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Vocal health is crucial for a performer, especially in an eight-show week environment. Playbill.com speaks with go-to vocal coach Liz Caplan (read more about her in our Booking It! column) and performers who have faced the biggest sings on Broadway: Shoshana Bean (the first replacement for Idina Menzel's Elphaba in the blockbuster musical Wicked), Constantine Maroulis (a Tony Award nominee for Rock of Ages, a show that requires vocal pyrotechnics), Ramin Karimloo (a Tony nominee who currently stars as Jean Valjean, one of the biggest male roles in the musical theatre cannon, in the Broadway revival of Les Misérables) and Melissa Errico (a Tony nominee who underwent vocal surgery following her performance in the most recent Off-Broadway staging of Stephen Sondheim's Passion). They share their secrets and talk about how to maintain in good voice when under the weather.

Winter Blues

Liz Caplan: The winter months in NYC are challenging for the singer/actor. Keeping the neck and throat warm are of paramount importance. In Chinese medicine, the head (base of skull), neck and throat are referred to as wind points. If you are feeling vulnerable in any way (this includes both physically and emotionally), and you get a draft or chill on these areas, it's likely that the seasonal bug will get you.

I recommend to all my students to stick to drinking warm or hot beverages and cooked food. The lungs tend toward dampness during these months, so warm beverages and warm/hot food will help remove the clammy cold feeling.   These next recommendations for the season come with a caveat:

Hot and spicy foods and condiments actually increase metabolism (heat) and clear all sorts of phlegm from lungs and mucus from sinuses from stagnation. However (big however), spicy foods tend to create acidity in the throat. We have to be careful as to when we take such foods in.

Turmeric, oregano, garlic and cinnamon help to get mucus and phlegm stagnation out. Wasabi is also excellent. Imagine how your body reacts when you eat wasabi. You tear up and generally get a runny nose. This is actually excellent--things are moving and moving out.

Excellent winter foods:

Apples 
Brussels sprouts 
Parsnips
Pears 
Rutabagas 
Cauliflower 
Winter Squash (There are many varieties of winter squash — including butternut, acorn, delicata and spaghetti squash — and they are all excellent choices in the winter.)
Pumpkin 
Sweet potatoes 
Turnips 
Pomegranates 
Dates 
Grapefruit 
Tangerines 
Dark leafy greens (such as kale, chard and collards; [they] thrive in the chill of winter when the rest of the produce section looks bleak. In fact, a frost can take away the bitterness of kale. These greens are particularly rich in vitamins A, C and K).

Melissa Errico: This winter I am not in a musical, but when the twins were eight months old and Victoria was three years old, I played Betty in White Christmas on Broadway and never missed a show! I made sure to get seven-eight hours of sleep a night, took vitamins D3 and B12, and I drank an Emergen-C vitamin drink almost every day and must have had a half gallon of water myself every single day.

The challenge was the days when we were invited to do early-morning television, like "Good Morning America," and had to wake up at 5 AM to be on the TV set before a two-show day or sometimes a nine-show holiday schedule. I was so appreciative of the opportunity (and loved my red dress!) that I just plowed through a few sleepy days. This winter, I have concerts almost every other week, so in a way it's differently challenging when you aren't on a structured schedule. I have time off and then have to rally again.  Like all actors, its hard to maintain discipline when there isn't a rehearsal, show or audition focusing our minds. We have to keep up good routines even when no one is needing us!

Got a Cold?

Liz Caplan: Taking a probiotic daily acts as a preventative. Most illnesses begin in an unstable digestive tract. To get the yeast and bacteria balance in the digestion is a good way to achieve successful immune support. (Read more about probiotics.) 

Throat coat tea works well for some people. It does tend to dry some people's throats out. The ingredients within might be healing, but we have to watch out for immediate side effects. Adding organic local honey could help offset the dryness. I like drinking echinacea tea from either traditional medicinals or Yogi teas. Hydration is crucial at this time of year. I like coconut water (if too sweet, [it] can be mixed with smart water for the electrolytes). Coconut water lubricates the throat (larynx and vocal cords) well. Between the heat inside apartments and buildings and the extreme cold, one does need to rehydrate and often. 

Sleep is of the utmost importance when one is feeling under the weather. The cells need to reboot, and sleep is the only instance where one can shut down to let the body miraculously heal. And the throat is quiet for a change. Meditation, when practiced regularly, has the same benefits. Placing heat on the chest at night is also wonderful for keeping warm. And it is also relaxing.

