I'm assuming you have AD/SD. If not, this advice will not apply.If you still have a weak/breathy voice after botox in September, it is more than likely that it a) definitely worked; b) was in the right spot; and c) was clearly not a bad batch.
The weakening of one's vocal muscles is the "main effect" of botox. This is often confused with the concept of a "side effect." The goal of botox, in my opinion, is to achieve the least amount of weakening possible, while leaving a highly serviceable/near-normal voice (without spasms/tremors/straining/effort). The definition of a "highly serviceable voice" will vary among individuals. Depending on one's tolerance for breathiness (or lack thereof), botox dosages can be adjusted up and down significantly, or injected in one versus two cords. It can take several tries to hone a workable system.
Whether the dose was too high is subjective. In this case, it sounds like you were prefer a stronger voice at this stage, perhaps implying that it was too high.
When people say botox didn't take, it should very simply mean their voice is *exactly* the same as it was the day before they received the injection. No change whatsoever, for better or for worse. It does not mean their voice changed, but they don't like the change. In that instance, the botox "took" (i.e., it did something, it works, the person is not immune) but it simply didn't do what the individual person wanted it to do.
In the instance that people have multiple problems competing with their SD (i.e., vocal nodules, polyps, essential voice tremor, smoker's voice, other focal dystonias in the laryngeal/pharyngeal area, among others), this advice regarding botox will not relate 100%.
It sometimes helps to chart and/or record your voice week to week and then present that to your ENT or neurologist at the next visit in order to work toward a more ideal system.
Laurie
