Everywhere you go, people are screaming over the crowd at the bar, talking way too loudly into their mobile phone in a crowded area or while they’re driving down the road, or yelling at their kids. That list goes on and on. What that means is that people are not recognizing that there are limits to what their voices can do and that there is damage they can do to their vocal cords if they don’t take care. (Michael M. Johns III, M.D., Emory Voice Center)

As a clinical speech pathologist and voice specialist, I travel around the state, frequently having conversations and giving lectures regarding vocal health to various individuals and groups, ranging from small community groups to large state-wide conventions.  What I have found is that most people don’t often think about what it would be like to live without our voices…that is, until they’re silenced or won’t work easily anymore.  Movie goers who have seen “The King’s Speech” know what can happen to our voices when we are hampered by fear or low self-esteem. But the ability to create the magic of sound and communication can also be impaired — or even totally lost — by smoking, drinking, chronic cough, hoarseness, aging, and illnesses such as head and neck cancer and disorders of the vocal folds.

To address these voice issues in central Indiana, which have likely affected someone you know, we began Performance Voice Solutions, the vocal rehabilitation division of Northside ENT, Inc.  I work with the physicians of Northside ENT daily to find the best solutions for our voice patients, whether that includes therapy, surgery, medications, or some combination of the above, in order to return them as soon as possible to their life.  Often, we are happy to say, our patients comment that their voices are better now than they ever were before.

I also work with physicians all over the Central Indiana, in their attempts to help their patients regain their voice.  Listen to that again.  We help people find a voice, their voice.  Our voices are so much more than our ability to phonate, yes? They are the way we say “I love you”, or “please” and “thank you”, and sometimes, the ability to say “No, you can’t do that anymore”.

At Performance Voice Solutions we care for performing singers, actors, and other professional voice users, as well as any person with hoarseness, throat pain or irritation, vocal fatigue, or difficulty breathing.  That often means we help people get back to their favorite athletic endeavors, back to the stage or back to reading bed time stories to their children and grandchildren.

Photo © www.yorku.ca

The goal of World Voice Day is to increase public awareness of the human voice and the need for vocal preventive care and treatment. Take the below survey: if your answer to any of the seven questions below is “yes” you’re probably not enjoying optimal vocal health, and should consider seeking medical assistance.  We hope you will consider Performance Voice Solutions in your return to good vocal health.

• Have you been hoarse for more than two weeks?
• Do you have to strain to be heard?
• Does your voice get tired?
• Does your voice give you difficulty at the end of your work day?
• Do you have difficulty swallowing?
• Does food get stuck or go down the wrong way?
• Have you been told you have acid reflux from your stomach into your throat?

For information on vocal health, visit www.performancevoicesolutions.com.

Rebecca Miles Risser, M.M., M.A., CCC-SLP
Director, Clinical Speech Pathologist and Voice Specialist
Performance Voice Solutions

The American Medical Association and independent researchers The Lewin Group reported these statistics from a new study.

Office-based physicians in Indiana paid $9.6 billion in wages and benefits, and $581.4 million in taxes.

“Most people don’t think of physician practices as small businesses. As such, they contribute greatly to the economic vitality of our local communities and state,” Brent Mohr, M.D., Indiana State Medical Association president, says.

Office-based physicians almost always generate more for state economies than hospitals, law firms, nursing homes and home health organizations.

To read more about the report, visit the American Medical Association.

Your office-based doctors face a 22-25 percent cut in Medicare reimbursement unless Congress acts to permanently correct a flawed formula that determines these rates.

To keep your office-based physicians, please make your voice heard.

Sign the Medicare petition.

Let your representative know how you feel.

Performance Voice Solutions is a division of Northside ENT.

Patients can get relief through lifestyle changes.

The following Reflux Symptom Index (RSI) (Koufman, Belafsky, Postma, et.al 2002) uses nine items to help you rate the severity of your condition specific to LPR.

A score of 10 or more on the following quiz is considered clinically significant.

Within the last month, how did the following problems affect you?

0 = No Problem 5 = Significant Problem

The first line of defense is behavioral:

Diet Dos

• Eat slowly
• Eat sitting up
• Eat smaller meals
• Avoid overeating
• Chew food thoroughly
• No food 2-3 hours before bedtime
• Restrict liquid/food intake before singing and/or lifting, bending or stooping

Diet Don’ts

• Alcohol
• Soda
• Citrus juice
• Tea/coffee
• Breath fresheners
• Mints
• Milk
• Chocolate
• Spicy and/or fried foods
• Lozenges and cough drops
• Tomato products
• Tobacco

For one week, write down what you eat and drink through the day along with symptoms in the morning, afternoon and evening. This will help identify what affects your gastric reflux more.