Try to avoid coughing and clearing your throat as much as you can. Both of these things irritate the delicate membranes of your vocal cords, which will cause them to swell.  Inhale steam. This will help soothe your cords and loosen some of the congestion in your lungs naturally. Be very careful, though, as hot steam has the potential to burn your mouth or throat. 

Gargle salt water. Like inhaling steam, this will naturally clear away some of the phlegm that lives on your cords, clearing them up for those beautiful tones to come through.

Warm up. This is the absolute best thing you can do for yourself and your voice. Start with a very quiet hum or hum related exercises on a consistent and comfortable pitch to warm up the cords. Your cords will need the extra warm-up time to loosen up and shake off the phlegm and infection. 

Be careful with decongestants. Although they can clear away the phlegm, they do so by drying out the mucous that your body is producing to help clear away the infection, so you will ultimately take longer to heal. In addition, they dry out the membranes, which could cause you to lose your voice entirely. So it's better to consider medication decongestants as an absolute last resort. Keep in mind, too, that you won't entirely know what you sound like on the decongestants, so it's better to experiment with them a day or two before the performance or concert, just to see what happens. 

Singing with congestion: Excess mucus forms due to stomach-spleen disharmony. So, based on this thought, one should eliminate all dairy products if congestion is a normal state.

Of course, if you are staying away from dairy products, it will be important to get your calcium supply elsewhere. One can take calcium supplements. Calcium can be found in leafy green vegetables as well. One can substitute milk products with almond milk, rice milk and other non dairy beverages all which contain tremendous amounts of calcium.

Doing a netti-pot once a day is advantageous to keeping the sinus cavity clear. As well, homeopathic and non-medicinal sprays would help keep bacteria out and sinuses lubricated. Any saline-based product is valuable. 

Turn to your private teachers as well for sinus-busting exercises. There are certain combinations of consonants and vowels that work together to help release the soft palate and move some congestion around so that you can feel your sinus cavity resonance.

All this information and more about  specific sinus busting exercises and vocal health are contained in my apps found at the Apple App Store for iPhone and iPad.  

Ramin Karimloo: I take Oregano Oil if I'm feeling under. I up my Zinc and Vitamin D during the winter months.

Melissa Errico: My dressing room looks like this: A humidifier, a face steamer (I like a few puffs of steam while I am warming up, if I can't get a good 20 minutes in a shower), Grethers Pastilles (I like the ones with sugar), lemon/lime Ricolas, throat coat tea and raw honey and a huge bottle of water. I only need the throat tea if my throat is sore, but even on a regular day I like warm tea because I like to get my body super warm before I sing.  As for medication, I have an allergy to steroids or prednisone and cannot take that stuff. If I could, I would have had a lot easier days recovering from colds or any hoarseness over the years. I have had to go the natural route and sometimes that simply means no medicine, lots of water and rest. Okay, here's a sexy fact: you can wash your nasal passages with a Nettie Pot! One medication I can use sometimes, if you drink enough water, is Mucinex, which is a mucus thinner and can loosen up a cough or help with dry air.

 What To Do In a Pinch!

Melissa Errico: In my case, I tend to ease into a show if I am not feeling my very best and really focus on telling the story for the audience moment by moment. My husband always tells me that he played some of his best [tennis] matches when he was sick because he was forced to focus on hitting the ball with maximum efficiency. He probably meant he was prone to show off less, get less emotional about points and just be simple in his tennis playing.

I've also found that the speaking sections of a musical (the dialogue) can cause a lot of vocal fatigue if you are playing a character who yells, laughs or hoots a lot (such as Eliza Doolittle, which I played on Broadway, a character that howls often with that famous cockney AAAAOOOOOOWWWWW sound). There might be some sections of dialogue which an actor can ease back on or just be really careful not to push. For example, during the recent run of the new musical Bull Durham (at The Alliance in Atlanta), I played Annie Savoy, a sassy character who was also the main narrator. I was the first person on stage beginning with a flirty monologue and then leading into a bluesy, belty opening number. During a short preview sprint ([approximately] ten days), we had full days of rehearsal every day with new material constantly given to us, followed by press nights in the evening. That went great, and very few people got sick. Once we opened, we had been through a lot mentally, and yet eight shows a week doesn't give you a chance to recover much. Once we settled into our run, I was a bit tired so for a week I eased into my opening number more than usual — not throwing my voice too hard and using my head voice a bit more and with nasal resonance so it was still satisfying for the rock style.

