Answers for Singers with Colds
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Lois Marshall - An Appreciation
Answers for
Singers with Colds
by Dr. Francoise P. Chagnon, FRCS
Professional voice users dread the occurrence of upper respiratory tract infections which herald the onset of vocal disability and threaten their commitments to professional engagements. The "common cold" refers to a viral infection which affects mainly the nose and throat. The "flu" refers to a more generalized influenza viral infection of the respiratory tract associated with high fever, aches and pain. Other viruses may affect the larynx or the trachea predominantly. The prevalence of such infections and the absence of curative therapies leads to many myths and home remedies. Physicians share patient's frustration in coping with these annoying recurrent viral illnesses. The best treatments are dictated by common sense, as suggested by the following answers to frequently asked questions:
Can anything be done to avoid such viruses?
The influenza vaccine offered each fall does not protect against all common colds or flu viruses. The vaccine is based on the previous year's most virulent influenza virus strains. Unfortunately, new viral strains keep arising for which you have no acquired immunity. The virus spreads rapidly throughout the community by airborne and hand transmission of nasal and throat secretions. The only way to diminish transmission of the virus is for infected individuals to wear protective masks and gloves. In reality, it is not possible to isolate oneself completely from the many viral epidemics which ravage our community. Frequent hand washing and avoidance of close personal contact with individuals affected by the common cold can minimize the chances of catching the disease.
Homeopathic medicines claim to improve one's immunity. If homeopathic medicines have any benefit it seems to be on the long term and not when symptoms have already manifested themselves. The same can be said for vitamins and mineral supplements. Traditional medicine still maintains that proper nutrition, adequate daily rest and minimizing negative stress in our lives, does more for the immune system than any so-called remedies. Hormonal and metabolic disorders (such as diabetes or anemia) may make you more susceptible to catching the cold or flu viruses and weaken your ability to combat the disease.
I keep catching one cold after another! What is wrong with me?
Beware. What you believe to be recurrent colds may actually be exacerbations of chronic sinonasal infections. Allergies are a common underlying cause. Allergies will cause swelling of the lining of the nose and sinuses and favour the development of infection. Anatomical deformities of the nose and sinuses such as deviations of the nasal septum, often lead to mechanical obstruction of the sinus openings and narrowing of the nasal passageways. The added swelling of the nasal lining by the cold virus simply favours the retention of secretions of the sinuses. Other disorders of the nasal turbinates (those special filters within our nose) that also lead to protracted upper respiratory tract infections. Two to three common colds a year may be acceptable, particularly if you travel a lot. Anymore than that deserves a proper medical evaluation (including special radiographic imaging of the nose and sinuses) to seek underlying precipitating factors.
I caught a cold and I have a recital tomorrow. Should I cancel?
Once the virus has infected lining of the respiratory tract nothing much can be done to halt it's progression. Medications, old folk remedies, traditional or alternative medicines, all have palliative rather than curative effects. Nevertheless, they can hasten the resolution of symptoms and prevent sinonasal or pulmonary complications such as sinusitis or pneumonia. The ability to perform vocally while suffering from a cold has more to do with the overall respiratory status than actual infection on the vocal cords. There are times when the vocal cords may be capable of singing through the tenacious mucus but there is no point in pursuing this task when the body is ill. Denying yourself time to recover only lengthens the illness.
Cancelling a performance because of a bad cold or the flu requires professionalism. Fainting on stage or collapsing after a performance or in the middle of a tour, will win you empathy but will reflect poorly on your judgement. Having said that, I admit that physicians are no better than singers and other professionals when acknowledging one's limits. We are all guilty of pushing our bodies beyond the limits when there is a duty to perform. Your laryngologist will understand your mindset when it comes to making a decision to perform with a cold or the flu. A strict contraindication to singing would be the presence of significant swelling or hemorrhage of the vocal cords. In my experience, this is a rare finding. More often than not, it is the presence of sinonasal infection and a productive cough as well as generalized malaise which will justify the need for vocal rest. The singer may have already decided to cancel a performance but needs the formal support of the laryngologist to convince the manager and to avoid financial penalties.
I have a cold. What should I do?
The principles of therapy are to decongest (decrease the swelling of the glands and lining of the respiratory tract) and humidify. This will favour the expectoration of secretions, improve nasal breathing and decrease coughing. A multitude of over-the-counter medications are available for this purpose. You should avoid medications which have drying side-effects (such as some anti histamines). While they give temporary relief from a running nose, with repeated use they tend to make secretions more tenacious and difficult to expel. Look for medications that are pure decongestants (such as pseudoephedrine). Some formulations also include an analgesic/anti-inflammatory (such as acetaminophen) to the decongestant to relieve headaches and fever. Stick to medications which contain a single or few ingredients. It will be easier to match the medications to your symptoms and minimize side-effects. If decongestant medications leave you feeling jittery and unable to sleep (as if you have had too much coffee) try taking a long acting (12 hour) preparation early in the morning and none at night, or decrease the recommended dosage by half.
