First, I asked my doctor for a tongue depressor crosswise to bite on during his injections, reducing the need to swallow. Thanks so much for the suggestion from whomever postedf it (sorry, I forgot who!). The doc thought it was a great idea. It worked surprisingly well, with no urge to swallow, and the doc said he will offer it to other patients in the future. Such a great little tip!!! Thanks, thanks!

I also wanted to share my experience with others regarding the doctor's eval of AB vs. Mixed. I found it very interesting: Rather than just injecting for AD, he did a temporary nerve block with Lidocaine in the muscle he would normally inject for SD. Then he did a couple of different scopes/video tapes of the chords and how they were functioning. From the temporary paralysis, we could see that I did, indeed, show I would benefit from an AD injection.

Since beginning laryngeal AB Botox injections a year ago, I've gradually gotten much better. I was actually got worse in the beginning and that was discouraging. But it turned out I needed 3 units in each chord, rather than the one unit that was initially used and gradually increased.

However, my voice quality is still not as good as the doc and vocal therapist think I could be... and I still have some trouble with "H"s, etc. As soon as he did the trial injection, it took much less effort to speak "normally".

So, I go back tomorrow morining for the AD injection, which will initially focus on paralyzing one chord, with Botox still in the muscles for AB. I thought it was fantastic that the doctor was able to simulate the Botox effect temporarily with Lidocaine, and then scope and make a decision on what he and the vocal therapist saw and heard on scopes. (Has anyone else with possible mixed symptoms been given this test option?)