Hello 2016

Posted by Rob H on March 15, 2016

Wow I didn’t realize how long it had been since my last posting. What’s been happening since then?

Let’s see…Donald Trump (??!!!) is about to win the Republican nomination. That’s pretty crazy to put into print.

What else? Well seeing that my last post was in August 2014, I guess 2015 happened! I only had one shot in 2015, it was on July 20. I was able to stretch my Botox injection almost exactly 1 year (from July 21, 2014 to July 20, 2015). My old voice doctor retired, and I got a new doctor who is an industry expert with many studies & speaking arrangements to his credit. I also still have the same “shot guy” I’ve always had. They do the injection as a 3-person team, with a nurse on hand taking down notes to my file while the anethestist does the injection, guided by my voice doctor to ensure it goes in the right spot.

The funny thing was, my shot lasted so long that my doctor joked “see you in a year” when I was leaving. I hope so.

Ok now for some additional details on my last shot: I was really preparing my co-workers for a breathy, weak voice for 2-4 weeks after the shot. That’s what I have typically experienced, and my shot in July 2014 caused quite a long breathy voice period (close to 4 weeks, much longer than previous shots). So what did I do last time? The exact same thing. I figured I can live with 1 month of breathy voice if I can get 11 more months of useful voice after that.

Funny thing is, this time wasn’t the same (even though I got the exact same dosage). That’s the unknown factor when dealing with these Botox treatments. Some are “duds”, some work beautifully, and some are in between. It’s hard to know from time to time exactly what will happen. So this time, in July 2015, I had NO down time on my voice. Ok maybe a couple days where it was “weaker”, yes, but my voice never bottomed out like it has on every other shot. I have no idea why.

Now, as for the length of time I get out of it: that’s still up in the air. I am now 7 1/2 months out from that last treatment, and my voice is definitely weakening. The same thing happened last time, I kept wondering how long I could stretch it out and I think the last time, I went past where I should have but it was still a usable voice so I “lived with it”. I would estimate I had about a 30-40% voice by the time I had my last shot in July 2015.

Right now, my voice is probably about 65%. It’s definitely weaker but not bad yet. So it’s hard to plan my summer as I don’t know how fast the decline will be & when I need to plan my next shot. I hope it’s in July or later but we will see.

End of August 2014 update (with a BUNCH of audio)

Posted by Rob H on August 30, 2014

What a rollercoaster it’s been since my last post. Mostly downs, unfortunately, but hopefully on the up-swing now.

As I type this, on August 30th, I still do not have a full voice back yet. It’s getting better, but still probably only 50% at this point with NO ability to speak up in a loud environment…I might as well not try in those situations.

So listed below are several voice samples taken over the past month, to show the different phases/sounds of my voice as the Botox started to take effect. This first one is taken on my way to the appointment, before the Botox:

Audio #1 – 7/21/14

Audio MP3

(here’s a link for audio #1 in case the player doesn’t work)

This next one was taken right after the appointment. You will hear me talk about this particular shot being more traumatic than normal. I mean, it always sucks having a needle stuck into your throat. But this time was different. As you’ll hear in the recording, the shot made my voice IMMEDIATELY worse which has not happened before.

Audio #2 – also 7/21/14

Audio MP3

(here’s the link for audio #2 in case the player doesn’t work)

Audio #3 – 7/22/14

Audio MP3

(here is the link for audio #3 in case the player doesn’t work)

My voice still sounds pretty good on audio #3, but it’s about to change real soon…………

Audio #4 – 7/23/14

Audio MP3

(here is the link for audio #4 in case the player doesn’t work)

Audio #5 – 7/26/14

Audio MP3

(here is the link for audio #5 in case the player doesn’t work)

As you can hear in audio #5, I was getting a little bit of a cold. This would morph into a major, voice-crippling cold later. I will go into more detail on that in just a bit.

Here’s audio #6 – 8/1/14

Audio MP3

(here is the link for audio #6 in case the player doesn’t work)

As of this audio recording, my voice was “trying” to come back like normal, about 2-3 weeks after the shot. However, I still had this pesky cold wreaking havoc & not allowing my voice to fully come out. We proceed:

Audio #7 – 8/6/14

Audio MP3

(here is the link for audio #7, in case the player doesn’t work)

As you can hear from the voice sample from audio #7 above, my voice is continuing to TRY to come back as it started to do in the previous recording. However, it’s very erratic and in some ways, more frustrating to have it this way than to have a “weak but consistent” voice. This is because it’s difficult to modulate my tone when speaking to somebody, particularly at work or on the phone. I find that as my voice cracks in & out, the actual volume goes up & down too (which is normal)…and it makes it hard to put together long conversations with somebody.

