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Posted by: silental ® 07/01/2008, 09:59:08 |
I had my first Botox injections yesterday. I have been diagnosed with MTD with a possible SD component to it. I have tried therapy with a very good otolaryngologist who suggested I follow through with the injection before I continue therapy. The injections were into the false vocal chords with the purpose of weakening them to force me to have to readapt to proper use of my true vocal chords. I'm really worried this a.m. as I have almost no voice. The M.D said they injected at several location for about 60 units total. The procedure was done in an OR under a general anesthetic through a scope down my throat. Can someone please tell me how I should expect the effects progress when done into the false vocal chords? I have asked the doctors and have gotten general answers. would love some reassurance from some patients. Thanks. |
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Posted by: silental ® 07/05/2008, 13:09:58 |
I have NOTHING but a breathy whisper. This is scaring me. I can't even cough. I've scoured the internet for answers but don't really find anything. I go for therapy on Wednesday. I'm not optimistic. |
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Posted by: momof2boys ® 07/05/2008, 22:37:43 |
I'm 8 days into my 1st Botox injection, and I have a breathy, low volumed voice, too. I am also having difficulties with liquids. My voice was actually better the first 2 days after receiving the injections, but I was told it can and often gets worse before it gets better. So don't worry...this is just part of how they will adjust the dosage next time. momof2boys |
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Posted by: Paula B ® 07/05/2008, 23:52:07 |
Hi, I'll try to help you. You mentioned getting 60 units on your first dosage. Is that right? Usually, as far as I recall, they'll start you on a smaller dosage. My first injection was .5, or half of a unit. Now, three years later, I use 5 units, with very good results unilaterally. The amount of botox that you have received will weaken as time goes by. Hang in there, things will get better. Things can be very frightening when dealing with something new. The next time you can get a smaller dose, and the reactions probably will be different. Take notes to see how long your symptoms last, so that you can report them to your Dr on your next visit. Good luck, Paula |
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Posted by: silental ® 07/06/2008, 10:03:04 |
Thanks Mom and Paula. I've read here or somewhere on the internet that there are different "units" of measure used for Botox. After the injections, I asked one of the doctors attending how much (the number of units, strength, etc.) they injected and she said "60 units". I have no idea what "units" she was referring to or even if she had the number right. She was not the primary doctor who actually performed the injections. It was done under general anesthesia and through a "scope" down the throat. I have been diagnosed with MTD and am a little skeptical about the doctors' familiarity with and confidence in using Botox for MTD. In theory, it is injected into and weakens the muscles of the false vocal cords, which were the muscles I was primarily using rather than the true vocal cords, resulting in a strained and hoarse sounding, weak voice. It's day 6 now and I am still only able to talk in a whisper. I can also manage a low, breathy hum. That's it. I go for therapy on Wednesday and can't imagine what therapy can be accomplished with almost no voice to work with. We'll see. Thanks for your posts!!! Al
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Posted by: The Godfather ® 07/06/2008, 20:35:05 |
I'm not sure if I can help, but after reading many posts on this BB on and off for about 2 years now I must admit that 60 units sounds like a huge amount. But like you said who knows in what type of units that could be. Like Lori said from another post, apparently some Dr's have there own way's to measure Botox.
As far as your side effects go, I had too much Botox on my first injection (2.5 units bilaterally) and was breathy and couldn't swallow liquids for a few weeks. My good voice kicked in about 6 weeks after. I did have 3 solid months of a great voice though! I'm down to 0.35 units unilaterally and will go even lower next time for my ideal dose. I'm not sure what they can accomplish at your therapy either if you can't speak. I'll be really interested in reading your future follow up postings of how this will work out for you. I tried therapy for my strained voice, but for me Botox was/is a better solution. Best of luck, Raymond AD/SD and or possible MTD? |
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Posted by: Maria ® 07/07/2008, 06:14:51 |
Hi! You have mainly been using your false vocal cords to produce sound for a while and now that option is gone. Well, it might be quite logic that you are completely without a voice before you re-learn to use your proper vocal cords??!! 60 units sounds like a lot, but maybe that's what is needed to completely paralyze the false vocal cords. So there might be a chance that they know what they are doing... :-). On the other hand, Botox wears off, so the damage shouldn't be permanent if you were given way too much. I do hope you'll be able to get the vocal cords to function properly in time. Maria
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Posted by: silental ® 07/07/2008, 14:14:42 |
Thanks Godfather and Maria. I will definitely post the outcome of my therapy on Wed. And Maria, what you said is exactly what I'm thinking...the loss of my voice is due to the lack of "availability" of the false vocal cords. It just seems that my normal vocal cords should somehow not be totally "unavailable". Maybe I'm wrong. Nothing has changed since the day after the injections. It's been a week of frustration and pessimism. :( |
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Posted by: Sybil Rae ® 07/10/2008, 19:34:53 |
I am very interested in hearing about your progress. I, too, was diagnosed with MTD by two different and reputable doctors. I have been in voice therapy for a year and it's gone from bad to worse. I will be seen at the University of Iowa Hospital on Tuesday, July 15. Dr. Harry Hoffman will determine if he thinks botox would be helpful. Please let me know how you're doing.
