Post-Surgery Care: Vocal Rest

Voice rest is very important after certain vocal fold injuries and surgeries. Your vocal cords will not heal properly if they are overused during this time. Just as you would not consider running a day after knee surgery, you should try not to talk or make any noise after surgery on your vocal cords. Below are some general guidelines for voice rest. These will be tailored to meet your specific needs by your physician, speech pathologist and/or singing voice specialist.

What to expect after voice surgery

• Typically, your physician will prescribe three to seven days of voice rest after surgery.
• This means absolutely no talking, throat clearing, whispering, or coughing (if you can avoid it).
• Any noise that you make can be damaging and may make it difficult for the vocal cords to heal properly.
• Exercise, such as weightlifting, straining in the bathroom, and any other activity that produces forceful vocal cord closure may result in injury and effect the post operative result.
• Playing some musical instruments, like wind instruments, may result in forceful vocal cord contact. If you are an active instrumentalist, please discuss this issue with your voice care team prior to vocal fold surgery.

Your first post-op visit with speech pathologist and/or physician

• Your provider will examine your vocal cords to see how they are healing.
• Your speech pathologist will begin to take you off voice rest if appropriate.
• You will be given a guideline for your return to voice use.
• You will be allowed to use your voice, but you must not overdo it.

Guidelines for gradual return to voice use

These times are the maximum amounts of cumulative voice use in each day. Your voice use will be tailored by your therapist and physician to meet your specific needs.

• This is a progression. If you have any trouble, back up and do not progress until you are ready. Everyone heals at different rates.
• Remember, you should never keep talking if your voice wears out or gets tired, or if there is any discomfort or serious change in quality or volume with talking. This is your body’s way of talking to you. You should rest your voice if this happens.
• Singers should remember that these cumulative voice use amounts include any singing that you do. They are not in addition to your singing. Your first singing after surgery should be done in a supervised setting, for example, with your speech pathologist or singing voice specialist present. Singers should also respect the difference between a healthy, functional sound and a musical performance sound. In the days and weeks immediately following surgery, they should not expect nor attempt to produce their performance sound quality, intensity or range. It is better to have a patient, steady and successful recovery the first time. After surgery, you will need to distribute your singing practice into several short sessions scattered throughout the day. This is actually a good habit to have all the time, not just after an injury. It helps you to avoid fatigue and accelerates the retraining of your neuromuscular coordination. Public performance as a post-operative singer should be delayed until all members of your voice care team give you the green light. Even then, repertoire choices and performance commitments should be made conservatively until full function and self-confidence are at 100 percent.

Things to remember

• Use an easy, natural voice.
• No phone use until three weeks after surgery.
• Always avoid extremes such as yelling, singing, throat clearing, talking for a long period of time without a break. Avoid heavy lifting and strenuous exercise.
• If you experience any pain, fatigue, hoarseness, call your physician or speech pathologist.
• Drink plenty of water and avoid caffeine and alcohol.
• Take vocal breaks. For 20 minutes of use, take a 10 minute break.
• Don’t feel like you have to respond to every phone call or request. Use e-mail and voicemail to control how much you have to talk on any given day.
• Place visual reminders of your good voice use habits around your home and office and in your car. Make healthy voice use an automatic part of your life.
• Voice therapy with a speech pathologist and/or singing voice specialist may be indicated to help you attain the best voice possible following your surgery and to help stop any negative voice techniques that led to your original voice condition.
• You may be prescribed an acid-blocking medication after your surgery. It is very important to take these medications after your surgery as prescribed. Medications will help your vocal folds to heal by eliminating any irritating acid exposure from your stomach that often occurs.

Further specific instructions and exercises may be provided by your physician, speech pathologist and/or singing voice specialist.