Audio #8 – 8/14/14

Audio MP3

(here is the link for audio #8, in case the player doesn’t work)

You can probably hear in my voice at the beginning of audio #8, I have become frustrated at this point with the lack of results. At the time of this recording, it had been over 3 weeks since the Botox injection and I really didn’t anticipate it taking this long.

Audio #9 – 8/22/14

Audio MP3

(here is the link for the audio of #9, in case the player doesn’t work)

By this point, it’s been fully 1 month since the Botox injection, and still my voice is not back. It certainly sounds better than the previous recording, but still you can hear at the end my voice goes back out again. In all my previous Botox treatments, my voice was back to full force by a month later so this was very unexpected.

You hear me speculate in the recording about the correlation between the Botox injections and getting a cold. It has happened quite frequently and I don’t know why that is. It’s something I am going to bring up to my doctor and see what he thinks but the last two times I have gotten shots (December 2013 and July 2014), I have gotten bad colds…not just the little colds you get every now & then but full-blown bad colds. And in between shots, I get a bunch of mini-colds. I remember talking about it in a previous post last year sometime, it seems I get more frequent colds but none are bad, just a bunch of minor colds. Well, I guess I jinxed myself.

Audio #10 – 8/30/14

(This one was taken just now, while typing this blog post)!!

Audio MP3

(here is the link for audio#10, in case the player doesn’t work)

That’s all I have for now, but you can see a definite progression, albeit slow…I still have not gotten back to what I would consider a “good voice” and have even begun to wonder if this treatment was a “dud”. Only time will tell.

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.

December 17 update – Post Botox (with audio)

Posted by Rob H on December 17, 2013

Lots of updates since my last post.

November 25


I was scheduled for my next Botox shot on November 25. Actually, let me back up just a minute. My last shot was back on May 20 and it was for a dosage of 1.5 bilaterally. This was a reduction from the previous times, which were 2.0. So my results from the lower 1.5 dosage were that I never reached what I consider an “excellent” voice (like I did with the 2.0 dosage)…but I did get to a “good” voice that has lasted just as long as the 2.0 dosage. November 25 would have been over 6 months since the previous shot at the 1.5 dosage, so I can’t complain about the results.

For some reason, the period of time I had a weak voice was LONGER even though I had a smaller dosage. It lasted about 4 weeks. You can hear a voice sample on a previous post that was 3 weeks out, if you click here. But I did not have much of the swallowing difficulty so that part was good.

Ok now back to November 25, I went in for the appointment and went through the normal pre-shot ritual with the doctor – he asked me questions pertaining to how my experience was with the latest shot. “How would you rate your voice at its peak?” and “What kind of side effects have you had?” and “When did you reach baseline?” That last question always makes me wonder how long I could really go. Because I have NEVER reached baseline since I started receiving the Botox injections. I can still function with the voice I have, even 6-7 months out. I hope I’m one of the people that can continue to stretch out my benefit period longer & longer…I’ve heard of that happening and if that’s the case, maybe I can get it to 12 months or longer between shots. We will see.

So after the doctor asked these questions, we decided to try the 1.5 dosage again. My first thought was to go down another notch, with the thinking that the “weak voice” period would be reduced. However after a discussion, the decision was made to stick with the 1.5 again to see if the same thing happens, or if my experience was just a “blip” on the screen. That sounded reasonable to me. Just as they were about to start the procedure, I mentioned that I was dealing with a cold and suddenly the doctor stopped in his tracks and said that in his opinion, we should wait until next month. I had heard a cold can effect the treatment and this seemed to confirm it. So I walked out and we re-set the appointment for December 16.

December 16

I did finally go through with the appointment yesterday, December 16. That marked nearly 7 months since my May 20 shot and my voice was still usable and not too bad at that point.

Below is a voice sample from December 9, you can hear how it sounds and you will see what I mean about my voice still being usable and pretty good:

Audio MP3

The conversation in the doctor’s office yesterday December 16 was pretty similar, he went over the questions again and of course there was no change in the answers…but due to the fact that my voice was still the same and we were even FARTHER out than last month, he agreed that maybe it’s a good idea to reduce the dosage to 1.25 this time and see what happens. Really it’s all trial and error until we find the right dosage for me, everybody is different. What we’re trying to find is a “sweet spot”, a dosage that allows for a good to excellent voice, for as long as possible, with as little side effects as possible. If we can achieve that, we’re happy. I would gladly give up the “excellent” range for my voice and trade that for a “good” voice for a long time with no side effects.

