San Francisco Voice and Swallowing

It was certainly a very different company year end party....Although it was nice to be able to wear jeans or leggings and still look festive, we definitely missed seeing everyone in person! Looking forward to a new year of health, hope, and vaccines for all! #sfotolaryngology #sfallergy #sfaudiology #sfvoiceandswallowing #happyholidays #zoomparty #staysafe

May not be how we would have liked to spend the holiday, but there's still plenty to be thankful for! Happy Thanksgiving! #thanksgiving2020 #gratitude #framily #thankful #sofull #staysafe

Today is Transgender Day of Remembrance/Transgender Day of Resilience This can be a challenging day for those of those of us who are trans, especially if we have lost loved ones to violence. The high number of trans people especially trans women, especially Black trans women who are killed each year is much too high. (Any number greater than 0 is too high.) We ask our cisgender friends to please address transphobia in their communities, families and themselves. We especia...lly want to honor and celebrate all the beautiful trans people in our lives. To our beloved trans community, we love you, we see you, and we are working to make this world better!Thank you for existing and for the beautiful gifts you bring this world! #tdor #MoreThanAHashtag #trans #nonbinary #BlackTransLivesMatter #TransgenderDayofRemembrance #transdayofremembrance #transawarenessweek #transdayofresilience

Happy Halloween from my only kid who can still be bribed to get in costume and take a photo....and the rest of us at SFVS! #halloween #happyhalloween #halloweenpuppy #staysafe #notricksjusttreats

Happy Transgender Awareness Week! Let’s talk about 2 of our favorite topics: voice and trans-ness. Voice is a big topic for the transgender and gender expansive community. At SFVS and Passaggio, we like to queer up mainstream, cis stereotypes of voices: For example, feminine people can have low voices, and masculine people can have high voices. No one is required to change their voice. All trans voices are beautiful! (And of course, for those who DO wish to change and/o...r expand how their voice expresses their gender, there are ways.) And because we especially envision a world that is led by Black trans/gender expansive voices, we want to celebrate some of our personal favorite singers- Shea Diamond, Dua Saleh, Lex Allen! Check out their links below! Shea Diamond: https://www.facebook.com/iamsheadiamond/ Lex Allen: https://www.theofficiallex.com/ Dua Saleh: https://en.wikipedia.org/wiki/Dua_Saleh #transgenderawarenessweek #TransAwareness #transawarenessweek #transgendervoice #transgender #transrightsarehumanrights #transisbeautiful

Congratulations to our very own Wendy Vastine, MA, CCC-SLP for being awarded the Distinguished Early Career Professional (ECP) Certificate by the American Speech-Language-Hearing Association (ASHA) ! This very well deserved award is for individuals who are making an impact in the areas of leadership, volunteering, or advocacy at the local, state and/or national level. We're so proud of their achievements and so lucky to have them on our SFVS team! #sfvoiceandswallowing #laryngology #voice #speechlanguagepathology @ashaweb #asha #slp #slpeeps #genderaffirmativevoice

Had a great time chatting with Dr. Aaron Ziegler, Ph.D., CCC-SLP about one of my favorite topics--Treatments for Unilateral Vocal Fold Paralysis! Here is a video of an awake, in-office vocal fold injection augmentation for right vocal fold paralysis using a per-oral approach that was made for the MedBridge course. Notice that at the end of the procedure, the right vocal fold is very full and her voice is quite strained. The injection material will settle and her voice will i...mprove over the next 1-3 days. Other awake approaches include thyrohyoid, transcartilaginous, and cricothyroid. The approach is tailored to the individual patient. Let me know if you want to see videos of the other approaches! Thanks again for inviting me to take part in the @medbridge_education course, @asz_slp! #sfvoiceandswallowing #laryngology #voice #otolaryngology #speechlanguagepathology #slp #officeprocedures #surgeon #ilooklikeasurgeon #wio #shent

