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<v Speaker 1>Oh Hi, it's her Bobby Pin under the couch cushion.

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<v Speaker 1>Ali Ward and listen. If you're new around here, we

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<v Speaker 1>usually do not throw so many two parters your way

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<v Speaker 1>at once, but this and the Dreams episode both just

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<v Speaker 1>really deserve them. And we had nearly four hundred questions

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<v Speaker 1>for this one. So yes, a two parter it is. Also,

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<v Speaker 1>this is an ologist I was just thrilled to meet

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<v Speaker 1>after having a patron by the name of doctor Jessica

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<v Speaker 1>Randolph write in to say please, this ologist is a brilliant,

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<v Speaker 1>hilarious surgeon who works on voices. Have her on so

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<v Speaker 1>a voice surgeon, yes, practicing in this field since two

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<v Speaker 1>thousand and eight and specializing in voice disorders and airway issues.

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<v Speaker 1>An expert. So I happened to be in New York

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<v Speaker 1>and I got myself to the Bronx to meet up

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<v Speaker 1>with this MD and fellow of the American College of

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<v Speaker 1>Surgeons who's the director of the Division of Laryngology, ODO,

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<v Speaker 1>Rhino Laryngology and Head and Next Surgery at Montfiore Einstein

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<v Speaker 1>Medical Center. And we met up in the lobby. We

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<v Speaker 1>stayed masked and we ducked into a small conference room

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<v Speaker 1>and I learned so much about the voice, and also

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<v Speaker 1>that we have a lot in common, and that I

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<v Speaker 1>as a person have grown and I've changed. And I'm

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<v Speaker 1>leaving the word mucus unbleeped in this episode. I've bleeped

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<v Speaker 1>it in past episodes because i just can't deal. It

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<v Speaker 1>gags me out, but I'm living it in one thing

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<v Speaker 1>that does not gag me out. Our patrons, thank you

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<v Speaker 1>for joining at patreon dot com, slash ologies and for

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<v Speaker 1>submitting questions for the show. Thank you to everyone in ologies,

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<v Speaker 1>merch Wearing it ologiesmirch dot com has things. Thank you

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<v Speaker 1>to everyone who rates and subscribes and leads reviews for

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<v Speaker 1>me to read. Here's one this week to prove that

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<v Speaker 1>I read them all. It's from Bess Sarah, who wrote

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<v Speaker 1>that this show's quirky sense of humor mixed with science

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<v Speaker 1>is the perfect blend of fun and facts and it's

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<v Speaker 1>great for everyone, kids too, if they're used to a

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<v Speaker 1>little cursing, which reminds me that smologies episodes those are

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<v Speaker 1>trimmed of my filth, and they're shorter and their classroom safe.

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<v Speaker 1>So that's Whatsmology's episodes are for. They're for kids. Anyway,

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<v Speaker 1>Onto the Interview, Part one of it, where we will

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<v Speaker 1>use our voices to discuss your voices, plus Austin's Elvis drawl, hormones,

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<v Speaker 1>deep voices, squeaky ones, Tips for singers, free life hacks

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<v Speaker 1>that will make your skin glow and your brain work better,

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<v Speaker 1>vocal feminization, surgery, turning back time, anatomy you may not

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<v Speaker 1>know you have, and more, And then come back next

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<v Speaker 1>week for whistle Tones Mariah, damage to your voice, box,

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<v Speaker 1>throat singing perfect, pitch stress and voice cracks, and more

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<v Speaker 1>with your new favorite laryngologist, doctor Rohnda Alexander. Oh my god. Okay,

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<v Speaker 1>so here's your mic. There. They're stage mics, so they're

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<v Speaker 1>super hardy, So just kind of get up in it,

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<v Speaker 1>especially since we're masked.

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<v Speaker 2>I'm up in the mic. I'm up in the mic.

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<v Speaker 1>Perfect, Let me see, let me check your levels.

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<v Speaker 2>Recovering theater kid, recovering theater kid, person who loves Broadway,

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<v Speaker 2>person who sings the soundtrack to six in the shower

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<v Speaker 2>and hasn't seen it yet and that's her biggest embarrassment.

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<v Speaker 1>Literally, My first question doctor, is do you sing so done?

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<v Speaker 3>Amazing?

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<v Speaker 2>Wonderful?

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<v Speaker 1>One first question ask if you can say your first

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<v Speaker 1>and last name in your pronounce Yes.

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<v Speaker 2>First name Ronda, are O Nda, last name Alexander. My

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<v Speaker 2>pronouns are she her?

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<v Speaker 1>No extra h in that Ronda, Nope.

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<v Speaker 2>I am the daughter of Ronald and so I am

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<v Speaker 2>our o Nda.

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<v Speaker 1>Oh do any other doctors in your family? How do

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<v Speaker 1>you become a surgeon? That is just something that I'm

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<v Speaker 1>cannot even fathom.

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<v Speaker 2>It requires. There is a delightful mix of ignorance and

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<v Speaker 2>perseverance and encouragement, those three together. So it is one

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<v Speaker 2>of those things where if you knew the full scope

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<v Speaker 2>of the sacrifice and discomfort that it would be, you

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<v Speaker 2>might not do it. But the pathway for me began

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<v Speaker 2>way back in the eighties with first grade, where I

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<v Speaker 2>was very, very fortunate to be in a scholastic environment

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<v Speaker 2>where my teachers and my peers and my family all

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<v Speaker 2>just really encouraged academic talent. Definitely not a situation where

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<v Speaker 2>that was not a cultural fit. They were like, oh,

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<v Speaker 2>this is this is great. We love this. We love

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<v Speaker 2>when you bring home these report cards with all straight lines.

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<v Speaker 2>We love it very much. Good job kid. And then

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<v Speaker 2>you know, high school, I went to university down in Louisiana.

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<v Speaker 2>I went to Zaba University of Louisiana, a historically black college,

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<v Speaker 2>and then I went to medical school. And at that

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<v Speaker 2>point now I am twenty twenty five, about to turn

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<v Speaker 2>twenty six when I finished medical school, and I have

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<v Speaker 2>secured a very coveted spot in the very competitive specialty

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<v Speaker 2>of odo laryngology, head and next surgery. There are only

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<v Speaker 2>about two hundred and twenty jobs in the country when

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<v Speaker 2>you finish medical school. It's gone up a little bit.

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<v Speaker 2>But the time when I was coming out to twenty was.

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<v Speaker 1>It, Wow, two hundred and twenty openings every year to

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<v Speaker 1>join the established ten to twelve thousand laryngologists in the US.

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<v Speaker 1>And for context, I look this up. Every year the

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<v Speaker 1>NBA hires about sixty new players, so your chances are

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<v Speaker 1>only like four times better than getting into the NBA.

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<v Speaker 1>But doctor Ronda Alexander is at the top of her field, so.

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<v Speaker 2>And I was able to secure a position actually right here.

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<v Speaker 2>I trained at this same place where I work. Now,

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<v Speaker 2>you did, I did.

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<v Speaker 1>But you were in Houston for a while as well.

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<v Speaker 2>Yes, I worked down there for a decade. So after residency,

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<v Speaker 2>which is five years of pushing your body and brain

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<v Speaker 2>to the limits, being awake as long as thirty hours

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<v Speaker 2>or so back when I did it, and finding safety

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<v Speaker 2>in that and sacrifice and enjoy all of those things together.

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<v Speaker 2>Then I did a one year FELLA in laryngology which

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<v Speaker 2>had a bent towards NEU laryngology, so nerve based disorders

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<v Speaker 2>of the head and neck and voice box. And then

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<v Speaker 2>I left New York and I went down to Houston,

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<v Speaker 2>and I practiced there for over twelve years before coming

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<v Speaker 2>back to New York.

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<v Speaker 1>And you've said so many ologies in the last minute.

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<v Speaker 2>So our training that first five years is comprehensive odorhino laryngology,

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<v Speaker 2>head and neck surgery. So that's everything from taking tonsils

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<v Speaker 2>out of a small child with breathing problems or putting

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<v Speaker 2>ear tubes in so they can hear well, to taking

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<v Speaker 2>care of cancers of the thyroid or mouth or tongue,

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<v Speaker 2>to taking care of allergies and polyps in the nose

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<v Speaker 2>or heaven forbid, also there can be cancers in there

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<v Speaker 2>that we take care of as well, all the way

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<v Speaker 2>to cosmetic things like using botox to soften wrinkles and

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<v Speaker 2>lines fillers to plump up the face and make it

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<v Speaker 2>even younger looking, and then my part, which is voice

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<v Speaker 2>airway swallowing disorder.

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<v Speaker 1>We do that.

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<v Speaker 2>Did I leave anyone out? Hearing? That's right, so otology

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<v Speaker 2>and neurootology, that's going to be the specialties of hearing

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<v Speaker 2>and balance and restoring that. So we have a broad

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<v Speaker 2>umbrella and our field in general is about how we

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<v Speaker 2>interact with the world. So we're in charge of hearing, taste, smell,

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<v Speaker 2>the way your face looks, and the way your voice sounds.

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<v Speaker 2>So we're really all about how you interact with your environment.

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<v Speaker 1>Oh my gosh, what about now? What would you say?

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<v Speaker 1>A lot of your work now is.

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<v Speaker 2>So my work now concentrates in two main areas, and

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<v Speaker 2>that is voice health and airway health. So voice health

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<v Speaker 2>is going to be are there injuries or developmental problems

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<v Speaker 2>in the voice box, anatomy or the way that the

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<v Speaker 2>person uses it that are getting in the way of

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<v Speaker 2>them being able to present themselves authentically, confidently and in

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<v Speaker 2>a healthful way. And then a lot of I do

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<v Speaker 2>airway disorders, So that's going to be people who have

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<v Speaker 2>had an injury or inflammation or surgery on the voice

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<v Speaker 2>box that has led to a narrow place in particular,

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<v Speaker 2>And so we do lots of reconstructions and things to

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<v Speaker 2>help get them so they can live a tube free life.

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<v Speaker 2>So most of those folks are going to have a tracheostomy,

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<v Speaker 2>which is an artificial whole from the skin down to

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<v Speaker 2>the windpipe or trachea, and so finding ways to get

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<v Speaker 2>that out because most people just don't want them.

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<v Speaker 1>Is There are a part of your job too that

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<v Speaker 1>deals with why someone can sing or not sing, In

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<v Speaker 1>particular me, why can't I sing?

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<v Speaker 2>So that ends up being in vocology or phoneology. So

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<v Speaker 2>that's going to be the province of professional singing teachers

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<v Speaker 2>and coaches. So we work oftentimes in collaboration with them

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<v Speaker 2>and another discipline called speech language pathology, and together I'm

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<v Speaker 2>in charge of the anatomy and the medical health. The

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<v Speaker 2>singing teacher is in charge of technique and maybe style,

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<v Speaker 2>and the speech language pathologists also overlaps with technique and

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<v Speaker 2>also breathing health and reducing things like coughing. And they

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<v Speaker 2>do a lot of coaching on things like reflex habits

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<v Speaker 2>to collaborate with us as well. And you sing, I've

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<v Speaker 2>been known to sing.

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<v Speaker 1>Sing did not have any did performance have any influence

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<v Speaker 1>in which field you went into?

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<v Speaker 2>So I think it did earlier than I originally remembered.

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<v Speaker 2>It definitely played a role in medical school where the

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<v Speaker 2>patient's problems made sense to me when everyone else was like,

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<v Speaker 2>who cares if they're missing a half step? And I

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<v Speaker 2>was like, that makes a difference between whether they get

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<v Speaker 2>a role or not, and if they don't get that role,

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<v Speaker 2>that's whether they eat or not. And so like for me,

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<v Speaker 2>it was a very practical thing, even though it's esoteric

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<v Speaker 2>and high level and people think, oh, it's only on Broadway,

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<v Speaker 2>But same for teachers, same for professional parents. If you

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<v Speaker 2>can't use your voice with your child, are you able

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<v Speaker 2>to do your job effectively? No, So everyone who uses

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<v Speaker 2>their voice as a part of their job is a

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<v Speaker 2>professional voice user as I consider them. They may not

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<v Speaker 2>be performance voice users, but they are professional voice users.

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<v Speaker 2>So heaven forbid to to if Ali gets a voice disorder,

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<v Speaker 2>which I've heard you have, You've had colds and whatnot,

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<v Speaker 2>and thought through it done it's pad anyway, lady, It's true.

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<v Speaker 2>But like, if you can't do your job without your voice,

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<v Speaker 2>you're a professional voice user and you deserve the best

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<v Speaker 2>voice health.

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<v Speaker 1>And you mentioned a half step, and I have no

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<v Speaker 1>idea what that tho. Well musically, okay, is is that

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<v Speaker 1>like an octave or.

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<v Speaker 2>So it's one sixteenth of an octave?

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<v Speaker 4>Okay?

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<v Speaker 2>Active is eight notes and a half step would be

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<v Speaker 2>in between.

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<v Speaker 1>Okay. See already learning so many things. Obviously I'm not

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<v Speaker 1>a singer. It's okay, But how does a person make

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<v Speaker 1>words and sounds like? I don't even know what a

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<v Speaker 1>voice box is? Is that the Adam's apple or what

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<v Speaker 1>do we call a voicebox?

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<v Speaker 2>So the larynx, which the Adam's apple is a part

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<v Speaker 2>that you can feel, is composed of a few paired cartilages.

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<v Speaker 2>Cartilage is kind of that scrunchy version of bones, squishy, flexible.

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<v Speaker 2>So the single unpaired cartilages are the thyroid cartilage. And

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<v Speaker 2>that's the one that in people who have had testosterone

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<v Speaker 2>driven puberty, they're going to get a big prominence that

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<v Speaker 2>comes out. We call that the thyroid prominence. And that's

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<v Speaker 2>the Adam's apple.

