Thank you for replying Colleen! I was referred, by my Rheumatologist at Mayo, to ENT at Mayo because I'm having problems singing and that is very important to me. (Sung all my life, in many choirs (mostly at church), with groups both a capella and with instruments, i.e. amateur musician.) ENT Dr found RA has affected joints in my larynx, weakening one vocal cord in particular. Result is vocal cords are not functioning well together, voice can be weak, "wobbly", or produce no sound at all in some situations. He also found "silent" GERD (acid reflux) that is asymptomatic. I am now on Omeprazole. He referred me to a vocal therapist (also at Mayo) and have exercises to do, drink plenty of water, no shouting or talking or singing loud, no singing without a designated microphone. And don't talk too much! I am distraught about this, music is a huge part of my life. I'm sorry for the long reply, but I needed to vent. Thank you for "listening". 🥲