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October 31, 2014  
HEARTBURN NEWS: Feature Story

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  • Painful Tune of Acid Reflux Disease

    Vocalists Sing the Painful Tune of Acid Reflux Disease


    September 29, 2004

    By Stephanie Riesenman for Reflux1

    Dr. Dana Talley was only 30 years old and already in his third year of performing as a principal tenor with the Metropolitan Opera when he experienced his first attack. He was in the middle of a concert and he felt the excruciating pain in his chest.


    “It was really scary. They called an ambulance, and I went to the emergency room and it turned out to be acid reflux. I thought I was having a heart attack,” said Dr. Talley who still speaks with the vocal control and sonorous sound of a youthful stage performer.


    Dr. Talley’s bout with acid reflux is no exception in the vocalist profession. In fact, it is quite common. Many reflux sufferers are not consciously aware of the symptoms because chronic reflux often dulls the sensation of the esophagus. Reflux may or may not distort the singing voice.


    “A pain or tension anywhere affects the voice,” said Dr. Talley. “Singing is about relaxation, and anything that happens that isn’t relaxed is manifested in the sound.”


    Those with voice problems who do seek help have reflux ranging from mild to severe. Professor Rosalie Loeding is a voice teacher and specialist in voice problems, and currently works in Illinois. She has published extensively on the topic of acid reflux disease, or GERD, in the singing profession. She says there are many reasons singers tend to develop acid reflux. The first is that the intra-abdominal pressure, needed for performing, works against the esophageal sphincter, which is a one-way valve that is supposed to prevent the backwash of stomach acid into the esophagus. When a singer “supports the tone” the stomach contents are pushed up toward the diaphragm, weakening the sphincter.


    Secondly, since a full stomach interferes with abdominal support of the voice, many vocalists will not eat before performing. And when they perform it is often late in the evening, which in turn means they eat late and then go straight to bed. The whole routine is a prescription for heartburn.


    The most common exacerbator of acid reflux is stress—both personal and performance stress.


    “There is a saying in the Metropolitan Opera—you’re only as good as your last performance—no matter how good historically your career has been,” said Dr. Talley.


    He added that the presence of acid reflux is magnified depending upon the nervousness and importance of the situation in which a vocalist is going to perform.


    “If I’m going to be in the Metropolitan Opera auditions and I’m going to get a contract if I sing well,” said Dr. Talley, “my acid reflux is really bad.”


    Dr. Talley’s GERD was diagnosed by his physician. Doctors can usually recognize reflux by inspecting the vocal chords, identifying the presence of red and swollen mucosa. They may also perform a Barium swallow, a 24-hour pH monitoring, or an endoscopy to visually examine the esophagus. Experts recommend seeing a doctor if several symptoms are present such as, bad breath, heartburn, thick phlegm, scratchy sore throat, vocal fatigue, and chronic hoarseness, just to name a few.


    Dr. Talley said the scariest thing about his reflux was that it would come out of nowhere; sometimes convincing him it was something more serious than heartburn.


    “So there’s this moment of confidence, and then rumbling up in the chest would be this terrible pain and you thought it was controlled,” said Dr. Talley. “This happened to me so many times over the course of a 30 year career.”


    Fortunately Dr. Talley’s acid reflux is under control today. He uses Prevacid every morning, which suppresses the production of stomach acid. Antacids, which act to neutralize stomach acid are also effective, depending on the severity of the disease.
    Singers are also recommended to avoid acidic foods such as tomatoes and citrus fruits, and to cut intake of alcoholic beverages and caffeine. Peppermint, chocolate, milk products and spicy foods are also discouraged.


    Dr. Talley said he also made sure he was hydrated and he avoided eating right before a performance, but made sure not to fast for too many hours before he sang. These strategies helped.


    After a long career with the Met, performing in nearly every European country, Russia seven times, and each of the 48 contiguous United States, not to mention many other prestigious performances, Dr. Talley now uses his voice to shape the talents of young amateurs as a professor in the music department at Nyack College in Manhattan. Together Dana and his wife Sue, who is director of the program and a concert pianist, have grown the department from just a few students to a program of 60 majors and 63 in the choral.


    “They come as diamonds, many with remarkable talent,” said Dana Talley, “some of them don’t even know they have a talent and it has to be discovered.”


    Several of the undergraduates are from the inner city and have never even heard of classical music. But twice a year they draw an audience that sounds more like a cheering football crowd. It may not be the usual concert decorum, said Dr. Talley, but it is certainly welcomed by the students.

    Last updated: 29-Sep-04

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