In addition to decongestant pills, you may use decongestant nasal sprays (xylometazoline) for the rapid relief of nasal obstruction (particularly before sleep). Do not use these nasal sprays beyond the recommended daily frequency and do not use more than five days in a row. Saline nasal sprays, on the other hand, are innocuous and beneficial to most nasal disorders. Generous vaporisations of the nasal passageways with saline (four to five times a day, five vaporisations each nostril) is beneficial when the nasal secretions are thick and purulent or when the nose feels dry and stuffy. Seek the advice of your pharmacist in choosing medications which are compatible with your metabolism and meet your needs.
Humidifying the ambient air and drinking plenty of fluids are well known precautions taken by professional singers. In the absence of a humidifier, lock yourself into the bathroom, run the shower to stream up the room while you drink a litre of mineral water. You will not be cured by this ritual but you will have given your body the means to detoxify itself. Ultimately, everyone finds their own remedy and ritual which works for them. You will find that independent of the remedies used, the three "R"'s principles prevails; Resign yourself to Rest and Recover.
The benefits of vocal rest and total body rest are underestimated. Returning the vocal organ to it's most primitive function of respiration is the goal. It is during quiet respiration that the laryngeal biomechanics are the most efficient. Forcing the larynx into phonation when the biomechanics are not optimal calls for misuse of the laryngeal muscles. Quite unbeknownst to the inexperienced singer, patterns of laryngeal muscular tension will rapidly set in and remain even after the infection has passed.
Can a cold damage my vocal cords?
Upper respiratory tract viral infections rarely cause serious damage to the vocal cords. The vocal cords will develop some swelling and will be weighted down by tenacious secretions. The degree of vocal disability is usually out of proportion to the degree of vocal swelling. In other words, you may sound terrible (or have no voice at all!) yet the vocal cords don't look that bad. Coughing may bring worry that the vocal cords are being damaged. In fact, coughing is a normal physiological reflexive function aimed at protecting the lower respiratory tract from further infection. A productive cough which expels secretions from the trachea should be assisted by the use of expectorant medication (guaifenisin) and lots of humidification and hydration. It is the dry spasmodic cough which seems to originate from a tickle in the throat which has the potential to strain the larynx. A cough which interferes with sleep and impairs easy breathing should be suppressed by dextromethorphan or codeine elixir. A protracted cough beyond 7 days, requires medical evaluation to rule out bronchitis, pneumonia or asthma. It is not unusual for the trachea and bronchus to retain a heightened sensitivity to irritants while recovering from an infection.
Don't singers with colds deserve antibiotics?
Antibiotics will do nothing for the common cold. Unfortunately, they are prescribed by physicians succumbing to patient's incessant demands. Antibiotics are not as innocuous a believed. They can cause serious side-effects including allergic reactions to colitis (inflammation of the bowel). It is best to reserve antibiotics for the treatment of complications of the common cold such as sinusitis or tonsillitis or pneumonia. It is true that respiratory tract infections that are initially of viral origin may be complicated by bacterial infections. It takes a thorough physical examination and clinical judgement (often substantiated by radiological investigations) to decide upon the need for antibiotic therapy. Antibiotic therapy at the onset of a cold will not prevent complications from occurring and will not shorten the duration of the illness.
While recovering from a cold when can I start singing?
If your cold did not affect the quality of your speaking voice, you may return to singing within 48 hours of the acute phase of the illness. If your speaking voice is hoarse, maintain voice rest as much as possible and reassess on a daily basis. Gentle humming within your vocal range and deep breathing exercises will help clear tracheal secretions and re-establish breath control and the pneumophonetic association. When recovering from dysphonia, keep the total daily voicing to 4 hours non-continuous. Progressively increase to 6 and 8 hours a day of voicing paying particular attention to your "break-point" ( the point at which you start experiencing vocal fatigue). Do not push your voice beyond your break-point. If you have not recovered full vocal efficiency within ten days of the onset of your cold, a laryngeal examination is warranted to further guide your rehabilitation.
Fortunately, the common cold and the flu are self-limiting infections, which resolve in 7 to 10 days. For the singer and vocal performer, full recovery may take 2 to 3 weeks, which seems like an eternity when singing is your raison d'etre. The near future will likely bring vaccination and antiviral medications to rid society of these common viral infections which encroach on our quality of life.
