Here's my story

My take on this is that what you have experienced is not uncommon. The botox injections can be very variable, both between patients and within an individual patient's experience. On the bulletin board, we have experience with both unilateral and bilateral injections - there is no consensus that one method is better than the other generally, but with individual patients it does make a difference. In my case, I prefer unilateral because I experience less breathiness after the injection than I do with bilateral shots.

The first injection can wear off quite quickly (faster than subsequent ones) and I'd also speculate that your dose, first time, was too low - although the right dose is only arrived at after a series of injections over time.

With your third injection, it sounds like it is probably working as it should. Your voice should improve over the next few weeks.

Make sure you ask and keep a record of the dose given each time - it's important that you work with your doctor at arriving at the best treatment pattern.

Good luck, and let us know how you get on.

I've been getting injections for a little over 2 yrs. now and as David says, it takes a while to stabilize on the proper dosage for the patient. I now have 2.5 units injected unilaterally. I had 2.5 in each side a couple of times but the breathy stage was extended and aspirating liquids was a much greater problem. I also remember not being able to cough productively. I was beginning to believe that the side effects of the chords going essentially flacid was at least as bad as the strangled voice. I now have the unilateral injections. Unfortunately the injection I had in early December did absolutely nothing...zip...nada. I think he actually missed my vocal chord. But what can a guy expect for a mere $1200?

Maybe the missed botox shot could explain the swollen ankles? Private joke folks!!

You may be on to something there. If a guy could target that swelling sort of like a smart bomb....hmmmm.