Voice Problems

Your voice is a powerful muscle, and sometimes it needs special care. Jaime Moore, M.D., an Ear, Nose & Throat Specialist, discusses how you can take care of your voice, and what to do when it needs a little TLC.



Jessica Noll: Your Voice is a powerful instrument and sometimes needs special care. Dr. Jaime Moore is an ear, nose and throat doctor with VCU Medical Center who specializes in voice disorders. She joins us this morning to share more. We appreciate you being with us Dr. Moore.

Dr. Moore: Well thank you for having me.

Jessica Noll: You specialize in voice disorders, swallowing and airway disorders.

Dr. Moore: Correct. Yes.

Jessica Noll: Are these things that a typical patient you would see maybe knows what they have? How do they ultimately discover there are issues there?

Dr. Moore: Typically they’ll notice some hoarseness or some pain with talking. A lot of our patients are professional voice users. That’s not just singers, but also professors who use their voice like lawyers, teachers, who have problems using their voice every day to kind of maintain their job. So those are the kind of people who come in when they start to have problems – like hoarseness and pain when speaking.

Jessica Noll: From time to time maybe we’ve all woken up with a horse voice, you know horse throat, and does clear up. Sometimes it can take longer than others. When do you know that it’s a problem that you need to seek further treatment for?

Dr. Moore: If you have sudden voice changes then I suggest you always come in to see us because it can be something serious like a vocal cord hemorrhage or tear and that requires medical management in that we tell you to do voice rest and potentially other things if you don’t get better. So in that case if you have a sudden voice change, particularly after something violent like coughing or yelling you should come in and see us immediately. Otherwise you can change your vocal hygiene, so hydration and control your reflux and those things a lot of times can make your voice better.

Jessica Noll: Dr. Moore, you mentioned that this can happen suddenly. Is that always the case? Or are these things an evolution? Is there a breakdown that leads to it.

Dr. Moore: Sometimes voice changes can be sudden. That can indicate something severe has happened, like a hemorrhage. But they can also be gradual. We see a lot of people with age related changes to their voice. As they get older their vocal cords atrophy and they start to lose volume and projection in their voice. They come in with a gradual change in their voice.

Jessica Noll: Interesting. And of course there are going to be mild cases and very severe cases. When you’re working with patients what should they expect if they’re on that mild end? And then what does the severe end look like?

Dr. Moore: If you come in and we find something severely wrong, most of the time we set you up to do either voice therapy or voice rest because we want to minimize any more trauma to the area. And then we send you to a voice speech language pathologist who works with you to improve your vocal hygiene and to minimize the damage that being done to the vocal folds. Even for mild cases we also do that, too. They can help you improve things to the point that you would never need any surgery or any other intervention.

Jessica Noll: So this isn’t something that you wake up and brush off and say “I’ll do a salt water gargle and that’s going to take care of things?”

Dr. Moore: Hopefully not. Hopefully you make your way in to see us.

Jessica Noll: You talked about swallowing and airway disorders. Are all of these related in the sense that one will lead to the other or are these specialties within that specialty that you cover?

Dr. Moore: Sometimes they are related and sometimes they aren’t. Sometimes they’re completely separate. For example if you have a vocal fold paralysis you might actually aspirate food and have swallowing problems in addition to having a weak voice.

Jessica Noll: We talked about this happening quickly. If you’re a parent, should you be watching this for your children/ Are you watching for yourself? If you have an aging parent, are you keeping a lookout for them?

Dr. Moore: Yeah. Anybody who needs their voice or starts to have problems using their voice should have it checked out.

Jessica Noll: All right, well, treatment can be achieved. How long should someone expect that this might take if it is in the severe category and they are going through treatment with the speech pathologist and everything?

Dr. Moore: It usually takes 6-8 sessions before we see that they’ve made an improvement, whether they’re going to get better or not or whether surgery would be needed at that point.

Jessica Noll: Very interesting. All right, so a specialist in ear, nose and throat. You’re seeing a lot of people this time of year, I’m sure, where allergies are impacting the way they sound. That can be a temporary thing. Or can it bring on a long term problem?

Dr. Moore: Some people have environmental allergies, where it’s dust and mold, so they can have that chronic irritant throughout the year. Or it can be a seasonal in nature. Either way it can bother you and bother your voice.

Jessica Noll: Best to get it checked out. Thank you for being with us. Connect with Dr. Moore by logging onto vcu.edu/ent or by calling 323-0830. The office is located at 8700 Stony Point Parkway, Ste 220 in Richmond.

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Contact Jaime E. Moore, M.D.

VCU Health Systems - Stony Point
9109 Stony Point Drive, Suite 1200
Richmond, VA 23235
Phone: (804) 323-0830 
Fax: (804) 327-8076

VCU Medical Center - Nelson Clinic
401 North 11th Street
Richmond, VA 23219
Phone: (804) 628-4368
Fax: (804) 828-8299

VCU Medical Center Department of Otolaryngology