Talk Docs

Some people’s voices are unmistakable—think Arnold Schwarzenegger, James Earl Jones, and Julia Child. You could recognize their voices with your eyes closed. There are millions more people such as teachers, preachers, and telemarketers whose voices are also part of their identity and their livelihood. Tamar Philbrook of Fort Kent is one of them. A third grade teacher and softball coach, Philbrook was self-conscious of her naturally raspy voice.

“A parent once commented on my voice and said, ‘I just figured you were a smoker,’” Philbrook says. “I have never smoked a day in my life! I was totally humiliated. It made me wonder how many other people have thought the same thing but haven’t mentioned it.” She met with a speech therapist who told her she had two options: She could quit teaching or stop talking. Not liking her choices, Philbrook decided to get a second opinion. She saw an ear, nose, and throat doctor who suggested she make an appointment at the Voice and Swallowing Center located at Waldo County General Hospital in Belfast.

Michael Towey is the manager of the speech pathology department at the Voice and Swallowing Center. He says voice problems like Philbrook describes are not unusual. “You hear many people speaking in the community whose voices sound hoarse, gravelly, or whiskey-sounding. Those are all voice disorders,” he says.

The first thing staff at the Voice and Swallowing Center inspected on Philbrook, as they do with any new patient, were her vocal folds. During this procedure, Towey guides a small scope on a long plastic tube through the patient’s nose and down into the throat to take a look. A small amount of anesthesia is used in the process. “We look to see if there is any disease on the folds like a polyp, nodule, cyst, or swelling,” he says. “Even if there is disease, you can still talk correctly. It’s when you have something wrong with the vocal folds and those folds try to overcompensate that make the problem worse.”

Most of the patients who visit the center don’t have a disease on their vocal folds—they’ve just been using their voice inefficiently for years. It is Towey’s job to retrain them to use their voice properly through various exercises and techniques that include humming, having them say “ah” or “me, me, me,” and teaching them to reposition their tongue when pronouncing words.

After scoping Philbrook’s throat, Towey confirmed she had nodules on her vocal folds. Nodules are solid raised bumps that are similar to calluses. Philbrook began working with Towey on voice therapy that day at the center, and when she returned to Fort Kent, the treatment sessions continued via telemedicine. Philbrook and Towey had videoconference therapy sessions via Skype, a free Internet calling site. By using a webcam on their computers, Towey could see how Philbrook was forming words with her mouth and Philbrook didn’t have to make the nine-hour round-trip drive to Belfast.

“He was able to help me with amplifi-cation of my voice in the classroom and see what the atmosphere was like,” she says. “My third grade students were very excited because I had them involved the whole time, telling them I was going to try different things with them and at times I may sound silly.”

Oftentimes, Towey and his staff can help a person with voice problems in just one session. A woman from Searsport who was incorrectly diagnosed with asthma is now medication-free after one therapy session with Towey. “Ninety-nine out of 100 times a person who goes to a doctor with wheezing breath is diagnosed with asthma. But when you hear wheezing problems while inhaling [rather than exhaling] that’s not asthma,” Towey says.

Patients who have swallowing problems, like those who have suffered a stroke or have Parkinson’s disease, may need more than one session of therapy to retrain their throat muscles. Towey says the center doesn’t perform surgeries and patients are not given medication to correct their voice or swallowing problems. All treatment conducted at the center is done through physical therapy.

Philbrook’s voice is now the strongest it has ever been and her nodules are gone. “I’m a very excited and enthusiastic teacher,” she says. “Through voice therapy Michael [Towey] showed me how to use my voice properly. I’m thrilled.”