Vocalist.org archive


From:  "John Messmer, M.D." <jjm23@p...>
"John Messmer, M.D." <jjm23@p...>
Date:  Tue Feb 6, 2001  12:33 am
Subject:  Re: [vocalist] MED: Help!! Steroid Inhaler Nightmare Question



. They took her to an ENT doc who put
> her on an antibiotic, tamiflu, and gave her a steroid inhaler (asthmacort)
> and told her to use it 8 times a day and not to sing until the day she was
to
> perform her talent...I called my local ENT because I was afraid
> that the inhaler was a little much, but he agreed that it was the right
thing
> to do. He also called her in a medrol dosepak. She was much better the
next
> day, and by the time I saw her, on Friday, she felt better but sounded
> "Breathy" when she spoke. Her performance was a nightmare. She literally
> had no voice. She sounded hoarse and bone dry. Needless to say she
didn't
> win anything............As soon as we got her home I took her to a doc in
a
> nearby town who works a lot with singers, and he felt like the inhaler
just
> really dried her out. He put her on modified voice rest for 10 days and
said
> that she would be fine but to come back in 2 weeks if she was not. It has
> been 2 weeks today and she just called me crying from a chorale rehearsal,
> she says she can't sing at all. She does have a sore throat, but she has
> been sore ever since she used the inhaler. She is sore all the way down
into
> her chest. There is a lot of crud going around here, and she may just be
> sick, but we are afraid that the inhaler may have permanently damaged her
> vocal cords

It is unlikely she has permanent damage. It was way too short a time of
use. As long as she did not abuse her voice during the time, her vocal
apparatus should be fine.

Steroid inhalers can be drying, although Azmacort is the one that seems best
tolerated by singers. I can not say why her voice is doing what it is
doing, but I suspect the inhaler was only a minor issue. If she was on a
Medrol dosepak she probably could have skipped the inhaler, but that's water
under the bridge now.

It sounds like the steroids didn't help. Probably she just needs more time
to recover from the respiratory illness.

As to whom to consult, I'd suggest she see someone with experience
specifically in vocal disorders, especially for singers. If Vanderbilt is
accessible to you, go there.

John

John J. Messmer, M.D.
Assistant Professor, Family & Community Medicine
Penn State College of Medicine


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