I was in ICU in February. I thought I just had a bad cough… I’d lost my voice and thrown up and felt shocking and my GP told me it was viral and to take aspirin. Two days later, I was blue-lighted to hospital with Flu, severe pneumonia, strep A and sepsis. I went into septic shock and was put into a coma for 9 days. I know I’m very lucky that I had a relatively speedy recovery- I was out of ICU altogether by day 14. The biggest problem that remains for me is that nearly 4 months later, I don’t have my normal voice back. Everyone on the ICU thought it was the common side effect of having a ventilator, but that clearly wasn’t the case for me! I’ve seen ENT and they have diagnosed me with silent reflux an and that has swollen my food pipe and irritated my vocal cords. I’m on week 5 of treatment and my voice is SO much better, but still croaky and limited in volume. I’m a teacher, so although I feel able in every other aspect, I can’t return to work. It is believed I now have this silent reflux courtesy of all the induced-coma-tubes. Wondering if anyone else has had this problem? If so, how long did it take for you to get your voice back and do you have any top tips to help speed the process up?
Thanks in advance!
Lucy x
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Lucindar
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I now have a hiatus hernia after ICU so took meds for that for a time. To regain strength of voice I had to regain core strength and strengthen my diaphragm - box breathing, yoga & Pilates will help all this. Check out cc-sn.org who run online sessions specifically for us.
I saw a speech and language therapist who gave me some exercises. Can only remember 2 - singing and reading to my little girl doing the different voices. But they made it clear not to push my voice. Not sure mine was the same cause as yours exactly though so see if you can see an SLT.
Hi Yes it is a common side affect, I ended up with voice changes still not back to normal but it’s a lot better. Also swallowing issues from breathing tube which I saw SALT team. Have to drink lots of water with every bit of food I have now. Good luck
Morning, Lucinda. I was intubated x3 whilst in ICU with a Covid pneumonia four years ago I could only speak in a whisper upon returning home and had a problem with feeling something sticking in my throat, excessive mucous etc. Over several months post-discharge I had to seek help from physios, speech therapists, and even a private appointment with an ENT consultant as the waiting list was excessively long on NHS. Endoscopy, bloods, X-rays, scans etc thankfully ruled out any sinister reason for the problem but the endoscopy did show that there’d been some vocal cord damage (probably caused by the repeat intubations) and there was a noticeable paralysis of one of the cords. Fast forward four years. The paralysis has rectified itself, the cord now working quite well even if slightly sluggish. I still have excessive mucous, oft feeling a need to clear my throat. I also suffer with acid reflux (never did before my Covid/ICU experience) and this too can affect voice quality. I take antacids on a regular basis and avoid mucous & acid producing food and drink. Dairy products & fats are particular triggers for worsening symptoms. It’s now become clear though that my voice has permanently changed. It’s rougher, raspier, weaker in volume, less range, more difficult to project, and requires effort when in a noisy environment. It’s frustrating, but I’ve finally come to accept it’s probably now as good as it’s ever going to be. Breathing excercises provided by physio & speech therapist were of some use, and understanding the effect of breathing on voice was particularly helpful. So easy to fall into ineffective, problem breathing, particularly after suffering a severe respiratory illness & a spell in ICU. Wishing you well in your continuing recovery… 🍃
Oh my gosh Myfanwy! What a journey!! I’m wondering if you can remember where you were at vocally around 4 months after your discharge? Just so I can compare. Although, I’ve had an endoscopy and they told me my vocal cords were ok 🤞🏻 Just my career depends on my voice 😅😅
Hi Lucindar. Firstly, good to know you’ve had an endoscopy that confirms no vocal cord damage/trauma. That’s one thing out of the way! In reply to your question, at 4 months post-hospital discharge I was definitely still experiencing considerable voice problems and remained under the care of physio, speech therapist and ENT dr re same. There had been a slight improvement in strength, projection and range but it was nowhere near my previous norm. Some 4 years later it still isn’t. I must say though that at 4 months post ICU I was still very much in the early stages of vocal recovery, a further slow but steady improvement noticeable over the following year or so. I would think that’s quite possibly the trajectory for many folk. Like you and your profession, as nurse/counsellor my voice was so important to me. During the Covid pandemic it was needed even more than usual, particularly as so much work had to be carried out over phone and video link requiring much more effort than direct face to face communication. I found this very difficult and voice fatigue was a significant issue for at least a year or so. It was during this period that I found the help of physio and speech therapist to be of benefit, particularly around breathing and the effects of this on voice. I became aware of bad respiratory habits developing and had to unlearn same. This is where physio and speech therapist came into their own. So, 4 months into your recovery? I think it’s likely early days. Here’s to continuing improvement 🤞
This part of your comment is the same for me. My intubated coma was January 2018. I still struggle vocally, my voice dies out, alters tone and pitch, still at times such immense effort required to project my voice. My voice was lower than a whisper after extubation, gravelly and hoarse. No power to blow nose properly, sounds even now like a child who is learning to blow their nose. I have had a little voice/speech therapy which was abruptly stopped due to the absolutely lovely therapist having something awful going on in their life and them then leaving. The individual who took over wasn’t as dedicated, didn’t give a toss, was clearly bored and very uninterested making no effort, and just ceased contact. I said nothing to that person, it was just them completely uninterested in their profession and their patients. No dedication. So hoped the previous speech therapists circumstances became better and they returned. They haven’t as far as I am aware. I left hospital Feb 2018. Speech therapy was started a significant while after leaving hospital, they acknowledged they had forgotten to refer me and apologised.
