Little Big Town's Machine Back Up and Running Following Risky Vocal Surgery

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Kimberly Schlapman, Jimi Westbrook, Karen Fairchild and Phillip Sweet of Little Big Town perform onstage during the 2015 CMA Festival on June 13, 2015 in Nashville, Tennessee.

When Little Big Town's Jimi Westbrook posted a thumbs-up photo from the recovery room of a Boston hospital in June, he put on a brave face. But inside, he was struggling with anxiety, as he had been for months.

Westbrook had developed a polyp on his vocal cords that was no more than a millimeter in size. Dr. Steven M. Zeitels -- a surgeon who has helped the likes of Sam Smith, Adele and Steven Tyler -- was enlisted to extract the growth, making tiny incisions on a lump that had huge repercussions. The slightest mistake could've destroyed Westbrook's career and left the creative futures of his bandmates, crew and business partners in doubt.

"Your vocal cords are covered in this membrane that literally looks like Saran Wrap," Westbrook says. "The thing is, if you go too far in that surgery and damage any of that, there's no coming back from it. It's a high-risk surgery, but with him and his skill level, it's not so high risk because he is so talented."

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Westbrook's recovery went well. On Aug. 22, nearly two months to the date after his surgery, Little Big Town returned to the stage during the Eastbound Hoedown in Newfoundland. He was ecstatic about the way his voice responded, and it gave the band a sense of relief.

Postponements and cancellations over vocal problems are just common enough that the average fan -- perhaps even the average music-industry employee -- gives little thought to the emotional drama behind it. A singer relies disproportionately on one body part -- the throat -- to earn a living the same way that a baseball pitcher counts on an arm or a marathon runner leans on the ankles.

Just how extreme is the role of the voice box? Zeitels studied Tyler for a 2007 National Geographic Channel special, Incredible Human Machine, and found that those reedy cords that produce the pitch and tone smack up against each other 270 times per second during a vocal performance. That adds up to roughly 500,000 times in a full concert or around a billion times throughout a 30-year career.

"There's no part of the human body that likely sees these kinds of collision forces and sheering stresses, which is why vocal folds essentially wear out over time," Zeitels said during the program.

It's one of the reasons vocal problems seem to rear their head periodically for country artists, especially in the current era. Concert sound systems have been built to pump out higher decibels than in previous decades, and the genre's popularity means more artists than ever before are playing in large environments -- such as arenas and stadiums -- that require bigger sound.

"That is definitely a factor," says Westbrook's new vocal coach Diane Sheets, whose clients have included Diamond Rio and Christian artists Natalie Grant and Jason Crabb. "There's rumbling in your body; you feel the intensity of the sound."

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Even though sound systems are capable of delivering the voice at the proper level for the entire venue, artists may feel a psychological need to strain to reach the required decibel peak. Artists are particularly susceptible in the early years of their career, as many are performing more frequently. They're also likely to develop habits that could become exacerbated in time.

In Westbrook's case, the polyp likely grew over several years. He didn't know it existed, and had unknowingly adapted to it until the growth finally got his attention.

"The brain is so powerful that even when you have an injury and a mass that is developed on your vocal cords, your brain figures out how to work around it," he says. "I realized my texture had changed over the years, but I didn't really think it was because of something like that."

Westbrook, of course, is not alone. Other country acts who've had vocal surgery include Kenny Rogers, Kathy Mattea, Patty Loveless, Heidi Newfield, Lauren Alaina and Gary Allan, who had other band members hit the high notes on his behalf during concerts at the height of his vocal strain.

"I had lost my falsetto," Allan says. "Things where it really hurt me were like 'Smoke Rings in the Dark.' Like on the second song in, my vocal cords would fail and I had all mid-voice. I had none of that falsetto."

Keith Urban, who had vocal surgery in November 2012, offered encouragement to Westbrook. That was particularly meaningful because Urban could point to positive results: His post-treatment range and tone had improved significantly, and that in turn upped his game when he recorded his current album, Fuse.

"It's a new voice in so many ways," Urban says. "Subconsciously that gave me a lot of confidence to then go out and try a lot of different things."

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Sheets has encountered a bit of a stigma about vocal coaches, though she thinks it's a misguided attitude.

"A singer is very much like an athlete," she says. "Athletes work with trainers for the whole life of their career, because of the importance of making sure that you're performing at your peak and that you're mitigating some of the risk for injury."

Post-surgery, Westbrook certainly brings a different viewpoint to vocal maintenance. Bringing an entire organization to a halt was gut-wrenching, and he would prefer to avoid doing that again.

"Being the one that had to make the train stop was a heavy emotional part of the decision," he says. "But there was no other option for me. It was going to keep getting worse if I didn't take care of it."

Preventing a recurrence? That definitely gets a thumbs-up.

This article first appeared in Billboard's Country Update -- sign up here.