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<v Speaker 1>But just a side note, you can also call it

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<v Speaker 1>a prominentia laryngia if you're fancy. But don't feel bad

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<v Speaker 1>about ditching Adam in the Adam's apple name, because since

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<v Speaker 1>it was likely just a bad translation from some Hebrew

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<v Speaker 1>term meaning the swellings of a man. But if neither

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<v Speaker 1>an Adam's apple or a prominentia laryngia are just not

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<v Speaker 1>striking a chord for you, just call your throat cartilage

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<v Speaker 1>a goozle, and yes, I will use it. In a

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<v Speaker 1>sample sentence provided by an online dictionary quote, they served

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<v Speaker 1>real good cold beer in those days. It almost froze

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<v Speaker 1>your goozle pipes. But it pains me to tell you

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<v Speaker 1>that goozle is a term that actually has its dance

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<v Speaker 1>card pretty filled with meanings, because, according to another word

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<v Speaker 1>origin site, a goozle can be any substance with the

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<v Speaker 1>consistency of thickened gravy, not necessarily going down your goozle,

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<v Speaker 1>but moving on moving downward.

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<v Speaker 2>Below that is another cartilage called the crichoid cartilage, and

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<v Speaker 2>that one is like the strong beam of the airway,

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<v Speaker 2>keeping it nice and open for all the parts that

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<v Speaker 2>need to move about. And now paired cartilages are going

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<v Speaker 2>to be the a retinoids. These are like sailboats, sail

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<v Speaker 2>shaped cartilages that do a lot of the moving. The

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<v Speaker 2>vocal cords are actually strung from them. Oh, they have

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<v Speaker 2>a complicated series of pulleys muscles make them move in

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<v Speaker 2>several different directions to allow the voice box to achieve

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<v Speaker 2>closure and opening.

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<v Speaker 1>And your vocal cords are pretty much right where your

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<v Speaker 1>head meets your neck, in the front, just below the

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<v Speaker 1>hyoid bone. What the fuck is a hyoid bone? No

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<v Speaker 1>one ever told me I had this bone. It's in

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<v Speaker 1>the front of my neck. It's floating in my neck.

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<v Speaker 1>A hyoid apparently means you shaped in Greek. And this

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<v Speaker 1>thing does look like a horse shoe or half a

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<v Speaker 1>bread crust right under your jaw. Why didn't you tell

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<v Speaker 1>me I had a floating toast bone that anchors my

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<v Speaker 1>tongue to my skeleton. Anyway, that bone is just upstairs

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<v Speaker 1>from the vocal cords.

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<v Speaker 2>So where does the voice come from? It comes from

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<v Speaker 2>three different parts. The lungs of the power source they

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<v Speaker 2>send up the air. The vocal folds do the vibrating.

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<v Speaker 2>That's the base sound, and then the resonators are the throat,

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<v Speaker 2>the mouth, the lips, to tongue, the teeth, and that's

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<v Speaker 2>how you shape the sound to be like you. So

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<v Speaker 2>we'll often describe the act of vocal production that we

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<v Speaker 2>are an instrument to. So in a piano you have

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<v Speaker 2>the body of the piano, that's your resonator. The power

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<v Speaker 2>comes from when the hammer inside hits the strings, and

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<v Speaker 2>you're the source when you're banging on the keys. And

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<v Speaker 2>so similarly in us we have those same three things,

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<v Speaker 2>a power source, a vibrator, and resonators.

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<v Speaker 1>So when people say that my voice is my instrument,

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<v Speaker 1>they're not. They're they're not dicking around. That's real.

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<v Speaker 2>No, it's totally real. Yeah, absolutely, maybe my mom.

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<v Speaker 1>And what about different qualities of a voice over time? Obviously,

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<v Speaker 1>if a kid calls you on the phone, you're like,

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<v Speaker 1>I know, this is a kid, you know. And then

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<v Speaker 1>if your grandpa calls you on the phone, it's gonna

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<v Speaker 1>sound like your grandpa. So what is it about age

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<v Speaker 1>that changes the quality of a voice.

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<v Speaker 2>So, yes, our voice box and our resonators change over

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<v Speaker 2>the course of our lifespan. When we're young, everything's tiny,

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<v Speaker 2>and so you'll hear people say children have small voices.

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<v Speaker 2>It's because they do. Their resonating system is small, and

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<v Speaker 2>they tend to just be up here. They also haven't

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<v Speaker 2>gone through any of the hormonal changes which might which

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<v Speaker 2>will when puberty hits impact the shape of the voice

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<v Speaker 2>box and the vocal folds themselves. We actually have hormone

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<v Speaker 2>sensitive tissues inside of our voice box, and depending upon

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<v Speaker 2>which hormones we get more of during puberty, the vocal

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<v Speaker 2>folds make it's thicker and wider, and then the voice

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<v Speaker 2>box stretches as the thyroid cartilage changes. For those folks

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<v Speaker 2>who get testosterone proberty, and.

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<v Speaker 1>Then if you are, let's say, going through menopause or

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<v Speaker 1>if you are taking testosterone for you know, gender affirming therapy,

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<v Speaker 1>how does that change what's going on there as well?

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<v Speaker 2>So for my fems who are going through it, durynus

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<v Speaker 2>down there is associated with dryness up here, really, so

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<v Speaker 2>your overall moisture levels are going to change as you

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<v Speaker 2>approach I like to think of that as like the

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<v Speaker 2>last puberty, as I head into it myself.

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<v Speaker 1>Agonizing and agonizing surprise, exciting.

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<v Speaker 2>Life is exciting, That's one way. Yeah, So which hormones

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<v Speaker 2>you're getting are going to influence everything from the texture

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<v Speaker 2>of your mucus to the thickness of the tissue itself,

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<v Speaker 2>which kinds of proteins and carbohydrates. It's to be tending

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<v Speaker 2>to secrete, how thick your vibration layers are going to

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<v Speaker 2>be all of those are going to be impacted by

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<v Speaker 2>the hormones that you're experiencing. Wow, And to go back

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<v Speaker 2>to the whole lifespan. As we age the same way,

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<v Speaker 2>our pectorial may muscles and our arm muscles begin to

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<v Speaker 2>droop and what we call atrophy or lose the body.

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<v Speaker 2>The vocal folds can do that as well, So older

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<v Speaker 2>voices will tend to be maybe a little thinner, you

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<v Speaker 2>may describe it. We call it esthenic because they've lost

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<v Speaker 2>muscle bulk. And we have things that we can do

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<v Speaker 2>to help folks who are in that situation, who still

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<v Speaker 2>need to use their voice because they may still be working,

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<v Speaker 2>or just to feel more confident as well.

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<v Speaker 1>Yeah, you know, my dad was really sick recently. My

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<v Speaker 1>dad just passed away. But as he was getting sicker,

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<v Speaker 1>he was losing a lot of weight and his voice

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<v Speaker 1>changed a lot, And I never was sure what that

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<v Speaker 1>was about. And it's interesting to think that his muscles

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<v Speaker 1>were maybe atrophine.

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<v Speaker 2>But also like loss of power. Yeah, that's another thing

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<v Speaker 2>we have in common. It was my mom in June,

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<v Speaker 2>my Aloma. Really yeah, no, absolutely, absolutely, we're like little twinkies,

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<v Speaker 2>the two of us.

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<v Speaker 1>Holy shit, up, So sorry. How long was she sick for?

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<v Speaker 2>Oh? So she actually was diagnosed when I was a

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<v Speaker 2>chief resident, so back in two thousand and seven. So

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<v Speaker 2>we've had we had fifteen bonus years.

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<v Speaker 1>Yeah, we had ten with my dad. I'm so sorry.

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<v Speaker 2>We're just together in heart.

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<v Speaker 1>So to learn more about this cancer I hate, you

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<v Speaker 1>can listen to the hematology episode on Blood and for

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<v Speaker 1>my Loma patients, the uncut hematology file on my website

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<v Speaker 1>has a lot of extra questions I asked for patients

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<v Speaker 1>and that'll be linked in the show notes. And an

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<v Speaker 1>extra donation for this episode will go to myloma dot

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<v Speaker 1>org in memory of doctor Alexander's mom, the late and

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<v Speaker 1>wonderful Reverend Barbara Alexander. I'm so sorry you lost her though.

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<v Speaker 2>Oh yeah, it's had it totally. Had a therapy appointment

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<v Speaker 2>about this morning. So you know, we just we keep

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<v Speaker 2>doing stuff.

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<v Speaker 1>I've got one on Friday.

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<v Speaker 2>Yeah yeah, yeah. It's the rest of our lives and

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<v Speaker 2>we just we live it.

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<v Speaker 1>I'm sure she was so proud of you.

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<v Speaker 2>Oh yeah, she's a character.

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<v Speaker 1>And my dad are somewhere right now, just like going,

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<v Speaker 1>hey nice.

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<v Speaker 2>She's probably bosting him around too. Yeah, yeah, I'll take it. Yeah,

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<v Speaker 2>because Grandpad was gentle.

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<v Speaker 1>Yes, he was a very Grandpad was a very gentle guy.

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<v Speaker 1>It was it was interesting not to hear that, you know,

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<v Speaker 1>as you get weaker and even if you're sick, or

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<v Speaker 1>you're tired, or you know, is that something that people

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<v Speaker 1>ever come to you wanting to turn back the clock on?

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<v Speaker 2>Absolutely?

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<v Speaker 1>Really yeah.

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<v Speaker 2>Yeah. They want to get their young, robust voice and

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<v Speaker 2>the same way they want to get their young robust face.

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<v Speaker 2>And hopefully we can get them to get their young

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<v Speaker 2>robust hearing by just wearing the hearing aids. So we

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<v Speaker 2>can do procedures either under general anesthesia full sleep, no pain,

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<v Speaker 2>no memories, no moving, or under local anesthesia mild discomfort,

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<v Speaker 2>with lots of coaching through the event that we that

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<v Speaker 2>can actually just plump up the vocal cords with injections.

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<v Speaker 1>Wow, this is called a voice lift. Who knew, not me,

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<v Speaker 1>but the gravelly, raspy the grip of time can be

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<v Speaker 1>plumped up and then the song of youth returns, if

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<v Speaker 1>that is what you want. And I watched some videos

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<v Speaker 1>down the glottal hatch of people's vocal chords before and

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<v Speaker 1>after a voicelift. I don't know how to describe this delicately,

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<v Speaker 1>but my first impression of it, it looked the atrophied

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<v Speaker 1>older vocal folds looked kind of like a vadge that

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<v Speaker 1>was open wide, and then the rejuvenated ones kind of

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<v Speaker 1>look like of a gene that was caught midwink, kind

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<v Speaker 1>of closed up. Speaking of voice and crotches and changes,

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<v Speaker 1>we're gonna talk a lot more about puberty and gender

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<v Speaker 1>and vocal matters later on in this episode.

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<v Speaker 2>Yeah, they can last anywhere from six weeks to around

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<v Speaker 2>two years to some that are quasi permanent, but those

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<v Speaker 2>are usually going to be understurgery because we have to

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<v Speaker 2>do a little bit more work and you shouldn't be

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<v Speaker 2>awake for that.

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<v Speaker 1>Yeah, yeah, that's a lot. I'm sure the recovery time

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<v Speaker 1>is at least a few weeks, right.

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<v Speaker 2>Well, most of them, I get them talking within two days,

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<v Speaker 2>and I just give them three rules. No whispering, because

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<v Speaker 2>whispering is actually really bad for your voice box because

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<v Speaker 2>you're putting a lot of pressure and squeezing to bank

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<v Speaker 2>that quiet but strong voice. That was exhausting even just that.

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<v Speaker 2>No talking on the cell phone outdoors because people forget

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<v Speaker 2>that they're competing with the noise in the background, and

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<v Speaker 2>so they're actually talking louder than they think. And then

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<v Speaker 2>the third rule is if you can't touch them, you

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<v Speaker 2>can't talk to them. So no shouting through the house.

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<v Speaker 1>Wow, oh my gosh. Okay, now what about coughing. What

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<v Speaker 1>is happening when you're coughing to your vocal cords? Is

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00:20:34.559 --> 00:20:36.799
<v Speaker 1>it chaos down there? It is?

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00:20:37.160 --> 00:20:43.799
<v Speaker 2>It's misfortune. Absolutely. They are experiencing a forceful slamming shut

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<v Speaker 2>followed by an air eruption. And so because we rarely

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00:20:46.960 --> 00:20:51.519
<v Speaker 2>cough once, they're slamming together pretty hard. And we have

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00:20:51.720 --> 00:20:54.960
<v Speaker 2>seen people who just from a coughing disorder, whether it's

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<v Speaker 2>pneumonia or unfortunately recently COVID being a coughing disorder, or

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00:21:02.680 --> 00:21:06.880
<v Speaker 2>from even if really hardcore throat clearing, where the banging

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<v Speaker 2>together actually destroys part of the lining and puts them

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<v Speaker 2>at risk for a thing called a granuloma, which is

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00:21:13.359 --> 00:21:17.160
<v Speaker 2>an irritation that grows and it kind of makes like

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00:21:17.160 --> 00:21:20.160
<v Speaker 2>a popcorn looking thing and stops your vocal cores from

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00:21:20.160 --> 00:21:23.039
<v Speaker 2>closing really well. And it's a cycle because having it

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00:21:23.079 --> 00:21:26.079
<v Speaker 2>there is an irritant which makes you cough and coughing

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<v Speaker 2>makes it worse, and it getting worse makes you cough,

404
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<v Speaker 2>et cetera. Et cetera.

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<v Speaker 1>Is that how a cough from an illness can become chronic,

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<v Speaker 1>Like even though you're not infectious or anymore, or you're

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<v Speaker 1>not infected with say, you know, pneumonia or bronchitis, that

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00:21:39.799 --> 00:21:41.720
<v Speaker 1>cough becomes chronic from that irritation.

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<v Speaker 2>Chronic cough comes from a few different kinds of things.

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<v Speaker 2>It can come from the after effects of an infection,

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<v Speaker 2>like if you had a sinus or nose infection and

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<v Speaker 2>it's dripping gross, that'll make your cough. But also there

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<v Speaker 2>can be nerve based coughs cough from the original issue.

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<v Speaker 2>But then also we kind of get into the habit

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<v Speaker 2>of cough and it ties closely to throat clearing where

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<v Speaker 2>we're all the time, and we actually have certain kinds

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<v Speaker 2>of rehab where we basically teach you to ignore that stimulus,

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<v Speaker 2>to extinguish the stimulus. When you feel like you want

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<v Speaker 2>a cough, you take a drink of water, or you

420
00:22:17.400 --> 00:22:19.359
<v Speaker 2>do a different thing, or you say something, or you

421
00:22:19.440 --> 00:22:21.519
<v Speaker 2>just let the air out gently. So instead of going

422
00:22:22.200 --> 00:22:25.839
<v Speaker 2>they just go and let the air out so that

423
00:22:25.880 --> 00:22:29.160
<v Speaker 2>they're not giving that irritating stimulus again so that we

424
00:22:29.200 --> 00:22:32.279
<v Speaker 2>can help break the cycle of the coughing. She's got

425
00:22:32.319 --> 00:22:35.599
<v Speaker 2>this incredibly grotesque throat clearing tick.

