She's back! Specialist Speech & Language Therapist Tor Spence returns with in-depth advice on the bane of a singer's life - ACID REFLUX.
And if that wasn't enough, we're talking noses.
Nasal breathing and its benefits, why Tor recommends it, and why Jeremy has reservations
Dr Jamie Koufman's book Dropping Acid: The Reflux Diet, Cookbook and Cure is here
https://amzn.to/3mtW9vO
The Complete Acid Reflux Diet Plan: Easy Meal Plans & Recipes to Heal GERD and LPR, by Nour Zibdeh MS RDN CLT
https://amzn.to/3Ha9NxS
Tor can be found under the VoiceFit banner here
https://www.instagram.com/voicefituk/
https://www.facebook.com/voicefituk/
https://twitter.com/voicefituk
https://voicefit.co.uk
Here's the link to Tor's online modular course for the developing voice therapist
https://voicefitschool.thinkific.com/courses/voicefit-to-practise
ENT UK - here's a link to the Patients section of ENT UK (the professional membership body representing Ear, Nose and Throat Surgery) https://www.entuk.org/patients/conditions
To find out more about voice, vocal health and singing techniques, check out the Vocal Process Learning Lounge - full access to 16 years of voice training resources for less than the price of one singing lesson
https://vocal-process-hub.teachable.com/p/the-vocal-technique-learning-lounge,
She's back! Specialist Speech & Language Therapist Tor Spence returns with in-depth advice on the bane of a singer's life - ACID REFLUX.
And if that wasn't enough, we're talking noses.
Nasal breathing and its benefits, why Tor recommends it, and why Jeremy has reservations
Dr Jamie Koufman's book Dropping Acid: The Reflux Diet, Cookbook and Cure is here
https://amzn.to/3mtW9vO
The Complete Acid Reflux Diet Plan: Easy Meal Plans & Recipes to Heal GERD and LPR, by Nour Zibdeh MS RDN CLT
https://amzn.to/3Ha9NxS
Tor can be found under the VoiceFit banner here
https://www.instagram.com/voicefituk/
https://www.facebook.com/voicefituk/
https://twitter.com/voicefituk
https://voicefit.co.uk
Here's the link to Tor's online modular course for the developing voice therapist
https://voicefitschool.thinkific.com/courses/voicefit-to-practise
ENT UK - here's a link to the Patients section of ENT UK (the professional membership body representing Ear, Nose and Throat Surgery) https://www.entuk.org/patients/conditions
To find out more about voice, vocal health and singing techniques, check out the Vocal Process Learning Lounge - full access to 16 years of voice training resources for less than the price of one singing lesson
https://vocal-process-hub.teachable.com/p/the-vocal-technique-learning-lounge,
this is a voice podcast with Dr. Gillyanne Kayes and Jeremy Fisher. Hello and welcome to this is a voice series five episode four.
Gillyanne:The podcast where we get Vocal about voice.
Jeremy:And she's back! There was so much that we wanted to talk about with Tor about voice, so we brought her back for a second week.
Gillyanne:Okay. I am going to do a link to acid reflux by asking you what about people who cough at night in their sleep and wake up coughing?
Tor:Yeah. So the nocturnal cough, the true nocturnal cough that wakes somebody up. And I differentiate between that and a cough where somebody wakes up feels a tickle or a need to cough and then coughs. So the true nocturnal cough may be set off by a little spasm in the larynx or something that's happened to cause that cough when someone's been asleep and then it wakes them up. And the cause of that can be acid reflux. Usually laryngo pharyngeal reflux, that's coming up to the top of the esophagus and into the area around the larynx and the pharynx. And it can cause the vocal cords to go into slight spasm and that wake someone up coughing. Now how that's treated and whether we can actually prove it's reflux, that's causing that cough. It's quite tricky. And the way we talk about laryngo pharyngeal reflux and the way it's diagnosed, it's It's a difficult thing to diagnose. And I think it's probably a little bit over-diagnosed based on what we're looking at in the larynx. So if we look at the larynx and we think this person might have some laryngo pharyngeal reflux, we're often saying that because we're seeing some swelling in the posterior part of the larynx or we're seeing some inflammation between the arytenoid cartilages or some redness along the of the vocal cords, and that's causing that maybe causing someone persistent throat symptoms. But how can we prove by looking at the larynx that's because of reflux, it's quite a hard one.