Posture & Weight Dos

• Achieve and/or maintain your ideal weight
• Expand your abdomen when breathing in

Posture & Weight Don’ts

• Exercise right after eating
• Tight clothing around your waist
• Slumping down in a chair
• Heaving lifting
• Kneeling
• Bending at the waist

Other Lifestyle Modifications

• Stop smoking
• Reduce stress and tension
• Avoid sedatives
• Sleep with the head of your bed elevated 4-6 inches via cinder blocks, wood or bricks under the legs of your bed
• Sleep on your side, preferably your left side

Remember, acid reflux at the level of the larynx (LPR) is often “silent”. Positive or negative results from this quiz do not necessarily correlate with positive or negative results upon examination.

For more information, talk with a voice specialist at Performance Voice Solutions at (317) 705-2732.

Scott A. Hackett, M.D., F.A.C.S., president of Northside ENT, was voted a top doc by physician peers in Indianapolis Monthly’s survey, reported in this month’s magazine.

This marks the fourth consecutive time fellow doctors have named the board certified otolaryngologist.

Indianapolis Monthly magazine partners with Castle Connolly Medical Ltd. to take the guesswork out of choosing a doctor. The independent researchers survey thousands of doctors to identify the top five percent of board certified physicians in the Indianapolis metropolitan area.

Dr. Hackett joined Northside ENT in 1991. He also serves on the board of Naab Road Surgery Center. The ear, nose and throat specialist is a past president of the department of otolaryngology – head and neck surgery at St. Vincent Hospital.

Active in patient care and medical education, Dr. Hackett has been named “Specialty Teacher of the Year” twice by St. Vincent Hospital family medicine residents. He has trained residents in this program since 1991.

He graduated from Indiana University School of Medicine with highest distinction. The doctor also completed specialty training in otolaryngology – head and neck surgery in Indianapolis.
Dr. Hackett is a fellow in the American Academy of Otolaryngology – Head and Neck Surgery, American College of Surgeons and American Academy of Facial Plastic and Reconstructive Surgeons.

He is a member of the Indiana State Medical Association and Central Indiana Otolaryngology Society. Dr. Hackett is also an associate member of the Radiological Society of North America.

The ENT specialist sees patients of all ages with diseases and disorders of the head and neck. Special interests include minimally invasive treatment of parathyroid and sinus disorders; thyroid surgery; voice problems and pediatric diseases.

Dr. Hackett and his wife Tricia have two children, Stephanie and Emerson. Mrs. Hackett is a member of the school board for Carmel Clay Schools.

Northside ENT has served Central Indiana patients since 1977. Specialties include pediatric and adult ear, nose and throat disorders affecting the voice, allergy, sinuses, tonsil and adenoid, ears, thyroid, parathyroid, head and neck cancer, and sleep apnea.

Performance Voice Solutions and Total Hearing Solutions are divisions of Northside ENT.

For more information, call (317) 705-2732.

Read the entire article here

Videostroboscopy allows a voice specialist to see very small changes in your vocal folds’ ability to vibrate and produce a clear voice.

This video gives you a close up view of vocal cords as the voice specialist guides her patient through a videostrobe exam. Rebecca Miles Risser, M.M., M.A., CCC-SLP is one of the few certified speech language pathologists, specializing in voice therapy, in Central Indiana.

Performance Voice Solutions is a division of Northside ENT.

Videostroboscopy is the gold standard for taking care of your voice. But here are a few things you can do at home:

Drink eight glasses of water daily, as this helps to lubricate your vocal cords. Well-hydrated vocal folds require less effort from the lungs to vibrate. They also recover from injuries faster when they are well lubricated.

Don’t smoke or inhale second-hand smoke, as this is strongly linked with lung cancer and laryngeal cancer. The combination of tobacco smoke and alcohol is particularly risky for esophageal and laryngeal cancer.

Limit your use of caffeine and alcohol because they cause your body to lose hydration.

Use a saltwater rinse to gargle, and avoid peppermint and spearmint, as these promote stomach acid to reflux into your esophagus.

Avoid coughing and throat clearing. Both are very hard on your vocal cords. Try to sip water, swallow hard or clear your voice silently.

During the winter, keep either a hot steam or cool mist vaporizer in your room with the door closed. The ideal room humidity for your voice is 40-60 percent. Mold tends to grow at humidity levels greater than 60 percent.

Eating healthy foods and eating in moderation helps to control excessive stomach acid from spilling into your throat. Eighty percent of people with laryngopharyngeal reflux won’t feel it.

