Saturday, April 14, 2012

Kashu-do (歌手道): Acid Reflux: More Insidious Than I Thought II --- Thanks For the Love


Today, I arrived at the main train station in Dortmund, Germany, looked at my phone and notice that I had received a new email, the latest of more than a hundred emails I received from students, friends and many readers of this blog wishing me well!  This email drew tears!  (I changed his initials to maintain anonymity).


Dear Jean-Ronald,

My name is W.R... I once had a Skype lesson with you (more of which later), and exchanged some emails with you afterwards. On reading your blog post today, I was deeply saddened to see you still suffering from the horror of GERD, particularly that you are now considering surgery. I'd like to tell you a story of how mine began, and how I cured it. I'm sorry this is so long - I didn't intend it to be. 

About 4 years ago, I was working full-time and undertaking a masters part time. I was actively involved in triathlon's, drama and music. I was (am!) a very driven, I suppose successful person, with no fear of undertaking any challenge. Indeed the greater the challenge, the greater I relish it. In honesty I'm probably a workaholic. However during this period of about 2 years, I began to suffer from pretty bad back pain, with some days worse than others. Being the type of person I am, I endeavored to find the root of the problem. I did yoga, stretching, core exercises, walking, tried different shoes, back supports, diet, supplements, saw several physiotherapists, chiropractors and eventually a surgeon. I woke up and went to bed thinking about it - I WOULD beat it. 

But I didn't. All the money, time, effort and perseverance got me nowhere. There was NOTHING I hadn't tried physically to beat this thing.I eventually stopped exercising for fear of further hurting my back, began limiting all my activities, even social events with my girlfriend, friends and family. I fell into depression that I would be crippled by this forever. I was 28 years old. 

And then I read a book ( I have no recollection how I got this book). The book was called "Healing Back Pain: The Mind-Body Connection" by Dr. John Sarno. It proposed that back pain (along with many other ailments) was an emotional/personality disorder manifesting itself physically. I outlined the people prone to this disorder - high achievers, people who perceive themselves to be strong willed,  hard workers (and more). All the things that I was. The diagnosis was simple enough. The treatment not so easy. Find out the root of the emotional problem(s), confront them, bring them to the fore. Recognize that you are not perfect. Throw out all "aids" for your disorder - they only perpetuate the myth that it is physical. Do ALL of the things you think you can't do because of your physical disorder. Live!

For about a week I was as bad or worse than I had ever been. But I refused to dwell on the physical. Instead, every time the pain returned, I would examine what was emotionally wrong with me, what stresses was I under, where was the anger and fear coming from. And then one evening, I realized. I hadn't had any pain ALL DAY. I went back running, weight lifting, singing - everything. I went back to living.

That was 3 years ago, and I have ALMOST NEVER had back pain since. Remarkable given that I afflicted by it every day for nearly three years.

How does this relate to reflux? Well, about 18 months my  girlfriend and I moved to Vancouver on a once in a lifetime adventure. We took all our savings, left our jobs and families and tried to give it a go in Canada, at least for a year. However, after a month I still couldn't get any work. I had always been the provider for us (my girlfriend was still in college), and we were hemorrhaging money at an alarming rate. I was desperately trying to get work, working for hours on end on resume's for specific positions, doing interviews, calling to potential employers. And I began to suffer from the most incredible burning in my chest, throat and gut. I assumed I had picked up some sort of bug. I eventually found a job, but a super-high pressure one with an up and coming internet company about to make it big. The rewards were good, but the pressures were unbelievable. I was working anywhere from 12-16 hours a day. And my condition got worse and worse. Again, I began looking at every physical possibility, diet, bugs, lifestyle. I WOULD find a cure. I researched and researched, looking for an answer in the physical world. And never did I see the connection. This went on for many months, with my general health and voice suffering horribly. Eventually pressures subsided in work, and my symptoms did too. At the time I was trying "natural" remedies for my reflux - (acidophilus etc), which I attributed to my recovery.

