. The more I practiced and became aware, the more I naturally started using my frontal tone voice. For once, I started to feel like I could actually get my voice back and working properly.

As for my reflux situation, my vocal therapy sessions landed right in the middle of football season. As much as I wanted to be healthy on the weekends and not have alcohol or eat bad food, it was hard to avoid them. Justine suggested that I make sure I use antacids and my prescriptions that Dr. Rosow prescribed and to stay away from the “avoid” list on the “Reflux Treatment Plan” as much as possible. It took a while for the omeprazole and the antacids to fully work but each week I would have less mucus forming in my throat. Running a business I’d find myself working late and eating late. I battled with always having to lie down after eating dinner because it was already bedtime by the time I ate. Justine suggested that I raise my pillows or buy a special one that helps with sitting up at night. She always came up with a solution and it always seemed to help remedy every situation.

The Final Verdict

I was nervous going to my check-up appointment with Dr. Rosow only because majority of my therapy sessions were during football season and that’s the hardest time of year for me to not overuse my voice, not eat unhealthy foods and not drink on the weekends; however Justine’s and Dr. Rosow’s methods seemed to have worked because my vocal cords went from being inflamed and red to pearly white over 3-4 months. The scar tissue on the one side of my vocal cord also went down immensely. I was so elated and so were the doctors!

The next day Justine and I met for a follow-up appointment. She was so excited that I felt like I had won an award; it was a great feeling. We decided that I had graduated vocal therapy boot camp and Justine helped me come up with a list of “SMART Voice Goals” to help me in the future if my voice ever became raspy again (Smart, Measurable, Attainable, Reachable, Testable Goals by Dr. Ana Flavia – See attachment of our plan). The goals were as follows: start vocal exercises again, practice having at least one conversation a day without using Glottal Fry and only using my frontal tone voice, avoiding alcohol and spicy foods, and reducing tension and stress by going to yoga class more. All of these goals I still use to this day to avoid going back to a raspy voice.

Overall, I was very impressed with Justine. She was very knowledgeable about vocal therapy and the latest research. She was also great about taking notes each session to monitor my progress. We would go over her notes at the beginning and end of each session, discuss the differences and growths and decide which areas I needed to work on the most. We would also use my phone to record my voice most sessions and that helped immensely for me to realize how much progress I was really making. Her best quality was that she was very good about praising me when I did a vocal therapy exercise correctly and that made me want to try harder.

Everyone in the office was so pleasant and the nurses were all great too. The receptionist would even greet me by name each week and that made me feel like everyone at UHealth really cared about my health and well-being. I would recommend anyone to Justine, Dr. Rosow and UHealth. World Voice Day is December 15 and I am happy to say on this date that I have a voice again! Thank you!