426
00:22:35.720 --> 00:22:36.119
<v Speaker 3>It's like.

427
00:22:39.880 --> 00:22:41.359
<v Speaker 2>It's like she's sticking for clams.

428
00:22:41.839 --> 00:22:43.319
<v Speaker 1>Well, what's happening with a cough drop?

429
00:22:43.519 --> 00:22:45.759
<v Speaker 2>So, cough drops are doing a couple of things. They

430
00:22:45.880 --> 00:22:49.599
<v Speaker 2>often contain menthol, and menthol just kind of like opens

431
00:22:49.680 --> 00:22:52.359
<v Speaker 2>up all the passages in the nose, does a little

432
00:22:52.400 --> 00:22:54.759
<v Speaker 2>bit of shrinking of how much mucus you're making, so

433
00:22:55.119 --> 00:22:58.440
<v Speaker 2>there's less irritant going on when you're breathing it in.

434
00:22:58.839 --> 00:23:01.319
<v Speaker 2>It's also soothing and doucing some of the mucus in

435
00:23:01.359 --> 00:23:03.160
<v Speaker 2>the throat. And then the third part is you put

436
00:23:03.160 --> 00:23:05.279
<v Speaker 2>any candy in your mouth, you're gonna make more saliva,

437
00:23:05.680 --> 00:23:08.799
<v Speaker 2>and so you're getting wetter saliva instead of the thick

438
00:23:08.920 --> 00:23:11.279
<v Speaker 2>MUCUSI one that the mental is drying up, and so

439
00:23:11.319 --> 00:23:13.400
<v Speaker 2>your throat is just happy that you're getting a little

440
00:23:13.400 --> 00:23:15.000
<v Speaker 2>bit more saliva to help soothe it.

441
00:23:15.039 --> 00:23:16.839
<v Speaker 1>Is that cool? Is it cool to have cough drops

442
00:23:16.839 --> 00:23:17.440
<v Speaker 1>if you need them?

443
00:23:17.519 --> 00:23:19.640
<v Speaker 2>So they're okay, okay, I just want to like that's

444
00:23:19.640 --> 00:23:21.279
<v Speaker 2>one of those things where it's like follow the package

445
00:23:21.319 --> 00:23:24.680
<v Speaker 2>directions you shouldn't have a cough drop every hour on

446
00:23:24.759 --> 00:23:27.799
<v Speaker 2>the hour for several days. That's like, okay, well, what's

447
00:23:27.839 --> 00:23:30.599
<v Speaker 2>really going on here? And examine? Am I drinking enough water?

448
00:23:31.279 --> 00:23:33.240
<v Speaker 2>When am I eating? And what am I eating? Am

449
00:23:33.240 --> 00:23:36.240
<v Speaker 2>I eating a whole turkey dinner? And then laying straight

450
00:23:36.240 --> 00:23:38.440
<v Speaker 2>down and giving myself reflex which is gonna burn my

451
00:23:38.559 --> 00:23:42.200
<v Speaker 2>voice box? Oh hello, fast paced people who work in

452
00:23:42.240 --> 00:23:42.920
<v Speaker 2>these jobs.

453
00:23:43.039 --> 00:23:46.960
<v Speaker 1>Yes, indeed, I mean, is there something that is better

454
00:23:47.119 --> 00:23:49.240
<v Speaker 1>for reflex? Is it better to eat at like seven

455
00:23:49.319 --> 00:23:51.319
<v Speaker 1>pm if you're going to bed at eleven and just

456
00:23:51.759 --> 00:23:54.640
<v Speaker 1>give your body time to not burp up acid?

457
00:23:54.839 --> 00:23:57.400
<v Speaker 2>Right, So you're gonna transit the food that you put

458
00:23:57.440 --> 00:23:59.480
<v Speaker 2>in your belly within three to four hours. And so

459
00:23:59.519 --> 00:24:02.400
<v Speaker 2>I try to folks a window. You can eat almost

460
00:24:02.480 --> 00:24:04.640
<v Speaker 2>whatever you want. Pay attention to your body and how

461
00:24:04.640 --> 00:24:07.000
<v Speaker 2>it responds to different foods, but you want an empty

462
00:24:07.000 --> 00:24:09.559
<v Speaker 2>belly and went into bedtime. So last food must be

463
00:24:09.640 --> 00:24:12.200
<v Speaker 2>done for my beginners. I tell them two hours because

464
00:24:12.400 --> 00:24:14.559
<v Speaker 2>they got to get in the habit and it's so hard.

465
00:24:14.640 --> 00:24:16.720
<v Speaker 2>Where it used to there's always a snack at the

466
00:24:16.759 --> 00:24:19.119
<v Speaker 2>side of the bed, there's cookies. I went to bed

467
00:24:19.119 --> 00:24:21.160
<v Speaker 2>with toast. I went to bed with the fruit. But

468
00:24:21.279 --> 00:24:24.279
<v Speaker 2>especially if you have symptoms of cough, voice trouble, or

469
00:24:24.319 --> 00:24:28.160
<v Speaker 2>specifically heartburn, you got to tighten it up empty belly.

470
00:24:28.279 --> 00:24:30.599
<v Speaker 2>So really three hours I would love to see before

471
00:24:30.640 --> 00:24:33.519
<v Speaker 2>you lay down at all. Now, going thinking back to

472
00:24:33.559 --> 00:24:36.680
<v Speaker 2>like my medical school and residency days, if I got

473
00:24:36.720 --> 00:24:39.279
<v Speaker 2>home at nine or ten pm, I'm not staying up

474
00:24:39.319 --> 00:24:40.559
<v Speaker 2>till one because I have to get up the next

475
00:24:40.599 --> 00:24:43.759
<v Speaker 2>morning at five. So that meant making modifications, which we

476
00:24:43.799 --> 00:24:46.799
<v Speaker 2>recommend to folks all the time. So I for years

477
00:24:46.799 --> 00:24:50.160
<v Speaker 2>slept in a recliner. Oh if I was having a

478
00:24:50.200 --> 00:24:52.599
<v Speaker 2>late day, so I would have my meal and I

479
00:24:52.599 --> 00:24:54.119
<v Speaker 2>would have to go right to bed, and so I

480
00:24:54.160 --> 00:24:55.440
<v Speaker 2>would just make sure I was at a little bit

481
00:24:55.480 --> 00:24:58.480
<v Speaker 2>of an incline, give your head some support. And that's

482
00:24:58.519 --> 00:25:01.039
<v Speaker 2>just a modification. Just like you would modify an exercise

483
00:25:01.079 --> 00:25:02.920
<v Speaker 2>for your own health. You can modify the things you

484
00:25:02.960 --> 00:25:04.599
<v Speaker 2>have to do. You don't always have to sleep in

485
00:25:04.599 --> 00:25:04.920
<v Speaker 2>a bed.

486
00:25:05.039 --> 00:25:07.319
<v Speaker 1>I would never have thought of that as like a

487
00:25:07.319 --> 00:25:09.559
<v Speaker 1>as a fix for that. You know there are because

488
00:25:09.599 --> 00:25:11.680
<v Speaker 1>there have been times when I have come home with

489
00:25:11.720 --> 00:25:15.519
<v Speaker 1>my purse still on and microwaved a frozen dinner it's

490
00:25:15.519 --> 00:25:17.880
<v Speaker 1>been like this is the picture of like such a

491
00:25:18.440 --> 00:25:19.799
<v Speaker 1>just a haggard career woman.

492
00:25:19.880 --> 00:25:22.759
<v Speaker 2>You know it's glamorous. We're both living glamorous sides.

493
00:25:23.599 --> 00:25:27.799
<v Speaker 1>What about does sleep apnea fall under your like surgical

494
00:25:27.839 --> 00:25:29.480
<v Speaker 1>interventions at all or so?

495
00:25:29.720 --> 00:25:33.240
<v Speaker 2>In the broader umbrella fields sleep sleep surgery is also

496
00:25:33.240 --> 00:25:35.960
<v Speaker 2>a part of odoran alaryngology head next surgery, and so

497
00:25:36.000 --> 00:25:38.079
<v Speaker 2>there are surgeries that can be done to reduce the

498
00:25:38.160 --> 00:25:41.839
<v Speaker 2>resistance in the nose and also to keep the tension

499
00:25:41.920 --> 00:25:44.119
<v Speaker 2>in the tongue and throat at a level that keeps

500
00:25:44.160 --> 00:25:47.559
<v Speaker 2>it open. Because sleep acne is really about collapse. Sometimes

501
00:25:47.559 --> 00:25:51.440
<v Speaker 2>that's nerve based, sometimes it's bulk based. But regardless of

502
00:25:51.480 --> 00:25:54.519
<v Speaker 2>weight bm I, whatever measure you want to choose, it

503
00:25:54.559 --> 00:25:56.920
<v Speaker 2>can happen to anyone having that sleep apnea. So it's

504
00:25:56.960 --> 00:25:59.640
<v Speaker 2>the answer is not always just lose weight. Yeah, there

505
00:25:59.640 --> 00:26:01.480
<v Speaker 2>are certain that you may need to be done to

506
00:26:01.519 --> 00:26:05.240
<v Speaker 2>help reduce the resistance in the airway. Rarely we involve

507
00:26:05.279 --> 00:26:07.559
<v Speaker 2>the voice box, but we can do that if they

508
00:26:07.559 --> 00:26:12.039
<v Speaker 2>have a condition called Larringo Malaysia Space LA r y

509
00:26:12.200 --> 00:26:15.279
<v Speaker 2>g O m A l a CIA Space for editing

510
00:26:17.039 --> 00:26:20.400
<v Speaker 2>Loringo Malaysia Laaringo Malaysia is a condition where the voice

511
00:26:20.440 --> 00:26:23.839
<v Speaker 2>box collapses under the pressures of breathing in and can

512
00:26:23.880 --> 00:26:26.200
<v Speaker 2>contribute to the sleep acnea. So we can make some

513
00:26:26.279 --> 00:26:29.880
<v Speaker 2>modifications to help it stay open and more strong, but

514
00:26:30.000 --> 00:26:33.920
<v Speaker 2>mostly for sleep acnea. My concern is again you're breathing

515
00:26:33.960 --> 00:26:37.599
<v Speaker 2>against resistance. What happens the chest pressure goes down and

516
00:26:37.640 --> 00:26:41.359
<v Speaker 2>the belly pressure sucks up more reflux. So folks who

517
00:26:41.400 --> 00:26:45.440
<v Speaker 2>sleep acne is not treated also have more reflux symptoms

518
00:26:45.519 --> 00:26:46.759
<v Speaker 2>very commonly.

519
00:26:46.640 --> 00:26:50.039
<v Speaker 1>So double whammy and not good whammies either one of them,

520
00:26:50.240 --> 00:26:52.920
<v Speaker 1>but not all. Snoring is related to bulk in the

521
00:26:52.960 --> 00:26:55.400
<v Speaker 1>throat and also, as we have discussed on this podcast,

522
00:26:55.440 --> 00:26:58.839
<v Speaker 1>BMI is a very loose and kind of shady metric

523
00:26:59.039 --> 00:27:03.519
<v Speaker 1>for determining body composition. It was invented by an Austrian

524
00:27:03.960 --> 00:27:08.720
<v Speaker 1>astronomer was not even a medical doctor, but even a

525
00:27:08.799 --> 00:27:10.839
<v Speaker 1>legit MD can tell you that. Of course BMI does

526
00:27:10.880 --> 00:27:12.640
<v Speaker 1>not tell the whole story at all, and it's not

527
00:27:12.680 --> 00:27:16.119
<v Speaker 1>fair to bodybuilders or to me. The day after I

528
00:27:16.160 --> 00:27:20.519
<v Speaker 1>have ramen, I'm like a juicy, salty sham wow of

529
00:27:20.559 --> 00:27:25.359
<v Speaker 1>a person. But the condition lo Ringo Malaysia, which she mentioned,

530
00:27:25.640 --> 00:27:29.839
<v Speaker 1>can also show up in babies who have floppier vocal cords,

531
00:27:30.200 --> 00:27:34.480
<v Speaker 1>and it leads to something called strider or noisy breathing, which,

532
00:27:34.759 --> 00:27:38.480
<v Speaker 1>out of all of the loud things that a tiny

533
00:27:38.519 --> 00:27:42.200
<v Speaker 1>baby can do from either end of their little soft bodies,

534
00:27:42.240 --> 00:27:45.200
<v Speaker 1>I never knew that just breathing could be a loud thing,

535
00:27:45.359 --> 00:27:48.319
<v Speaker 1>these poor little babes. What should people do if they

536
00:27:48.519 --> 00:27:50.359
<v Speaker 1>have sleep at near their sleeping like shit? They feel

537
00:27:50.359 --> 00:27:52.440
<v Speaker 1>like shit? They go to a doctor the doctor's leg

538
00:27:52.640 --> 00:27:54.440
<v Speaker 1>just loose some weight and get back to me and

539
00:27:54.599 --> 00:27:57.119
<v Speaker 1>it's not that's not the problem. Like, are there any

540
00:27:57.160 --> 00:28:00.519
<v Speaker 1>diagnostic things that people should should make sure that they

541
00:28:00.519 --> 00:28:01.240
<v Speaker 1>get checked out?

542
00:28:01.440 --> 00:28:06.759
<v Speaker 2>Yeah? So the gold standard testing to diagnose sleep apnea

543
00:28:07.440 --> 00:28:11.519
<v Speaker 2>is what we call a polysum nogram or a sleep study,

544
00:28:11.759 --> 00:28:14.000
<v Speaker 2>And those can sometimes you're done at home as a screen,

545
00:28:14.160 --> 00:28:15.839
<v Speaker 2>or they can be done in a lab where we

546
00:28:15.920 --> 00:28:18.759
<v Speaker 2>are checking what are your brainwaves doing to make sure

547
00:28:18.799 --> 00:28:20.720
<v Speaker 2>you're a sleep and what stage of sleep you're in.

