- Voice surgery, at the best of times,
can be a daunting experience.
During the surgical procedure,
we have virtually no control,
and we have to trust in the skills of the surgeon
and the theater staff.
But the moment we wake from general anesthetic,
we become an active player in our post-operative recovery.
So what can we do after phonosurgery
to secure the best possible outcome
for ourselves and our voice?
Well, I'm glad you asked.
Stick around, I've got some super handy tips
that will have you up and singing again real soon.
- [Woman] Sound check.
Check one, check two.
- Hello there, my name is Dr. Dan,
and I'm a singing voice specialist.
It's my job to help you get the very best
out of your singing voice,
and sometimes my expertise is applied to singers
who are recovering from vocal fold surgery,
what the medical profession call phonosurgery.
As I stated in my introduction,
phonosurgery can be a scary scenario for many singers.
For some, having their voice operated on
is akin to losing all personal control.
It can be a time of feeling highly vulnerable and helpless.
These are all very real feelings,
but rest assured, if you are under the care
of a skilled surgeon who you trust,
there is no reason to feel that the surgery
won't be a complete success.
And as we continue into today's video,
it's important for me to state
that the information that I'm about to provide you with
should in no way be used to supersede the instructions
that you have been given by your laryngologist.
Let me be clear: always follow the instruction
of your surgeon.
They are ultimately responsible
for your post-operative recovery.
But, if for some reason you don't trust their instruction,
seek a second opinion from another surgeon, not YouTube.
Yes, the information I'm about to provide you is sound
and based on latest research,
but that does not mean that your surgeon
is not the medical professional best placed
to direct your vocal recovery.
So, with that important caveat in place,
let's talk through some of the things
that you can actively do to enhance
your post-surgical recovery.
- [Woman] Sound check.
- I think the first question every
phonosurgery patient asks is,
"When can I start talking again after surgery?"
That's a good question.
The current approach is for patients to observe
between zero to 14 days of absolute rest.
That is, no sound making of any form.
The length of absolute voice rest
will be dependent on your surgeon
and the type of surgery that you're receiving.
For example, many laryngologists
will instruct the patient to start talking within
48 hours following the removal of bilateral nodules,
whereas more intrusive surgical procedures,
for example, the removal of laryngeal cancer,
may require longer periods of post-operative silence.
As surgical practices advance and develop,
the need for extended periods of absolute voice rest
is being reduced.
Once you've been given the go-ahead to recommence talking,
you enter the second phase of your recovery,
called relative rest.
Relative rest is defined as clear,
normal, level speech that is neither loud nor whispered,
and your vocal loads should be relatively
less than the everyday vocal activities.
For example, speaking for more than
two to three minutes on the telephone
when on relative vocal rest would be deemed too much.
Talking in loud environments,
such as cafes and restaurants,
would also fall outside the boundaries
of what is considered relative rest.
You should also do your best to avoid throat clearing,
coughing, crying, excessive laughing, and heavy lifting
during your post-operative recovery.
Each of these activities places
the larynx and vocal folds under extreme load,
and can compromise the healing process of the voice.
Now, relative rest should be observed
for between seven to 21 days,
during which your post-operative therapy should commence.
- [Woman] Sound check.
- No vocal surgery is complete
without post-operative voice therapy.
Some specialists advocate for resonant vocal activities
in the two to three days immediately following
the surgical procedure,
and while the question of how soon
is keenly debated amongst voice professionals,
it is widely accepted that voice therapy
should have commenced, in most cases,
within the two weeks following surgery.
Again, you are going to need to be directed by your surgeon,
but if there is no advocacy for
post-operative voice therapy,
I would encourage you to inquire as to why not,
and if necessary, seek a second opinion
from another laryngologist.
Post-operative rehabilitation for the voice
should take between five to 10 sessions
with a speech therapist, and where appropriate,
a singing voice specialist like myself.
Your voice therapist will guide you and your voice
along a path of exercises
designed to slowly but surely strengthen the voice,
all while assisting the post-operative healing process.
I cannot stress enough the importance
of your post-operative voice therapy.
It literally can mean the difference between
returning to full, healthy voice use
or, alternatively, returning to the surgeon's knife
for secondary procedures.
I typically instruct my rehabilitation clients
to wait approximately two to three weeks
before the introduction of light singing exercises.
Singing places the voice under higher loads
than does talking, so I think it prudent
to walk before you run.
Singing rehabilitation generally takes
between six to 12 weeks, after which,
if the client has been diligent,
and there are no obstructive circumstances,
full voice use, both talking and singing,
can be returned to with every confidence.
Perhaps you have a question about vocal surgery
that I have not covered in today's video.
Feel free to write your questions
in the comment section below,
and I'll do my best to answer them promptly.
In the meantime, I'd love for you
to check out my channel for more videos about singing.
Each one has been designed to develop your voice
and improve your sound, so until I see you
in the next Voice Essentials video,
I'm Dr. Dan, sing well.