DRHOOK- Free speech: Don't let laryngitis get you down

the handsome doctor John Hong of Charlottesville

Elton John is the Rocketman. In October, I could "Feel the Love Tonight" when he sang "Your Song" at the JPJ here in Charlottesville.

But how in the world did he sing three hours nonstop without even clearing his throat? With so many rock singers destroying their voices of the years, Sir Elton has been performing over 40 years. Yet, the young American Idol, Jordan Sparks, actually hemorrhaged her voice cords in 2008 from singing! 

What happens when you don't have a voice?

Laryngitis and hoarseness of the voice means there is a change in vocal quality. It can be weak like The Spice Girls or breathy like Marilyn Monroe. Strained and fatigued like Bill Clinton after months of campaigning, or low pitched and scratchy like Bonnie Tyler singing "Total Eclipse of the Heart" for the millionth time.

Acute laryngitis from a cold is almost always viral in nature, and usually resolves within two weeks. I have known some people who recorded their voice-mail message during this time because they sounded sexier. "Please leave a message... achoo, baby!"

However, if hoarseness lasts more than two weeks, and ear-nose-throat evaluation is often warranted to make sure a tumor or cancer isn't responsible... especially in smokers and drinkers.

The vocal cords kind of look like PacMan, and they close up to make sounds (instead of eating little dots). But a tumor can prevent the cords from closing up to touch, and that cause the voice to change. Also, if a tumor is compressing the nerves to the voice box or blocking the sounds from coming out right, it can make Placido Domingo sound like Rod Stewart.

Chronic laryngitis can result from irritants to the vocal cords, such as smoking, chemical fumes, and alcohol. I remember Billy Joel was drinking bourbon or something during a concert saying he wanted to have a whiskey sounding voice. (Keep drinking, Billy.)

But acid reflux and postnasal drip can irritate the vocal cords too. A lot of people don't believe that, but when I ask them if they clear their throat a lot, most of them do without even knowing it. I clear my throat a lot due to postnasal drip from allergies, and people in lines always think I'm irritated at something.

"No, I'm not trying to make you go faster. I just have snot in my larynx, thank you. But now that you mention it..."

As a professional whiner yet karaoke wizard, I don't abuse my vocal cords. But some people scream due to working in a noisy environment or because they have to project their voices to a large crowd. Guess which profession is affected the most by vocal cord strain? Teachers!

"No more pencils, no more books, no more teachers screaming off the hook." 

My skating coach yells all the time, "Push! Extend! Move it!" By the end of each session, she sounds like Tina Turner. I keep telling her to take voice lessons, but then she makes me do an extra skating lap.

With enough strain, polyps can develop on the vocal cords. Look at poor Julie Andrews who couldn't sing for a while due to them. She went from Maria von Trapp to Maria voice Trapped.

Neurological disorders can disturb phonation, such as spasms to the voice muscles, ALS, diabetic neuropathy, and strokes. Katherine Hepburn had essential tremor and had that wavy, tremulous voice, "Happy Bi..ii..rth..day, de....ar, Norman...."

Get an evaluation if laryngitis/hoarse voice lasts more than a couple of weeks. There might be some people who would prefer you not to talk, but remember that your freedom of speech is more than just a Constitutional right.


Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.



F.Y.I. Elton John has lowered the keys to most of his songs and no longer even tries to hit high notes - he has a 'stunt' singer in his band who sings the high parts -or didn't you notice? And Billy Joel never drank bourbon. He drank Scotch -Dewar's White Label to be precise. And it had the desired effect. His voice did get rougher (although he no longer drinks hard liquor). All singers lose a certain amount of upper vocal range with age. It's simply a matter of human tissue becoming less supple. But many gain richness in the mid-to-lower vocal range - like Elton John and Billy Joel.