548
00:28:21.160 --> 00:28:23.200
<v Speaker 2>They've got a little band around your chest to see

549
00:28:23.240 --> 00:28:26.119
<v Speaker 2>are you making the effort to breathe. They've got all

550
00:28:26.200 --> 00:28:29.640
<v Speaker 2>kinds of heart monitors and blood oxygen monitors to see

551
00:28:29.680 --> 00:28:33.240
<v Speaker 2>if you are getting air and then sometimes there'll be

552
00:28:33.279 --> 00:28:35.279
<v Speaker 2>a little monitor that kind of is hanging out in

553
00:28:35.319 --> 00:28:37.519
<v Speaker 2>the throat to see what the pressure is. And so

554
00:28:37.640 --> 00:28:40.319
<v Speaker 2>obstructive sleep apnea, which is the kind that most folks have,

555
00:28:40.480 --> 00:28:42.920
<v Speaker 2>is the kind where you're trying to breathe but there's

556
00:28:42.960 --> 00:28:45.720
<v Speaker 2>a blockage, and so the sleep study is what's going

557
00:28:45.759 --> 00:28:49.200
<v Speaker 2>to diagnose it. And so if you specifically ask for

558
00:28:49.240 --> 00:28:52.240
<v Speaker 2>a sleep study and your doctor will not refer you

559
00:28:52.359 --> 00:28:55.240
<v Speaker 2>for that, unfortunately, I would say break up with that

560
00:28:55.279 --> 00:28:58.920
<v Speaker 2>person because healthcare is about teamwork. Like I'm the content

561
00:28:59.039 --> 00:29:02.240
<v Speaker 2>subject matter expert and you're the expert in your life,

562
00:29:02.279 --> 00:29:04.440
<v Speaker 2>and so together we got to sort out what we

563
00:29:04.480 --> 00:29:05.759
<v Speaker 2>can do to make your life better.

564
00:29:06.240 --> 00:29:08.920
<v Speaker 1>Who doesn't love to dump an asshole? So don't sleep

565
00:29:08.960 --> 00:29:12.480
<v Speaker 1>on that good advice, Say goodbye, find someone better, cut banks,

566
00:29:12.640 --> 00:29:15.960
<v Speaker 1>text a crush. We're all gonna die, doctor's orders. What

567
00:29:16.200 --> 00:29:18.599
<v Speaker 1>is snoring then, because if clearing your throat and coughing

568
00:29:18.680 --> 00:29:21.039
<v Speaker 1>is not good for your vocal cords, snoring's got to

569
00:29:21.039 --> 00:29:24.119
<v Speaker 1>be bonkers because you sound like a muppet. It's just

570
00:29:24.240 --> 00:29:26.839
<v Speaker 1>like it's the like, what is happening in there?

571
00:29:27.160 --> 00:29:30.599
<v Speaker 2>So snoring is a vibration, usually of the soft palate,

572
00:29:30.720 --> 00:29:33.519
<v Speaker 2>the little hang down dingly the bell that we call

573
00:29:33.559 --> 00:29:34.359
<v Speaker 2>the uvula.

574
00:29:34.519 --> 00:29:36.079
<v Speaker 1>I don't even know what that does.

575
00:29:36.319 --> 00:29:38.559
<v Speaker 2>So that is it's a part of the throat. We

576
00:29:38.640 --> 00:29:41.480
<v Speaker 2>don't we don't really know why we have the hang

577
00:29:41.559 --> 00:29:44.839
<v Speaker 2>down bit there, but it is. That part of the

578
00:29:44.880 --> 00:29:47.039
<v Speaker 2>palette is a part of closing off the nose so

579
00:29:47.079 --> 00:29:50.079
<v Speaker 2>when you swallow food doesn't go up your nose. But

580
00:29:50.200 --> 00:29:52.599
<v Speaker 2>that part vibrating is usually what's going to give you snoring.

581
00:29:53.039 --> 00:29:54.640
<v Speaker 1>Really, the uvula vibrating.

582
00:29:54.759 --> 00:29:57.640
<v Speaker 2>Oh yeah, and the whole soft palette. Wow, yeah, yeah, yeah,

583
00:29:57.640 --> 00:29:58.279
<v Speaker 2>it's bonkers.

584
00:29:58.559 --> 00:30:01.039
<v Speaker 1>If you want to know where is my so palette? Exactly,

585
00:30:01.400 --> 00:30:03.960
<v Speaker 1>run your tongue along the roof of your mouth toward

586
00:30:04.000 --> 00:30:08.519
<v Speaker 1>the back until it starts feeling squishy. There you go,

587
00:30:08.640 --> 00:30:12.039
<v Speaker 1>that's your soft palette. So snoring can happen when the

588
00:30:12.119 --> 00:30:14.720
<v Speaker 1>root of your tongue and your soft palette kind of

589
00:30:14.920 --> 00:30:17.759
<v Speaker 1>flappity flap onto the back of your throat, and so

590
00:30:17.839 --> 00:30:21.480
<v Speaker 1>you're vibrating your airway by skimming air sometimes through your

591
00:30:21.519 --> 00:30:24.640
<v Speaker 1>mouth because your mouth goes into the windpipe without having

592
00:30:24.640 --> 00:30:27.480
<v Speaker 1>to do with that roadblock of that flappity flap palette.

593
00:30:27.759 --> 00:30:31.559
<v Speaker 1>But obstructive sleep apnea takes things a step further with

594
00:30:31.920 --> 00:30:36.200
<v Speaker 1>these blockages that pause your breathing for seconds, sometimes in

595
00:30:36.279 --> 00:30:39.319
<v Speaker 1>some people minutes at a time, holding your breath while

596
00:30:39.319 --> 00:30:42.519
<v Speaker 1>you're asleep and you're gasping and snorting yourself awake for

597
00:30:42.599 --> 00:30:45.160
<v Speaker 1>air so many times a night, Which is why that

598
00:30:45.240 --> 00:30:48.240
<v Speaker 1>machine that forces air into your lungs but it looks

599
00:30:48.359 --> 00:30:52.799
<v Speaker 1>like a space octopus is preferable to actually suffocating on

600
00:30:52.880 --> 00:30:56.640
<v Speaker 1>your own throat meat. But your it's not doing damage

601
00:30:56.640 --> 00:30:57.960
<v Speaker 1>to your vocal cords.

602
00:30:57.960 --> 00:31:01.240
<v Speaker 2>Not necessarily, but having untraded sleepna is just setting you

603
00:31:01.279 --> 00:31:03.799
<v Speaker 2>out for a whole host of troubles. Yeah, and what.

604
00:31:03.839 --> 00:31:08.839
<v Speaker 1>About performers, opera singers, Shakespearean actors who are using their

605
00:31:08.920 --> 00:31:12.960
<v Speaker 1>whole diaphragm, which to me, whenever someone is like, just

606
00:31:13.039 --> 00:31:15.640
<v Speaker 1>use your diaphragm, I'm like, I don't really fully understand

607
00:31:15.680 --> 00:31:19.079
<v Speaker 1>what that means. Is that just an expansion of your lungs.

608
00:31:19.079 --> 00:31:21.799
<v Speaker 1>What's happening when people are projecting? Ah?

609
00:31:22.079 --> 00:31:27.160
<v Speaker 2>So, projecting is maximizing both the power source and your

610
00:31:27.160 --> 00:31:29.960
<v Speaker 2>resonators and aiming them the right way for the audience,

611
00:31:29.960 --> 00:31:32.559
<v Speaker 2>which is why, like when you're watching stage plays that

612
00:31:32.599 --> 00:31:35.240
<v Speaker 2>are not miked, or when you're watching opera that's not miked.

613
00:31:35.279 --> 00:31:38.960
<v Speaker 2>It's very unnatural because I'm singing to you about you,

614
00:31:39.039 --> 00:31:43.559
<v Speaker 2>and I'm facing the other way towards the audience, because

615
00:31:43.559 --> 00:31:46.960
<v Speaker 2>we have to aim the sound our resonator towards who

616
00:31:47.039 --> 00:31:48.960
<v Speaker 2>we want to hear it. And since you're in the cast,

617
00:31:49.000 --> 00:31:50.759
<v Speaker 2>you already know what I'm saying. You don't need to

618
00:31:50.799 --> 00:31:53.559
<v Speaker 2>hear it. The audience needs to hear it. So to

619
00:31:53.680 --> 00:31:57.440
<v Speaker 2>understand your diaphragm better, We're gonna put one hand on

620
00:31:57.480 --> 00:32:00.559
<v Speaker 2>your toumube tum right below your ribs and just take

621
00:32:00.559 --> 00:32:02.839
<v Speaker 2>a natural breath, and what happens to your tum tum?

622
00:32:03.279 --> 00:32:07.400
<v Speaker 1>Thankfully, my tumtumb wasn't already distended with coleslaw or beans

623
00:32:07.480 --> 00:32:07.920
<v Speaker 1>or anything.

624
00:32:09.319 --> 00:32:10.920
<v Speaker 2>What do you feel does it go in or out?

625
00:32:11.000 --> 00:32:12.319
<v Speaker 1>I feel like it goes out a little bit.

626
00:32:12.480 --> 00:32:16.720
<v Speaker 2>Yeah, so that's normal. The diaphragm is the muscle that

627
00:32:16.920 --> 00:32:20.200
<v Speaker 2>separates your belly cavity with your guts in it, from

628
00:32:20.359 --> 00:32:22.799
<v Speaker 2>your chest cavity, which has your lungs in your heart,

629
00:32:23.000 --> 00:32:28.480
<v Speaker 2>and so in its relaxed state, that's breathing out exhaled

630
00:32:29.079 --> 00:32:31.519
<v Speaker 2>when you breathe in that muscle because it's like a

631
00:32:31.559 --> 00:32:34.960
<v Speaker 2>dome the muscle contracts so it gets smaller, and that

632
00:32:35.000 --> 00:32:38.640
<v Speaker 2>actually pulls your chest cavity bigger. And so to do that,

633
00:32:38.680 --> 00:32:41.359
<v Speaker 2>your tumtum actually should come out to make room for

634
00:32:41.400 --> 00:32:44.440
<v Speaker 2>your guts to be that way, and so a good

635
00:32:44.480 --> 00:32:51.319
<v Speaker 2>breath has your tummy coming out. And that's why costume

636
00:32:51.359 --> 00:32:55.000
<v Speaker 2>designers are really smart, because almost all of those gorgeous

637
00:32:55.559 --> 00:32:58.559
<v Speaker 2>fem opera costumes have an on pure waist because their

638
00:32:58.559 --> 00:33:02.440
<v Speaker 2>belly has to move. There is no hourglass shaped opera

639
00:33:02.480 --> 00:33:04.000
<v Speaker 2>costume because you gotta breathe.

640
00:33:04.359 --> 00:33:07.559
<v Speaker 1>Wow, I never thought about that. Okay, So there's a

641
00:33:07.599 --> 00:33:11.839
<v Speaker 1>difference between using your chest muscles to fill the upper

642
00:33:11.839 --> 00:33:16.240
<v Speaker 1>part of your lungs versus expanding your belly with your

643
00:33:16.240 --> 00:33:19.039
<v Speaker 1>diaphragm and having your diaphragm do the work to fill

644
00:33:19.400 --> 00:33:22.519
<v Speaker 1>the lower lung too. And singers want to get as

645
00:33:22.599 --> 00:33:25.720
<v Speaker 1>much air in so they can have more power and

646
00:33:25.759 --> 00:33:29.319
<v Speaker 1>they can take fewer breaths too. But on the chill side,

647
00:33:29.480 --> 00:33:31.559
<v Speaker 1>several studies are on top of it when it comes

648
00:33:31.599 --> 00:33:36.279
<v Speaker 1>to researching the whys of that deep diaphormatic breathing and

649
00:33:36.359 --> 00:33:39.640
<v Speaker 1>how it switches your brain out of panic mode. And

650
00:33:40.160 --> 00:33:44.640
<v Speaker 1>in one twenty nineteen Frontiers and psychology paper titled Pulmonary

651
00:33:44.720 --> 00:33:48.400
<v Speaker 1>afferent activity patterns during slow deep breathing contribute to the

652
00:33:48.480 --> 00:33:52.960
<v Speaker 1>neural induction of physiological relaxation. The authors note that recent

653
00:33:53.000 --> 00:33:57.759
<v Speaker 1>evidence suggests that breathing at six breaths per minute promotes

654
00:33:58.039 --> 00:34:03.279
<v Speaker 1>behavioral relaxation. Hope we love that and barrel reflex resonance

655
00:34:03.319 --> 00:34:06.440
<v Speaker 1>effects and appears to elicit resonant and coherent features in

656
00:34:06.480 --> 00:34:10.360
<v Speaker 1>neuro mechanical interactions that optimize physiological function, as well as

657
00:34:10.639 --> 00:34:13.519
<v Speaker 1>support the expression of slow cortical rhythms to induce a

658
00:34:13.559 --> 00:34:17.320
<v Speaker 1>functional state of alert relaxation and via nose breathing, recruit

659
00:34:17.400 --> 00:34:20.960
<v Speaker 1>hippocampal pathways to boost memory consolidation. I had to do

660
00:34:21.079 --> 00:34:24.440
<v Speaker 1>diaformatic breathing just to get through that sentence. But I

661
00:34:24.480 --> 00:34:26.159
<v Speaker 1>know you don't know what that means, and that's okay,

662
00:34:26.159 --> 00:34:28.400
<v Speaker 1>because neither do I. But guess how much it costs

663
00:34:28.679 --> 00:34:32.719
<v Speaker 1>zero dollars. It's to feel more chill air. It's free.

664
00:34:32.880 --> 00:34:36.559
<v Speaker 1>So deep belly breathing is not just for your sister's

665
00:34:36.840 --> 00:34:41.199
<v Speaker 1>Lululemon obsessedro made. It also does science things that are

666
00:34:41.280 --> 00:34:43.960
<v Speaker 1>great for the brain area. And yeah, it's why you

667
00:34:43.960 --> 00:34:46.760
<v Speaker 1>don't see a lot of opera stars lacing their rib

668
00:34:46.800 --> 00:34:51.000
<v Speaker 1>cages into bone filled sausage shapes like a lot of

669
00:34:51.039 --> 00:34:54.920
<v Speaker 1>period costumes, less their hearts. I mean, that's their hearts corsets.

