Voice strain - Part 1 - June 2007 to Feb 2008

Soon after realising that I had RSI, I ordered Dragon NaturallySpeaking 9.5. I felt a bit self-conscious talking to my computer, but managed to get over it. I soon found the software to be an invaluable but frustrating tool. It can be used both for typing, and for controlling Windows. For example, you could start programs (e.g. "Start Notepad"), click on web links and minimize or switch windows.

Undoubtedly, the typing mode of the software is superior to the command mode. When it worked well, it was superb – and was even sometimes slightly faster than typing. But more often than not, it would misrecognise a few words per paragraph. When this happens, you can correct the mistake by saying "Correct" and then the mistyped word. And usually this worked, but it broke up the flow of dictated speech.

The command mode was also excellent when it worked, but it worked less consistently than typing. During my six months of using the software, I noticed that under certain circumstances it would frequently fail to recognise some or all commands – and it was clear that the problem was generally due to a bug in the software rather than a failure to recognise my speech. I could give more info on why I know why this particular problem was a bug, but that would be a distraction from the point of this post. Needless to say, when the software failed to recognise me, whether due to a bug or me not having spoken clearly enough, it often led to me trying the same command over and over again, getting increasingly frustrated.

While researching voice recognition software, I had read several web pages which advised that in some circumstances, use of such a system could lead to voice strain. None of the pages gave any details of what to look out for and what to do if you did get voice strain. They did advise taking regular breaks, talking in your normal voice (as opposed to a monotone voice) and even consulting a speech therapist in order to train your voice to use the software in a safe manner.

I had some difficulty with the advice not to speak in a monotone. My voice is already somewhat monotone to begin with, and I found it difficult to speak to the computer in the same way that I’d speak to a person. Partly this was due to having to make an unusually high effort to speak clearly, but it was also because typing text or entering commands with your voice is, psychologically, a completely different experience to having a conversation with a human.

It wasn’t long after I started using Dragon that I first noticed my voice getting tired. This didn’t even necessarily happen after particularly long sessions. It was clear that if I were to use the software at work, I would have to take very regular breaks. I was initially apprehensive about using the software at work, due to not wishing other people to hear what I was typing. When I did start using it there, I would speak in a quieter voice than normal. I suspect this may have put extra strain on my voice, due to having to simultaneously speak clearly and quietly. Plus, I have read that speaking very quietly can in some circumstances require more effort from the vocal cords.

Even before I started using Dragon at work, I found that my ability to type with it was not limitless – sooner or later, my voice would become tired, and I would have to rest it. Another problem soon became apparent – sometimes, I would be speaking to the software and it would feel like my voice would run out of stream – I would be in the middle of a sentence but suddenly no sound would be coming out of my mouth. At this point I had to clear my throat before I was able to speak again. I should have taken this as a warning sign, but given that Dragon was my only means of working, I carried on regardless.

As the months went on, the problem of voice tiredness seemed to increase. Getting through a work day became a tedious struggle, as I had to spend more and more time resting my voice. By January 2008, it got to the point where I was regularly taking days off work to give my voice time to recover. I also started thinking about seeing a speech therapist, as the web pages mentioned earlier had advised.

Around the start of February, it was becoming increasingly clear that my voice tiredness was lasting longer and longer – and was now impinging on my life outside work. On the 11th of February, I noticed that not only was my voice tired, it was sore - even when not talking. By the 15th, it had got worse, to the point where I no longer felt able to work, so I took two days off sick. This was the last time I used speech recognition. On the 20th of February, I made an appointment to see a doctor. As it turned out, it was the same doctor who had been of no use whatsoever when I spoke to him at the start of my RSI problems. He simply told me to try going back to work and see if it got better. That afternoon I went back to work and had some normal conversations with people - nothing that I would have thought would stress my voice much. However, that evening the soreness became much, much worse - to the extent that I only slept for half an hour that night. Not only was my throat incredibly sore, I also felt that my breathing was slightly constricted – a symptom that continued to crop up frequently from this point onwards.

I remained off work, and made another appointment to see the doctor. By the time I saw him, the soreness had reduced somewhat. Once again, he told me to go back to work and see what happened. He also told me he didn't think there was much more that could be done to help me. This was obviously nonsense - at the very least, he could have arranged to have a specialist look down my throat. After speaking to him, my voice again became a lot sorer. I tried going back to work yet again as he had suggested, but once again my voice failed to recover. At this point, it was clear that this problem wasn't going to resolve itself in a few days, or even weeks. To make things even more fun, I went onto Statutory Sick Pay, which only just covered my (relatively small) mortgage payments, leaving me losing many hundreds of pounds each month on all my other expenses (including the physiotherapy sessions which were essential to my recovery from RSI).

At some point (I’m writing this six months later and can’t remember exactly when it happened), I started to experience a lot of mucus in my throat. I often felt the need to cough or clear my throat, and the mucus often interfered with speaking.

By late February 2008, I was trying to completely avoid speaking – often resorting to writing down what I wanted to say on paper. Obviously this wasn’t very practical, and I couldn’t do that much of it anyway, due to my RSI. I was barely able to use the computer, so I spent the next few weeks having almost no social interaction of any kind.