Gillyanne:I heard that in fact and I'm guessing often it's diagnosed based on experience and again, talking with the patient about. What's going on for them. I've got a bit of personal stuff to share, which I did warn you about, or which is, I first found out that I had acid reflux because what used to happen was I'd start to drop off at night, when you first begin to drift off and then I'd have this weird dry cough. And I remember saying to Jeremy, oh, I feel I got asthma or something. What's going on. I'd have this little cough, then I'd drop off again. Then it would happen again. And eventually of course, I'd go to sleep. Now across time, what happened was I got a, you know a full on LPR event, which is, I woke up feeling like I'd got a swarm of bees in my larynx. It's so painful when that you get the spurt of acid. And of course you're in danger of. choking. And it's really unpleasant. And that's when I first realized, oh my goodness. I didn't know acid reflux could do that. And then I started reading about the different types of acid reflux, the lower esophageal sphincter and they the upper and would you like to talk more about that? Because many singers don't know the difference, well, any professional voice users, to be honest, and they also have some very weird ideas about what to do about it, including things that introduce acid into the larynx, because they'd been told you your stomach, obviously isn't making enough acid, true. So therefore you need lemon juice inside of it.
Tor:Interesting. Yeah.
Jeremy:Unpack that please Tor.
Gillyanne:That's a lovely, lovely little rabbithole.
Tor:So gastroesophageal reflux is when stomach acid flows back into the esophagus, connect, which connects your mouth and your stomach. So that backwash irritates the lining of the esophagus, and that causes quite typical symptoms of heartburn, indigestion, chest pain which is quite different sometimes to the symptoms that people get when they get reflux further up. So laryngo pharyngeal reflux comes up to the top of the esophagus. Now that can be silent. So you deleted, it sounds like you've had very, clear symptoms at night, particularly. A lot of people, we term call it silent reflux because it's not what people are expecting of reflux. People are thinking or whatever, any heartburn or indigestion, it can't be reflux, yet they're waking up, they're being woken up in the night by a cough. They've got sticky throat and sticky mucus around that part in the morning. And they're having to cough their voices fluctuating. They're noticing a cough or having to throat clear a lot. And then they end up coming to see ENT who might have a look at the larynx and either say, oh no, it all looks absolutely fine or no, there is some inflammation. And then what do you do? Um And it's a difficult thing. There's no sort of blanket treatment or advice that we can give that suits everyone. It has to be holistic and we have to take a really detailed history and work out what is in this person's medical history, lifestyle, even the sort of psychosocial elements of it and what could be exacerbating reflux and what other causes of inflammation or cough at night there could be as well. So when it comes to the treatment of LPR, or we could call it persistent these persistent throat symptoms, or perhaps some inflammation that someone's got in their larynx, lifestyle management is very important. And I'll talk through realistic modifications that people can make. So if I'm working with a singer, for example, we'd talk a lot about kind of patterns and in sort of eating and meal times. We'll talk about that when someone's eating, perhaps in relation to when they go into bed we'll talk about, even things, diet. What they're eating that may be specifically triggering the symptoms or, you know keeping food diaries is sometimes a vital part of that to recognize the patterns between what they might eat on a certain day or in the evening, and then how their symptoms are. So again, it's that awareness, it's that sort of mindfulness of the sort of lifestyle issues that might be contributing to things. And then of course there's the medication side of things. So we know now that for the treatment of LPR or persistent throat symptoms caused by laryngo pharyngeal reflux, that proton pump inhibitors, those medications that are used to suppress acid production, they don't work for persistent throat symptoms. There's some really clear evidence now that we, these patients who have historically been quite blanketly prescribed PPIs when they've presented to primary care with such symptoms we don't want to do that anymore. We really want to move away from that because we know they don't work for throat symptoms. So interesting too. I knew you weren't a fan of PPIs, but I didn't know that evidence-base existed. If there are any papers or anything that you want to share with us at the end, you've read we'll put them in the show notes. Absolutely.
Gillyanne:Luckily my laryngologist did not prescribe PPIs. I'm sure you're going to move on to something that you can take that is in fact not a chemical.