670
00:34:55.079 --> 00:34:56.360
<v Speaker 2>I won't do it. I won't do it.

671
00:34:56.480 --> 00:34:59.960
<v Speaker 1>Nope. What about when let's say that you're a sing

672
00:35:00.519 --> 00:35:03.679
<v Speaker 1>say you're a professional singer. I remember hearing like Adele

673
00:35:03.760 --> 00:35:07.480
<v Speaker 1>having nodes, and it was the worst thing that a

674
00:35:07.519 --> 00:35:11.440
<v Speaker 1>singer can ask for. What are those? And why does

675
00:35:11.880 --> 00:35:13.920
<v Speaker 1>vocal rest help? So?

676
00:35:14.559 --> 00:35:18.000
<v Speaker 2>Vocal fold nodes or nodules fall under a category of

677
00:35:18.239 --> 00:35:22.840
<v Speaker 2>voice box injury that we call phono trauma, or injuries

678
00:35:22.880 --> 00:35:26.320
<v Speaker 2>that come from producing sound. It also includes things like

679
00:35:26.400 --> 00:35:29.320
<v Speaker 2>polyps and cysts, all of which have to do with

680
00:35:29.800 --> 00:35:32.239
<v Speaker 2>the part of the voice box. I gets the most

681
00:35:32.960 --> 00:35:36.000
<v Speaker 2>of the energy delivered to it from the vibration effects,

682
00:35:36.000 --> 00:35:39.360
<v Speaker 2>and nodes or nodules are on both sides, and they

683
00:35:39.400 --> 00:35:42.239
<v Speaker 2>are kind of like a callous that forms. So I

684
00:35:42.280 --> 00:35:44.760
<v Speaker 2>think about if you do manual labor, or if you

685
00:35:44.760 --> 00:35:47.039
<v Speaker 2>play a sport. When I was a kid, I played baseball,

686
00:35:47.159 --> 00:35:50.840
<v Speaker 2>and so I had horrifying callouses after I had blisters

687
00:35:51.440 --> 00:35:54.159
<v Speaker 2>because that's where all the force was going. Now I

688
00:35:54.199 --> 00:35:57.239
<v Speaker 2>got good coaching, and my coach said, put on some batting.

689
00:35:56.920 --> 00:35:59.239
<v Speaker 1>Gloves, get yourself some gloves.

690
00:35:59.000 --> 00:36:03.360
<v Speaker 2>Right and are soft again. And so vocal fold nodules

691
00:36:03.400 --> 00:36:07.400
<v Speaker 2>are often a sign of not having had enough good

692
00:36:07.440 --> 00:36:10.199
<v Speaker 2>technical coaching, and you're kind of pushing through and so

693
00:36:10.239 --> 00:36:13.280
<v Speaker 2>you're getting callouses instead of finding where your natural range

694
00:36:13.360 --> 00:36:16.800
<v Speaker 2>is and having the right support again from your breath

695
00:36:17.079 --> 00:36:20.880
<v Speaker 2>and from your resonators. So those are treated with therapy

696
00:36:20.920 --> 00:36:24.599
<v Speaker 2>where we work to improve your technique. Almost never need surgery,

697
00:36:24.840 --> 00:36:30.719
<v Speaker 2>almost never need surgery. But also fem luringies sometimes just

698
00:36:30.760 --> 00:36:32.239
<v Speaker 2>have a little bit of a shape like that, And

699
00:36:32.280 --> 00:36:35.119
<v Speaker 2>so we've learned that they're not always a problem, not

700
00:36:35.159 --> 00:36:37.800
<v Speaker 2>always a disease, not always a pathology. If we looked

701
00:36:37.840 --> 00:36:42.239
<v Speaker 2>at a thousand femme lringies, we might see six hundred

702
00:36:42.360 --> 00:36:45.599
<v Speaker 2>or so with kind of an hourglass shape where they

703
00:36:45.719 --> 00:36:48.159
<v Speaker 2>meet early in the middle. And in maybe fifteen twenty

704
00:36:48.239 --> 00:36:50.199
<v Speaker 2>years ago, we just said, oh my gosh, you have nodules.

705
00:36:50.440 --> 00:36:52.639
<v Speaker 2>But if they don't have a problem with their voice,

706
00:36:52.679 --> 00:36:55.320
<v Speaker 2>they don't have nodules. Really, they have a fem voice.

707
00:36:55.679 --> 00:36:59.960
<v Speaker 1>Aha, what about surgeries to feminize a voice?

708
00:37:00.679 --> 00:37:00.960
<v Speaker 2>Yeah?

709
00:37:01.079 --> 00:37:05.519
<v Speaker 1>Is that shortening the width of the vocal cords.

710
00:37:05.599 --> 00:37:09.599
<v Speaker 2>So when we do feminizing voice surgeries, the goal is

711
00:37:09.639 --> 00:37:13.440
<v Speaker 2>to increase the pitch. Right around two hundred cycles per

712
00:37:13.480 --> 00:37:17.239
<v Speaker 2>second is the inflection point where we kind of culturally say,

713
00:37:17.280 --> 00:37:19.760
<v Speaker 2>at least in the US, we say, this is a

714
00:37:19.800 --> 00:37:23.159
<v Speaker 2>mask voice, this is a fem voice. And so we

715
00:37:23.199 --> 00:37:26.440
<v Speaker 2>want to get our particular transpatients, we want to get

716
00:37:26.480 --> 00:37:30.320
<v Speaker 2>them above two hundred so that their voice is concordant,

717
00:37:30.719 --> 00:37:35.039
<v Speaker 2>similar in line with their physical presentation and their internal sensation.

718
00:37:35.360 --> 00:37:37.960
<v Speaker 2>So to do that, what we end up usually doing

719
00:37:38.039 --> 00:37:40.360
<v Speaker 2>is shortening the length of the vocal fold so that

720
00:37:40.360 --> 00:37:43.440
<v Speaker 2>that same power is going through a shorter space, so

721
00:37:43.480 --> 00:37:45.599
<v Speaker 2>it has to vibrate faster, and so that takes the

722
00:37:45.679 --> 00:37:49.920
<v Speaker 2>frequency higher. So shortening the voice box usually by about

723
00:37:50.639 --> 00:37:54.760
<v Speaker 2>one third to half while maintaining breathing space, is what's

724
00:37:54.800 --> 00:37:56.320
<v Speaker 2>going to get that pitch to go up.

725
00:37:56.559 --> 00:38:00.400
<v Speaker 1>That can help a lot with the dysphoria, with feeling

726
00:38:00.440 --> 00:38:04.199
<v Speaker 1>like you're not sounding like you you feel absolutely yeah.

727
00:38:04.280 --> 00:38:10.840
<v Speaker 2>Misgendering is a psychologically harmful experience that isn't always even intentional.

728
00:38:11.199 --> 00:38:12.960
<v Speaker 2>When you're in the drive through or on the phone,

729
00:38:13.519 --> 00:38:16.800
<v Speaker 2>we make assessments based on that frequency, and you know,

730
00:38:16.880 --> 00:38:20.039
<v Speaker 2>on a bad day, I get misgendered. But because overall

731
00:38:20.320 --> 00:38:24.159
<v Speaker 2>I'm aligned and cys like I can throw that off

732
00:38:24.199 --> 00:38:26.920
<v Speaker 2>one time, but if it's happening all day, all the time,

733
00:38:27.039 --> 00:38:28.039
<v Speaker 2>it can wear on a person.

734
00:38:28.159 --> 00:38:31.599
<v Speaker 1>Yeah. So feminization surgery can address the length of the

735
00:38:31.719 --> 00:38:35.199
<v Speaker 1>vocal folds themselves, but there are other factors in affirming

736
00:38:35.199 --> 00:38:37.400
<v Speaker 1>a voice, and that can include the shape and the

737
00:38:37.440 --> 00:38:41.000
<v Speaker 1>depth of the larynx itself. And a twenty twenty paper

738
00:38:41.159 --> 00:38:45.639
<v Speaker 1>titled Vocal Feminization for Transgender Women, Current Strategies and Patient

739
00:38:45.679 --> 00:38:50.679
<v Speaker 1>Perspectives notes that the first voice feminization surgery may have

740
00:38:50.760 --> 00:38:55.199
<v Speaker 1>been performed by the Catholic Church, which prohibited women from

741
00:38:55.199 --> 00:38:59.000
<v Speaker 1>singing in services and instead performed castration on boys to

742
00:38:59.119 --> 00:39:02.400
<v Speaker 1>preserve their child pitch for singing in the higher registers

743
00:39:02.599 --> 00:39:05.960
<v Speaker 1>in the Cystine Chapel. Not sure what the consent was

744
00:39:06.280 --> 00:39:09.119
<v Speaker 1>back then, but either way, the voice box has a

745
00:39:09.159 --> 00:39:13.079
<v Speaker 1>lot of androgen receptors, so the onset of puberty and

746
00:39:13.119 --> 00:39:16.599
<v Speaker 1>a flood of testosterone means that the length and the

747
00:39:16.639 --> 00:39:20.280
<v Speaker 1>thickness of the vocal chords increase, as does the diameter

748
00:39:20.320 --> 00:39:23.480
<v Speaker 1>of the lynx. So think of a flute turning into

749
00:39:23.480 --> 00:39:26.280
<v Speaker 1>a trombone. But if you're a person with ovaries but

750
00:39:26.360 --> 00:39:30.079
<v Speaker 1>you have a hormonal condition that increases your testosterone, you

751
00:39:30.119 --> 00:39:32.840
<v Speaker 1>can also experience deepening of the voice. And if you're

752
00:39:33.079 --> 00:39:36.760
<v Speaker 1>signed female at birth but are on testosterone, your voice

753
00:39:36.760 --> 00:39:40.679
<v Speaker 1>box will likely respond to that extra testosterone and deepen

754
00:39:40.760 --> 00:39:43.519
<v Speaker 1>your voice. But if you don't have access to testosterone

755
00:39:43.559 --> 00:39:47.519
<v Speaker 1>injections or vocal feminization surgery, which can cost up to

756
00:39:47.639 --> 00:39:52.079
<v Speaker 1>fifteen grand, there is the non invasive option of vocal therapy,

757
00:39:52.360 --> 00:39:56.880
<v Speaker 1>and that's practicing and modulating your voice using your throat

758
00:39:56.920 --> 00:39:59.559
<v Speaker 1>and tongue and vocal chords to change the pitch and

759
00:39:59.599 --> 00:40:01.800
<v Speaker 1>even the patterns of your voice. And I was doing

760
00:40:01.800 --> 00:40:04.639
<v Speaker 1>some research and found an app called Eva that has

761
00:40:04.840 --> 00:40:07.440
<v Speaker 1>video instructions and lessons in pitch and they have a

762
00:40:07.480 --> 00:40:10.559
<v Speaker 1>tune tracker and exercises. For trans people who want to

763
00:40:10.599 --> 00:40:13.880
<v Speaker 1>modulate their voice without hormones or surgery or just want

764
00:40:13.920 --> 00:40:16.199
<v Speaker 1>to practice, there is this app called Eva. It costs

765
00:40:16.199 --> 00:40:19.400
<v Speaker 1>around eighty bucks, but she within surgery will it stick?

766
00:40:19.480 --> 00:40:19.719
<v Speaker 4>Though?

767
00:40:20.360 --> 00:40:23.199
<v Speaker 1>I don't know? Why don't you ask Elvis or rather

768
00:40:23.280 --> 00:40:27.559
<v Speaker 1>Austin Butler, or really just asked doctor Alexander about Austin Butler,

769
00:40:27.679 --> 00:40:29.679
<v Speaker 1>which I did yesterday I texted her. I was like, hey,

770
00:40:29.960 --> 00:40:33.159
<v Speaker 1>if a person were to say, train himself to speak

771
00:40:33.360 --> 00:40:36.199
<v Speaker 1>like Elvis for a few years, could his voice get

772
00:40:36.239 --> 00:40:38.199
<v Speaker 1>stuck like that? Or is it really more of a

773
00:40:38.239 --> 00:40:41.079
<v Speaker 1>brain habit? And doctor Alexander wrote me right back. She

774
00:40:41.119 --> 00:40:43.719
<v Speaker 1>was like, brain body habit, and the way we speak

775
00:40:43.880 --> 00:40:47.639
<v Speaker 1>is part anatomy and part learned. So sweet, Austin Butler

776
00:40:47.960 --> 00:40:52.559
<v Speaker 1>could unteach himself his current voice, but we should ask ourselves,

777
00:40:52.840 --> 00:40:55.719
<v Speaker 1>should he? And then she put a smiling emoji with

778
00:40:55.760 --> 00:40:58.679
<v Speaker 1>a halo, So perhaps he spent so long learning the

779
00:40:58.760 --> 00:41:02.239
<v Speaker 1>voice his muscles have really internalized those patterns. If you

780
00:41:02.239 --> 00:41:04.960
<v Speaker 1>want a deeper voice with less effort, you could also

781
00:41:05.039 --> 00:41:08.960
<v Speaker 1>just get a cold, which causes vocal fold inflammation and thickening.

782
00:41:09.079 --> 00:41:10.960
<v Speaker 1>But don't do that. No one needs it. And do

783
00:41:11.000 --> 00:41:14.199
<v Speaker 1>you find that I'm always so interested that when we

784
00:41:14.280 --> 00:41:16.599
<v Speaker 1>have a cold or we sound a little husky, we're like, ooh,

785
00:41:16.639 --> 00:41:20.760
<v Speaker 1>I'm like Demi Moore, I'm sul trium whatever, Kathleen Turner.

786
00:41:21.119 --> 00:41:23.840
<v Speaker 1>But obviously people who are a mask because of just

787
00:41:23.920 --> 00:41:27.480
<v Speaker 1>internalized misogyny. Also just in general, being perceived as having

788
00:41:27.480 --> 00:41:30.039
<v Speaker 1>a femme voice is almost like insulting it.

789
00:41:30.599 --> 00:41:33.639
<v Speaker 2>Is because femininity is an insult.

790
00:41:34.760 --> 00:41:37.920
<v Speaker 1>And how have femmes or people assigned female at birth

791
00:41:38.199 --> 00:41:41.639
<v Speaker 1>responded to that subconsciously or consciously? A little something we

792
00:41:41.679 --> 00:41:44.559
<v Speaker 1>talked about in the twenty eighteen Phonology episode with doctor

793
00:41:44.639 --> 00:41:47.920
<v Speaker 1>Nicole Holiday, but you may have heard it on like

794
00:41:48.400 --> 00:41:51.360
<v Speaker 1>countless reality programs, et cetera.