School is in session at the San Francisco Conservatory of Music! We had a great time giving a vocal health talk to the vocalists albeit remotely. It's so important for singers to understand how their instrument works and how to take care of it! #knowledgeispower @sfconservmusic #sfcm #vocalhealth #voice #voicedoctor #singer #vocalhygiene #musicschool #operasingers #backtoschool

DEFINITION: Passaggio [puh - sah - gee - oh] Bridge, crossing, passageway... Transition or middle part of the singing range The Gender Affirmative Voice Program at San Francisco Voice and Swallowing We are excited about Passaggio! Our main goal with Passaggio is to help our patients find their authentic voice, and for that voice to feel easy and sustainable. We are here to honor individual preferences, while giving patients the tools to access a spectrum of vocal possibilities. With Wendy Vastine, CCC-SLP as our director of Passaggio, SFVS is the only multidisciplinary voice center in the country with a gender affirmative voice program that is trans and non-binary led, thus bringing a level of nuance and understanding to this work that is rare. Whether trans or cis, the members of our interdisciplinary team are deeply committed to providing the best behavioral and/or surgical care for our patients. Additional important missions of the Passaggio program are education and giving back to the community. We want to train other trans leaders in gender affirmative voice training. Despite current COVID19 constraints, we have still been able to offer shadowing and training opportunities for trans/non-binary/gender non-conforming speech language pathology students. To support the health of the trans community as a whole, a portion of our proceeds each quarter are going to a local or national community organization. This quarter we are giving to the TGI Justice Project to support Black Trans Leadership. We have also previously supported Trans Lifeline. Come check out Passaggio at San Francisco Voice and Swallowing Center to Unlock the Voice in your Heart! #passaggio #sfvoiceandswallowing #laryngology #voice #speechlanguagepathology #genderaffirmativevoice #transgendervoice #authenticvoice #voicefeminization #voicemasculinization #genderaffirmation @translifeline @tgijustice

Success = performing a nasopharyngeal swab on your sleeping child (in preparation for in-person school) and although he grimaces and rubs his nose, he stays asleep!!! #doctormom #womeninsurgery #womeninmedicine #momlife #mamasinmedicine #physicianmom #doctorsofinstagram #covidtesting #otolaryngology #womeninotolaryngology #shent #ilooklikeasurgeon

Attending the AAO-HNSF 2020 Virtual Annual Meeting in my office. Although I definitely miss catching up with friends and colleagues (especially the gossipping that happens in the back rows ), I'm actually loving the on-demand experience! Even when we can meet back in person, I hope some of these features stay in place! #otomtg20 @aaohns #otolaryngology #entsurgeon #laryngology #medicaleducation #alwayslearning #notimechange #notravel #noneedtodressup #no8ammeetingsthatfeellike5am

"Women belong in all places where decisions are being made." - RBG Thank you for everything you have done for us, even fighting until the very end. You will be sorely missed. #restinpower #RBG #womensrights #genderequality #westillhaveworktodo #womeninsurgery #womeninmedicine

I've decided to pick up the violin again after a 25+ year hiatus. It is absolutely humbling to screech and stumble through pieces I last played in the 1980s, but studies have shown that playing a musical instrument as an adult can help protect brain health. And more importantly, I've noticed that everyone in the house leaves me alone when I practice! No one interrupts me with questions, requests, arguments, etc. I know it's because they want to stay far, far away, but I'll take it! #physicianmom #womeninsurgery #momtips #mommytime #musictherapy #brainhealth #practicemakesperfect

The view from my house today at 10am One of my friends articulated my thoughts precisely, At some point, it all feels like too much. You think you're handling 2020 OK, feeling the feelings, adapting, focusing on what you can control, resisting doomscrolling and leaning into the things that give you joy and meaning. But when that stable, familiar blue sky is replaced by orange and there's darkness all around you, a small feeling of grief and panic wells up inside. While we ...worry about COVID-19 and air quality from the wildfires, don’t forget to take care of your emotional health as well. Here is a link to many useful resources: https://www.cdc.gov//daily-li/managing-stress-anxiety.html I will make it a point today to take some time out to unwind, connect with my family, but also carve out some time for myself. How about you? #californiafires #sanfrancisco #bayareasky #sfsky #mentalhealth #mentalhealthawareness #takecareofyourself #stressmanagement #weneedabreak

