6 HEALTH & SCIENCE SUNDAY, APRIL 26, 2015 . THE JERUSALEM POST Voice of the people Most people take the sounds that come out of their mouth for granted, but when acute or chronic conditions appear, ear-nose-and-throat and clinical communications specialists should be consulted. Judy Siegel-Itzkovich reports any teachers suffer from it, as do tele- marketers, sales- persons, aerobic teachers, lawyers, Mactors, stall owners and employees in public markets, Knesset members and maybe a few journalists. And because exuberant, hot-blooded Israelis do a lot of shouting, chronic hoarseness is a widespread condi- tion that requires good habits, guid- ance and sometimes treatment. World Voice Day was marked on April 16 around the globe and in Israel to increase public awareness of throat diseases (dysphonia) such as hoarseness, which affects some six percent of the general population at all ages and 10% or more of people in problematic professions, as well as 30% of children. Other conditions DR. MICHAL ICHT (Courtesy) are throat cancers. The annual event was marked in larynx are much rarer and often con- cialists in Israel, but this may occur various institutions, including Sheba nected to difficulty breathing. Any in the future. It would be a shame Medical Center at Tel Hashomer and problems breathing during an illness for people to study for four years in Ariel University in Samaria, where requires emergency evaluation. the academic field and then find no students produced flyers on vocal A vocal cord can become paralyzed work, she stressed. hygiene that were widely distributed. or weakened (paresis) from a viral Some 45 or so graduate from the Dr. Michal Icht, a clinical commu- infection of the throat, after surgery clinical communications depart- nications specialist teaching at Ariel in the neck or chest, from a tumor or ment at Ariel. The students work University who also has a private growth along the laryngeal nerves or with patients during their studies, practice treating patients in Herzliya, for unknown reasons. and after they graduate they have to gave an interview to The Jerusalem If the vocal cords are spastic or if spend a year under supervision with Post recently to mark the occasion. they have difficulty closing, injec- professionals in hospitals, health There are famous cases of people tions of Botox (botulism toxin) pro- fund clinics, schools, kindergartens whose careers depend on having vide effective although temporary and other locations. healthy voices who have suffered relief. Surgery may be performed to “What limits the number of profes- from hoarseness, such as actress and move a vocal cord to a different place sionals is the number of places where singer Julie Andrews, who had to to be more effective. Fat can also be they can get supervision from a stop singing for years. injected to improve the voice. It there licensed and experienced profession- The late Israeli actor and comedian is no pathological problem, one of al. This is a lot of work and responsi- Sefi Rivlin died last December after a Icht’s main tasks is to teach clients bility. Those who complete the year long struggle with throat cancer; in (TNS) how to breathe properly. have to pass a Health Ministry exam- the earlier stages, he had to use sign ination before getting their license.” language and erasable tablets to com- its fifth year). device, the electro-larynx or a hole larynx – can be caused not only by AS FOR what can help the voice be As Arab-Israeli communications municate. But many ordinary peo- Women constitute the vast major- made in the throat and the speak- viral, fungal or bacterial infection but healthy, one should rest is whenever specialists are too few in number, it ple suffer from throat problems, said ity of practitioners, as it is a “caring” er covering it with a hole to make also by acid reflux disease (in which possible, Icht advised. Inhalation of is fortunate that some attend aca- Icht. There are even politicians, such profession, said Icht, who worked for sound possible from the chest. Better acid from the stomach rises to the water vapor [hydration therapy] is demic institutions in Jordan and as Zionist Union chairman MK Isaac years as a clinician at Maccabi Health still, a hole can be punctured in the throat), excessive coughing and clear- beneficial, “which is probably why return here for work. A number of Herzog, who had to learn to improve Services, but some men entered it neck between the esophagus and tra- ing of the throat, thermal or chemical some people sing in the shower.” Jews who immigrated from the For- their voices so as not to strain them through voice therapy. “It is as much chea and a plastic device inserted to burns, laryngeal trauma and allergy Someone with laryngitis will not mer Soviet Union practice here, but and to earn more public credibility an art as a science,” she