Posted by: ron huggins ®
08/25/2005, 19:48:47
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Hi Lula,
I have abductor type dysphonia, and was diagnosed in 1978.
At times however, when I've had a really horrible vocal day, it seems I begin to produce a very tight strangulated type of voice. But I'm thinking this is not the same as 'mixed' sd. Of course, both can result in the loss of voice and both serve to be most distressing. I think there are those on the BB who have indicated this 'mixed' diagnosis and perhaps they will weigh in with advice and encouragement. Good luck.
Ron
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Posted by: Lulamadden ®
08/26/2005, 10:54:57
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Ron - Thank you for your reply. My Otolaryngologist is going wants to try a botox injection to see if anything will happen. He says unfortunately "mixed" sd is harder treat with botox but right now I am willing to try anything once. I spend about 90% of my job speaking on the phone. Thank again for the encourgaement.Lula
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Posted by: Paula B. ®
08/26/2005, 11:27:20
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Lula,I know someone from this bb who posted a while back, but doesn't really read or post anymore. Anyway, he has both AD and AB and has gotten a Botox injection that did work. Now adays there is a lot more out there to help us. Good Luck, Paula (Chicago,IL)
ADSD since February 2005
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Posted by: sbayle ®
09/03/2005, 17:27:08
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Lula-
I have mixed SD: both abductor and adductor.
Treatment for SD is very individualized and medical professionals who treat this voice disorder also tend to have their own perceptions on how to best go about managing SD. It may make sense to have injections first for AD as it is a much less invasive procedure. It may provide you with enough relief to be satisfied.And, if you decide to receive injections- it may take several months or longer to determine the optimal shot. It can be frustrating but can also make the world of difference if you find a treatment which helps. Good luck-
And keep asking questions!!!
Sarah Bayle
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Posted by: mary salisbury ®
08/27/2005, 15:09:11
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Lula... Yes, there are folks on this site (including me) with mixed AB/AD and I hope more of them will reply to you. Maybe we can all help each other by posting our own experiences with treatment.I was diagnosed with spasmodic dysphonia in Feb. this year after an upper respiratory virus. I'd had rather mild symproms for many years (10) but this year my post -virus laryngitis just got worse and worse. I kind of baffled my voice therapists and ENT because everytime I went in for an appointment I sounded different, but my laryngoscopy showed up as classic AB. Like you, trying to talk was extremely exhausting. There were days when my stomach and chest just ached from trying to push the words out. My blood pressure went up and I'd get lightheaded and have headaches. (Poor breathing.) Also, although I did not have MTD (muscle tension dysphonia), one of my voice therapists did help me learn to relax my neck and shoulders more, since that's where I tend to hold stress--and they thought it could be exacerbating my SD. Learning to relax didn't help my SD but I sure felt better all over! Learning to relax can also help as a preventative --to keep you voice from tightening up even more when you get in tense situations. Most people with SD notice their voices get worse when they're under stress. I received botox in the muscles that cause the AB symptoms in March and April-- and at first didn't think it did much. (These muscles are behind the larynx and a little harder to get to unless you have a fairly flexible larynx which I do. I guess the success rate for botox for AB is about 50% which may be partly a reflection of the skill of the doctor doing the injections.) (Also--FYI for anyone else who gets botox for AB--my ENT in Minneapolis says there is a doctor in Chicago who is having a better success rate (for AB) by going THROUGH the FRONT of the larynx rather than going in behind the larynx with the injections. Anyone else heard about that method of doing AB injections?) I got 3 units of botox in each side one month apart. My ENT likes to do the AB muscles a month apart for first time patients to avoid any problems with breathing that can rarely occur.) After I was "botoxed,"
I almost immediately sounded AD !! --with a strangled voice sometimes getting so bad that words wouldn't come out at all. So overnight I went from being AB to sounding AD! (That's why I thought the AB botox shots didn't do anything. But they did work--I just couldn't tell because the AD symptoms started showing up.) My voice therapist was fascinated by this change in my voice and she and the ENT she works with at the Univ. of MN decided I must have AB with an underlying AD dysphonia (that only showed up after I was botoxed for the AB). In June I was botoxed on both sides
(bilaterally) with 1.5 units for the AD muscles. Two weeks later I was talking fairly normally after a period of quiet, very soft voice (the typical reaction to botox for AD symptoms) which gradually strengthened and got louder. Breathing in a relaxed way is much improved now, too. Now it is almost September and my original botox for the AB problem is wearing off (but it lasted almost 5 1/2 months for which I am very grateful! ) I'm scheduled for botox to reinject the AB muscles in September. We'll see what happens! In the meantime I am very fortunate to be treated by two excellent voice therapists who both specialize in voice disorders-- and one (the one at U of MN) who works with several patients who have SD. Both
