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April 2014 update

Posted by Rob H on April 5, 2014

I just realized I haven’t updated this blog in awhile! I’ve been doing ok, I did start a new job in late February so I’ve been there a little over a month now and I do enjoy the work. Best of all, it’s a job where speaking isn’t absolutely necessary so if my voice does get bad again, it shouldn’t affect my job. The downside is, it’s just a job and not a real advancement in my career. There are possibilities for advancement though, so that’s at least out there as a possibility.

As far as my voice, I have had some less-than-average results so far from this latest round of Botox. I had it done in December so we’re coming up on 4 months, and really my voice never got to what I would consider great…I would say at its best, I’ve been about 70-75% of what used to be my “normal” voice.

A couple factors are influencing this: A lower dosage, and multiple colds.
As I mentioned in a previous blog post, I had a lower dosage of Botox this last time. We are still trying to find the “sweet spot” dosage: the longest benefit period with the lowest side effects.

I will say, the side effects this time have been very minor. I didn’t really have much of the choking on liquids, which is the main side effect…but my voice weakness still was there. In fact, I went on a vacation in mid-January and at the same time, got a fairly severe cold…and for about 4-5 days, I had practically no voice at all. I certainly could not be heard in any sort of loud environment.

The cold, I think, had an effect on the Botox effectiveness. I have previously had this confirmed by my doctors, they theorize that having a cold can limit some of the Botox benefits. In fact, my original November 2013 Botox shot was pushed back to December for this very reason (I had a cold in November).

A couple further observations: I have had a couple “minor” colds over the past couple months, since that major January cold. Every time, my voice weakens but not to the point where I can’t talk or be heard. Every once in awhile, I have to repeat myself but I can still effectively communicate with no problems. Sometimes I can even tell a cold is coming on before I have any real symptoms…just by my voice weakening. Usually I can take some echinacea which works pretty well for me, and head it off before it gets severe.

Another observation is that I have had stretches where my neck muscles are strained. One such stretch was about 2 weeks ago, it lasted about a week and it almost feels like the Botox is leveling down a notch. Instead of gradually wearing off, it’s almost like it goes in stages. I get the muscle strain in my neck, my voice gets a notch weaker (maybe 5-10%)…then levels out again for several more weeks. I have experienced this with previous Botox treatments as well, it’s just that this time I NOTICED it…really I hadn’t given it much thought until now.

I also hadn’t given thought to the actual muscle strain until recently. I have assumed all along that the muscle strain IS the thing that’s causing my voice problems (muscle strain —> tightens the muscles —> strangles the voice). Now, however, I’m wondering if there are two separate things going on. Because the muscle strain is more typical of MTD, I believe. So I’m beginning to wonder if I have both SD and MTD. I’ll talk to my doctor and see what he thinks.

I do need to get clarification on this because I’ve been researching/considering surgery to fix my condition. What I don’t want to happen is to have the surgery, my voice gets fixed, but I still have neck strain. The neck muscle strain in and of itself is something I don’t want to live with for the rest of my life. This muscle strain causes pretty intense headaches and it’s just not pleasant. I would hope a surgery would take care of both the voice problem AND the neck muscle strain. So I’m doing more research on this subject.

That’s all for now, I’ll have voice samples soon but for now, if you heard a recording you would consider my voice pretty normal.

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