Voice has got stronger yet still the control over tone/pitch and casting is a problem I am stuck with. My voice starts off these days strong and it can then be heard weakening and fading out. Sometimes still my voice is just a whisper. I do find talking is significant effort when it a flowing conversation and it drains my energy so much and makes my throat ache in a way I can’t even describe other than fatigue and exhaustion setting in quickly and needing to rest/sleep. My Dad rages at me angrily because of my voice not understanding at all that it is clearly damaged from oral intubation. He hates my voice and makes me feel as if I shouldn’t speak. He’s had open chest heart valve replacement surgery, years later severe flu, bleed on brain discovered and which had stopped its bleed and considered possibly old. Later he had sepsis and either endo or myocarditis was in hospital months but not icu though very poorly initially and huge concern for his heart valve being destroyed by both illnesses. He left hospital months later in following year and started having funny turns again he had been having after the severe flu, then he had seizures and now on preventative medication however still has funny turns and has not been the dad I knew and had before sepsis. He now can’t listen/tolerate different opinions to his own and he rages, yet only we see him doing this, he puts on a fabulous mask to outsiders which blindsides them completely. He is not a mentally well man and sadly recently I had to call the police after he decided to attack me, he denies doing that, he’s lied to the police and is deceiving himself only. Alarmingly he is a full time carer for my Mum yet isn’t not doing the best by my Mum and he my Dad is in denial and refusing outside help/support despite claiming he needs help/support. It gets offer and he refuses it ranting he doesn’t need it, is coping and then in a few weeks he is back to saying he needs help/support, that none available and nobody cares. He has been offer ed so much help and support but masked everything and sadly my Mum is trapped there with him in his unpredictable state of mind and him being extremely controlling and dictative aggressively blowing up if people don’t obey him/dare to question him on his behaviour/dare to have differing opinions/dare to disagree with him. He is silencing and over talking my Mum and getting worse. Nobody sees so nobody believes because he masks so well and Mum stays silent so afraid to speak up and out incase he blows up.
Most people think my Dad is great and how wonderful he is a carer for Mum. They don’t see his behaviour to guests/visitors/friends/other family is a front/a mask to deter people because he wants complete control of Mum and only people around he knows he can fool into believing he is absolutely fine and coping extremely well. Nobody but myself, my adult child and my Mum see how he is behind closed doors. My sibling living abroad knows but can do nothing as to far away unable to return. It all falls on me and certain individuals end up against me as they don’t see what we do behind those closed doors. My heart breaks for my Mum always trying to obey/appease/comply/pacify him.
Why nobody can see I really don’t understand because it is obvious. I can only guess they do see and just like my Mum is afraid of setting him off, so are outsiders/other relatives/friends, so they turn a blind eye and pretend everything normal and congratulate my Dad on doing a great job. They are lying because in private certain things have been said to us three that contradicts their behaviour towards my Dad.
I wish someone else would stand up beside me and be honest and tell that he really does need help, they won’t though, they don’t want him against them, they don’t want to get involved etc etc. And all that so very very sad for my Mum. Every person who backs off my dad grows more powerful and controlling feeling as if he can do what he wants and feels he can fool almost everyone.
And sadly he does and I am left profoundly shocked in utter disbelief and it includes professionals too. It is horrendous and extremely alarming just how blind people do deliberately choose to be to live in pretence with less hassle/less paperwork/less effort and less care. Perhaps my Dad is right to think nobody cares when he sees how quickly he can deceive and dupe them and how readily they lap it up to get away fast without the hassle of trying to help/offer support. Those people are praying before arriving they can quickly walk away claiming no issues/no help/support required. My dad plays them like puppets for his amusement knowing in advance exactly how they are going to react/behave even when they know he is not being honest with them. All face value and no digging a bit deeper.
Anyway:
Here’s the part of your comment I was referring to as being the same for me.
It’s now become clear though that my voice has permanently changed. It’s rougher, raspier, weaker in volume, less range, more difficult to project, and requires effort when in a noisy environment. It’s frustrating, but I’ve finally come to accept it’s probably now as good as it’s ever going to be.
I’m so sorry that your voice hasn’t returned to its pre-illness/intubation norm and that you’re still experiencing difficulties. It can be so frustrating. I know how self-conscious I sometimes feel about it, particularly when trying to hold lengthy conversations, trying to make myself heard in noisy environments or when speaking with people who don’t know me. Perhaps if troubling you, a discussion with your GP might be helpful. I know there’s such pressure on our health services at present, but he/she might feel a re-referral to speech therapy will be of benefit to you? Alternatively, their breadth of knowledge combined with their history taking skills might even detect some other reason for your voice difficulties eg I’m aware of some post ICU/intubation pts who have developed voice problems as a result of gastro issues such as excess acid production etc and that they’ve improved considerably following treatment for same. I guess this is where the GPs knowledge comes into its own, being so skilled in differential diagnosis’.
I’m sorry, too, that your home circumstances are so very stressful. I can identify with some of which you describe. Feeling there’s no-one to turn to who will listen & understand can be extremely debilitating. It’s so very important to have at least one person who you can share all these concerns with and know that you’re being heard. Perhaps in the first instance you could start with your GP who can sign-post you to various statutory and voluntary organisations out there who can help support you in the midst of these extremely stressful sounding familial relationships? One such organisation that instantly springs to mind is ‘Hourglass’. Here’s their contact info so you can learn a little about them and discover if perhaps they can help support you in some way:
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