Tor:Yes. Exactly. So we're moving away from... obviously, if there is a clear signs of heartburn and indigestion and gastroesophageal reflux and PPIs are very important. But when it's throat symptoms and laryngo pharyngeal reflux, what works better, but what's also under trial. There is a randomized control trial going on as we speak or that they're finding people to take part in this randomized controlled trial to look at the use of alginates in persistent throat symptoms. And this is the same team of people up in Newcastle, carrying out this research and alginates form a raft over the contents of the stomach. So the most common one we'll hear about in the UK is Gaviscon Advance or Gaviscon generally, but the advanced version of Gaviscon forms a barrier for much longer than the regular Gaviscons. So if you are eating something, after you've eaten or drunk something, if you put a thin layer of Gaviscon Advance over the contents of your stomach, that will prevent against that backflow or that reflux certainly really minimize the risk of. So it's really effective taken before bed. If you've eaten earlier in the evening, you've left a few hours between going to bed, you're taking a spoonful of Gaviscon and it's protecting your esophagus and particularly your larynx against the backflow. What about the Gaviscon and taking alginates like this.
Jeremy:That I didn't know, which is once you've taken it to don't eat or drink anything else.
Gillyanne:Because you'll breach the raft.
Jeremy:Because then you basically, you sink the raft.
Gillyanne:And people might think that, even if they're brushing their teeth, before they go to bed, they then might think, oh, they normally swallow water. But that's not the plan, is it?
Tor:No. So the timing is everything. And that's another thing I'll spend time with people on, let's say if they've been on PPIs as well, post the proton pump inhibitors, and Gaviscon, sometimes people are on those two things together, particularly if they've got gastroesophageal reflux and throat symptoms. And the timing of both is really crucial. And I S water is absorbed quite quickly. And if someone wakes up two hours after going to sleep and they've taken some Gaviscon two hours ago, I'll say, if you're really thirsty, have a small sip of water, but just one at a time. Definitely don't gulp it down. Think of anything, that barrier lasting about four hours and anything that sits on top of it could just be reflux or sink the barrier. Yeah, that's important. And it's not just about medications or alginates. I want to really make that clear because a lot of people will contact me when I talk about this and say, I don't want to take any of this. Surely there are lifestyle modifications I can make. And there are, you know we've talked about some it's again, very holistic and looking at everything to do with what you eat, but also general health taking exercise um stress management or the things that could be exacerbating the reflux, but. An algenate is not a systemic medication, so it's not absorbed into the body. There are minimal side effects, Gaviscon Advance is a soluble fibre. So once it's done its job, it just moves through us. So it should create minimal problems for someone. Obviously you do want to check with a pharmacist or with your doctor before you start guzzling Gaviscon that it doesn't interfere with any of your other routine medications.
Gillyanne:And what about sleeping habits? Cause I know you've spoken about this on Instagram and things that you can do actually with your bed.
Tor:Yeah. So there's some evidence that by raising the head of the bed by at least six inches that you will reduce the risk of reflux. So And again, lots of this advice should be used in conjunction with other pieces of advice as well. It's not to say that, just that will stop you from getting laryngo pharyngeal reflux, but it is useful to know about. And a lot of people will say, I can't do that because my partner won't sleep. If one side of the beds raised, there's quite clever ways to raise and think about raising the whole mattress, the head of the mattress up. Extra pillows... if nothing else, if you can't do anything else and perhaps an extra pillow might be helpful, but you've got to get the body tilted rather than just the head and the neck. And then you might wake up in the morning with all sorts of pains and difficulties as well. So yeah, raising the whole head of the bed.
Gillyanne:We did it didn't we?
Jeremy:We did, yes.
Gillyanne:Bricks. Yes. Just put house bricks underneath. Yeah.
Tor:Brilliant.
Gillyanne:And what about, cause I'm I'm drawing from Sue Jones, who was at the Wythenshaw for 30 years and she always recommended, if you can, sleeping on your left side, I always start off on my left side. Now, of course it, you get a bit bored when you're sleeping. Sometimes you want to move around, but it does seem to make a difference. Why is that?
Tor:It's all to do with the anatomy of the stomach and where the stomach opens up into the esophagus. So if you lie on the side where above, where the acid will sit in the part of the stomach but not near the opening into the esophagus, then you'll be better and safer and less likely to reflux in that. Hmm
Gillyanne:Oh actually, can I ask, can you talk to us please about Pepsin and why it matters.
Tor:Yeah, I should have mentioned that before, actually. So pepsin is an enzyme that is within the stomach that we use to digest, help us digest. These good old PPIs we were talking about. Certainly they will suppress acid production, but they won't stop the pepsin. Okay. So pepsin is one of the contributors to the irritation and oedema or swelling that might occur in the larynx if people have laryngo pharyngeal reflux. That's where the role of alginates comes in, particularly to be very relevant at stopping the pepsin. Cause pepsin can sit in the throat and wait for us to eat something acidic, which can then activate the pepsin. So that's why dietary modifications and things are particularly relevant as well.