therapists are teaching me some great voice, breathing, and relaxation techniques that really help make speaking and day to day life a little easier. No my voice isn't perfect--I still have good days and bad days--but the good days are better and the bad days aren't as bad. I have a fairly functional voice for conversing with family-- and I can sort of use the phone on some days. So anyway...this turned into a long way of telling you how I'm being treated. I basically get alternating shots for the AB and AD. Stronger injections for the AB since it seems to be primary. For the next year the challenge will be to see if we can figure out a predictable schedule for all these injections that gives me the maximum benefit with the shortest amount of time possible with a breathy or quiet voice after the AD shots. It's an adventure! I'm fortunate to have supportive family and friends. I hope you do too! Feel free to write me at my own email address if you have more questions. Good luck and just know that figuring out how best to time injections and how much botox to use takes many months -- but so far for me, I'd say it's been worth the effort and time. Sorry this is so long! Mary Salisbury, Minnesota
Modified by mary salisbury at Sat, Aug 27, 2005, 15:14:14
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Posted by: Lulamadden ®
08/29/2005, 11:34:25
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Mary - Thank you so much for your reply. I too started out with a respiratory infection and I would always get laryngistis out of the blue a couple of time a year since I can remember, perhaps that was my sign of things to come. I appreciate you telling me your experience with botox injections for mixed SD. I go tomorrow (Tues.) for my first injection which he wants to inject the side that was augmented in Feb. 2005. I happen to work at the Univ. of CA, Davis, Med. Center and also being treated there as well. My Otolaryngologist and Speech Pathologist are wonderful, my oto is considered one of the best in voice disorders (which is very comforting). I also work for a doctor who has polyps on his vocal cords so he understands a lot of my frusterations, too, My family is wonderful, my parents even go to drs. appt. with me when they can because they want to understand better. Anyway, I will let you all know how botox goes tomorrow.
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Posted by: mary salisbury ®
08/29/2005, 13:28:38
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So glad to hear you're receiving oto care from someone so good in a university hospital. We're both lucky we live in such close proximity to docs who are familiar with and regularly treat SD.Good Luck tomorrow. You have lots of people pulling for you on the BB and we'll be thinking of you til we hear from you. Also, I agree with what you said on the other post you wrote today (under the 'School" thread.) You have a great attitude. Just take everything one day at a time. It takes awhile to assimilate all the changes that SD can bring. (I'm still on the "figuring it out" road, too, but then, I guess everyone's on that road in one way or another--with or without SD) Give yourself time, and I like how you're thinking about new ways you can meaningfully live your life. Watercolor sounds wonderful! Are your shots tomorrow for the AD or AB muscles? Whichever it is, all the best to you! Mary
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Posted by: Lulamadden ®
08/29/2005, 14:24:34
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Thanks for the encouragement. Tomorrow I am getting the shots I believe in the adductor becuase he wants to weaken the side that I had the augmentation on. I had radiance injected onto one of my vocal cords in Feb. because I had/have some paresis. He forced my vocal cords together and now he wants to relax them. Your right it does take time to assimilate all of the changes SD is bringing my way. Its just weird how I use to have so much to say and didn't have a problem saying it and now I have some much to say but yet somehow can't as much. I will let you know how it goes tomorrow. I understand from all of you that I need to give it time to work, I will try but I am not very patient sometimes!
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Posted by: Lulamadden ®
08/30/2005, 17:44:29
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Just had my first botox injection about an hour ago...hate them!!! My Oto & Speech Pathologist gave me a very low does because in my Oto's words, I have stumped them! As I have written before, I started out with vocal cord paralysis. I am sore in the neck, coughing up blood, and talk with a whisper. But I will wait and see what happens. My Oto & SP say that they want to at least try and help me, which makes me feel better because you can see it their face. I told them its nice to know that the do really care. I am fortunate because I work at the same hospital I get treated, Univ. of CA, Davis, Med. Center. Thanks for your encourgement!
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Posted by: magick ®
08/31/2005, 09:59:18
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Hi, I also have mixed SD. For now, Botox injections seem to be only solution. Hang in there. When I first contacted SD I was an aerobics instructor and personal trainer. (18 years ago.)When I talk a lot I get tired also. I still try to work out but I gave up the teaching. When I did teach classes I used a lot of hand signals and a microphone. I want to encourage you to keep working out. Try weight training.
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Posted by: Lulamadden ®
08/31/2005, 11:43:34
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Thank you. Giving up exercising is the last thing I want to do. Over the past 7 years, I have managed to loose and keep off 100 pounds! I was doing cardio and lifting weights over for about a year and half before I got sick and my voice went to pieces. The doctors told me that because my lungs were so infected it would take time for them to recover, but then the voice went and I get out of breath just speaking. It’s especially hard since my job requires a lot of speaking (love my job but am considering re-thinking what I do). The drs. even say that lifting weights puts strain on your vocal cords. So, I am looking into yoga and other forms of exercise that have a more calming approach than cardio and weights.
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