So that’s what we’re striving for. For today, December 17, I recorded another voice sample. It sounds pretty similar to the last one. We’ll see how this one goes, as I continue to update this blog.

Audio MP3

July update – Jobless (voice samples with audio)

Posted by Rob H on July 26, 2013

So as you can see from the title, I am now jobless! After working for a large real estate title company (Old Republic) for over 5 years, suddenly it’s over. Their business is massively down due to the slowdown in refinancing but I never expected to be out this soon. I did know the writing was on the wall and they did a massive layoff just last month which I was safe from…but this 2nd round got me.

I was a supervisor and was the most senior supervisor there…which leads me to believe I was a victim of “making too much money”…even though I didn’t make that much in reality. The other possibility is that my boss didn’t care for me. My wife has told me she thinks he is threatened by me as I constantly give good feedback to not only him but other supervisors, as well as lower-level workers. I never did trust my boss, always felt uneasy and now my instincts are confirmed. Any good company knows that they need to keep their good employees and if there are layoffs, they should find other positions for those employees. Instead, this company (specifically this boss) cuts back based purely on numbers with no regard to the actual makeup/skill level of the remaining employees. I felt this way during the last layoff and I certainly feel that way now that I am a part of it. I already received countless phone calls, texts, emails, etc telling me they couldn’t believe the company wouldn’t reassign me to another department, at least.

So that’s all for my venting. It’s still fresh so I could go on & on & on but I won’t. I am now strategizing about my next chapter and you never know, this could be the best thing that ever happened to me. I am approaching it that way.

As for my voice, of course this complicates things. I’m at a point where the Botox effects are starting to fade a little bit. I have started experiencing more headaches and muscle strain in my neck area. For job interviews, I should be fine (although I haven’t been on an interview in over 5 years!). I have interviewed many candidates in my former position but have not been the actual interviewee in a long time. So I am hoping my voice holds out for awhile longer. Of course, there’s the thought in the back of my mind, if I get hired by somebody then have to go get a Botox injection within the first month of employment (a probable scenario)…I’ll have to go through the entire explaining process again to a new group of people. Also I will worry that it will affect my ability to perform my job. Of course, these are the fears of anybody that has spasmodic dysphonia or muscle tension dysphonia.

So I did record a couple voice samples since my last blog post. Take a listen below.

This is from July 14:

Audio MP3

Edit: The audio player seems to be having issues. If you can’t hear the audio, here is the link to it:
July 14

This is from today, July 26:

Audio MP3

Edit: The audio player seems to be having issues. If you can’t hear the audio, here is the link to it:
July 26

It doesn’t sound too bad (yet) and I am hoping the Botox effects wear off super slow because as you can see, I have a lot of stress back in my life and dealing with a bad voice is not something I want to add to it.

On a brighter note, I have cranked up some side real estate investing and should be making a little extra money soon. Nothing huge but I’m hoping it’s the start of something huge. We will see.

Still uncertain – nearly 3 weeks post-Botox (with audio)

Posted by Rob H on June 10, 2013

On my last post, I mentioned that I had a nasty cold that was somewhat concealing my true voice…normally when I have a cold, my voice is much lower and this was a really bad cold…my voice was in a lower range for a good 5 or 6 days. Just yesterday and today, I finally started noticing my lower voice going away as my cold finally began to subside.

As the lower voice went away, however, I started to get more of the Botox-sounding voice back. So apparently, the post-Botox side effects of a weaker voice is still hanging around. Tomorrow will mark the 3-week mark since the injection and I was really expecting my voice to be normal by now. Especially considering the fact that I had a lower dosage this time, I thought it would mean my “regular” voice should come back sooner. Not so, I guess.

Below is a voice sample from a few days ago, Wed June 4…I still had my cold during this recording, so my voice is working pretty well and you can hear me speculate whether it’s the Botox or the cold that is causing the good voice.

Audio MP3
.
**Edit: If the audio isn’t loading properly, click on the link here to hear the recording.
…and below is another voice sample from yesterday, June 8. My cold on this day was going away at this point and you can hear my voice is in & out quite a bit.

Audio MP3

**Edit: If the audio isn’t loading properly, click on the link here to hear the recording.

I don’t have a recording for today, but it’s similar to yesterday’s recording. In & out quite a bit, no consistency in my voice.

I have heard from others who have taken Botox shots for SD, that the doctors don’t like to give Botox shots while you’re under the influence of a cold or flu. The reasoning I have heard is that the Botox MAY not be as effective. I don’t know why, but I have heard this more than once. So I don’t know if my cold has short-circuited my latest Botox shot but only time will tell.

