Steve Uliana
Speech Pathologist
Singing Voice Specialist
UC Davis Center for Voice and Swallowing

Steve Uliana is a Speech Pathologist and Singing Voice Specialist at the UC Davis Center for Voice and Swallowing where he sees a variety of patients for upper airway and voice disorders as part of a multidisciplinary clinic. Prior to his career in speech pathology, Steve was a professional classical singer, having performed with opera houses and symphonies both nationally and internationally.  Outside of the clinic, he can be found running with his chocolate Labrador, Vinny, cooking with friends, and occasionally singing the national anthem for professional sporting teams in the surrounding area.

“Ahemmmm… eee…EEE!” As I did every morning of an audition, the moment I woke up, I began to vocalize to take stock of where my voice was sitting. After a minute or two of making sounds that might make my hotel room neighbors fret a cat was being tortured, it became very clear to me that getting my voice in performance-shape for today’s audition would be a “journey.” I made a plan to get to the audition venue extra early to allow for an extensive warm-up and began to get myself together.


I had recently graduated from Moores Opera Center with my Master’s of Music in classical singing and had been to enough auditions to have my preparation process firmly established. Even so, I always had a degree of inconsistent vocal quality and function on a daily basis and was never quite able to understand why. Years later, I would learn that acid reflux, specifically laryngopharyngeal reflux disease (or LPRD), had been playing a major role in my vocal fluctuations. But during this particular audition, I was not yet blessed with that knowledge.


I had the cab drop me off at the hall and immediately darted into a practice room to get into voice. After nearly an hour of warming up in every way I knew – vocally, physically, mentally – I just couldn’t get the top range working. I immediately started to melt down. Not only was my voice not working, but I was offering several new arias (operatic songs) for this audition. New. A true rookie mistake. I told my accompanist before entering the room to “pray for me” if they called for the French aria, which, of course, was the second piece they requested.


The piece began, and for the first time in my history, it was clear I would not make it through. As the first high note approached, my mind began flashing through ways I could problem solve: Should I pretend to faint? Maybe I should fall on the ground right here and feign passing out. But I didn’t. I took the largest breath I could muster and said, “I’m sorry.” I stopped singing – the cardinal sin of auditioning. I actually stopped. My accompanist stopped. Everything stopped.




And then, from the back of the concert hall, a voice rang out, “One, two, ready, sing!” And what I can only describe as a divine power overcame me, and I BURST in on that high Bb. And it was good! And the piece continued. Now, this particular song repeats the high note. Surely, they would know if I couldn’t sing the first one in context, now that I was more tired, I would be unable to sing the second. Surely, they would stop me. But no, the note approached, I tanked up on air, and…


“I’m sorry!”




“Ready, GO!” The voice rang out, and I – again, like a trained monkey – burst into the high note. Again, it was good! The piece ended, and the voice calling out to cue me, whom I later learned to recognize as the artistic director of the opera house, shouted, “I want to be there when you make your first recording to say, ‘Wait, wait! Sing!’”


We all laughed.


I left the hall.


And immediately began contemplating what my next career would be.


I hadn’t really concerned myself with acid reflux at the age of 25, and so had no idea that it could affect my voice in such a significant way. While the average voice user may not notice the impact a bout of reflux can have on their voice, opera singers use the very extremes of what their voices are capable of in very nuanced ways. I also didn’t know that opera singers were prone to acid reflux. As operas are typically performed late into the night, the lifestyle of an opera singer lends itself to large and late meals which can lead to increased severity and frequency of reflux episodes. Opera singers also generate a huge amount of intra-abdominal air pressure to healthfully generate the breath support needed to soar over an orchestra, further predisposing them to developing reflux. 


Had I known those things, I would have chosen to eat dinner before 8:30 the night before. Had I known those things, I probably wouldn’t have gone for the white garlic pizza for my dinner. Had I known those things, I would have been more proactive about managing symptoms that I now know were directly related to acid reflux. Later in my career, I would eventually go on a medication regimen that included a PPI and H2 blocker to better manage the effect reflux had on my voice.


Now, as a Speech Pathologist who occasionally sings professional gigs, I don’t feel the need to go on such robust medications. The knowledge of reflux-friendly eating habits and nutrition is often enough for me to keep my voice healthy for when I need it. And when I’m struggling a bit more or want to still enjoy myself around the time of a performance, I’ve found alginate therapy to be wonderfully effective. In a health system that can be too eager to fix a problem with medication, it’s reassuring to know of a therapy that’s naturally derived and successful in managing a symptom that could otherwise derail the many years of training and experience I’ve invested in my voice.    




It’s amazing what a good night’s sleep (with my upper body elevated, of course), a nutritious diet (low in acid, of course), and some alginate therapy in my back pocket can accomplish…not to mention stress management, but that’s another story. It takes years and years of dedication and training to live the dream of expressing oneself via their voice…and just a few slices of garlic pizza, a late night, sleeping flat, and enough stress to cause a coronary event to make anyone reconsider every life choice they’ve ever made.


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