There are vocal modes which aren't throaty belting but can still deliver lots of power and volume and are more conservative. As a soprano who has started belting a lot myself, it is what I am working really hard on. Where I am at in my life is that I am surprising myself with some big belting!  In my 40s, this new voice has come out of me, and I guess playing a saucy femme fatale requires it!

Ramin Karimloo: Well, the good thing is what hasn't killed me has hopefully made me stronger. Some shows require less effort for singing than others, depending on how my energy levels are or if I'm healthy. You know, our minds and spirit can totally take over our bodies. So, mostly, I try and stay positive. I love what I do, so that carries me through a lot. If I am sick or vocally tired, I just make sure my body is warmed up and I get my "head in the game." ... This is a taxing show and role, so you just go out and tell the story.  Everything else usually just falls into place. I try not to stress about it. It's something new every night. Thankfully, I've never been in a situation where I couldn't get through a song or hit the high note. There was a show recently where I was on the fence whether it was wise to go on, but once you make the decision that you are doing it, then you go out and tell the story. Then you go straight home and crash. Shoshana Bean: You rely on technique or you just pray… Usually — this is going to sound super corny — but the body is capable of way more than you think it is. It's when you go into Panic Mode and into your head that everything falls apart, so in those moments, I just go back to the lyric, and I would tell anyone to do that. You'd be amazed what then will happen when you just don't focus on that, and you go back to what you're singing about and what story you're telling. Now, there have been instances when [the voice is] clearly gone, and you're clearly sick... Instances like that in Wicked, I'd have to go off stage and say, "I can't do it" because sometimes when you're in that position, you're just going to do more damage by staying and trying to push through. And, it's a horrible, horrible feeling. Usually, it's not as bad as you think it is, and you can just focus on the lyric and not whatever is happening.

But, if you're sick, and you have vocal damage, there's just no way around it. You just get through it — and there's plenty of embarrassing footage all over YouTube to prove how many times people have tried to get through it — and it happens. I feel like I can say all that, [but] you just learn by experience. You learn your own way, you learn your own voice, and I'm so grateful for all of that. I know my voice inside and out. I know exactly what it's going to do, where it's going, how to maneuver… Me and my voice are pretty much best friends! I think that's the benefit of going through all of those ups and downs in shows and colds and lessons.

You rely on technique, you rely on the lyric and you freaking take care of yourself as soon as you get off the stage!

Constantine Maroulis: You know, you've got to navigate! Maybe instead of ripping through a phrase, it maybe becomes a shorter phrase. Come off it a little bit, instead of ripping through the whole thing. I can navigate, and that's what you have to do. The fans want you there, and there are people who have come for the first time who have never seen the show, and they're expecting to see "opening night." Yeah, they waited six years to see the show, but they are hungry for the rock and for a great performance, and you have to give it to them. Sure, I crack… Referencing the recent drama with Idina [Menzel], this is one of our greatest power vocalists, and for her to receive any such criticism is just stupid. It's impossible to sing live on television at these events where they are moving a new band in and out, and the soundcheck doesn't sound like the performance, and she's wearing ear [pieces], and she's getting something different than she thought that she was getting, and then there's some static or the band or the track is too loud, and then you can't hear… Sh*t happens that you can't really avoid.

 What To Avoid

Liz Caplan: In as much as it's difficult to live a total monastic life in New York City, I think many whom are in challenging roles on Broadway (see: nearly every show on Broadway at present) would agree that dialing socializing way back has to happen.  Between the cold weather and loudness in every bar/restaurant/city streets scenario (luckily smoking is no longer allowed indoors), it's best to place a limit on time spent around noise. When we get into rooms that are pressured with the sheer volume of patrons as well as loud decibels, the body finds its own way of retreating. Wax builds up in our ears to protect them. Then we try to speak and can't really hear ourselves within the ambient noise. So we bear down on our larynx and vocal cords unnaturally. That generally won't bode well for vocal health. If one does find themselves in these ambient circumstances, it's best intensely focus on very deep low breaths so the neck muscles don't engage to help push out sound. 

Alcohol is drying. It will also hinder the fluid movement of the vocal folds. Everyone is different and has different capacities with regard to imbibing. If you know you can handle a drink without it effecting the integrity of your vocal muscles, still be sure to drink water to rehydrate. Dehydration is what causes hangovers and does not help your vocal muscle response. If all this could wait until your day off, it would serve your eight-show week better.

Melissa Errico: The hardest thing I had to learn was not to go out after shows and socialize. I adore going out with large groups and having a luscious dinner at a long dining table — it's such a celebration to get a good role, and usually there are so many loved ones who want to celebrate with you. The hardest thing is having to say, "I am so glad you came. Now I have to be boring and go home."