Gillyanne:That was a game changer for me, finding that out from a speech and language therapist, friend who sent to me Jamie Cooperman's dropping acid book. And then I realized that unfortunately, I've got to stop drinking Sauvignon Blanc, which is my favourite wine because although it tastes really sweet, it's actually the most acidic of the white wine. I was happily quaffing, you know, a glass of that every night before my meal and introducing acid into the throat, but we need the pepsin don't we, because we can't digest without it. What we don't want is to get it up here, because we've got lots of tissue there. That is we don't want the pepsin digesting our larynx, so to speak.
Jeremy:So the tissue is edible.
Gillyanne:It sounds horrible, but it needs acid, doesn't it. In order to operate. That's why we don't introduce acid into the throat if we've got
Tor:yes, absolutely. Yes. If you think about it in that sense that, every time you eat something acidic, if you're getting laryngo pharyngeal reflux and pepsin is in the top part of the esophagus or up into the larynx it could then be activated and start essentially digesting the tissue there, and certainly causing irritation and these persistent throat symptoms. Yeah. And that's where, the carefully thinking about your diet and particular triggers and, it's going to be slightly different for everyone. But it's important to have support to do that.
Jeremy:Is there anything in timing of eating?
Tor:I say to people too, Whatever that routine is, try and stick with the routine because the body is such a clock. So the body will expect food when it expects it, it will have secreted the acids and prepared all the enzymes and everything for digestion. If you don't eat when your body's expecting it you may be more likely to reflux. Skipping meals for that reason, eating late at night, things like that are probably to be avoided. But, some so often I'm working with people where we'd just need to look at all those factors and work out what's realistic. If someone's working late shifts or performing in the evening and needed to eat something afterwards, it would just have to try and get a balance for different individuals and work out what's important.
Jeremy:It's very much like having your own jigsaw. You have all of these pieces and you have all of these behaviors that you do that are part of your life. And you rearrange the jigsaw to make sure that you don't get certain things and you do get others.
Gillyanne:Do you know what you brought joy to my heart because I'm a little bit food police these days aren't I? Once, once I started to get to grips with what was going on, I actually changed my diet. I read another book called the acid reflux diet, which I'll share written by a nutritionist. First of all, what I did was I eliminated acid, for anything acidic from my diet, but you don't need to do that for very long. And then you gradually introduce more stuff. And what I found was that the timing of food was really important. And what you're saying is the body gets used to preparing itself for food at a particular time. And I think in modern life, we just completely override this.
Jeremy:I love that piece of information. I think it's really fascinating.
Gillyanne:Oh, you're thrilled.
Jeremy:And I didn't know that. So the idea that if you're missing meals, you're actually messing with the preparation that your body's made, let alone any nutrition that's going in. I love that.
Gillyanne:Your body clock, fascinating.
Jeremy:And of course we work with so many performers who eat either before the show and then go and work or after the show. And. This may not even be a question that you can answer, but is there a period of time after you've eaten that you should take before you go to sleep?
Tor:I generally say three to four hours now. I don't particularly, I can't think of that being written or research, you know, proper... I don't, I can't give you a reference for that, that it does tend to be what we recognize what we recommend from a medical point of view, but, you have to be realistic and not everyone's lifestyle is going to suit that. So I think, ideally an hour, a couple of hours, at least I would say between eating particularly have a good, a full, proper meal,
Gillyanne:If I can't do three hours, out comes the Gaviscon.
Jeremy:Yeah. And in performance terms, that's okay if you're in performance week, but if you're in performance and rehearsal week, that's a killer.
Gillyanne:Yeah, it's hard, isn't it? Yeah. And also, if you think about it, Jeremy, the way that singers work, particularly with the abdominal wall, it obviously they're going to be using that abdominal wall quite a lot. So that's going to be putting pressure right on the area where we might stimulate a reflux anyway.
Jeremy:It's it makes sense why singers in particular can be picky about food.
Gillyanne:Absolutely.
Jeremy:And when they eat, because there's a lot of things that they have to deal with.
Gillyanne:We understand, friends.
Jeremy:We do.
Tor:It's a very complex routine to have to get sorted. And then so many elements, if something knocks off our routine of any reason, which of course it's going to, particularly for a performer where things are just right. But if they're knocked off in some way people do worry that it's gonna impact on their voice and their throat. And yeah.