Doctor Francoise P. Chagnon is Montreal born and educated and received her medical degree from McGill University in 1981. She specializes in Otolaryngology and head and neck surgery. In 1993, as a travelling fellow of the Royal College of Surgeons of Canada, she perfected her subspecialty interest in laryngology and the professional voice at the Vanderbilt University Voice Center. She is currently assistant professor of Otolaryngology at McGill University and Director of the Voice Laboratory at the Montreal General Hospital. She is a certified laser surgeon and a member of many professional societies, including the Canadian, American and British Voice Foundations, and the American College of Surgeons. She lectures frequently to voice students and professionals.
The Montreal General Hospital / McGill University Voice Laboratory is a diagnostic, research and teaching endeavor of McGill University's Department of Otolaryngology. The Voice Lab houses specialized equipment to study the human voice and its disorders. This equipment includes digital audiovisual laryngostroboscopic examinations and sound spectrography. The Voice Lab caters to all individuals presenting with voice and throat disorders as well as providing expertise to singers and professional voice users. The Voice Lab is staffed by a multidisciplinary team consisting of technicians, speech-language pathologists, voice scientists and laryngologists. Appointments are given upon referral at the following number 514-937-6011, ext. 2285. For further information, please contact Doctor Francoise P. Chagnon at the same number or fax your inquiries to 514-934-8200.
Ask the Throat Doctor
Do you have any specific questions for Dr. Chagnon about the voice or vocal ailments? Submit them to Ask the Throat Doctor c/o La Scena Vocale, 5411 Waverly, Montreal, Quebec, H2T 2X8, or by email at chanw@ere.umontreal.ca
Does Echinacea help cure the common cold?
Not according to a study reported in the February 25th broadcast of the CBC TV show Marketplace. - WKC
Lois Marshall -
An Appreciation
by Dr. Howard Dyck
The musical world was saddened to learn of the death last month of the Canadian soprano Lois Marshall. Miss Marshall, who had just turned 72, died in hospital in Toronto on February 19 following surgery for cancer.
Lois Marshall was internationally regarded as one of the great sopranos of our time. And while she was blessed with a superb natural voice, it was the deeply emotional, personal, heartfelt dimension of her singing that was so distinctive.
Her strength of character was borne out of adversity. At the age of two, she was struck down with polio which crippled her legs. Although her disability prevented her from achieving international recognition on the opera stage (she did sing some opera, most notably with the CBC Opera Company in the 1940s and 50s), she enjoyed an illustrious career as a concert, oratorio and Lieder singer. At the age of 22, she was engaged by Sir Ernest MacMillan to sing the soprano solos in his annual presentation of Bach's St. Matthew Passion. Six years later, Arturo Toscanini selected her to appear with the NBC Symphony Orchestra in a performance of Beethoven's Missa Solemnis. In 1956 she made her London debut with the Royal Philharmonic Orchestra under Sir Thomas Beecham in a performance of Mozart's Exsultate Jubilate. Later that year, Miss Marshall also sang in Beecham's productions of Handel's Solomon and Mozart's The Abduction from the Seraglio.
As a recitalist, Lois Marshall was acclaimed for her numerous international tours which took her to Australia, England, Germany, the Netherlands, new Zealand, the US and the USSR (which she toured six times). In the mid -1970s, Miss Marshall began to sing as a mezzo-soprano. This closing phase of her active singing career resulted in a number of memorable Lieder recitals with distinguished pianists such as William Aide, Anton Kuerti and Greta Kraus.
Although her discography is extensive, many of the earlier recordings fail to do justice to her splendid, ringing, nuanced voice. In recent years, CBC Records has issued three CDs featuring this prodigious talent: Lois Marshall - Arias by Handel, Haydn &Mozart; Franz Schubert: Winterreise (with Anton Kuerti); and Franz Schubert: Die schoene Muellerin (with Greta Kraus).
Two days after Lois Marshall's death I was honoured to present a two-hour tribute to her on the English-language CBC Stereo Network. I was amazed at the depth of emotion expressed by people across the country. They all commented on her uniquely beautiful voice, but even more on the passionate commitment she brought to every performance.
My fondest memory of her is the first time I heard her sing a live concert. Lois Marshall was in Winnipeg to sing Handel's Messiah in the Civic Auditorium. Her delivery of the two main soprano arias Rejoice Greatly and I know that my Redeemer liveth will be forever etched in my memory as some of the most beautiful singing I have ever heard. Her performance that December night in 1962 inspired me and confirmed my decision to pursue a career in music.
