TONY Season: Stage, Stress, and Survival
A Laryngologist’s View of TONY Season
The TONY Awards are coming Sunday June 8th! While being a nominee is a major accomplishment, making it to and through the Award show is a herculean achievement. Much the same as getting through the NBA playoffs having a game every other day. Too much, too often...repeat, for six straight weeks. As if singing and performing eight shows a week was not tough enough. There are no days off. All week and on what was your day off, days are filled with press, TONY events where you need to talk and schmooze over the din of the party, early morning wake ups for the TODAY Show and the like. There is the associated anxiety and stress, fatigue and lack of sleep. In addition, for some it is allergy season. More inflammation, and mucous, on top of it all. This stretch wreaks havoc on the body and the voice.
I am lucky enough to have many of these performers trust me with their voice over the last two decades. In the best case scenario we have a relationship prior to the storm and have them in optimal shape. Other times, the first time we will meet is just a few weeks or days before they need to perform at the TONYs. What can we do to help and what can they do to optimize the chances of making it through these weeks in top performing shape?
Most of it is vocal hygiene and vocal load management, as well as good care of the entire body. Sleep, whole foods, hydration, stress reduction. Spacing out vocal obligations so you can rest the voice between interviews, instead of piling them together and resting afterward. Sometimes we will need to cancel some of the obligations. The Company is generally very agreeable if the doctor is insisting on it. Some performers like vitamin or immune IV drips. While I cannot say the vitamins have a proven benefit, IV fluids alone can help acutely with fatigue. It is important to choose a reputable company as an IV sounds benign but it is invasive.
Medically, it is my job to identify the cause of and minimize any inflammation that can contribute to voice issues, as well as be a trusted partner of reassurance and calm at a very anxious time. An ill timed upper respiratory infection, cold, or sinus infection can knock one off the tightrope that is being walked. These happen more often during this time due to the extreme exposure in close quarters with lots of people, some who may be sick, as well as the general fatigue that will decrease a performer’s immune system. Acid reflux, seasonal spring allergies, exacerbation of other underlying medical disorders may also contribute. Finally, there is vocal inflammation from the massive speaking and singing demand.
This can all be treated with a modified reflux diet and medication or natural antacids and alginates, nasal sprays, and lots of vitamin C if a cold is coming on. Sometimes antibiotics are necessary. A specialized neck and laryngeal massage with our expert voice therapists who are Speech Language Pathologists and Singing Voice Specialists can be extremely helpful for neck and laryngeal tension and soreness. And while there is nothing available to directly treat the inevitable vocal fold inflammation, we can give steroids to bring the swelling down if it is severe enough to make performing impossible or vocally dangerous. Steroids work very well but they must be used prudently and with caution.
That these artists can make it through this trying time is a testament to the hard work and grit of the Broadway performer. They are hardened by the fire of the stage eight shows a week. With that mindset and the adrenaline around the run up to the TONYs, they usually make it through without missing extended time from performance or a vocal injury. The night will be exhilarating for all, fulfilling to some, and disappointing to others. But once they are on the other side, returning to normal eight shows a week will feel like a breeze. As the Laryngologist, it is an honor to have the trust of these performers and it is a treat to watch them succeed in front of so many fans. That they make it all look so easy, when it is anything but, is one of the many reasons they are TONY nominees!
- Dr. Michael Pitman, MD