Gillyanne:And you are actually setting up your own courses now aren't you to guide other SLTs who might be interested in voice.
Jeremy:You're already a mentor.
Tor:Yeah. Yeah. So I love being a mentor. I, over the past eight years, Supervised and trained sort of generalists therapists who see some voice patients, but it's not the majority of their caseload, but they've wanted to build their skills. And I've done that on the NHS and in private practice. But last year or the year before I thought to myself, how can I put all this experience and knowledge of what the developing voice therapists needs into an online course. And of course at that time, everyone was online. Everyone was wanting and finding it easier to learn online and the flexibility that brought to people. So I ended up developing VoiceFit to Practise, which is for a developing voice therapist, whether that's therapist at the beginning of their career, or a few years down the line, or any time what they want to specialize in voice. So it really covers what's essential learning and development that first 12 months. And I provide supervision within the course. It's all online, very flexible and ideally studied alongside a caseload with supervision. So people hopefully get the most out of it. Yeah, that's one of my favorite things and really is supporting people with that.
Jeremy:And we will put a link to your course.
Gillyanne:Have you got time to talk about nasal breathing? I know you're a fan and it's sometimes it's a bit of a moot point sometimes for singers because of course, singers tend to need quite high lung volumes in order to sing long phrases. And particularly if they need to project acoustically we often feel actually, we can't get enough air in when breathing through the nose. But recently there's been a lot of interest in nasal breathing, in terms of downregulation of the sympathetic nervous system, which let's face it, we've all needed to do over the last two and a half years. And people are very interested in it from that, holistic point of view. But from your perspective as a speech and language therapist, why do you think nasal breathing is beneficial?
Tor:So my interest in this has come from working with an asthma service with obviously patients with the laryngeal component to their symptoms. But a lot of these patients have breathing pattern disorders or dysfunctional breathing, whatever you want to call it. This is based on observations of someone's breathing patterns. That does include the channel which they're breathing through, the mouth or the nose, but also talks about and observes things like where's the air going? Is it apical or thoracic, or is it diaphragmatic? It looks at the speed with which someone's breathing. It looks at whether it's audible or silent as it should be. And it looks at the rhythm or whether someone's breathing patterns are erratic. So there's lots that goes into breathing patterns and there's a lot of reasons why they can be knocked off, but it made me really aware of my own breathing. It made me really aware of just generally other people's, and how people are breathing and why. And when we're born, we're breathing completely spontaneously, automatically, beautiful involvement with the abdominals and the diaphragm. It's quiet. It's slow, it's through the nose usually. And like with other things in life posture and whatnot, life has a huge impact on how we do these bodily functions. So breathing is an essential part of voice, obviously, and an essential part of the, of how and why the upper airway functions. Nose breathing, if we isolate that for a minute, the nose. It's how we should breathe. And those is designed for breathing. I say to people, nose for breathing mouth, for eating or talking the nose keeps the air warm. It keeps it wet. And it allows for the production of nitric oxide in the parasinuses, which helps for the absorption of oxygen and for using the oxygen more efficiently. Um So there's lots of benefits of nose breathing and it's difficult. I see lots of people who will say, I just can't do it. I can't nose breathe. It doesn't feel comfortable. I can't do it when I'm talking. I can't do it at rest. I certainly can't do it when I'm exercising. And I say to people, it will feel strange. It will feel really strange if you're not used to it, but with practice and with educating people on the benefits of it it's really worth persevering with.
Gillyanne:That's very interesting. Since reading some of your Instagram posts, I have started noticing that, sometimes if I'm just walking up to the shops around here and I'm speeding along, I tend to breathe through my mouth. I actually think I got into a pattern of doing that because I developed a heart arrhythmia um about three years ago. So I thought, okay I'll just try breathing through my nose every so often while I'm doing the walk and actually I found I could do it. And so I'm very curious about it. I've also invested in some of those tapes, around the mouth which are recommended by actually they recommended for asthma people aren't they. But I found that it's very helpful at night, so that I don't breathe through my mouth at night, less snoring. So I just think it's very interesting, not only about the nitrous oxide, but you're talking really about the patterning of nasal breathing.
Jeremy:I'm going to I'm not going to gently disagree, but I am going to do a contextual thing. Because it's only in fairly recent years that I've been able to nose breathe. I have very narrow passages, so I just literally can't get enough oxygen in, but that's changed over the years.
