Striking a cord

When the singing starts at Southeast Baptist Church, John Prim's voice usually leads the way. He is, after all, the worship leader. And Prim, one of the church's pastors, sometimes preaches. He's also chaplain for the Real Salt Lake soccer team.

Around Christmas, his smooth voice disappeared into a Louis Armstrong rumble. He'd had a sinus infection. It cleared, but his voice didn't.

Jodie Carson's voice left, too. The suddenly whispery remnant was inaudible during book club discussions. She quit taking her children swimming because the noise drowned her out completely. She even fretted walking the kids, 4 and 7, across a parking lot, knowing she couldn't shout a quick get-out-of-the-way warning.

Donna Johnson's voice was her profession and a source of joy. She often per- formed in operas and had soloed with the Utah Symphony. Mostly, though, she used song to express her pleasures and her sorrows, singing to herself to suit her moods. She'd always been careful with her voice. She lost it anyway.

Today, all three can talk about their experiences — as loud as they please. But only because they learned how to come back from an enforced and unfriendly near-silence.

Voice problems are nothing new to the folks at the University of Utah Voice Disorders Center in Research Park. Among the most common injuries are those caused by simple overuse, says Cara Sauder, clinical director and a speech pathologist.

They treat lots of people who rely on their voices professionally: teachers and preachers, singers and customer service phone staffers — all professionals at risk for voice injuries.

Voice problems can be caused by airway disorders, or by vocal folds that stick on top of the trachea. A membrane surrounds and protects vocal folds, with a muscle that opens and closes it. Lesions often occur on that membrane, which needs to be healthy for the sake of the voice.

Common voice problem symptoms include hoarseness, "effortful" speech, persistent pain, chronic sore throat with voice use, reduced volume, persistent cough or throat clearing and reduced vocal endurance.

They may signal recurrent laryngitis, vocal fold paralysis, aging voice, papilloma, cancer of the vocal folds, benign essential tremor, vocal fold web, muscle tension dysphonia, or benign vocal fold growths including polyps, nodules, cysts and granulomas. The voice box may also create breathing disorders that may not affect the voice but need to be treated.

That's one reason the problem may be misdiagnosed. A girl was told she had asthma but didn't get relief from her medications when she gasped for air. Finally she saw an ear, nose and throat specialist, who recognized that her vocal folds were not opening well, making an incomplete airway.