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Hey Doc, 
I am a singer and have been struggling with mega phlegm in my low register.  (E above middle C down to F below middle C)  The phlegm at times feels so thick that my vocal chords for a second seem paralyzed.  They best way to describe this sensation is that I feel like I'm singing through molasses.  Pitch problems occur and sometimes the pitch will even change on it's own!  I know I am compensating by tensing throat muscles to create pitches (which is probably not good). What is even worse is that this has been going on for years.  I don't have this problem at all in my high register.  It's very frustrating and I'm starting to wonder if something is wrong.  What should I do?
James P Thomas MD's picture
Submitted by James P Thomas MD on Sat, 2012-04-07 12:36

Dear Lindsay,

There are quite a few reasons to have the sense of phlegm building up or as some people describe it “postnasal drip”. I seldom see large quantities of phlegm in anyone.


On some occasions, I see people with rather thick secretions. There may be reasons such as dehydration, for example, especially when patients are on diuretic blood pressure pills.


More often, normal amounts of secretions tend to accumulate because of some irregularity in vibration. For example, swellings on the vocal cords dampen the vibration of one segment of the cord, so secretions accumulate on the swelling. In people with bowing of the vocal cords, secretions tend to accumulate at each end of the by vibrating segment of the vocal cord.


The only real way to know is to have an appropriate examination. I do list some physicians who are especially interested in voice disorders on the "Home:physicians" page.


Best wishes.