Ramin Karimloo: I am not a fan of loud spaces before or after a show. I don't smoke, and my alcohol intake is minimal, but that's more for my weight training and macro diet more than anything. Alcohol has never really bothered my voice. It's usually the loud places that go with alcohol that knacker the voice.   Constantine Maroulis: I've played in sh*tty bands my whole life, where you can never hear, and the band was too loud, and I was screaming over everyone. In a way — I'm sure doctors would disagree — I built the instrument up to be very durable, like an athlete does his body. But, honestly, I do not drink, I do not smoke, I sleep, I vocal rest, I take hot baths with eucalyptus and different oils. I do salt baths, and I take a hot shower before the show, and I like these lozenges I found a few years ago from overseas — they're called Vocal Zones. I use a little honey loquat in some hot water, stir it up, I do exercises, and I warm up my whole ride into the city. There's never a moment where I'm not thinking about the show that night — from the moment I wake up.

Dealing With Vocal Damage

Melissa Errico: I sang the musical Passion with a nagging bronchitis. In retrospect, I coughed and cleared my throat often, and for about two straight weeks. I regret not visiting the throat doctor, but I thought I was managing well, and my singing was never effected. Once the cold really hit me hard, I took a few days off and coughed intensely. A small blood vessel broke from the cough, and my ENT told me to rest another week and a half. In retrospect, perhaps I should have been on voice rest while I was feeling the cold coming on. I have learned that a nasal cold is okay to sing on, but once a cold starts to hit the chest, you are in dangerous water. Clearing your throat (grinding the cords together to clear the sound) is really bad for a vocal cord, and I think I could have been more conservative. Try telling me that back then: I was in love with the show, and nothing could keep me from showing up.

I chose to have a laser procedure to "zap" the weakened vessel, so it could never be an issue again. The doctor (Steven Zietels of Mass General Hospital in Boston, who has also treated Adele, Denyce Graves, Roger Daltrey and countless others) said he could hardly find the problem once he went to repair it. The level of expertise involved in this is incredible, and the laser (called the KTP) he used simply did not exist until fairly recently. We all felt it was smart to address the broken vessel for my future, and I am grateful beyond words that I feel so strong again. I was very moved by emails and phone calls from some of the biggest Broadway stars in the business who had had the same successful procedure. I was amazed that their injuries or setbacks had mostly been shrouded in secrecy, and in this new day and age, I chose to blog about my medical experience — including the shock, the sadness, the isolation, the decisions, the patience involved and ultimately the fantastic medical resources I discovered. I hoped to start a more open understanding that singing is like sports in some ways, and setbacks happen and can be overcome. I was moved that Julie Andrews herself is the head of Dr. Zietels' board and aims to share a message to all singers of nurturing vocal health with good maintenance habits.

Liz Caplan: The first thing I recommend is to make an appointment with a well respected ENT (Ear Nose Throat specialist), who specializes in singers. No one should try to self-diagnose or self-prescribe. That would only delay the healing. Sometimes vocal rest is in order and can bring swelling down. An ENT might recommend a steroid in the form of prednisone for dire cases. These would entail having to open a show where there are no understudies that could go on while you heal. And, it's the only way a doctor can see the actual damage once swelling goes down. 

Clearly avoiding loud environments, drinking a tremendous amount of water and nutrient rich beverages. Silence for long stretches would certainly help the reparation of damaged cords. Meditation to heal the cells as well as quieting the mind is very beneficial.  If affordability [of an ENT appointment] is an issue, there are some clinics related to Broadway that will see people for reduced fees. If one gets diagnosed with a nodule, it might require surgery if it changes/grows. Nodules are generally of a hard consistency and cause the vocal cords to not be able to come together making it hard to fully phonate. Sometimes proper vocal technique can address the nodule and hope to bring it down over time. Most often, surgery would be warranted to remove the nodule. But then the singer would have to revisit vocal technique to make sure a nodule never appears again. Nodules occur due to overuse and mistreatment of the voice. This could happen because of diet, emotional state, family dynamics, as well as misuse of the speaking/singing voice.

A polyp tends to be of a softer texture. If soft and fluid filled, it can be reduced with vocal silence for a time and then gentle vocal eases to navigate while it slowly disappears. If the polyp does not change, then it too can be removed. The voice generally comes back a week after polyp surgery with gentle use initially and then gentle vocal exercises to bring stamina and endurance back to the instrument. It might take a bit longer with nodule surgery.