795
00:41:52.119 --> 00:41:55.000
<v Speaker 2>Oo, all right, vocal fry. We're gonna go there. Oh yeah,

796
00:41:55.039 --> 00:42:00.639
<v Speaker 2>it's super controversial because vocal fry has been kind of

797
00:42:00.679 --> 00:42:03.960
<v Speaker 2>like the straw Man argument for aging men hates young

798
00:42:04.000 --> 00:42:05.280
<v Speaker 2>woman's voice on radio.

799
00:42:05.559 --> 00:42:09.039
<v Speaker 4>Yeah, something called vocal fry that is creeping into the

800
00:42:09.079 --> 00:42:10.760
<v Speaker 4>speech patterns of young women.

801
00:42:10.880 --> 00:42:12.559
<v Speaker 2>Is there anything equivalent in men?

802
00:42:12.800 --> 00:42:13.599
<v Speaker 3>No, there isn't.

803
00:42:13.800 --> 00:42:16.840
<v Speaker 2>But there is harm that's coming to your voice because

804
00:42:17.360 --> 00:42:19.480
<v Speaker 2>if you're not using enough air to support, then you're

805
00:42:19.480 --> 00:42:21.639
<v Speaker 2>going to be doing a lot of that squeezing and

806
00:42:21.639 --> 00:42:25.119
<v Speaker 2>you're putting yourself at more risk for the phono trauma,

807
00:42:25.199 --> 00:42:28.239
<v Speaker 2>the injuries to the vocal fold from trying to push through.

808
00:42:28.880 --> 00:42:32.599
<v Speaker 2>You would not try to keep running the marathon if

809
00:42:32.599 --> 00:42:35.320
<v Speaker 2>you hadn't eaten anything the day before, And that's what

810
00:42:35.400 --> 00:42:38.000
<v Speaker 2>it is. If you're trying to talk without any air power,

811
00:42:38.159 --> 00:42:41.159
<v Speaker 2>that's how you get into this zone with the fry,

812
00:42:41.960 --> 00:42:44.599
<v Speaker 2>and it's literally asking the car to keep going with

813
00:42:44.639 --> 00:42:46.400
<v Speaker 2>no gas. Just take a breath of people.

814
00:42:46.480 --> 00:42:49.400
<v Speaker 1>Ah okay, that's actually very very that's so good to know.

815
00:42:49.840 --> 00:42:52.880
<v Speaker 1>Too much vocal fry, which is your vocal cords flapping

816
00:42:52.880 --> 00:42:57.679
<v Speaker 1>a little more chaotically than rhythmically, could possibly damage them

817
00:42:57.719 --> 00:43:00.639
<v Speaker 1>in the long term. Most doctors say it's probably not

818
00:43:00.679 --> 00:43:02.840
<v Speaker 1>going to happen. And also, just today I saw the

819
00:43:02.840 --> 00:43:06.440
<v Speaker 1>headline the doomsday clock reveals how close we are to

820
00:43:06.440 --> 00:43:09.159
<v Speaker 1>total annihilation. So I'm just going to urge you to

821
00:43:09.159 --> 00:43:12.480
<v Speaker 1>worry about other things, especially if it's just because some

822
00:43:12.559 --> 00:43:15.320
<v Speaker 1>guy farting into a leather recliner left a comment on

823
00:43:15.320 --> 00:43:17.000
<v Speaker 1>your social media telling you that you sound like a

824
00:43:17.039 --> 00:43:19.719
<v Speaker 1>valley girl. Just keep moving, babies. In the topic of

825
00:43:20.079 --> 00:43:23.239
<v Speaker 1>sounding the way that we want to be perceived, obviously,

826
00:43:23.280 --> 00:43:26.960
<v Speaker 1>if our whole face is a resonator in our neck,

827
00:43:27.239 --> 00:43:30.559
<v Speaker 1>why do we sound so different on recordings than we

828
00:43:31.119 --> 00:43:32.599
<v Speaker 1>are hearing day to day.

829
00:43:32.840 --> 00:43:38.039
<v Speaker 2>Ah So we both never see ourself and never hear

830
00:43:38.119 --> 00:43:41.679
<v Speaker 2>ourself outside of a photograph or a recording, because when

831
00:43:41.719 --> 00:43:46.480
<v Speaker 2>you're hearing your voice, you're hearing the vibrations up through

832
00:43:46.519 --> 00:43:49.000
<v Speaker 2>your own head, and so you're not hearing what other

833
00:43:49.000 --> 00:43:51.199
<v Speaker 2>people are hearing. You're not necessarily hearing that through the

834
00:43:51.360 --> 00:43:54.079
<v Speaker 2>entire mechanism of your ear until it's played back. And

835
00:43:54.119 --> 00:43:56.840
<v Speaker 2>that's why it sounds foreign, because when you're talking and

836
00:43:56.920 --> 00:44:00.239
<v Speaker 2>learning to talk, you're hearing actually the vibrations directly to

837
00:44:00.320 --> 00:44:03.800
<v Speaker 2>your cochlea from your temporal bone inside your head, which

838
00:44:03.800 --> 00:44:05.800
<v Speaker 2>is why you can hear yourself hum and it hasn't

839
00:44:05.840 --> 00:44:10.079
<v Speaker 2>really gone anywhere, and we only ever see ourselves in

840
00:44:10.320 --> 00:44:15.039
<v Speaker 2>mirror image, which that extremely disturbing phenomen on to those

841
00:44:15.079 --> 00:44:16.679
<v Speaker 2>filters where they're like, this is how people see you.

842
00:44:16.719 --> 00:44:19.199
<v Speaker 2>I'm like, no, thanks, yeah, no, it's it's I'm like,

843
00:44:19.239 --> 00:44:21.440
<v Speaker 2>who's that lady? Or does she look like a Picasso

844
00:44:21.440 --> 00:44:25.000
<v Speaker 2>painting straight? Like you know what it's because it's like off,

845
00:44:25.039 --> 00:44:27.519
<v Speaker 2>but it's ten percent off, Like what is that?

846
00:44:27.679 --> 00:44:29.679
<v Speaker 1>It's like Uncanny Valley with your own head.

847
00:44:30.400 --> 00:44:34.119
<v Speaker 2>That sucks me, But it's also you know, exploring that,

848
00:44:34.719 --> 00:44:36.440
<v Speaker 2>Like listening to this episode is going to be an

849
00:44:36.440 --> 00:44:40.599
<v Speaker 2>exploration of accepting myself the way others perceive me and

850
00:44:40.639 --> 00:44:43.039
<v Speaker 2>hearing my voice the way others hear me because I

851
00:44:43.119 --> 00:44:43.880
<v Speaker 2>rarely hear it.

852
00:44:44.280 --> 00:44:47.840
<v Speaker 1>Yeah, it's a trip for me every time. It's so difficult,

853
00:44:47.880 --> 00:44:50.679
<v Speaker 1>even as someone who professionally uses their voice, and as

854
00:44:50.719 --> 00:44:55.079
<v Speaker 1>someone who professionally uses their voice and is not so

855
00:44:55.159 --> 00:44:59.039
<v Speaker 1>smart about it. I have a question about ice. I

856
00:44:59.079 --> 00:45:01.760
<v Speaker 1>have a problem with ice that I love it too much,

857
00:45:02.480 --> 00:45:05.239
<v Speaker 1>too much. I have an industrial ice machine in the

858
00:45:05.239 --> 00:45:07.559
<v Speaker 1>garage because I was constantly running out the ice in

859
00:45:07.719 --> 00:45:10.880
<v Speaker 1>the freezer. Okay, And I also do some voice over

860
00:45:10.920 --> 00:45:13.519
<v Speaker 1>work on the side, and it occurs to me that,

861
00:45:13.559 --> 00:45:15.599
<v Speaker 1>like I'm in the booth drinking ice water, they can

862
00:45:15.599 --> 00:45:18.679
<v Speaker 1>probably hear the ice clink, and that is probably super unprofessional.

863
00:45:19.320 --> 00:45:23.320
<v Speaker 1>What is up with temperatures and what you're drinking? Is

864
00:45:23.360 --> 00:45:25.320
<v Speaker 1>ice bad? Is hot coffee bad?

865
00:45:25.400 --> 00:45:25.440
<v Speaker 2>Like?

866
00:45:25.480 --> 00:45:26.679
<v Speaker 1>What are we doing to ourselves?

867
00:45:26.840 --> 00:45:29.920
<v Speaker 2>So the range of temperatures that don't cause you pain

868
00:45:30.079 --> 00:45:30.840
<v Speaker 2>are all okay?

869
00:45:31.000 --> 00:45:31.360
<v Speaker 1>Okay.

870
00:45:31.559 --> 00:45:35.920
<v Speaker 2>Ice for some people is about the chewing okay, And

871
00:45:36.039 --> 00:45:38.880
<v Speaker 2>for other people is about just getting the water in

872
00:45:38.920 --> 00:45:41.000
<v Speaker 2>a more controlled way since it has to melt as

873
00:45:41.000 --> 00:45:45.320
<v Speaker 2>opposed to just gulping down water. Also, when we give

874
00:45:45.320 --> 00:45:48.480
<v Speaker 2>ourself any cold stimulus in the head and neck and

875
00:45:48.519 --> 00:45:52.320
<v Speaker 2>in the mouth, it actually activates the calming part of

876
00:45:52.440 --> 00:45:57.639
<v Speaker 2>our nervous system. So you may be oh, treating yourself

877
00:45:57.920 --> 00:46:01.119
<v Speaker 2>in a way that's very helpful. By putting cold in

878
00:46:01.159 --> 00:46:03.880
<v Speaker 2>your mouth, it's going to slow your heart rate, it's

879
00:46:03.880 --> 00:46:07.079
<v Speaker 2>going to slow your breathing, and so any jitters or

880
00:46:07.079 --> 00:46:10.119
<v Speaker 2>nerves you have are going to be suppressed by your

881
00:46:10.119 --> 00:46:12.880
<v Speaker 2>nervous system. It's the parasympathetic system.

882
00:46:13.119 --> 00:46:15.400
<v Speaker 1>Wow. So it's like, show me you have an anxiety

883
00:46:15.400 --> 00:46:18.719
<v Speaker 1>disorder without showing me an anxiety sort having a big

884
00:46:18.760 --> 00:46:21.159
<v Speaker 1>gulf And if you do, it's like, welcome to the club.

885
00:46:21.960 --> 00:46:23.480
<v Speaker 2>But we're all not doing fine.

886
00:46:23.760 --> 00:46:27.639
<v Speaker 1>Yeah, third year of a pandemic and reading headlines about

887
00:46:27.639 --> 00:46:30.679
<v Speaker 1>the apocalypse anyone else but yes, I edited this episode

888
00:46:30.719 --> 00:46:34.239
<v Speaker 1>during a rainstorm while drinking a thirty two ounce iced

889
00:46:34.320 --> 00:46:37.880
<v Speaker 1>tea that was mostly just teed ice. There was so

890
00:46:38.000 --> 00:46:40.079
<v Speaker 1>much ice. But next to that iced tea, I also

891
00:46:40.079 --> 00:46:42.559
<v Speaker 1>had a mug of hot tea because I'm a chaotic

892
00:46:42.559 --> 00:46:43.400
<v Speaker 1>little bitch like that.

893
00:46:43.920 --> 00:46:48.760
<v Speaker 2>And for other folks, like the super hot sensations are stimulating.

894
00:46:48.800 --> 00:46:52.880
<v Speaker 2>It gets them going because warmer will tend to push

895
00:46:52.880 --> 00:46:55.559
<v Speaker 2>you a little bit more towards the sympathetic the amped

896
00:46:55.639 --> 00:46:58.800
<v Speaker 2>up body system in addition to the caffeine.

897
00:46:59.360 --> 00:47:03.360
<v Speaker 1>Does the cold water cause more mucous production or congestion,

898
00:47:03.519 --> 00:47:07.119
<v Speaker 1>or does it freeze up your muscles and your larynx.

899
00:47:07.239 --> 00:47:10.000
<v Speaker 2>So it won't freeze the muscles, but it will tend

900
00:47:10.039 --> 00:47:12.840
<v Speaker 2>to give you kind of a thicker mucus just because

901
00:47:12.920 --> 00:47:15.960
<v Speaker 2>it has less energy in it, and so it's going

902
00:47:16.000 --> 00:47:18.599
<v Speaker 2>to be an energy sink. It's going to take heat

903
00:47:18.679 --> 00:47:22.280
<v Speaker 2>out of the body, and so that's endothermic reactions. Because

904
00:47:22.480 --> 00:47:24.840
<v Speaker 2>I also really love I miss chemistry and math and

905
00:47:24.880 --> 00:47:28.880
<v Speaker 2>all that stuff. So it's pulling energy and warmth out

906
00:47:28.920 --> 00:47:33.199
<v Speaker 2>of you. Whereas warmer things, particularly steam, as it's going

907
00:47:33.199 --> 00:47:36.280
<v Speaker 2>from liquid to gas, it's a big energy jump, and

908
00:47:36.320 --> 00:47:38.639
<v Speaker 2>so it has a lot more energy in it, and

909
00:47:38.679 --> 00:47:40.679
<v Speaker 2>it's going to be able to thin the mucus secretions

910
00:47:40.719 --> 00:47:43.280
<v Speaker 2>that are in your throat. So steaming is fantastic for

911
00:47:43.320 --> 00:47:45.239
<v Speaker 2>the skin of the face. The voice box and the

912
00:47:45.239 --> 00:47:49.000
<v Speaker 2>airways love it as well. So you know, everybody who

913
00:47:49.000 --> 00:47:52.119
<v Speaker 2>does your nightly facial steaming your body is really pleased

914
00:47:52.159 --> 00:47:52.360
<v Speaker 2>with that.

915
00:47:53.280 --> 00:47:56.239
<v Speaker 1>For more on steaming your yoni, you can see the

916
00:47:56.239 --> 00:48:00.480
<v Speaker 1>gynecology and urology episodes. Friends. But of all the things

917
00:48:00.519 --> 00:48:03.920
<v Speaker 1>you can do with your genitals, doctors report that exposing

918
00:48:03.960 --> 00:48:06.360
<v Speaker 1>them to scalding hot gases should be at the bottom

919
00:48:06.400 --> 00:48:06.960
<v Speaker 1>of your list.