Sybil |
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Posted by: silental ® 07/12/2008, 10:37:52 |
Hi Sybil, I saw a speech therapist (who I had worked with unsuccessfully before the Botox) on Wednesday (7/9) and she seemed to be OK with my current breathy, weak voice. She had me do a couple of things that would tell her what's going on. One was to make and hold a "z" sound as long as I could. This was maybe 5 or 6 seconds. Then an "s" (hiss) sound as long as I could. This was much easier and I could do it for close to 30 seconds. She said the reason for the difference is the "z" requires the vocal cords, whereas the "s" does not. So my vocal cords are weak and are not closing properly, therefore allowing more air to escape. I am to go to see the ENT surgeon on Monday. They will likely scope my throat to see how my vocal cords are functioning on a monitor . I have a little more volume now, although mostly breathy and very low pitch to what tone I can produce. There seems to be no "tension" in what volume I do produce. This, at least, is a good thing and a reason for hope. I do have to be careful about swallowing liquids and food. It seems my entire esophagus has been weakened. Even coughing and sneezing has become next to impossible. I don't know what that's about. I'll let you know the results of my appointment on Monday. Good luck to you!!!! Al |
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Posted by: Sybil Rae ® 07/12/2008, 16:29:35 |
Gosh, Al, I'm really scared now. It doesn't sound like you've made much progress. I am at a whisper now. However, I can YELL. I'll look forward to hearing your report on Monday as my appointment is on Tuesday.
Thanks for keeping in touch. Sybil |
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Posted by: silental ® 07/12/2008, 22:10:43 |
Sybil, Sorry. Didn't mean to scare you. Oh, I could also "yell" quite well with the MTD. It was talking in a conversational voice that I could not do without the strained, hoarse sound. I think this is typical of MTD. No, I am not to happy that the Botox didn't make an immediate, dramatic improvement. But that's not really a realistic expectation with its use for MTD, from what I've been told. I agree with a previous post that it did exactly as expected...it weakened my false vocal cords and it will now be up to me and the therapy to "learn" to use my proper vocal cords. At least this is what I'm now prepared for. I will post again after I see the ENT doctor on Monday. Al |
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Posted by: Maria ® 07/13/2008, 06:54:02 |
Hi! Thanks for keeping us updated. 5-6 seconds of voice (z) when finally using your proper vocal cords might be good :-). If they are weak and not closing properly you will probably have to work quite a lot to get them stronger... I think it sounds great if the tension is gone. I think some of the people who overcame different voice problems first worked on reducing the tension and malfunction, then worked on increasing volyme and range. Sounds as if there is hope! Let's see what the ENT says. Maria |
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Posted by: silental ® 07/15/2008, 09:01:27 |
Yesterday, I saw the ENT doctors and they scoped my throat to see what's going on with my vocal cords. The true vocal cords are not closing as they should. The doctor said he knows what is happening but not why. Maybe some of the Botox migrated into the vocal cords from the injections into the false vocal cords??? Maybe there is something neurological that is the cause of my having begun to use the false vocal cords in the first place. In either case, it it very depressing to me. My speech therapist (MS, CCC-SLP) was there during the exam, met with the doctor afterwards, and them met with me to go over some "exercises useful for vocal cord approximation". I'm going to give it my best. The worst case scenario, supposedly, is that the Botox will wear off and I will go back to my MTD voice. :( |
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Posted by: Sybil Rae ® 07/15/2008, 20:22:11 |
Gosh, I'm so sorry to hear that, Al. I know you were hoping for much better results.
