Mine doesn't change the pitch of my voice. But it does have a distinct rhythm to it. It chops my voice into predictable, rhythmic breaks. Like A/A/A/A/A/A/A/A. Being breathy, it almost sounds like hey/hey/hey/hey. Like a tremolo effect, instead of vibrato. The speed is medium, and doesn't change much if I go high or low. Whispering and falsetto don't have any tremor. According to my ENT, she thinks it comes from my over-compensating false cords.

--fancynancy--

AB SD/MTD?/tremor with a beat (lol), central CA

The second ENT I saw after I developed SD last year thought that I was overcompensating with the false vocal cords because I'd had laryngitis. After sending me to speech therapy without improvement, he decided I had ABSD.

Very interesting that you and I may have the same kind of tremor, and both thought to be by overcompensation. Did you ever have a Scope done on your cords? If so, what did it look like? Mine were hardly visible, as the false cords were nearly covering them.

Also, have you tried Botox?

I haven't tried Botox. Have you? I guess I haven't been too encouraged by the prognosis for ABSD with tremor. I also would have to travel at least 150 miles (to the Chicago area) for the injections.

You may want to try Botox, if you can see Dr. Bastian in Chicago or someone equally skilled. He has some excellent techniques for injecting AB patients. He is so caring, skilled and current that, in my humble opinion, it might be worth a couple or three tries. Depends on if your voice is semi-functional or not.

I know several patients who go cross-country for their shots so it depends on what your vocal goals are. Don't do it before your SS-Diability case is approved though! You want to sound your purest worst for those folks!

Seems like alot of us are dealing with what you and -fancynancy- have described. And Marianne yesterday. Even with a severe case of AD, I have much more in common, lately, with AB patients (paralyzed, atrophied cord with false cords overlaying true cords and humoungous gap between cords, thus dramatically affecting breathing) than with untreated AD patients.

This is all excellent information to share. Too bad we can't all get in a room and check out the visual results of our scopes. Bet we'd all get an education out of that!

I see Dr. Bastian in Chicago, too, and he is very very good. Very nice, considerate and from what I hear of his reputation, a very knowledgable & leading member of the SD community. He's through Loyola University Hospital which also has a good reputation.

But I'm wondering what the false cords vs. true cords are and how one might overcompensate with the false. I'm an ADSD, and pre-Botox (which I've found very helpful) I talked a little deeper in my throat, or the sound came out deeper and more strangled. I'm not sure if the change is due to Botox or being more comfortable or what, but I feel like I am producing sound from a different and better area now - higher up. My voice actually cracks in a high pitch tenor (like in puberty) now especially after the injection for a couple weeks. Does this sound like any difference in what cords I'm using?

Bill

Glad to see you affirming Dr. Bastian's skill and reputation, as one of his patients. He is positive model, as a physician with scientic background and connecting with patients. I met him five years ago and was impressed. We talked in Michigan at an SD-symposium last year, and I was even more impressed.

In Miami, Dr. Mark Stacy (of the National Parkinsons Foundation in Phoenix) spoke about "partnerships" and communication between patients and doctors. Seems this is what Bastian has done so well for years. As patients, trying to educate ourselves and our doctors, this concept is a powerful one and will work when we find the right partners. We need to keep up the effort to locate, and work with, such medical practitioners. Doctors who remember what it is to be human.

On the issue of false v. true cords and trying to figure out what it all means. My theory is that some of this is old terminology. We're still being confused by old terms. Just like, prior to 1989, our disorder was called *Spastic Dysphonia* and years before that, it was called *Hysterical Dysphonia.* None of that particular terminology is descriptive. Frankly, it's negative. Thus, it has been upgraded over time to be more medically-descriptive, thus more positive.

The term "Spastic Dysphonia" went out of vogue over a decade ago, when the newly formed volunteer organization (which became the NSDA) decided that we didn't want to be "spastics" anymore. Or, "hysterical," for that matter. Some of us prefer the term, *Laryngeal Dystonia,* but I'll work with whatever term where I can get attention, from the public and the medical-community, for my disorder.

Re false and true cords and "folds" and all of the laryngeal anatomy, this is good to have a discussion on this BB as we patients deal with this terminology every time we go into a doc's office and get a scope. All the doc's speak different languages (terminology), based on when and where they were trained.

Frankly, I don't understand the difference between folds and cords (after 12 years of research). That's probably old terminology also. However, with viewing alot of recent pictures of my own laryngeal anatomy, I think the false cords are laryngeal muscles. Not sure which one yet though. It's not the PCA. Could be the TA. Not sure. I have all these pictures of *laryngeal anatomy* in front of me and can't quite figure it out. Wish I had some currently-trained otolaryngologist sitting here with me, figuring the whole thing out.

This brings up a point. In 30 years as a computer professional, things would completely change in the industry, about every three to five years. Thus, we always had a *Translation-Table* so that the computer programs would be able to figure out how things had changed. IOW, if it was this way four years ago, now it's changed to this way, so the software didn't need changing. The software would just pick up the current info on a table (like an index).

Seems like we need something like this for our "laryngeal terminology" also. Medical science has advanced so much, so quickly recently that terminology IS changing (for the better) and we need to know what our docs are talking about when they refer to our cases and dealing with those scopes. I hope we continue to discuss this on the BB. It would help all of us communicate with our doctors and each other.

Thanks for the links - I started looking at many of the related articles for Spasmodic Dysphonia on the Pubmed or Medline site. Very informative. Sound like you are a doctor or studying to be one, cause some of the text you wrote sure confuses the heck out of me.

One other thought - seeing & reading the sheer number of articles doctors are writing about SD research is amazing. I have never felt more admiration for doctors than right now. The commitment to that intense level of analysis is awesome. And since this is the holiday season, I'd like to thank al the dctors out there whoare making such amazing advances in SD.

Because really I am one of the fortunate ones who has SD but who was diagnosed relatively soon and who has good results from Botox injections. So thank you doctors, this BB, and everyone for continual sources of information and support.

Very interesting. Since I'm just a lay-person, trying to figure out what is going on (or has been going on over the years I've developed SD and then had surgery to finally talk again), thanks for this scientific information from a vocal professional.

Rather complicated...but makes sense.

I believe we SD'ers have much to learn from people, such as yourself. Twelve years ago when I got SD, I would have never thought that I would be fascinated by issues of the laryngeal anatomy and how our voices really work and sound. I thought I majored in History. Ha-ha!

Thanks. Great info.