instruction: hi doctor I had some vocal fatigue for a while and I have been resting my voice for pretty much one month now I was not so sure if I should start speaking again or not I am a bit afraid if it is going to affect my singing voice either way the first time I consult an ent they said I had hemorrhagic patches on my anterior one third of both of the vocal cords I have been drinking a lot of water and also I took some proton pump inhibitors I also have a phonatory gap but I do not think that is the problem here really anyway I was just wondering how much time do you think I still have to keep resting
output: hello I assume that these videos are one month prior to today condition I see some amount of inter arytenoid pachydermia suggestive of acid reflux and associated changes in the posterior part of vocal apparatus and anterior phonatory gap although I cannot see the anterior one third of the vocal cords that clearly I understand that your ent has found that those portions had some hemorrhages he was right in advising you voice rest and proton pump inhibitors ideally a week of absolute voice rest is sufficient followed by voice restriction vocal hygiene antiallergic treatment nasal sprays based on nasal symptoms increased hydration etc now considering you have taken a month of voice rest I think it is sufficient but do you have any symptoms whatsoever now any nasal symptoms or allergic symptoms any history of substance abuse do you suffer from diabetes or hypertension in my practice in addition to antireflux pi tablets antiallergics antihistaminics like fexofenadine allegra deslor etc hydration voice rest dietary and lifestyle changes I add some voice therapy probably you should explore some vocal hygiene tips from a speech language pathologist or voice therapist