I’ll have more updates soon, hopefully I’ll be able to post an update that my voice is back to normal very soon!

June 3 update, 2 weeks post-Botox

Posted by Rob H on June 3, 2013

Over the past couple of days, I THINK I have noticed an improvement in my voice. It’s been exactly 2 weeks since my Botox shot, and I was hoping with the lower dosage the breathy period would wear off quicker. At the time of my last post, my voice was bad about 95% of the time…typically the first word or the first couple of words of a sentence came out normal then the rest of the sentence and the rest of the paragraphs following that were in a weak voice. Saturday 6/1 I noticed in the first half of the day, I was getting more like 30% of the time with a decent voice, then fading to a weak voice again. But I was able to get more words out before reverting back to the weak voice.

Also Saturday, I noticed the beginnings of a cold. I have written many times in the past posts, that I seem to get more frequent, but not severe, colds. I’m not sure if the cold had anything to do with the “bump” in good voice or not. I think it’s entirely possible, as many fellow SDers I have talked to online have experienced the same thing…the voice gets better with a cold.

I still have had a limited vocal range and absolutely no singing voice…I tried to sing happy birthday and it was terrible, even for me.

Fast forward to Sunday 6/2 and I had a full-blown cold and a mild fever. I didn’t do much the entire day as I felt like crap. My voice didn’t improve any; in fact I would say it took a step back to about 20% “on” instead of the 30% the previous day. The main revelation for me though is that this was my first severe cold since getting my spasmodic dysphonia. My first full-on, bad cold in over a year and a half. That was a bit of a shocking observation for me, as I get at least one or two a year. Living in northeast Ohio almost guarantees it with the wild swings in weather in the spring and fall (and sometimes winter). I would bet this string of 1 ½ years without a major cold is some kind of record for me.

So now today 6/3, my cold has continued and my voice has bounced back to a better level. I estimate 40-50% of the time, my voice whas been good. What’s interesting is, when my voice goes out, it stays out for the remainder of that paragraph, no matter how long. If I were reading a novel, the first paragraph might start out normal, then my voice would be out for the rest of the day. But if I stop my conversation and start again a minute or two later, everything resets and my voice starts normal again then goes out again.

It’s all a part of the frustration in dealing with this disorder. Fortunately for me, I am not experiencing side effects this time, notably no difficulty swallowing. I have choked on liquids from time to time but it’s not often and it’s nothing I can’t handle.

More decline in voice…(with audio)

Posted by Rob H on May 31, 2013

Over the last 2 days, my voice has really changed for the worse. In fact, yesterday was one of the more frustrating days I can recall in quite awhile. Here’s what is happening:

  • Continued decline in voice
  • Increased breathiness
  • Slight headache

Continued decline in voice

The continued decline in voice is to be expected. From my experience with my first two shots, I know that there is a definite decline period before I begin to experience the benefit period. What’s been inconsistent is the timing and length of the decline period.

The first shot, the decline started just a couple days afterwards, was gradual and bottomed out almost exactly at the 2 week mark then rebounded gradually. It was easy to notice the decline and then the recovery on a daily basis. On the second shot, the decline was more in “chunks” and lasted longer – closer to 3-4 weeks. And the recovery was much different, there was no straight-line day-by-day improvement like I experienced the first time. It was more in chunks.

This time, on my May 20 shot, I had a period of about a week before any kind of drastic changes (which led me to wonder whether it was going to “take”). But lo and behold, it took all right.

Increased breathiness

This is something that has just happened over the last two days. It could just be my perception but it seems I am breathier than I was the first two times. In other words, my voice is a whisper and I seem to run out of breath easier. I think I have mentioned before that it’s almost like I switched from having Adductor SD to having Abductor SD. Those of you with this condition know what those terms mean, if you don’t know you can google them and find out.

There were even a few times today where I was talking and actually RAN OUT of voice…which I don’t recall happening the previous two times. It only happened twice today but it’s two times more than I had previously.

Here’s a voice sample, and you’ll hear right off the bat my voice is fairly normal but just for a few words, then my voice goes out and stays out for the remainder of the voice sample.

Audio MP3

Slight headache

My first instinct is that this is unrelated but I’ll continue to monitor the headache I’ve had the last two days. The only reason I have a concern is that it coincides with the sudden decline in voice and I have had “stress” headaches in the past from my neck muscles being fatigued. It’s possible the other muscles are being recruited to make up for the paralyzation of the Botox-injected muscles, and this extra “help’ is what’s causing the headaches. We will see. I have been able to control it with some regular Tylenol so it’s not a huge deal but something I will watch.

