Health and Harmony: If your voice is straining, you might need training

Voice therapist Linda Barrantes helps patient Peter Levine perform

voice exercises at her Boca Raton office.

Tim Stepien/The Coastal Star

By Paula Detwiller

    Peter Levine of Delray Beach wasn’t alarmed when his deep, baritone voice began to get raspy. But some folks at his synagogue were. Fellow congregants could hear Levine’s husky, strained voice when he led prayers during unamplified Sabbath services. 

    “People came up to me very concerned: are you OK? What’s the matter with your voice?” Levine says. 

    He went to an ear, nose and throat specialist who ruled out throat cancer and told him to “buy some honey, drink water and stop worrying about it.” So he did.

    But Levine — who uses his voice frequently as a court-system mediator, a member of several boards of directors, and a Type-A person who likes to make his point, intensely — got worse. His throat was constantly sore, and his voice got even deeper and more gravelly.

    A second specialist found a small polyp on one of his vocal cords, and noticed one cord was much narrower than the other. The doctor said Levine, 74, might need surgery — but suggested he first try voice therapy. 

    That’s when Levine met the therapist he calls his “lifesaver,” speech-language pathologist Linda Barrantes at Boca Raton Regional Hospital’s Davis Therapy Centers.

    “Peter had all the typical voice behaviors we see,” says Barrantes. “He was a fast talker, didn’t breathe, and spoke to the end of the breath, which creates a lot more strain and tension on the voice.”

    Barrantes taught Levine how to speak in a slightly higher register — “adjusting his pitch and volume and finding that smooth spot,” she says — and to breathe more frequently to support his voice. She trained him using software called Visi-Pitch, which gives instant visual feedback.

    “The vocal cords have to come together and meet in the middle — like mirror images of each other — so if there’s a little gap, such as that caused by thinning of the vocal cords, the person can’t project like they used to, or make themselves loud,” Barrantes says.

    Barrantes says what happened to Peter is very common in aging. As we get older, our vocal cords can thin. Suddenly we’re straining to make ourselves heard. Polyps, nodules, or cysts can develop on the vocal cords, weighing them down and changing how well they vibrate to produce sound.

    As you might expect, speech-language pathologists see a lot of aging teachers, salespeople, performers and others who’ve been heavy vocal users throughout life. And they don’t want voice problems to curtail their activities after retirement.

    Voice therapy teaches new behaviors and techniques to minimize vocal strain and reduce inflammation of the vocal tissues. Patients learn how to keep their voices durable throughout the day.

    Levine did his vocal exercises while “cross-country skiing” in his swimming pool.

    “My wife Elizabeth laughed when she heard me in the pool going ‘mah, moh, mee, moo’ at a higher pitch,” he says. “But she became a partner in all of this. She was my Jiminy Cricket when it came to remembering my exercises.”

    Levine’s vocal-cord polyp is still there, but it has shrunk and he no longer needs surgery. During Yom Kippur gatherings at his synagogue, he was able to talk nonstop for more than an hour without discomfort or strain. 

    “I’m living proof that this works,” he says, “but the key is, you have to be mindful and apply the techniques for the rest of your life. It’s a lifestyle change.”

    Outpatient voice therapy is also available at Bethesda Hospital’s Bethesda Professional Plaza on South Seacrest Boulevard in Boynton Beach.

Paula Detwiller is a freelance writer and lifelong fitness junkie. Visit her at


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