We moved home in September, and my experience the internet company got me a great job in a large company, again one filled with great pressure and responsibility. And sure enough, my reflux returned WITH A VENGEANCE. I was at a very exciting stage with my singing, truly seeing myself as a tenor at last. The reflux became vocally debilitating. My voice would tire incredibly quickly, and my voice was getting rough in the passaggio, and my newly developing top was disappearing. I began to return to questioning this "full voiced" technique I had been working towards. I went to a doctor and was prescribed PPIs, and I went back on my "natural" remedies. Neither did me any great service.

And then it clicked. The stress, strain and pressure put on myself to succeed, to be the one who could be relied on, determined to achieve anything I put my mind to - my mind was trying everything to tell me this was unsustainable - I just wasn't listen. So I began to. I began to meditate again. I started looking at my life to see what was important and what wasn't. I realized I hadn't been spending the kind of time I should with my friends and family, burying myself in my work - and for who? So I took a back seat in work for a while. I took it easy on pressuring myself. I stopped trying to get somewhere with all the things in my life - singing, work, exercise etc. I tried to reconnect more with what was actually important to me and FOR me. And I began to heal. Sure enough, within about a week, it was mostly gone. I'm still early in this phase, but each time I return to stressing and piling pressure on, it returns. Its now pretty clear to me. I am causing this through how I treat myself emotionally.


Though I won't go into it here, my girlfriend has also recently cured herself of terrible migraines caused by long term family problems through the same approach. She was as skeptical as I was at the beginning (and I'm sure you are), but is now living migraine free.

I'm sorry this is so long, but I felt the need to write to you this morning to share this. You are someone who kindly helped me, regardless of how busy you were, when I needed it, I see you as a similar person to me - a high achiever, one who feels no task is insurmountable, if we just work hard enough. And this, our self-admired work ethic, is our downfall. Perhaps I am wrong, perhaps your GERD is purely physical. However, I urge and plead with you to buy this man's book, read it, absorb it, and try it. Its a lot less risky than surgery, and a lot nicer to your body than drugs.

For a quick overview by the man himself (where he lists GERD as a primary symptom), please read this short interview:


Also, an interesting blog post from the wonderful Mr. Andrew Richards, who I glean from reading his blog and forum posts, is another "Type A" personality, where his reflux which he had rid himself of returns with a vengeance during a recent difficult period of his life.



Finally, I want to thank you for encouraging me to take a more "full voiced" approach to singing. Prior to talking with you I was classed as a leggiero tenor by many, (I could sing a reinforced falsetto very high) with an unusually dark and heavy chest voice. Others heard me as a baritone. You were the first singing professional ever to tell me that I was what I believed I was, and to provide me with a roadmap of how to realize my true voice. I've attached a clip from a recent practice, which I think shows me in my true fach - a full lyric tenor!  (I had to do a little editing as I fumbled over the words in places).

Thank you for leading me on a challenging, tough but ultimately rewarding vocal journey. I have a long way to go, but I am beginning to see the light. Your blog means a lot to me.

I hope you find a cure from this awful illness, and I hope that this email may help you in that journey. The mind-body approach is not easy (indeed it is sometimes more about "not doing" than doing), but it is amazing to be healthy and free of these disorders.

My sincerest regards,

W.R.

I agree wholeheartedly with the premise shared here by this good-hearted person who took time to share his story with me.  He analyzed me very well.  I am driven, I am consumed by my work and I believe most anything can be accomplished through hard work.   I will order the book and delve deeply into its contents.  Much to be discovered here for sure.

Not only do I want to thank the writer, but I would like to thank all of you who wrote to me with such care and genuine compassion.  You have all touched me very deeply.  We have indeed built a community here at Kashu-Do.  

I will share some good news with you.  I returned to the drugs as prescribed by my doctor but following the advice of two friends who gave me the same advice.  I am taking 20 mg of the PPI Pantoprazol (another form of omeprazole) in the morning before eating anything at all and 75 mg of Ranitidine (Zantac) at night.  The combination is working and several people have heard the difference in my speaking voice.  Singing is feeling much better but I will not celebrate yet.  I will give it two weeks and see how things improve.  I have also begun eating probiotic yogurt daily, which I believe is already having a good effect.  So far so good!