You are a “professional voice user” if your voice is required for your job duties. Examples include call center operators, teachers, radio show hosts, ministers, singers, etc.

If you find that your voice is tired, pay attention and try to rest it. Vocal fatigue is the first sign of vocal pathology. Please see your doctor, or one of our board certified otolaryngologists if you are hoarse for more than two weeks.

Performance Voice Solutions is a division of Northside ENT.

Others sometimes judge you by the way you speak. Whether your voice is monotonous or melodious, rough or smooth, your voice plays an important role in how others perceive you.

The sound of your voice comes from air passing from your lungs through your “larynx” or voice box. The vocal cords in your larynx are two bands of muscle that vibrate to make sound.

You can injure your vocal cords by talking too much, screaming, clearing our throats too much and smoking. These can lead to nodules, polyps and sores on your vocal cords. Other causes include infections, stomach acids moving up into your throat, growths due to a virus, cancer and diseases which paralyze the vocal cords.

Treatment for vocal conditions depends on the cause. But we can treat most voice problems successfully when they are diagnosed early.

Feel free to take this interactive voice quiz to learn how well your voice is working for you.

To make an appointment with a voice specialist at Performance Voice Solutions, call (317) 705-2732. Performance Voice Solutions is a division of Northside ENT.

A videostrobe exam is the gold standard for taking good care of your voice.

Videostroboscopy works like slow-motion photography. A videostrobe exam allows us to watch the vocal cords vibrate, then decide how to help them move normally again. If your vocal cords vibrate normally, you have a clear voice.

What to Expect

No preparation is required. You may follow your normal routine for meals and medication the day of your videostrobe examination. If your physician sent a script with you, please bring this to your appointment.

At your first appointment, your clinician will discuss your voice with you and use videostroboscopy to obtain images of your voice. Typically, a full examination is completed in approximately 60 minutes.

Your certified speech language pathologist, specializing in voice therapy, will insert a small endoscope either through your mouth or nose to your throat. That will enable your voice specialist to see your larynx.

As you are guided through various voice tasks, your clinician will be able to view possible irregularities of movement. This will also make it possible to assess the health of your laryngeal tissue.

Following this exam, your speech language pathologist/voice specialist will assess your recording, using the reflux finding score. This instrument and the reflux symptom index are the screening tools used to assess possible changes in your throat, consistent with laryngopharyngeal reflux (LPR).

LPR occurs when stomach acid travels up the esophagus and into the voice box or throat, during the day or night. The damage can be extensive.

Results

You will know your exam results immediately after the videostrobe examination. Patients are invited to review the videostroboscopic recording with the clinician to discuss the findings as soon as possible.

If results indicate the need for a medical, surgical or behavioral response/therapy, your voice specialist will let you know this. We will also give your physician our recommendations.

Videostroboscopy Video

Select videostroboscopy to watch a close up view of a patient exam including vocal cords in motion.

To make an appointment with a voice specialist at Performance Voice Solutions, call (317) 705-2732. We are a division of Northside ENT.

For a Medicare patient, a doctor can mean everything: independence, hope and security. Medicare makes it possible.

For a doctor, treating patients is everything. Our doctors have cared for many of your children and grandchildren. Our patients are family.

The last thing we want to do is tell our patients we can no longer care for them. We want to continue taking care of our Medicare patients.

Please understand that Medicare is already one of the lowest paying insurance plans in which most physicians participate.  However, your doctors stand to face a 22-25% immediate reduction in payments from Medicare unless Congress acts to permanently correct a flawed formula that determines Medicare reimbursement rates.

Even though the new healthcare bill promises to cover more patients, big problems still exist. This bill didn’t fix Medicare, our government’s largest healthcare program.

Congress must fix Medicare now, so Medicare patients can have the doctors they need when they’re sick. Medicare patients deserve to receive the care they’ve been promised.

Congress must focus on this problem it’s been putting off for more than 10 years.

A statewide effort is now underway to collect a million signatures. Indiana’s petition drive asks Congress to stop the Medicare meltdown so patients can choose their doctors and their doctors can stay in the program.

We can’t collect your signature on a petition because of government regulations. So instead, we’re sharing this information with you.

Please make your voice heard.

Sign the petition, asking Congress to continue its work and fix the crumbling foundation of our healthcare system.

Let your representative know how you feel. Members of Congress listen to their constituents.

Videostroboscopy Video

Select videostroboscopy to watch a close up view of a patient exam including vocal cords in motion.

To make an appointment with a voice specialist at Performance Voice Solutions, call (317) 705-2732. We are a division of Northside ENT.