We grieve Lois Marshall's unexpected passing, but we celebrate the memory of a great singer and splendid human being.
Dr. Howard Dyck is the Conductor and Artistic Director of the Kitchener Waterloo Philharmonic Choir and Chamber Singers, and the Consort Caritatis Choir and Orchestra. He is also Programme Host of "Choral Concert" and "Saturday Afternoon at the Opera" heard on CBC Stereo.
Czech It Out: Janacek's Jenufa on Disc
by Philip Anson
Both commercially available Jenufa recordings have much to offer (too bad Eve Queler's excellent version on BIS isn't in local stores though it may be special ordered from Scadinavian Record Imports). Bohumil Gregor's 1969 Jenufa, recorded in Zoffin Hall, Prague with the chorus and orchestra of the Prague National Theatre was the first stereo recording of Janacek's masterpiece. Digitally remastered at Abbey Road studios in 1994-95, it was released in EMI's mid-price opera series (EMI 5 65476 2 9), making it the cheapest Jenufa available.
Any Czech opera recording originating in Prague must get high points for authenticity. Gregor's cast is pure Czech and Moravian, so it would be presumptuous to criticise their diction or the "speech patterns" crucial to any Janacek opera. Singing Czech comes easiest to native speakers. All Gregor's singers are veterans of countless Janacek operas at the Brno Opera and the Prague National Theatre. Gregor doesn't squeeze more hysteria out of the score than emerges naturally according to Janacek's intentions. The unfolding tragic drama is nudged rather than driven by the glorious orchestration, and the sound is never harsh or fatiguing. This recording, in fine analogue to digital transfer, is musically not much inferior to costlier later recordings while offering authentic Cold War Janacek performance tradition. The notes and synopsis are skimpy and - francophones beware - the libretto is in Czech and English only.
That said, Sir Charles Mackerras's 1982 Jenufa, backed by the Vienna Philharmonic, and chorus, with Elisabeth Soederstroem in the name part is the best digital Jenufa going. It was the first of his Janacek cycle to be released on CD. Cast, chorus and conducting are vivid and superb. The second disc includes both versions of the closing scene plus Janacek's discarded "Jealousy" Overture. Mackerras's profound scholarship make this Jenufa (London 414-483) pretty well definitive. Jenufa at Opera de Montreal March 22, 24, 27, April 2, 5. 20H. $25-89.50. 985-2258.
Dear reader,
One year ago, our publication was founded by music lovers to bring together complete listings of vocal music events in the Montreal Ottawa-Quebec region. This expanded issue of La Scena Vocale celebrates this occasion.
At this time, we are looking for your input. We are thinking of incorporating as a non-profit organization, so that the periodical can be run more efficiently, and hopefully qualify for funding.
We are planning to hold a meeting to further discuss this possibility on Wednesday, March 19, at 7 p.m. at the Erskine and American Church, 3407 ave du Musee (corner Sherbrooke).
If you have any ideas on how La Scena Vocale should be organized, or if you'd like to help, please contact me before the meeting at (514) 274-0465, or by e-mail at chanw@ere.umontreal.ca.
Thank you for your continual interest and support of La Scena Vocale.
Yours sincerely,
Wah Keung Chan, editor
Letters
Congratulations on your newsletter which I have enjoyed receiving and reading. Phillip Anson's report on his operaphile's safari to New York was a particular delight. His enthusiasm, excitement, and critical good sense are all made even better by his excellent writing.
My advice is not to try and make your excellent publication into a lavish, glossy, expensive and advertiser-dependant magazine. Keep it the way it is - small is beautiful. Look what happened to the CBC's Radio Guide: too expensive to be maintained.
- John Stewart, Westmount, Quebec
Congratulations
to Jacques Desjardins for winning the Jan '97 prize: St. Lawrence Choir, Haydn:
Messe Nelson, Edwards, Schellenberg, Pudwell, Breault, Horst, Karam, Ensemble
Amati,SNE-622.
La Scena Vocale - March/April 1997 - Vol. 2, no. 7
Editeur/Editor: Wah Keung Chan
Assistant Editeur: Philip Anson
Contributeurs/Contributors: Francois Carrier, Francoise P. Chagnon, Howard Dyck, Serge
Medawar, Lise Pelletier
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email:chanw@ere.umontreal.ca
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La Scena Vocale is dedicated to the enjoyment of vocal music. It is published nine times a year. Readers will find listings of live concerts, conferences, films, broadcasts as well as articles and reviews.
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Next Issue: May 1, 1997 - Preview of Next Season's concerts
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Ver: 1997-03-05, Copyright (c) Wah Keung Chan