I made the 4 hour drive to the University of Iowa ENT clinic today for a re-evaluation. The doctors (there were 6 of them in the room) decided that Botox would not help. I worked for a while with Dr. Ann Fennell who is the therapist I worked with last fall. We did some exercises involving my yawning voice. I was able to make voice if I yawned at the beginning of each statement. They seem to believe that my muscles are functioning, but need to be retrained. They wrote a prescription for voice therapy 3X per week for 6 months. We'll see how that goes. Can you just see me in the fall back in my music classroom, yawning at the beginning of every statement? My students will fall asleep! Doesn't just reading about yawning make you want to yawn! lol Sybil |
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Posted by: The Godfather ® 07/16/2008, 20:30:43 |
One of my many tricks to hide my SD was to start my conversations with a yawn too. For some reason one of the worst times I had trouble speaking was when my wife and I where in the car. Before I even knew what SD was, and before I told my wife I was having a speech problem, I found that if I yawned I could get the sentence out so much easier. I had to laugh to myself because my wife started yawning with me, and would say "I'm so tired too" not even knowing what my problem was.
I'm now finally getting over my laryngitis voice from my 4th Botox injection, and my voice is really getting strong now, and no straining. I'm sorry Botox won't work for you, and to Al, sorry you had such a tough time with your first injection. My first was very tough also,(my dose was way too high) but wanted to stick with it because after the side effects wore off I had a great voice for a few months. Botox is not the perfect fix, but it's better than my strangled, strained voice! Good luck everyone, Raymond AD/SD and or MTD? 8years |
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Posted by: silental ® 07/18/2008, 10:34:40 |
Thanks Raymond. I'm day to day right now with little to no improvement. Still a very breathy whisper like voice. I'm telling my casual contacts I have laryngitis. I'm sure they're going to soon wonder why it's lasting so long. :( |
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Posted by: The Godfather ® 07/18/2008, 15:22:57 |
Al,
I hid my SD for many years. It started as an occasional thing, having more good day's then bad. This went on for a couple of years. I quickly learned tricks to hide it from everyone, because I didn't want to worry my family and I thought it would go away someday. Then as time went on I started having more bad day's and found it to be to much to hide from my wife and close family. Besides, people now started asking what was wrong with my voice. I would just lie and say it was a cold, or allergies. It became very stressful for me and I stopped being myself. I stopped going out to visit friends, stopped going to the local bar, anyplace I would have to talk I would avoid. A big turning point for me was my first Botox injection. While heavily Botoxed, extremely breathy, and just starting the Christmas holiday parties a few years ago, I now had no choice but to tell everyone about my SD. What I never expected was what a huge relief it was to "come out of the closet". At first I actually felt better about telling everyone, than the Botox was at making me speak more easily. Now most of my friends understand, are educated about SD, and I'm back to my old self. (just with a crappy voice at times) So, I know what your going through. Hang in there, your breathyness will go away in time, and a great voice will kick in soon. Botox injections aren't the greatest way to get our voices back, but it helps for the short term. For my lifestyle, speech therapy and surgery aren't for me, so Botox is still my choice. Hope I helped you cope a little, We're all in this together. Keep the faith! Raymond AD/SD |
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Posted by: mdubovick ® 07/20/2008, 23:11:22 |
Although I can't speak specifically to injections in the false chords, I can talk about Botox in general. It is completely normal to have a temporary loss of voice after a Botox shot.
In fact, if there was no loss of voice, it would mean the Botox was not working! This temporary loss of voice should gradually go away over the next week to ten days. That is the average for a Botox shot to the vocal chord muscles. Averages are just that; some take longer, some take less. Only experience will tell; And that assumes the Botox shots to the false chords acts the same as Botox to the vocal chord muscles. It may not be the same. I know a doctor who performs this particular type of injection without general anesthesia in the OR. He does it by numbing your throat and going in with a specially curved needle and scope. He is in Georgia and if you are anywhere nearby or want to travel there, write to me at meldubovick@comcast.net and I'll give you his name and contact information.
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Posted by: silental ® 07/21/2008, 14:42:43 |
Thanks, Mel. Dr. Lee Akst, Director, Section of Laryngology, Loyola Center for Voice and Swallowing Disorders did the injections. He certainly seems qualified, although Botox for MTD is not quite as straight forward as it might be for SD. It's been 3 weeks to the day now with little to no improvement or recovery from the weakened voice I had the day after the injections. I can't vocalize anything but a low breathy growl. I guess time will tell. I'm pretty depressed. |
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