Take Two for November 12, 2012

Voice therapy and training wards off illness that rob voices

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Mae Ryan/KPCC

Carol Ann Susi, who plays Mrs. Wolowitz on the CBS sitcom The Big Bang Theory, visits Cedars-Sinai’s Outpatient Voice Program for her weekly voice therapy sessions.

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Mae Ryan/KPCC

Voice therapist Robert Dowhy guides Carol Ann Susi through a series of exercises that teach her how to relax her throat muscles, use her vocal cords properly and breathe in ways that reduce voice strain.

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Mae Ryan/KPCC

Carol Ann Susi sticks out her tongue as far as she can during a warm-up session in her voice therapy class at Cedars-Sinai’s Outpatient Voice Program.

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Mae Ryan/KPCC

Voice therapist Robert Dowhy teaches Carol Ann Susi proper voice techniques. Voice training can teach how to properly use your vocal cords while widening your inflection range.

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Mae Ryan/KPCC

Carol Ann Susi warms up her vocal chords during a voice therapy session. After her sessions she now feels no discomfort after a day of shouting her lines as Mrs. Wolowitz on The Big Bang Theory.

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Mae Ryan/KPCC

During the therapy sessions patients practice singing using methods that are healthier for their vocal chords.

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Mae Ryan/KPCC

Therapist Robert Dowhy shows Carol Ann Susi new techniques for using her voice. Once relegated to an obscure place in medicine, voice therapy is now gaining mainstream traction thanks in large part to high-profile cases of voice illness among singing superstars.

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Mae Ryan/KPCC

Staying hydrated, avoiding late night eating, and limiting cell phone conversations while in your car can maintain vocal well-being.


When Carol Ann Susi shows up to work, her colleagues expect to hear a lot of yelling.

That’s because she earns her paycheck by playing  the overbearing Jewish mother, Mrs. Wolowitz, on the hit CBS television sitcom, “The Big Bang Theory.” 

Susi’s character never appears on camera. Instead, audiences only hear her as she communicates off-screen with her fictional son, Howard Wolowitz, mostly by hollering at the top of her lungs.

 “I’m screaming when I do Mrs. Wolowitz,” Susi says. “That’s what I do. That’s her character…the whole thing is yelling. That’s the joke.”

But all that screaming is no joke when it comes to Susi’s vocal health. Until recently, all that scripted yelling would cause her voice to go hoarse and leave her struggling to talk.

“I used to not speak over the weekend because we always tape our show on Tuesday,” she says. “So Saturday and Sunday I’m not talking to anyone because I really needed to keep my voice.”

But that did little more than delay the inevitable hoarseness that followed her work sessions.
 
Susi’s doctor eventually prescribed her more than a dozen voice therapy sessions at Cedars-Sinai’s Outpatient Voice Program where – like at similar voice centers throughout the Southland – a growing number of actors, singers and regular folk -  such as school teachers and lawyers – are seeking help for overused vocal cords.

On a recent morning, therapist Robert Dowhy guided Susi through one of her final appointments. He began with warmup exercises that relax her vocal cords and allow her to breathe in a manner that reduces voice strain.

“To minimize the risk of injury to a muscle, you want to first relax the muscles that are tense and then warm up and stretch them,” Dowhy says.

First, there are stretches that required Susi stick out her tongue as far as it could reach in every direction. Next were a set of trills, where she attempts to roll her “r’s” like a native Spanish speaker. Then came  a series of “pitch glides” in which she sings letters of the alphabet to musical notes Dowhy played on a piano.

Nationwide, voice therapy like this is gaining mainstream traction, thanks in part to recent high-profile cases of voice illness among singing superstars. In the past 18-months, British soul-singer Adele, who  underwent surgery for a vocal cord hemorrhage, country singer Keith Urban who had vocal polyps removed and singer/songwriter John Mayer who’s in continuing treatment for a vocal cord lesion known as a “granuloma.”

Experts in the field also say that technology is moving voice medicine to the forefront.  Fiber-optic cameras that can diagnose tiny vocal cord injuries and improvements in laser surgery are encouraging many with such with problems to seek treatment before they suffer permanent damage. 
 
“Voice medicine has come such a long way in the past ten, 20, 30 years and moving faster and faster as more young docs are getting interested in it,” says Joanna Cazden, a colleague of Dowhy’s and author of the book, “Everyday Voice Care: The Lifestyle Guide for Singers and Talkers.” 
“There’s really a lot that a combination of good medicine and good rehabilitation therapy can do."

Cazden says while vocal function is comprised of complicated physiology, maintaining vocal well-being is quite simple. It involves healthy habits such as such as keeping well-hydrated,  which allows your vocal cords to vibrate without irritation; avoiding late night eating, which can cause acid reflux that burns your throat lining and limiting cell phone conversations while in your car, which causes voice strain. 
 
“The other primary recommendation is to get some good training,” Cazden says. “It doesn’t need to be therapy if there’s nothing actually wrong with your voice.”

Voice training, she says, can teach you to widen your inflection range by bringing energy to your voice. Cazden says that in turn offers your vocal cords a chance to relax and stretch as you speak.

And, she says, it offers the added benefit of making it easier for your audience to tune in to your talk – whether you’re speaking before a classroom or a courtroom or whether, like Susi, you shout for a living before a live television audience.

“It’s a big, big difference because now I feel as though…there really is no pressure on my throat anymore,”  says Susi who says she hopes her new voice skills will pay off with even more acting roles.


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