I do not have both diagnoses, however, it may be interesting to you to know that I have been told by physicians that MS can produce an SD-sounding voice without SD being present. (Absent clinical test for SD, I don't understand how this is logically deduced, but I'm not a doctor.)

Thanks for responding. I was diagnosed with MS in 8/88 after searching for five years for an answer to all of the symptoms I was experiencing.

I started having trouble with my voice in 2/00 when I thought I was talking normally, but my family kept telling me to speak up because they could not hear what I was saying; then when I went to work full-time in 8/00 and had to talk on the phone many times a day, and my customers kept asking if I had a cold or was sick, I knew that something was going on! I visited our ENT here in town, and he mentioned myasthenia laryngitis and possibly teflon injections if things got worse, and said everything else was okay and that I should not lose my voice. As I have continued to work full-time and have customers constantly comment on my voice, I also noticed that it was becoming tiresome to try and get the volume I thought I should have when talking. I went to Virginia Mason Clinic in Seattle in 7/02 and had some speech therapy, but the therapist said that without going through the testing and scoping, that she could not give me a definitive diagnosis. I went to the Oregon Health Sciences University on 11/8/02 and had the testing and scoping done, and came home with a diagnosis of SD, AD type. I am in the process of trying to adjust my work schedule to go back down after the first of the year and have a Botox injection. I was disappointed that I could not have it done the same day since I was already there, but the Botox clinic is held only every other Friday, and would not be done until the next week! I had to get back home and to work (already had my plane tickets to return home.) My insurance does cover it so we just have to adjust our schedules and finances to make another trip down south. My husband works on the ferries up here and works one week on/one week off, and it is not practical for me to travel by myself since I either use a scooter or wheelchair to go any distance.

Well, that is the short version of the story. I will keep you posted.

You mention more than once in your writing above that volume is a challenge. There are excellent amplifiers available - certain types for "in person" communication, and other types for phone. These won't solve your problem but may do a lot to help you deal with it. I've tried many amplifiers and prefer ChatterVox for in-person, and Fellowes for the phone. What works best for others may, of course, be different.

There are many positive aspects of using amplification: it is easier for you, it is easier for the listener, and many of us speak "better" when we are not straining for volume.

I'm told that the moderators chose to send my reply to you via direct email. Please email me directly if I may assist you further. I've tried a variety of amplification devices and am happy to help you.

Take care.

As a "fellow-digger," (reason most of us are here), I'm glad you found a forum which helps you and pleased you're becoming active. Keep up the good work.

Philosophically (and related to info which we've discussed on this BB and is on the web and is presented in SD patient symposiums):

- MS and SD are both *conditions* of the neurological system (see my previous BB post re Teri Garr) so they are *related* because they are both in the same system of the body and that particular system - CNS - seems to control/affect many functions. Sometimes, that system "gets us good," unfortunately. Dog-gone-it!

- As we've learned in symposiums, and with all the literature we "diggers" (love that term) on the BB plow through, alot of this is related as all of the disorders may have a genetic-component but it's "take-your-pick" as to the ones you or any of us might get. Even with dystonias, it is rare for us SD'ers to get any other form of focal dystonia. But, periodically, there are combinations of neurological disorders, and an "SD-MS combination" is just as likely as an SD-torticollis combination or any other combination of neurological *things,* dystonia or otherwise. Makes sense to me.

I know someone who has SD and MS, and I was hoping she would see this on the BB and respond. I cannot speak for anyone else.

Also, a story to share. I spoke to a neighbor yesterday, who I have known for 22 years. Until recently, she did not realize I had such a severe neurological disorder. We don't talk that often so she hasn't kept up with my case, and I did sound pretty good for awhile. For years we just waved but now we have to discuss some issues, as neighbors. Since my voice/breathing is so bad these days, she is now seeing the trauma in my talking/breathing.

My neighbor asked me if I couldn't just have a vocal-cord transplant (the "uninformed" say that, like the ones who tell you to suck a lozenge) and when I explained that our disorder originated in the brain, she really lit up and went to town. We talked for an hour and she told me about stories in her own family. She asked what help *Stem-Cell Research* might have for all of us with SD, after I told her Deep Brain Stimulation surgery is not yet applicable for voice patients but we saw dystonia patients in Miami for which it really helped.

My response...Yes, *Stem Cell Research* would help us immensely. Or, at least help patients with our disorder who are younger than me.

Just a thought.

I don't have MS but my mother did and my sister was diagnosed at age 40.