920
00:48:07.440 --> 00:48:10.079
<v Speaker 2>So we want steam to be something that you can

921
00:48:10.119 --> 00:48:13.000
<v Speaker 2>put on this thin skin of the inside of your

922
00:48:13.039 --> 00:48:16.039
<v Speaker 2>wrists and it's comfortable. That's going to still be appropriate.

923
00:48:16.599 --> 00:48:18.639
<v Speaker 1>Do you have any hacks for if you don't have

924
00:48:18.880 --> 00:48:22.000
<v Speaker 1>a like seventy five dollars facial steamer from ben Bath

925
00:48:22.039 --> 00:48:22.440
<v Speaker 1>and beyond.

926
00:48:22.559 --> 00:48:25.320
<v Speaker 2>Yes, it's something that most of us who are housed

927
00:48:25.360 --> 00:48:29.599
<v Speaker 2>are going to have. And it's a cup of hot water, legit.

928
00:48:29.960 --> 00:48:32.800
<v Speaker 2>Like so, my folks, So we're here in the Bronx

929
00:48:33.000 --> 00:48:36.000
<v Speaker 2>and this is of the sixty two counties in New

930
00:48:36.039 --> 00:48:38.559
<v Speaker 2>York State. This is number sixty two in health outcomes

931
00:48:38.599 --> 00:48:42.119
<v Speaker 2>and economic opportunities. And so I am not recommending go

932
00:48:42.159 --> 00:48:45.159
<v Speaker 2>buy one hundred dollars thing to almost any of my patients.

933
00:48:45.199 --> 00:48:47.599
<v Speaker 2>And so I'm like, boil water on the stove, put

934
00:48:47.639 --> 00:48:49.800
<v Speaker 2>it into a mug that is safe, Maybe wrap a

935
00:48:49.840 --> 00:48:52.599
<v Speaker 2>towel around it and just hold it under your face

936
00:48:52.639 --> 00:48:55.079
<v Speaker 2>and breathe it in. And that's a steamer.

937
00:48:55.480 --> 00:48:55.800
<v Speaker 1>Nice.

938
00:48:56.440 --> 00:48:58.599
<v Speaker 2>So if you're on the go, get a cup of

939
00:48:58.599 --> 00:49:01.519
<v Speaker 2>just hot water from the deli and that's steaming too.

940
00:49:01.760 --> 00:49:04.239
<v Speaker 1>Oh wonderful. I'm going to start steaming my face. What

941
00:49:04.360 --> 00:49:07.719
<v Speaker 1>about I used to drink a lot of your mamate

942
00:49:08.079 --> 00:49:13.119
<v Speaker 1>because it is like legal drugs and it is so hardcore.

943
00:49:13.280 --> 00:49:14.960
<v Speaker 1>I would drink a cup of your ramonte and be like,

944
00:49:14.960 --> 00:49:16.679
<v Speaker 1>I'm going to go run a half marathon I've never

945
00:49:16.719 --> 00:49:19.559
<v Speaker 1>run before, Like, I don't know what's in it. There's

946
00:49:19.880 --> 00:49:24.880
<v Speaker 1>some catakins anyway. But I read that some studies correlated

947
00:49:24.920 --> 00:49:28.119
<v Speaker 1>to people in South America who drink it having higher

948
00:49:28.199 --> 00:49:32.280
<v Speaker 1>rates of esophageal cancer and throat cancer, and they determined

949
00:49:32.320 --> 00:49:35.320
<v Speaker 1>it was maybe the temperature of the water. Are there

950
00:49:35.360 --> 00:49:38.440
<v Speaker 1>any things having to do with throat cancer that are

951
00:49:38.559 --> 00:49:39.920
<v Speaker 1>we should or shouldn't be doing?

952
00:49:40.159 --> 00:49:43.199
<v Speaker 2>So I wouldn't put your mamate or hot things on

953
00:49:43.239 --> 00:49:45.760
<v Speaker 2>that list. We've I mean, we've had millions of years

954
00:49:45.760 --> 00:49:48.639
<v Speaker 2>of us drinking hot things because they've been important and useful,

955
00:49:48.679 --> 00:49:51.920
<v Speaker 2>particularly in the in the edges and the higher latitudes.

956
00:49:52.119 --> 00:49:54.519
<v Speaker 2>But the number one thing you shouldn't do to the

957
00:49:54.559 --> 00:49:58.079
<v Speaker 2>throat to prevent cancer is inhale a thing that's on fire,

958
00:49:58.480 --> 00:50:02.760
<v Speaker 2>got it. So, whether that's to back marijuana, any of

959
00:50:02.800 --> 00:50:05.840
<v Speaker 2>the other things that people smoke, we don't want to

960
00:50:05.840 --> 00:50:10.360
<v Speaker 2>be breathing in hot combusted on fire fumes into our

961
00:50:10.440 --> 00:50:13.000
<v Speaker 2>voice box. And because we know tobacco is the one

962
00:50:13.000 --> 00:50:15.440
<v Speaker 2>that we've studied the most, and that one it can

963
00:50:15.480 --> 00:50:17.280
<v Speaker 2>cause cancer from the lips all the way down to

964
00:50:17.320 --> 00:50:19.559
<v Speaker 2>the tips of the lungs, and so we just don't

965
00:50:19.599 --> 00:50:22.280
<v Speaker 2>want to get We want to stop kids from starting.

966
00:50:22.400 --> 00:50:25.119
<v Speaker 2>As far as vaping is concerned, it's good as a

967
00:50:25.199 --> 00:50:29.800
<v Speaker 2>transition to nothing as much as possible. The other big

968
00:50:29.840 --> 00:50:32.440
<v Speaker 2>contributor to throat cancer kind of higher up around the

969
00:50:32.480 --> 00:50:34.280
<v Speaker 2>tonsils in the back of the throat. It's going to

970
00:50:34.320 --> 00:50:36.559
<v Speaker 2>be human papaloma virus. And so I'm going to put

971
00:50:36.599 --> 00:50:40.360
<v Speaker 2>in a plug to get your gardasil. Get your HPV vaccine,

972
00:50:40.480 --> 00:50:44.000
<v Speaker 2>boy girl, or in between, get your HPV vaccine. I

973
00:50:44.000 --> 00:50:45.039
<v Speaker 2>think I just made them a slogan.

974
00:50:45.480 --> 00:50:46.519
<v Speaker 1>You literally did.

975
00:50:46.920 --> 00:50:49.199
<v Speaker 2>I'm going to put in a plug to get your gardess,

976
00:50:49.199 --> 00:50:54.280
<v Speaker 2>soe get your hpvvceine, boy girl, or in between, get

977
00:50:54.320 --> 00:50:57.480
<v Speaker 2>your hp bvceine, boy girl, or in between.

978
00:50:58.039 --> 00:51:01.039
<v Speaker 1>I mean, because there are some places that girls in

979
00:51:01.199 --> 00:51:05.039
<v Speaker 1>certain states were being dissuaded because they thought it would

980
00:51:05.079 --> 00:51:06.360
<v Speaker 1>make them sexually active.

981
00:51:06.519 --> 00:51:07.760
<v Speaker 2>Yes, and if they.

982
00:51:07.639 --> 00:51:12.599
<v Speaker 1>Got a vaccine that can prevent cancer. No one who's

983
00:51:12.599 --> 00:51:17.159
<v Speaker 1>ever had a paps mirror was I'm sure advocating for that, right.

984
00:51:17.280 --> 00:51:19.800
<v Speaker 2>There are some people in this country who are in

985
00:51:19.920 --> 00:51:24.480
<v Speaker 2>systems of bondage which they did not actively choose, and

986
00:51:24.760 --> 00:51:26.400
<v Speaker 2>a lot of their identity is wrapped up in it,

987
00:51:26.440 --> 00:51:28.920
<v Speaker 2>and attachment to community is wrapped up in it, and

988
00:51:29.119 --> 00:51:32.159
<v Speaker 2>it includes some harmful teachings that have come to them

989
00:51:32.199 --> 00:51:35.079
<v Speaker 2>from people who even represent my same faith, and I

990
00:51:35.119 --> 00:51:38.000
<v Speaker 2>get upset about it. But like the existence of apples

991
00:51:38.039 --> 00:51:40.920
<v Speaker 2>does not mean you have to have an apple, so

992
00:51:40.960 --> 00:51:43.320
<v Speaker 2>the existence of sex does not mean you have to

993
00:51:43.400 --> 00:51:46.960
<v Speaker 2>have sex. And so no amount of medical care is

994
00:51:47.000 --> 00:51:50.039
<v Speaker 2>going to make you have sex before you are ready,

995
00:51:50.320 --> 00:51:53.800
<v Speaker 2>and so at least it shouldn't. It shouldn't, and so

996
00:51:54.000 --> 00:51:59.800
<v Speaker 2>protecting your child or yourself from a viral mediated cancer.

997
00:52:00.239 --> 00:52:03.840
<v Speaker 2>The other activities come from conversation, not from an injection,

998
00:52:04.119 --> 00:52:07.760
<v Speaker 2>not at all. And if an injection is enough to

999
00:52:07.880 --> 00:52:10.119
<v Speaker 2>set your kid off doing anything, they were going to

1000
00:52:10.119 --> 00:52:12.679
<v Speaker 2>be doing it anyway. And so maybe it's time to

1001
00:52:12.760 --> 00:52:16.559
<v Speaker 2>examine the relationship and open up and have some talks

1002
00:52:16.599 --> 00:52:19.880
<v Speaker 2>with them about what they're thinking and experiencing. Because no

1003
00:52:20.000 --> 00:52:22.000
<v Speaker 2>vaccine has ever made me do anything. And I just

1004
00:52:22.000 --> 00:52:23.599
<v Speaker 2>got a couple in the past couple of years, I

1005
00:52:23.639 --> 00:52:24.400
<v Speaker 2>didn't change much.

1006
00:52:24.639 --> 00:52:29.239
<v Speaker 1>Yeah, and what a breakthrough to have that gardisil vaccine

1007
00:52:29.320 --> 00:52:32.519
<v Speaker 1>available because that's something that is so HPV is so

1008
00:52:32.760 --> 00:52:35.880
<v Speaker 1>prevalent in so many people. It can be transmitted in

1009
00:52:36.119 --> 00:52:38.199
<v Speaker 1>so many ways, that's right. And yeah, it can be

1010
00:52:38.320 --> 00:52:41.760
<v Speaker 1>lethal for people. So I know several people who have

1011
00:52:42.360 --> 00:52:47.280
<v Speaker 1>gotten cancer cervical and esophagal. Great news. If you are

1012
00:52:47.360 --> 00:52:50.480
<v Speaker 1>over nine years old, you can get this vaccine. If

1013
00:52:50.519 --> 00:52:53.159
<v Speaker 1>you're over twenty six, though, doctors are kind of like,

1014
00:52:53.519 --> 00:52:56.719
<v Speaker 1>don't bother, you've probably already been exposed. But folks of

1015
00:52:56.760 --> 00:52:59.360
<v Speaker 1>all genders can be vaccinated. And if you've got a

1016
00:52:59.400 --> 00:53:02.719
<v Speaker 1>cervix and have the vaccine, you are seeing a seventy

1017
00:53:02.760 --> 00:53:06.519
<v Speaker 1>eight percent reduction in cervical cancer. Thank you very much.

1018
00:53:06.639 --> 00:53:09.280
<v Speaker 1>So ask your doctor and at the very least get

1019
00:53:09.280 --> 00:53:11.480
<v Speaker 1>your paths yearly. If you can't get the vaccine. Now,

1020
00:53:11.519 --> 00:53:13.960
<v Speaker 1>we're going to take a quick break. But when we're back,

1021
00:53:14.519 --> 00:53:17.480
<v Speaker 1>a free tip that will improve your life and your skin.

1022
00:53:17.679 --> 00:53:21.280
<v Speaker 1>But first will donate some money to worthy causes. First

1023
00:53:21.320 --> 00:53:25.039
<v Speaker 1>toomiloma dot org, which has amazing resources for folks affected

1024
00:53:25.079 --> 00:53:27.519
<v Speaker 1>by this blood cancer. And that is in memory of

1025
00:53:27.599 --> 00:53:32.239
<v Speaker 1>Reverend Barbara Alexander. And also a cause of theologists choosing

1026
00:53:32.280 --> 00:53:36.440
<v Speaker 1>this week is the Laryngology Education Foundation Health Equity Grant Program,

1027
00:53:36.719 --> 00:53:41.360
<v Speaker 1>which supports endeavors that increase understanding and awareness of how

1028
00:53:41.519 --> 00:53:46.079
<v Speaker 1>racial disparities impact laryngology and speech language pathology care in

1029
00:53:46.079 --> 00:53:49.400
<v Speaker 1>the US, specifically for patients of the black diaspora, and

1030
00:53:49.519 --> 00:53:53.159
<v Speaker 1>it supports initiatives that address these disparities in our communities.

1031
00:53:53.599 --> 00:53:59.519
<v Speaker 1>So those donations were made possible by sponsors of the show. Okay,

1032
00:53:59.519 --> 00:54:02.880
<v Speaker 1>back into it. What about hot water lemon honey? What's

1033
00:54:02.920 --> 00:54:03.400
<v Speaker 1>that doing?

1034
00:54:03.599 --> 00:54:08.039
<v Speaker 2>So again, the steam is the main actor in hot

1035
00:54:08.079 --> 00:54:11.639
<v Speaker 2>water honey soothes the top parts of the throat, but

1036
00:54:11.719 --> 00:54:14.199
<v Speaker 2>it's not ever going to touch the larynx in a

1037
00:54:14.199 --> 00:54:17.079
<v Speaker 2>healthy person because the larynx is the airway. And this

1038
00:54:17.119 --> 00:54:21.639
<v Speaker 2>is another fun tidbit about the lringopharyngeal complex. This upper

1039
00:54:21.679 --> 00:54:24.079
<v Speaker 2>throat area, it's the only part of the body we

1040
00:54:24.119 --> 00:54:27.880
<v Speaker 2>ask to do three things. Other parts to get two responsibilities.