May 28 update (with audio)

Posted by Rob H on May 28, 2013

Voice finally changing

 

It’s taken awhile but the first real changes in my voice changing came over the weekend. I first started noticing a weakening of my voice on Thursday May 23 (3 days after the Botox shot), and it happened late in the day as I was unable to project my voice over a loud environment. Throughout the day, I had a fairly normal voice and even in the evening when I noticed the voice weakening, it still sounded normal – it just went a little “softer” randomly.

Pretty much the same thing happened the next day (Friday May 24) but on Saturday May 25, I noticed that my voice was weak throughout the day. I also lost a lot of my vocal range. I started to only be able to use my voice in a certain “middle range” – my higher voice was gone and my lower voice was gone. So I felt like I had sort of a monotonous voice. I could do some limited voice inflections but not my full range. And along with this limited range, my volume was only about 50% of normal. Despite this, I was able to attend a family function with no issues, I did have to repeat things a few times but it wasn’t bad.

Sunday May 26 was more of the same, with the weak voice and limited vocal range. Yesterday, May 27 (Memorial Day) – I experienced a very different kind of voice change. I started getting the “teenager” or “Peter Brady” voice, as I like to call it…where my voice is normal then it breaks…then normal then breaks…it’s a little more frustrating to have this voice because I don’t know when the breaks are coming. The only consistency I can find is that my first few words come out normal, then my voice breaks and “goes out” for the rest of that sentence/paragraph. Even today, I had the same voice. So we will see how this continues to develop. I’ll have a voice sample posted soon, I took a recording May 27 which I’ll have to get uploaded.

**update** here’s the voice sample from May 27:

Audio MP3

Side effects

As you may recall from my last post, I only had 1.5 units injected this time instead of 2.0 units which is what I had the first two times. We (the doctor and I) decided to do this to try to minimize the side effects. So far, it’s worked to near perfection. I have not had anything to complain about so far. I have had a couple isolated choking incidents, but it’s not a daily occurence. My sneezes over the last couple of days have gone into the “weird” sound I’ve come to expect with the paralyzation of my throat muscles. No big deal to me. The main thing I’m happy about (so far) is that I don’t have the swallowing difficulty. That to me is the worst side effect. I will have more updates in the coming days but wanted to get an update

May 22 update – 2 days post-Botox – with audio (2 samples)

Posted by Rob H on May 23, 2013

May 20 update

Well I went ahead and had my 3rd Botox shot done on Monday May 22, 2013. I put off the appointment a couple times (Cleveland Clinic does once a month)…and I actually could have put it off yet again, really my voice wasn’t bad. I did feel some tightening in my throat muscles, and my voice occasionally would fade out (but no spasms still)…so there was definitely a noticeable decline but only noticeable to ME. I realized that even though I noticed it, nobody around me noticed it. This key point was driven home by one of my employees, who has worked for me for 3 months now. I told my team that I was leaving early Monday for the shot, and most of them already knew about my voice condition so they knew what I was talking about. The newer employee didn’t know about it and asked, “what shot?” and so I explained it to her…she said she never would have guessed I had a voice problem. That made me feel GREAT!

So here below is a voice sample from earlier in the day Monday, May 22 (before my Botox injection). You can hear a slight decline in voice quality but still it’s nothing that’s going to affect my everyday life.

Audio MP3

May 22 update

So far today, I have not noticed much (if any) difference in my voice. I guess I would say it’s slightly softer, not quite as strong, but still no problems with projecting and being heard.

I did notice last night as I was drinking some water, I had my first 2 episodes of the “choking” that normally happens with the Botox. I had my head leaned back in a very relaxed position, and took a sip of water, and a little bit went down the wrong pipe. I didn’t think it was related to the Botox at first but changed my mind because it happened again a few minutes later. So I sat up a little straighter and had no more problems.

If that’s all the worse the symptoms get, I’ll be a VERY happy camper. I’m not expecting that, though. And in fact, if my voice doesn’t change and I don’t have any symptoms, I’ll probably begin to worry that the shot didn’t take.

A side note about this last shot

The first two times, I had 2 units bi-laterally. With the swallowing problems I had after the second shot, I talked to my doctor and he agreed that we should try a lower dosage this time to see if that minimizes the side effects. Of course, the benefit period is so outstanding, it’s almost worth the trade-off. If I could get the same side effects from my 1st shot, I would be fine. But the side effects from the second shot are what have me a little apprehensive. And it’s all a trial and error game anyway…trying to figure out the “sweet spot” and see what’s the perfect dose.

So without further adieu, here is the sample from this evening:

Audio MP3