Thank you so much for the replies. Short explanation: my voice is not compromised, I still can sing and talk clearly and quite loud. My throat cannot handle singing opera for 2 hours, it is just not made for it. So I accepted this fact and ready to move forward. I still can give private classes in singing and successfully demonstrate the proper vocal technique.
As for TOEFLE, I took it a number of years ago and did pretty good. Since then, I believe, my English has dramatically improved, so that should not be a problem, especially compared to a difficulty of GRE.