Fighting the Pressure

Shoshana Bean: I think anyone who steps into that role [of Elphaba] now, there are expectations and [thoughts of], "What riff is she going to do?" There's so much expectation and pressure that we already mentally have totally screwed ourselves. You can sit ten Elphabas down, and I would assume — the ones I'm close to, we all already agreed on this — they would say the same thing. It is a mental game. You can defeat yourself before you even start by just being scared of getting sick, by just being scared of calling out at intermission, by just being scared of losing your voice and not making it eight shows a week. There's just pressure to make it eight a week, and there's pressure [of], "What riffs are you going to do?"

Vocal-health wise, [one must maintain] mental and emotional health because the body, I believe, really reacts to what's going on mentally and emotionally... Whatever you need to do to feel peaceful and calm and relaxed and healthy on the inside... I always say the better you treat your body, the better your voice is going to feel. So, obviously, a lot of water and clean eating and probably not a lot of dairy and sugar. Whatever things make your body feel like crap are going to make your voice feel like crap. New York is really hard for eight shows a week because of all the seasons and all the allergies and all the things you breathe in, so sleep is really imperative and obviously bundling up. And, steam whenever! Steam has always been my best friend — direct steam, Vicks inhalers. It has saved me. I literally called out [during a] matinee of my last weekend — that Saturday matinee — and I was back the next matinee because I steamed all day long. I believe that it is the saver of all. I don't really recommend taking a lot of pills. People do a lot of Mucinex and allergy pills that dry you our incredibly. Drying out, I feel, is the worst thing for a singer — that and singing on a chest cold.

Warm ups, cool downs, regular vocal lessons — I was in voice lessons every two weeks when I was in [Wicked], and I would call her at intermission when I felt, "Why is everything so tight today?" And, she would tell me what to do. Muscularly — getting massages and keeping everything really open and relaxed. I think singers get really used to singing with tension. We're so used to how we've learned to sing, and that's jaw tension and facial tension in the shoulders. Once you're doing eight a week, you will not sustain with all of that. And, [with] technique — obviously, good technique — you can get around anything, really, except for a chest cold.

 Tricks and Tips!

Liz Caplan: Get Some (More) Sleep. The first and most important rule is to try to stay as well rested as you can. Getting fewer than eight hours of sleep a night makes you and your immune system far more vulnerable to any bugs that come along. Try to fit in those extra zzzs, especially before a big performance or audition. Keep in mind, too, that there is no such thing as paying off a sleep debt; one night of twelve hours of sleep after three nights of four will only serve to disorient your body. Keep it as consistent as you can, nap when you can, and keep those cords happy. 

Cut Down on Stress. Similarly, stress will make almost all parts of your body begin to break down, especially your immune system. Although it may be impossible to take away sources of stress, at least find a way to manage them: meditation (even in its simplest form, sitting still and consciously breathing slowly in and out) will allow your body to relax and be better able to handle whatever comes at it. If meditation isn't your thing, try taking a walk. Sometimes just getting your body moving and giving yourself time to clear your head can do wonders. 

Get Your H2O. Hydration, put simply, helps everything in your body work better, including your immune system (and your vocal cords!). So one of the best things you can do for yourself is to make sure you're drinking enough water all year round, but especially during cold and flu season. Guidelines vary as to how much you should be drinking, but a good rule is: "If your urine is clear, you're drinking enough water."

Eat a Healthy Diet. Yes, there are many reasons why you should be doing this anyway: Getting the nutrients you need from the food you eat is simply one of the best things you can do to give your body a fully stocked arsenal against colds and flu. Fruits and veggies, lean proteins, whole grains — make these the staples of your diet, and you'll be well equipped to sail through the flu season with hardly a sniffle. 

Exercise. Again, this is something whose benefits are so numerous that you should be doing it even if you can't sing a note. Exercising regularly will strengthen your body and boost your immune system reducing the chances of unwanted congestion. *The caveat here would be if you are struggling with a respiratory illness: bronchitis, pneumonia. Exercising is not recommended in these cases. The lungs are too weak and chances of scarring them would be too great. Ask your physician if you should do anything beyond gentle yoga or stretching.

Wash Your Hands. Your parents were right. The world is full of germs, and we come into contact with millions of them every single day. So give your immune system a hand and fight off the germs before they can get to you, by washing your hands or using a sanitizer. 

(Playbill.com staff writer Michael Gioia's work appears in the news, feature and video sections of Playbill.com as well as in the pages of Playbill magazine. Follow him on Twitter at @PlaybillMichael.)