Talk is not cheap: Speaking may be hazardous for teachers

I sympathize with teachers, as many of them, like you, suffer from throat and voice problems in school; it is an occupational disease, but there are things you can do.

Cartoon teacher (photo credit: ANDREW LUCAS/TNS)
Cartoon teacher
(photo credit: ANDREW LUCAS/TNS)
I started teaching seventh grade last year and now I have started the new school year. Last year I suffered from pain and hoarseness because it was a large class and there is also construction work nearby that made it difficult to be heard.
What can I do this year to protect my voice? V.N., Tel Aviv
Dr. Jonathan Lahav, director of the unit for the treatment of laryngeal diseases in the Kaplan Medical Center in Rehovot, responds:
I sympathize with teachers, as many of them, like you, suffer from throat and voice problems in school; it is an occupational disease, but there are things you can do. About 150,000 teaching staff began classes on September 1.
During the year, they will overuse their vocal cords in classrooms, during breaks, in conversations with parents and in various ceremonies. This effort can cause hoarseness and permanent damage in the form of warts, cysts, polyps and scars on the vocal cords. In fact, this is a widespread phenomenon that accounts for the largest percentage of referrals to the vocal cord clinic.
Improper use of the vocal cords can cause pain during speech, decrease the sound quality and make you fatigued. I strongly recommend that teachers speak calmly and quietly rather than strenuously in class. Anyone required to speak loudly and effortlessly during most of the day and often faces a noisy crowd will find themselves suffering from continuous exhaustion, with possible damage to the delicate tissue that surrounds the vocal cords. The problem is not just because they talk too much – but they do it wrongly, too much or too strongly.
In most cases the damage to the vocal cords is temporary, and the tissue restores itself, but in some cases irreversible damage is caused. It is important to emphasize that this is a disease that can and should be treated quickly to prevent future damage.
Away from school, try to speak with a quiet voice. Try to let your vocal cords rest whenever you can. When speaking, try to be calm and speak in a quiet voice. Your class will make an effort to hear you more than if you shout.
Try to reduce the use of your mobile phone, even if you wear headphones and are sure that no one can hear you talking. Do not shout into the phone and don’t strain your voice. Try to avoid as much as possible the use of a speakerphone, which almost automatically increases the strain on your vocal cords.
Of course, don’t smoke and avoid drinking excessive alcohol. Smoking causes severe and permanent damage to the vocal cords – from edema that reduces the sound to changes that may develop into cancer. The same is true for too much alcohol. Drinking plenty of water contributes to the natural moisture and helps to soothe the straining throat. Maintaining relative humidity and using a humidifier can help. When teaching, put a bottle of water in front of you so that you can take a sip when needed.
Avoid foods that are too acidic, sour, spicy or salty, as they may irritate the throat’s mucous membranes. Overconsumption of such foods may cause discomfort, a lump in the throat, phlegm and even pain as a result of the local irritation. If you suffer from excessive salivation, try to avoid dairy products. A lot of clearing of the throat does not usually contribute to easier speaking; on the contrary, it increases stimulation.
It is recommended that anyone who engages in a profession involving significant use of the voice should undergo at least one therapy session from a speech therapist. This treatment increases the awareness and inculcates good habits to protect the vocal cords. Our unit at Kaplan is ready to give advice and treatment.
It is important to apply these recommendations to prevent damage to the vocal cords, which can even hurt your career.
I am a 57-year-old man. I have been suffering from chronic onychomycosis (fungal infection) of most of my toenails for years. Not one of the treatments that dermatologists have offered me has worked. As I have a chronic liver condition that is under good control, I can’t take a medication that is supposed to be more effective against the fungus. I don’t wear sandals because I am ashamed of the broken, whitish and ugly nails.
I read recently on the Internet an ad from a US dermatologist who claims to “cure” the condition with a $37 product in a “few days.” Obviously, I am very suspicious of such ads. But what he also wrote scared me. He said that onychomychosis “poisons the body” and can lead to all kinds of diseases, even dementia, and may cause early death. Is there any truth in this claim that the fungus can affect other bodily systems? If so, what should I do?
B.T., Beersheba
Prof. Eli Sprecher, chairman of the dermatology department at Tel Aviv Sourasky Medical Center, answers:
There is no evidence that fungal infections of the nails can “poison the body.” In fact, most nail fungal infections are caused by agents that usually prefer the very superficial layers of our skin.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 9100002, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or email it to jsiegel@, giving your initials, age and place of residence.