Gillyanne:We're sharing a lot of information on this podcast.
Jeremy:When I was 20 years ago, there was only one of the conchae that was wide enough to take the camera. So I really do have my narrow passages, but contextual thing that I want to talk about is actually the act of singing. And the reason why I want to talk about it is because of the breathing patterns for singing in general, which is very fast intake in a very short space of time and then long ex exhale as it were when you're singing. And it's almost any singing style that interrupted pattern of standard breathing is there. So you breathe in very fast and then you use the breath for medium phrases or long phrases or very long phrases.
Gillyanne:It's also about sustaining the sub glottal pressure for particular pitches. Isn't it?
Jeremy:And so I'm perfectly happy with the idea that you can in real life nasal breathe, but I'm, I just don't get that you could do that when you're singing pretty much anything. Um Partly because I'm noisy if I breathe in nasally Uh at speed and I can't afford to do that as a singer I just don't get enough in. So not that I'm suggesting that everybody takes deep breaths all the time when they sing, they don't need to. But it is interesting that's the one area that I would say that it does not work for me, but the nasal breathing in general life. Yes, absolutely.
Tor:Yeah, no. And I completely get your point. And I think the majority of people when they're singing will probably breathe in through the mouth and that's not necessarily a bad thing. That's not going to turn everyone into mouth breathers at rest and chronic mouth breathers at night, for example. It's, you can be both. You can use your mouth when breathing in when you're singing, but you can also be a healthy nasal breather at rest.
Jeremy:I think it's, I feel quite strongly that it's important to say that because we are so much now bombarded with you must you must you must you must. And there's a whole list of you musts, and then you're trying to live your life with these you musts.
Gillyanne:Yeah. Particularly on social media posts, we're being advocated to do this and that and people pick things up. But I'm going to say from my point of view, that it was, it's an interesting exercise for me to breathe through my nose while I'm walking along. I wouldn't do it if I was running or probably wouldn't do it if I was mowing the lawn or anything like that. But I just noticed I'd fallen into this other pattern and I thought, hang on a minute. I don't think I really need to do this.
Jeremy:I agree with that. Yeah.
Gillyanne:And so it's another one of those you can intervene with that pattern. You don't have to get caught up in it. Yeah.
Tor:Yeah. So I worked very closely with the physiotherapists who work really with breathing pattern disorders. And a lot of our work now crosses over, particularly with the respiratory services and the NHS and that we re you know, again, really holistically at the whole body and what the whole body's doing when we're breathing and when we're exercising and how we can just optimize breathing patterns that we're never going to breathe perfectly all the time. You know We'd have uh uh you know things, so many factors, lots of variables, but there's lots of benefits for health, for voice
Jeremy:So, Tor, what's coming up for you.
Gillyanne:Yeah.
Jeremy:What's in the future?
Gillyanne:Yes, because there's a change in your life, isn't there, coming up right now or very soon. Tell us about it.
Tor:Yes, there is a change. So I've worked in the NHS for 15 years, I think, around that. And I've decided for various reasons, I'm just going to take a little break which is a huge sort of sacrifice in many respects, I comes saying goodbye to a job that I absolutely love in, in the NHS. But I may be back, but I'm just decided what's best for me at this minute is to take a break. And I'm going to focus on building my private practice and do more teaching and training and work on these, on developing these courses for voice and upper airway therapists. So yeah, I'm excited. It's it's going to be different more, I'll need more discipline to work under my own steam and keep that going, but...
Jeremy:Welcome to the world of the freelancer. So how can we find you? How can we contact you? What's your social media? What's your handles?
Tor:So I'm @VoiceFitUK on Twitter and Instagram and Facebook. So yes, I'm a big fan of social media, and Instagram, particularly for making ama... Like I met you guys on Instagram. For networking, for meeting, amazing people in this profession, in the world of voice. And what's your website? Um voice set.co.uk. Excellent.
Gillyanne:It's easy. It's just all about VoiceFit UK.
Jeremy:Yeah. Tor, it's been a pleasure.
Gillyanne:Yes, very much so.
Jeremy:Thank you so much for coming.
Tor:Oh, thank you so much for having me. I've loved it.
Jeremy:Everything that Tor has been describing, we'll have a huge list of show notes that people can find all of those links. So Thank you. Tor. It's been a pleasure.
Tor:Thank you!
Jeremy:This is a voice uh podcast with Dr Gillyanne Kayes and Jeremy Fisher