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Ahem: Be Kind To Your Voice

Personal Business: HEALTH


For Gregg Marano, yelling is part of the job. A foreign-currency trader at M.W. Marshall in New York, he spends his days shouting orders over a cacophony of brokers and customers squawking through speakerphones. Last year, the vocal strain got to be too much. Most afternoons, Marano's throat was so sore he could hardly talk. "You don't realize you're abusing your voice until it starts to go," he says.

Fortunately, Marano, like so many who use their voices for a living, was able to get help. He went to Mt. Sinai Medical Center's Grabscheid Voice Center in New York (, one of about a dozen clinics in the U.S. specializing in voice disorders. There, he had surgery to remove what was essentially a callous on his vocal cords. He also learned techniques to prevent strain.

Although voice centers are known for treating performers, many of their patients come from the business world. Typical are trial attorneys, CEOs, and even politicians such as President Clinton, who is prone to hoarseness from allergies and too much time on the stump. The widespread use of cellular phones has added to patient rosters. "What used to be quiet time in the car or on the subway is now talk time," says Dr. Robert Ossoff, executive medical director of the Vanderbilt University Hospital Voice Center in Nashville ( The result of all that nonstop gabbing is a raspy voice that often breaks and the constant urge to clear the throat.THE SCALPEL? While these symptoms can also develop from allergies, infections, or tumors, they are most often due to voice abuse, says Dr. C.Richard Stasney, director of the Texas Voice Center in Houston. During speech, air passing through the larynx, or voice box, causes your vocal cords to flap together to create sound. Talking too much or incorrectly can inflame the vocal cords (also known as vocal folds). Severe strain can cause bleeding and blister-like nodules that in extreme situations may require corrective surgery. In most cases, though, the problem can be rectified by behavioral and vocal therapies. Costs for an initial evaluation range from $195 to $900, and are covered by many health insurance plans.

Your first step back to vocal health, doctors say, is to shut up now and then. Schedule voice recovery time by spacing out speaking engagements and alternating phone calls with paperwork. Also, drink lots of water because it keeps mucous in the throat thin and emollient. "Thin mucous is like hand lotion for the vocal folds," Stasney says.

Avoid dehydrating substances such as caffeine and alcohol. And stay away from antihistamines and decongestants that dry out mucous. Fatty foods and dairy products can provoke an oversupply of mucous, which is equally problematic. Smoking, of course, is anathema.

Another source of irritation is gastrointestinal reflux. This occurs when stomach acid backs up into the esophagus and creates a burning sensation. If the acid washes all the way up to the larynx, it can inflame the vocal folds and interfere with speech. To combat this, doctors advise eating small meals that are not too acidic or spicy. Leaving at least two hours between eating and bedtime can help. And above all, reduce stress, a prime cause of reflux.

Learning to use your voice properly is key to keeping it in good shape. Dr. Peak Woo, clinical director of Mt. Sinai's voice center, says businesspeople are prone to the "Bogart/Bacall syndrome." That's a tendency to reach for a lower pitch, or to shout, to sound authoritative. You don't have to strain your voice to make an impression. But to create a sound worth projecting, you need proper breath support. Linda Carroll, a New York speech pathologist, advises swimming and breathing exercises for respiratory strength. Posture is also important. "If you slump or your head and neck stick out, it creates a bottleneck for the passage of air," she says. So, to avoid vocal gridlock, straighten up and speak right.EDITED BY AMY DUNKINReturn to top

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