There is always a feeling of excitement and anticipation at a patient’s first postoperative office visit after being on voice rest and this eagerness is even more amplified for our voice feminization patients. Although the voice at the first postop appointment is not at all the expected final voice result, we still can’t help being excited to hear a hint of the voice we can expect to develop over the next few months. Since we usually post a stable 3- 6 month post op voice and... exam, we thought it would be helpful to show what might be typical for a patient 2 weeks after surgery. In this case, our lovely patient had done 5 sessions of voice therapy with a wonderful speech pathologist @Sandy Hirsch, CCC-SLP who specializes in gender-affirmative voice (www.givevoice.com). Thanks to voice therapy, she reported that she no longer gets misgendered as a result of her voice. Yet, she felt that she often had to focus on her voice production and that it is hard work. She also noted a fear that she might spontaneously drop into a lower pitch if she is taken by surprise. After much discussion, she appeared to have reasonable expectations from surgery and understood the risks involved. She underwent uncomplicated endoscopic CO2 laser assisted vocal fold shortening glottoplasty for pitch elevation followed by 2 weeks of voice rest. Here is her exam at her 2 week follow up visit. Note the healing tissue at the surgical site and the mild redness of the vocal folds. Her vocal folds will soften and the anterior surgical site will heal and mature over the next few months. Even with the slight breathiness, she is already thrilled with her voice, which we expect to get even better. She is from out of state and will return home to work with Sandy for postop rehabilitation. We can’t wait to see her progress when she returns in 1 month for her next appointment! Note: Since there is a big range in how the voice sounds at the first postop visit after VFS, we also include a sample 2 week post op voice that is breathier for reference comparison. #sfvoiceandswallowing #voice #passaggio #laryngology #speechlanguagepathology #slp #transgendervoice #otolaryngology #pitchelevation #voicefeminization #genderaffirmativevoice #genderaffirmation

So upset that this happened to one of our Medical Assistants... Hawi and her husband Yema own a clothing boutique in Tiburon, CA. They were working in their own store at 1am when they were questioned by the police, who repeatedly demanded that they show proof of ownership. Hope this sad incident can fuel some positive change in our community. https://www.thearknewspaper.com//Store-owners-Late-night-e... @yemacalif #blackowned #blackownedbusiness #blm #yema #marincounty #tiburon

#vocalpower is a hotly debated topic among the world's foremost vocal perfectionists, #operasingers. When your job is to sing over an orchestra, you need really solid guidance to find the #singersformant- that characteristic quality in the voice that allows it to be heard over long distances and other instruments. In this patient example, we see the importance of finding a good singing teacher. During coachings, this 36 year old baritone was encouraged to make his voice 'm...ore dramatic', leading to an overly-dark, pressed quality. The patient started to experience chronic vocal fatigue and a loss of the coveted 'ring' in both speaking and singing. Notice in his initial pre-voice therapy exam that as a result of markedly excessive muscle tension, he has copious retention of frothy secretions and marked supraglottic constriction. Through a specially designed vocal warm-up and cool-down routine, as well as massage techniques for the neck and throat, he is able to achieve significant improvement in his sensation of effort with singing and speaking- and we are hearing that #singersformant coming back. His post-therapy exam was performed only 1 month after starting voice therapy and it is night and day! Next steps for him - referral on to a singing teacher with the ability to help grow his voice in a healthy way. We look forward to hearing him on the stage again! #sfvoiceandswallowing #laryngology #otolaryngology #voice #speechlanguagepathology #slp #professionalvoice #singingvoicespecialist #opera #operasinger #voiceteacher

A good tongue stretch can go a long way !!! Or maybe Pixy is demonstrating a yawn-sigh? #voicegeekhumor #voicegeek #speechlanguagepathology #slplife #slp #pandemicpuppy #globus #voice #laryngology #sfvoiceandswallowing