So, you’ve finally decided to set up an ENT appointment to get a voice evaluation—congratulations! Suddenly, you get that pit in your stomach...the one we get when we’re not sure what to expect or feel underprepared. Do not fret! This article will cover how to prepare for your upcoming appointment and offer some helpful tips to ease your mind.
Before proceeding, I recommend reading about what a laryngoscopy is and what you can expect from your appointment, which I addressed in my blog post, Laryngologist vs. Otolaryngologist: The Difference and Its Significance. Be sure to head back here to read my tips for a smooth and stress-free exam!
Preparation Mode
Write down your symptoms ahead of time. This strategy can help you think clearly and descriptively about your symptoms and what you are feeling. This can be helpful as the provider will likely ask specific questions to help them differentiate your symptoms. Try to think about when they started, how they’ve changed over time, and maybe jot down specific instances or experiences.
Make a list of all of your questions and concerns to bring with you to the appointment. I always recommend this to my patients. It’s common to become overwhelmed or distracted by the evaluation process, so it’s natural for your original agenda to get derailed. By writing your questions ahead of time, you won’t forget to ask them!
Bring a list of your medications and supplements. This is especially important if you are seeing this doctor for the first time, or have updates or changes to report.
Invite a friend or family member to come with you. Assuming that there are no protocols stating you cannot have anyone with you, bringing a confidante can help ease stress if you are nervous. Furthermore, they can take notes for you during your appointment to help with the information overload!
Laryngoscopy In Full Effect
Some of these tips may sound (and feel) a little silly, and while everyone’s experiences are different, I am confident that the following strategies will help your laryngoscopy procedure go as smoothly and as comfortably as possible.
Don’t underestimate the power of “mind over matter.” The stress or nerves that you bring into the exam room will impact the ease of your procedure. If you go in tense, your body will be in full defense mode. If you are mentally prepared and feel confident in the strategies below, it will help you remain calm and relaxed, and your exam will be over before you know it!
A numbing spray is likely available to you. It is common for the physician to offer a numbing spray to help reduce discomfort. It is optional, though it may significantly improve the outcome of your exam if you have a tight or congested nose and/or strong gag reflex. Others may find the below tips adequate to assist in their tolerance of the scope.
Tips for flexible laryngoscopy:
Breathe! Breathing through your nose will not only help keep you calm as it engages the parasympathetic nervous system, your “rest and digest” response, but it will also keep the nose open and allow the scope to travel through the nasopharynx into the throat with ease.
Your provider will guide you through sounds like “eeeee” and “ahhhh,” and sniffing in through your nose. Some may ask you to “inward gasp” (like a shocked or surprised sound) on an “eee” shape. Practice this sound—something like a short, quick “heee!” as you inhale. Be prepared to follow additional instructions for other sounds or phrases!
If singing makes you nervous, be mentally prepared that you may be asked to sing Happy Birthday or another simple tune with the scope in place. If you are a singer, prepare several bars of a song in your repertoire just in case.
The provider will guide you on when to swallow and when not to swallow to avoid any discomfort! Trust in their support and keep breathing in and out.
Tips for rigid laryngoscopy:
The stance and positioning for this exam requires slightly more work on the patient’s end compared to the nasal scope. Your tongue is forward, protruded out of the mouth while voicing. Your tongue is a muscle; practice stretching your tongue and holding it relaxed and as far forward as is comfortable to prepare you for this step.
Now practice holding the sound “eee” in a comfortable voice, keeping your mouth wide open while you hold that tongue position out of the mouth. It will feel a little awkward but the “eee” is important, as it positions the base of your tongue forward so that the camera can visualize a clear view of your vocal cords.
Continuously voicing or breathing will help reduce the sensation of a gag reflex. Practice cycling a sustained “eee” sound comfortably, inhaling through the mouth when you need to breathe, and immediately returning to the sustained “eee” again for several rounds.
After The Laryngoscopy
Wait 30-45 minutes before eating or drinking. If you were given spray to numb your nose or mouth, wait until the numbing effect has worn off before consuming anything, about 30-45 minutes. It could be dangerous to eat or drink when your throat is numb because you could choke or possibly burn yourself on hot liquids or foods.
Bring a notepad to take notes. Depending on your exam findings, there may be quite a bit of information provided. If you didn’t bring a person with you, be sure to request a visit summary from your physician and take your own notes of important details if needed. You may write down your diagnosis, terms you want to look up later, next steps (i.e. prescriptions, referrals, recommendations, additional appointments), and other details you want to remember. It may help to review your notes later when you have more time and a space to absorb the information.
Ask to take a picture or video of your larynx from the video screen, if available. Your doctor should be happy to oblige. You can have this for posterity, proof of bravery, and it may also be helpful to show other specialists (like your speech-language pathologist!) as needed. Smartphone to the rescue!
Follow through with recommendations and a follow-up, if needed. Be your own advocate and follow the doctor's orders for any dietary or lifestyle changes, prescriptions, referrals, speech therapy, additional testing, and other appropriate recommendations. Easier said than done--I know! Your voice and health will be happy you did it, and on the bright side you will have much to report at your next follow-up appointment with the doctor. (Disclaimer: of course trust your instincts and get a second opinion if desired).
If you’re anything like me, having a checklist and a Siri or Google reminder set up in advance will help you stay on track for your upcoming appointment. Now you can walk through those office doors with confidence at your evaluation and can place your focus and energy on what matters most: healing your voice.
Jessica Schwartz Smith, MS, CCC-SLP is a licensed and certified speech-language pathologist in Pennsylvania and North Carolina. She is the owner of Resonate Voice and Speech Services, a speech therapy practice based in Philadelphia that specializes in voice disorders, chronic cough, VCD/PVFM, gender affirming voice therapy, and adult dysphagia.