Michelle,
If you go to an ENT, or even better, and ENT doctor who specializes in the voice and throat (laryngologist) this type of specialist will be able to tell more about how your voice sounds than you are able to. There are simple in office observation procedures that can give you really pretty firm answers.
My first problems began with my voice and with breathing. The breathing I noticed, my voice changes were only pointed out to me by others. At first it was mostly over the phone. People would think I was coming down with a cold, or that they had wakened me. (I couldn't notice it at all in the beginning).
You will make yourself crazy trying to self diagnose yourself. There are many causes of changes with the voice. Believe me, I learned about several of them when we were trying to find out what was up with me.
Acid reflux is a very common culprit. Your doctor should be able to observe some inflammation in that area if this is why your voice is changing. Even if he/she does not see anything, probably trying a 2 week course of prilosec otc will help rule it out.
Auto immune diseases such a scleroderma [sp?]and lupus can cause changes to the vocal cords, and again, this will be seen right away.
Cancer is probably the most ominous reason, but again, this is something a doctor can see.
Loss of voice can be psychosomatic. I observed this firsthand. I was waiting to have an EMG, and the neuro came out of the procedure room with the patient who's appointment was before mine. I could overhear their conversation, and he was explaining to her how the EMG was completely normal, that that this was the last of the tests that could possibly be run. There was no physical cause to be found for her lack of voice, and she needed to go back to her psychiatrist. She nodded in agreement. This woman had virtually NO voice! I could barely hear her when she tried to speak... there is a cartoonist, I don't remember for certain, but I'm pretty sure its the creator of Dilbert. This guy lost his voice due to non physical causes. You can search via the internet if you're interested in finding out more about him and what he went through.
So, you can see why you're not going to really be able to get the answers you're looking for here. This is something you absolutely will need a specialist and clinical exam for.
In my own situation, an excellent ENT looked at my vocal cords (a little fiber optic light with or without camera is threaded down either through the nose or mouth to view the vocal cords) This doctor did not specialize in the voice or throat, he was a general ENT. He said that maybe my vocal cords looked a little thin to him, but he just did not know, he emphasized that I needed to go to a laryngoligist. Earlier he had been able to rule out the more obvious causes (which I listed above for you). But, once it was not any of those, and I was obviously losing my voice, it was time to move up to the next level of specialization.
It took a while for me to get in to see her. (the laryngologist) She, in contrast with the general ENT, took one look at my vocal cords, and saw the atrophy, saw that they were bowed, that they did not close together like they should because of the atrophy, and that they did not move properly when I spoke.
The fact that they did not move properly is a big point, because with a motor neuron disease, its important to understand that what happens is that a muscle loses its ability to recruit. In the case of vocal cord muscles, there are muscles which adduct, and also muscles which abduct. This means there are muscles which open the entrance to the windpipe, and muscles which close the entrance. Together they allow the vocal cords to vibrate, and by how much tension etc, it creates pitch.
So many people here on the forum think they feel weak, whether or not they actually are. But, with a weak muscle due to motor neuron disease, the muscle is weak, and loses its ability to contract. A trained doctor can note this, where as we, as the patient, may or may not be aware of weakness at first, because its not a feeling of fatigue, its inability to do something, no matter which muscle of the body affected.
Also remember that the muscles which move our vocal cords are very tiny. A healthy person can tire theirs and then the muscles need a chance to recuperate. If you're using your voice a lot more than normal, perhaps in the effort of self diagnosis, you're really not going to get answers, and may in fact, skew at first, what your doctor will find upon examination. So, conserve your voice, don't keep checking it out, and make an appointment to be seen.
A laryngoligist will have you vocalize different sounds, and observe how your vocal cords move while you do this.
Because of what she saw with me, my larynogologist set me up for an EMG of the vocal cords, (the results were diagnostic of motor neuron disease) and this was the beginning of finding the reason behind why my voice had problems.
I should stress, that even with the dirty EMG it was not like she and the neuro who did this test jumped up and said " Aha! you have PBP" In fact, no one mentioned "cranial nerves" to me for at least another month or two. There were still other causes to rule out.
good luck to you, and I hope you get some good answers in short order.