This however does not trump my friends suggestions above.  I am still determined to deal with the root cause of my reflux and will follow his advice above.

W.R., your clip sounds wonderful! Your progress is notable.  I wish you continued growth!  Thank you again for taking the time to write.

Thank you once more to all of you who have written to me.  You have so lifted my spirit this week!  I hope to share the fruits of success with you soon!

JRL

© 04/14/2012

Tuesday, April 10, 2012

Kashu-do (歌手道): Acid Reflux: More Insidious Than I Thought

Everything about the voice makes sense in the end and it is paradoxically a frustrated relief to know that Acid Reflux is still at the heart of some of my vocal problems.  What has been confusing to me throughout this ordeal is that over the last 18 months that I have gotten off of Reflux medicines, my voice has improved continuously.  My modal range became consistent up to C5# and my full-closure falsetto extended nearly an octave to E6b (one step below Queen of the Night high F).  I sang a couple of concerts and read through three tenor roles during this time--something I could not have done before.

On a rare clear day (little or no Reflux symptoms) I felt my voice do amazing things.  I have had the flexibility to sing Ecco ridente, Una furtiva lagrima, Every Valley and right after that Celeste Aida, Chénier Arias, Nessun Dorma, etc.  I began to believe that my issues were more technical than health related.  I will not say that I have not had serious technical work to do in the past 18 months, but I believe that if I had been fully healthy that my technical issues would have been dealt with much more quickly.

To make a long story short, after I experienced my easiest day of singing in months, touching on high Eb full-voice for the first time, I realized that my voice was inconsistent because the state of the mechanism was inconsistent.  So I visited my doctor and confirmed my chronic reflux.  The inflammation and mucous build-up, the redness in the arytenoid area, the difficulty closing the folds in the extremes, which would explain the raspy tendency in the lower voice, the husky bassy quality and the difficulties above B4b.  My doctor was direct. Either find a combination of Proton Pump Inhibitors (PPIs) and Acid Reducers or have the Endoscopic Fundo-Plication Surgery.  I have decided to go back on the acid controllers until such time as I find a more natural solution.  Surgery is not something I would elect when there are other choices.  If I exhaust all options, then surgery may have to be addressed.

In the end, I can no longer be cavalier about my own vocal output.  I have always said that my technique rests with me.  I have successfully trained a large number of singers with serious vocal issues to balance.  However, as a singer myself, it will always be reflected upon me, as to whether my viable technique holds water.  The day I post a high quality clip on this blog is the day that all doubts are cast aside.  I also know that my own success is crucial as a model for my Posse of Ex-baritone Tenors, who have undergone the transition from baritone to tenor with me.

I wanted to find the source of my Acid Reflux and deal with it naturally.  I still have that hope.  In the mean time, it is necessary to deal with the symptoms well enough such that the true quality of my voice can emerge.

A student of mine who had suffered terribly with reflux recommended Prevacid (a PPI) and Zantac (acid reducer).  She finds the combination very successful after she had tried other similar drugs that worsened her symptoms.  Another student recommended Acupuncture.  I am investigating that as well.  My dietary changes have been considerable over the past few years, but now I have to be even more diligent in dealing with the issue.  Eliminating the intake of carbonated drinks (including my San Pellegrino) I believe will be considerably important.  Furthermore, not drinking water before sleeping is also crucial.  The water comes up easily and accompanied by stomach acids can cause serious harm during the night.

The logic of my process is obvious to those who have taken time to understand it and as a result my studios have flourished.  I have begun to realize that posting clips of a voice hampered by inflammation gives a bad impression.  I don't know how long it will take before I am clear enough to post a clip of considerable difference in quality.  I hope I will be able to post something in the next couple of weeks.  In the mean time, your prayers and good energy is welcome in the fight against this extremely inconvenient and insidious disease.

Best,

JRL


© 11/03/2012