What Can I Expect After My Botox® Injection?

ADDUCTOR VS. ABDUCTOR SPASMODIC DYSPHONIA
Spasmodic dysphonia is a rare neurological voice disorder caused by involuntary spasms of the muscles controlling the vocal folds.

With adductor spasmodic dysphonia (ADSD), the vocal folds involuntarily close too tightly and can begin to spasm when you�re speaking. Your voice may sound either strained, choked, interrupted, or all of the above, especially with words beginning with vowels (a, e, i, o, u).

With abductor spasmodic dysphonia (ABSD), the vocal folds involuntarily move apart when you�re speaking. Your voice may be interrupted with air as you are trying to speak, especially with unvoiced sounds (h, p, t, k, s, sh).

Some people have mixed spasmodic dysphonia; sometimes the vocals folds involuntarily spasm when closed and sometimes when open.

BOTULINUM TOXIN (BOTOX®) INJECTIONS
BOTOX® injections provide many SD patients with the freedom to speak more easily. While not a cure, most patients notice a marked improvement in voice quality and speaking effort. The benefits of BOTOX®, which usually last from three to six months, are doubled with Speech Therapy sessions.

NO TWO INJECTIONS YIELD THE SAME RESULTS
Even though the technique and dosage are the same each time, results can vary. This can be due to many reasons, including small, unavoidable differences in placement of the medication in the very tiny vocal fold muscle.

Results always vary among SD patients, because of individual differences in sensitivity to the medication. Some patients experience smooth voices for longer periods of time than other patients, while others may develop recurrent spasms, breathiness or hoarseness. It is difficult to predict exact results in each patient.

FIRST PHASE: �TOO MUCH, TOO LITTLE, OR JUST RIGHT?�
Go on voice rest for the first 24 hours after the injection. Your first injection is always a �Mama Bear� dose to gauge how your body reacts to the medicine. You can expect to have immediate relief from spasms. If spasms continue, the dosage might have been too small and will be adjusted for your next injection. Your voice may sound breathy (but free from spasms) from one to eight weeks, and you may have to take more breaths, and have difficulty projecting over background noise. If the breathiness continues for several weeks, then the dosage might have been too large and will be adjusted for your next injection. Some people experience more hoarseness than breathiness for the first few days after an injection.

Before you leave the office Jeremy Hathway, our Speech-Language Pathologist, can show you how to easily swallow liquids to prevent a choking sensation, which can happen from 24 to 48 hours after the procedure.

Margarita Rodriguez, our Clinical Director, will call you a few days after your injection, to hear your voice and answer any questions you will have.

SECOND PHASE: �WOW! I CAN TALK!�
For the next three to six months (or more), your voice will sound and seem normal. Talking will be full of freedom and fun. You might even forget you have SD during this time. When you continue your speech therapy during this phase, the effects of the Botox® will last twice as long than without therapy.

THIRD PHASE: �OOPS! WAS THAT A SPASM I JUST FELT?�
As the Botox® effectiveness begins to diminish, a few spasms will occur. As they become more noticeable, call to schedule another appointment. You don�t want to wait until you begin to struggle to speak again.

YOUR VOICE IS IMPORTANT TO US!
Call us at (713) 796-2181 or for free long distance (888-733-0368) to let us answer your questions, or help you in any way we can.

Smith Tower Office
6550 Fannin Street
Suite 1723
Houston, Texas 77030
713-796-2181
Fax: 713-796-2349