Getting a smaller shot also presents problems, because with the lower dose he does not get as good an improvement with his voice. He also has to get the shot more often which means more time spent recovering from the treatment.....a vicious cycle.

Has anyone found ways of reducing some or all of these side effects?

I made some suggestions from my personal experience regarding this 'lose/lose' vicious cycle your refer to in a recent post - here is the link to it:

http://www.dystonia-bb.org/forums/sd/posts/11328.html

Best wishes

My consultant, who has a botox clinic every 2 weeks and has done for the past 7 years so has dealt with a lot of patients during this time, says that my reaction is unusual and I must be very sensitive to the botox. I too have been through a phase of reducing the dosage to try to reduce the side effects but like your husband, at a very low dose I got less breathiness and slightly less fatigue but very little good voice either.

I haven't taken the plunge and started to experiment with unilateral injections but am considering giving this a try next year. However given that it seems to work best when the dosage is increased but put into one chord, then I think there is a good chance that it won't help the fatigue at all.

Judy

AD/SD England