We've had quite a few posts about post-Botox breathiness over the years.

In most cases, if the patient is otherwise in good health and just has a straightforward case of AD/SD without other dystonic involvement affecting breathing, then what 'breathiness' or 'breathlessness' means is this:

NOT difficulty in breathing when at rest or after exercise, but running out of breath when talking. Typically this means being able to get out 4-5 syllables and then finding there is no more 'puff' left in the lungs to finish a sentence. Stretching/forcing for extra volume also means the breath is wasted.

The reason why this happens is that initially the Botox leaves the vocal cords so flaccid and weak that too much air escapes while speaking. You can feel this by holding your hand in front of your mouth while you speak - in a normal person you don't feel much air flow, in a post-Botox patient you can definitely feel the air escaping out of the mouth - it's almost like they are blowing the air out deliberately.

One way of dealing with this is to not push for extra volume, and keep your sentences/phrases brief. Breathe in more frequently. Don't talk for extended uninterrupted periods - if you do, you will hyper-ventilate (the breath wastage from speaking means you have to take in more air to replace it) and your fingers for example might start tingling, and you'll become light-headed.

If this 'breathiness' becomes a major issue for you then consider making changes to your Botox treatment regime - lower the dose perhaps, or try unilateral shots - I won't repeat advice on unilateral shots here, but if you are interested, see http://www.dystonia-bb.org/forums/sd/posts/11328.html

But don't worry too much about this until you have had a few Botox injections - you might be just fine having these done bilaterally.

Best wishes, and good luck.