noted. make sound possible. to cats, dust or other things. When benefit from swallowing honey or they also need to know Hebrew, she with a lower pitch. The communica- There are famous women, such as “There is no such thing, at least at the two vocal cords are swollen, it is the combination of honey, raw eggs pointed out. tions specialist thinks Prime Minister former minister Limor Livnat and present, as a vocal-cord transplant, always difficult to speak. Polyps in and oil, as these don’t reach the “In Ariel, there are many immi- Benjamin Netanyahu’s natural low Israel Radio military correspondent as the structure is so complex, but the nasal passages can also cause reso- vocal cords or trachea. “If people grants from the FSU. Young children voice accords him, in the ears of the Carmela Menashe, who have low, I’m sure physicians who are ear-nose- nance problems for the voice. think this helps, it is just a placebo are usually taken care of by Rus- public, extra credibility, especially raspy voices, apparently from years and-throat specialists [ENTs] are Chronic laryngitis can also be effect,” she said. If hoarseness con- sian-speaking grandmothers for a few before elections. Icht noted that one of smoking, that sometimes makes working on it,” said Icht, who added caused by low-grade infections such tinues for two weeks or more, go to years. Only later are they exposed to scientific study found a connection them sound male. that speech is possible even with a as yeast infections of the vocal cords an ENT or general practitioner. Hebrew in mandatory kindergarten between the baritone voice of a com- “Tobacco causes harm to the vocal single vocal cord. in people using inhalers for asthma. Clinical communications special- and in school. As the parents and pany’s new chief executive officer cords, but one can’t know if some- Speaking is a physical action requir- Chemotherapy patients or others ists work hand in hand with ENTs grandparents may not speak Hebrew and rises in the firm’s stocks. body smokes from his voice. There ing the coordination of breathing by whose immune system is not work- when a patient comes in complain- very well, some children need treat- are other causes – such as polyps or activating several groups of muscles. ing well can get these infections too. ing about his or her voice. ment for speaking problems in two HORMONES AFFECT the voices of cysts on the vocal cords – that can Like in any other physical task, there To take care of one’s voice, one “I will not work with people who languages.” teenage boys bursting with testoster- cause changes as well,” said Icht. are efficient and inefficient ways of should drink a lot of water, avoid come to me unless they have first Cantors, opera singers and popular one (making the pitch deeper); centu- Among her favorite voices in the using your voice. Excessively loud, stress, screaming and whispering gone to a physician, preferably an singers may also initially have voice ries ago, young singers were castrated media are Israel Radio’s Alex Ansky, prolonged, and/or inefficient voice (the latter two are equally hard on ENT, for an examination and assess- problems, she said, but they learn so their sweet, pure voices could be Israel TV’s Haim Yavin and Ya’acov use can lead to vocal difficulties, just the vocal cords), and not constantly ment,” said Icht. “If not, I might mis- very early in the profession how to preserved. Menopausal women and Eilon and Channel 2 TV’s Ilana like improper lifting can lead to back clear one’s throat (because it slams takenly instruct a patient to exercise breathe properly. middle-aged men whose hormone Dayan. Famous singers with hoarse, injuries. Excessive tension in the the cords together). Never smoke, their vocal cords in a way that can “A voice is like a fingerprint – levels change, said Icht, notice their rough voices include Aviv Geffen neck and laryngeal muscles, along and avoid cola, caffeine and salty hurt their voices.” unique because of the structure, voices have altered as well. and Gidi Gov, she added. with a poor breathing technique foods. “Don’t drink very hot or cold “I wanted to become a clinical com- length, position and mass of the Most people take their voice for during speech, leads to vocal fatigue, water,” said Icht. munications specialist,” she recalled, vocal cords and the throat,” said granted – meaning that they don’t THROAT AND vocal cord cancer or increased vocal effort and hoarseness. In general, situations harmful to “because I thought it was a very inter- Icht. “Even in identical twins, voices take care of them – but disorders of the physical trauma to the throat can Voice misuse and overuse puts you at the voice are speaking in noisy situ- esting field with a lot of variety, and are different, because other factors vocal chords and other parts of the cause severe problems.