1041
00:54:27.880 --> 00:54:32.719
<v Speaker 2>But this area needs to breathe, speak, and safely handle foods.

1042
00:54:33.320 --> 00:54:35.199
<v Speaker 2>And so the foods go around the side, the air

1043
00:54:35.239 --> 00:54:38.760
<v Speaker 2>go downs, goes down the middle, so nothing you're drinking directly.

1044
00:54:39.320 --> 00:54:41.360
<v Speaker 2>Is ever going to go directly into your voice box

1045
00:54:41.400 --> 00:54:44.159
<v Speaker 2>if you're in a healthy state. If it does, that's

1046
00:54:44.199 --> 00:54:47.599
<v Speaker 2>a condition called aspiration, where the food and drink is

1047
00:54:47.599 --> 00:54:50.800
<v Speaker 2>going into the lung direction, and we end up treating

1048
00:54:50.800 --> 00:54:53.679
<v Speaker 2>that as well. Aspiration. Is anything going into the lung

1049
00:54:53.719 --> 00:54:54.840
<v Speaker 2>that would that's not.

1050
00:54:54.800 --> 00:54:57.599
<v Speaker 1>Air, Yeah, anything which is pretty much you just want

1051
00:54:57.599 --> 00:54:58.000
<v Speaker 1>air in.

1052
00:54:57.920 --> 00:55:03.400
<v Speaker 2>There, only air and some lightly humidified air. So we

1053
00:55:03.480 --> 00:55:06.320
<v Speaker 2>want it to be warm and moist like the lung

1054
00:55:06.440 --> 00:55:07.760
<v Speaker 2>likes it to be. And so that's actually one of

1055
00:55:07.800 --> 00:55:10.800
<v Speaker 2>the functions of your nose is to warm and moisten

1056
00:55:10.840 --> 00:55:13.639
<v Speaker 2>the air, which is why nose breathing is preferred, because

1057
00:55:13.639 --> 00:55:15.800
<v Speaker 2>the air has time to pick up all the energy

1058
00:55:15.880 --> 00:55:19.480
<v Speaker 2>and molecules and moisture. But yeah, anything that's not air

1059
00:55:19.880 --> 00:55:22.519
<v Speaker 2>or humidified air going into the airway is a no.

1060
00:55:22.519 --> 00:55:24.800
<v Speaker 1>No, that's a no. Let's talk about Mariah Carey.

1061
00:55:24.880 --> 00:55:25.719
<v Speaker 2>Oh, let's me me.

1062
00:55:26.360 --> 00:55:29.280
<v Speaker 1>How does she do it? How does she make noises

1063
00:55:29.320 --> 00:55:31.400
<v Speaker 1>that some humans can't even hear?

1064
00:55:32.079 --> 00:55:35.360
<v Speaker 2>Right, So the whistle tones which I'm going to say

1065
00:55:35.360 --> 00:55:38.840
<v Speaker 2>that she is the air. To Minnie Ripperton, who's Maya

1066
00:55:38.880 --> 00:55:41.760
<v Speaker 2>Rudolph's mom from SNL Fame, I did not know. Minnie

1067
00:55:41.800 --> 00:55:49.800
<v Speaker 2>Ripperton listened to the song loving You. Okay, it's easy

1068
00:55:49.840 --> 00:55:55.039
<v Speaker 2>because you're beautiful, and then she does those whistle tones also, right, Yeah,

1069
00:55:55.039 --> 00:55:57.639
<v Speaker 2>that's right. So most of us have at least three

1070
00:55:58.320 --> 00:56:02.639
<v Speaker 2>registers or form of the voice, so just basically we're

1071
00:56:02.719 --> 00:56:05.840
<v Speaker 2>usually using our chest voice when we go into what

1072
00:56:05.880 --> 00:56:09.639
<v Speaker 2>we call falsetto. That's kind of the head voice, and

1073
00:56:09.679 --> 00:56:14.000
<v Speaker 2>that would be the difference between one two three and

1074
00:56:14.519 --> 00:56:17.920
<v Speaker 2>one two three. Like I went up in my falsetto,

1075
00:56:17.960 --> 00:56:21.639
<v Speaker 2>that's like lower lower pressure and I'm letting it just

1076
00:56:22.199 --> 00:56:26.559
<v Speaker 2>kind of resonate up higher. My vocal folds are tenser,

1077
00:56:27.599 --> 00:56:30.960
<v Speaker 2>and they're vibrating faster to do those higher pitches, and

1078
00:56:31.320 --> 00:56:34.440
<v Speaker 2>I'm not pushing and squeezing. I'm just letting it come out,

1079
00:56:34.440 --> 00:56:38.079
<v Speaker 2>so it's naturally quieter, okay. And then the whistle tones

1080
00:56:38.119 --> 00:56:41.199
<v Speaker 2>are an entirely different thing where they've tightened the voice

1081
00:56:41.199 --> 00:56:44.199
<v Speaker 2>box so much and they've positioned the vocal folds in

1082
00:56:44.199 --> 00:56:47.320
<v Speaker 2>the right manner where they're doing a frequency that's just

1083
00:56:47.440 --> 00:56:50.719
<v Speaker 2>on a next level higher, and so then the resonators

1084
00:56:50.760 --> 00:56:52.679
<v Speaker 2>are really just shaping it, which is why when people

1085
00:56:52.679 --> 00:56:54.679
<v Speaker 2>are doing their whistle tones, they're usually just going to

1086
00:56:54.760 --> 00:57:00.920
<v Speaker 2>do a single phoneme. It's usually just e or oh,

1087
00:57:01.000 --> 00:57:05.159
<v Speaker 2>because your articulators are focused on just getting really narrow

1088
00:57:05.280 --> 00:57:08.159
<v Speaker 2>and letting that sound out, and you can't do a

1089
00:57:08.199 --> 00:57:11.800
<v Speaker 2>lot of shaping of the sound because everything is squeezing

1090
00:57:12.199 --> 00:57:14.159
<v Speaker 2>to get it tight enough so that you can do

1091
00:57:14.199 --> 00:57:17.079
<v Speaker 2>those rapid vibrations at a high frequency that gets up

1092
00:57:17.079 --> 00:57:18.039
<v Speaker 2>into those whistle notes.

1093
00:57:18.360 --> 00:57:22.440
<v Speaker 1>Nice pipes. By the way, do you watch the national

1094
00:57:22.440 --> 00:57:25.639
<v Speaker 1>anthem and are you like you got this? You got this?

1095
00:57:25.760 --> 00:57:28.000
<v Speaker 1>You got this? You know, because it's such a difficult

1096
00:57:28.119 --> 00:57:31.280
<v Speaker 1>thing to sing. Yeah, yeah, And it has to happen

1097
00:57:31.320 --> 00:57:34.079
<v Speaker 1>before every ball game, every you know what I mean,

1098
00:57:34.400 --> 00:57:36.039
<v Speaker 1>whenever anyone goes up there. I was like, you got this,

1099
00:57:36.119 --> 00:57:37.280
<v Speaker 1>you got this? Come on, you got this.

1100
00:57:37.639 --> 00:57:38.960
<v Speaker 2>I mean, Fredgie did a great job.

1101
00:57:39.280 --> 00:57:52.280
<v Speaker 3>No sad, just dance star spaying.

1102
00:58:03.119 --> 00:58:05.519
<v Speaker 1>It was a choice. It was a bold choice, and

1103
00:58:05.679 --> 00:58:07.880
<v Speaker 1>I'm not going to leave a comment from my party

1104
00:58:08.039 --> 00:58:09.440
<v Speaker 1>recliner about it now.

1105
00:58:09.480 --> 00:58:12.920
<v Speaker 2>So that is one of the most difficult songs because

1106
00:58:13.000 --> 00:58:15.599
<v Speaker 2>of the range of notes that it covers, and I

1107
00:58:15.679 --> 00:58:17.760
<v Speaker 2>just I wouldn't recommend it as an audition song for

1108
00:58:17.920 --> 00:58:18.800
<v Speaker 2>just about anything.

1109
00:58:19.400 --> 00:58:21.159
<v Speaker 1>I have so many questions from listeners. Can I ask

1110
00:58:21.159 --> 00:58:24.519
<v Speaker 1>you one million, one million in two yes, we got

1111
00:58:24.559 --> 00:58:28.559
<v Speaker 1>them literally at present, three hundred and seventy seven questions.

1112
00:58:28.559 --> 00:58:33.639
<v Speaker 1>Not a big deal. Thank you, thank you. So that

1113
00:58:33.760 --> 00:58:35.719
<v Speaker 1>is why this is a blessed two parter. We will

1114
00:58:35.719 --> 00:58:38.039
<v Speaker 1>be back next week with so many answers to questions

1115
00:58:38.360 --> 00:58:42.679
<v Speaker 1>you'll be so glad patrons asked. But until then, take

1116
00:58:42.719 --> 00:58:46.840
<v Speaker 1>a big, deep belly breath or six and ask magnetic

1117
00:58:46.920 --> 00:58:51.280
<v Speaker 1>surgeons unsmart questions because your life will never be the same.

1118
00:58:51.599 --> 00:58:55.159
<v Speaker 1>And you can find doctor Alexander at your Voice MD

1119
00:58:55.400 --> 00:59:01.519
<v Speaker 1>on Twitter or your Underscore Voice Underscore Physicians on Instagram

1120
00:59:01.679 --> 00:59:04.519
<v Speaker 1>and say hello there. We are at Ologies on Twitter

1121
00:59:04.519 --> 00:59:07.920
<v Speaker 1>and Instagram, and I'm Ali Ward on both with one L.

1122
00:59:07.960 --> 00:59:11.360
<v Speaker 1>I'm Ali Underscore Ologies on TikTok now say hello. You

1123
00:59:11.400 --> 00:59:14.079
<v Speaker 1>can join patron at patreon dot com slash Ologies, where

1124
00:59:14.079 --> 00:59:16.760
<v Speaker 1>we have discussion threads each week about the episode. I

1125
00:59:16.800 --> 00:59:20.000
<v Speaker 1>love to read your reactions and chime in. Ologies Merch

1126
00:59:20.079 --> 00:59:23.039
<v Speaker 1>is available at ologiesmerch dot com. Thank you Susan Hale

1127
00:59:23.119 --> 00:59:25.800
<v Speaker 1>for managing that and so much else. Thank you Noel

1128
00:59:25.920 --> 00:59:30.599
<v Speaker 1>Dilworth for the scheduling. Aaron Talbert celebrates a birthday this week.

1129
00:59:30.639 --> 00:59:33.920
<v Speaker 1>Happy birthday, my sister friend. I love you forever. We

1130
00:59:34.000 --> 00:59:36.800
<v Speaker 1>have known each other since I was four and she

1131
00:59:36.880 --> 00:59:40.679
<v Speaker 1>admins Theologies podcast Facebook group with assists from Bonnie Dutch

1132
00:59:40.679 --> 00:59:43.719
<v Speaker 1>and Shannon Feltis. Emily White makes our professional transcripts and

1133
00:59:43.800 --> 00:59:47.559
<v Speaker 1>Caleb Patten bleeps them, and Zegredriguez Thomas and Mercedes Maitland

1134
00:59:47.559 --> 00:59:51.840
<v Speaker 1>of My Gym Media work on Smologies kid friendly shorter episodes,

1135
00:59:52.079 --> 00:59:54.519
<v Speaker 1>and Kelly ar Dwyer makes the website. She can make

1136
00:59:54.559 --> 00:59:58.320
<v Speaker 1>yours too. Mark David Christiansen and Jarrett Sleeper did additional

1137
00:59:58.440 --> 01:00:02.840
<v Speaker 1>editing on this episode alongside lead editor Mercedes Maitland, who

1138
01:00:02.920 --> 01:00:05.760
<v Speaker 1>has her own Maitland Audio. You can check that out.

1139
01:00:06.079 --> 01:00:08.320
<v Speaker 1>Nick Thorburn did the music and he is in a

1140
01:00:08.320 --> 01:00:10.280
<v Speaker 1>band called Islands. And if you stick around to the

1141
01:00:10.360 --> 01:00:12.159
<v Speaker 1>end of the episode, you know I tell you a

1142
01:00:12.199 --> 01:00:15.199
<v Speaker 1>secret this week. I'm gonna be real with you. I'm

1143
01:00:15.400 --> 01:00:18.960
<v Speaker 1>recording this from bed, and I've worked from bed all

1144
01:00:19.079 --> 01:00:22.639
<v Speaker 1>day and I don't know why I'm so tired. I'm

1145
01:00:22.679 --> 01:00:27.199
<v Speaker 1>getting over not feeling great, still not feeling great. COVID

1146
01:00:27.239 --> 01:00:31.320
<v Speaker 1>tests are negative, that's good, but yeah, either way, I'm

1147
01:00:31.360 --> 01:00:34.239
<v Speaker 1>like missing a spark plug or two but a better

1148
01:00:34.280 --> 01:00:37.480
<v Speaker 1>secret is that Jarrett got falafel as he was driving

1149
01:00:37.519 --> 01:00:41.239
<v Speaker 1>back from the gym, and for four days our car

1150
01:00:41.360 --> 01:00:47.079
<v Speaker 1>smelled just ripe, just inexplicably so. And then at a stoplight,

1151
01:00:47.599 --> 01:00:50.039
<v Speaker 1>I reached under the driver's seat and I found a

1152
01:00:50.280 --> 01:00:54.679
<v Speaker 1>cold moist and a pretty sizable onion right under the seat.

1153
01:00:54.719 --> 01:00:57.360
<v Speaker 1>It was like the size of an earthworm and sticky

1154
01:00:57.800 --> 01:01:00.920
<v Speaker 1>in that way, but stink here, and I was just

1155
01:01:01.119 --> 01:01:04.199
<v Speaker 1>so relieved. I've never been so relieved to touch something

1156
01:01:04.199 --> 01:01:08.199
<v Speaker 1>so smelly, and just to close that stinky chapter. But okay,

1157
01:01:08.599 --> 01:01:11.400
<v Speaker 1>enough out of my voice. I'll shut it for now.

1158
01:01:11.679 --> 01:01:13.679
<v Speaker 1>More voice boxes next week they'll come back.

1159
01:01:13.679 --> 01:01:35.320
<v Speaker 4>Okay, bye, bye, Focus on your diaphram.

1160
01:01:35.679 --> 01:01:36.519
<v Speaker 1>That was a diaphraend