I'm sure there are variations on the procedure, but here's how mine works. I've had 26 injections. My doctor is only 20 miles away, so I drive myself in and back home. The doctor first gives me a deading shot in the front of my neck where the botox needle will go in. That's the only thing that has a touch of pain, but not much. I wait about 10 minutes for the deadening to take effect, then sit in a chair like a dentist's chair. He sprays some novacaine-type stuff down my throat and into my nose (yum, tastes like peppermint), then inserts the laryngoscope (sp?) down one nostril. Doesn't hurt. It's a narrow tube with a video camera at the end, and when he doesn't block my view, I can see my vocal cords on the video screen. Sometimes he has me say eeeeeeeeeee so he can pinpoint where to place the shot. I breathe normally for him to give the botox shot (doesn't hurt), but I've learned to breathe in such a way to keep my vocal cords open and mobile for long enough for him to place the shot where he wants it. The trick is to inhale slowly so the cords don't move for several seconds. Then exhale, and inhale slowly again if he needs a second chance. I can tell when he actually gives the shot, but it isn't pain. The only sensation is an urge to cough, but he's usually through by that time. The actual shot takes about five or six seconds. The first time he had me sit around in the waiting room for an hour to be sure I wouldn't pass out or something, but now I just grab my keys and go home.

We had a discussion on the bb a while back about whether we should talk or not talk immediately after the shot, and doctors seem to vary in their instructions. Mine says not to talk the rest of the day, but I've talked a time or two and it didn't hurt anything.

The only pain involved is that I'm not supposed to eat that morning, and by that time I'm starving. I can't stop at a drive-in for a sandwich because I can't talk to order, and I have to wait till I get home to eat! That hurts!

Oh yes--my doctor has me take a steroid pill the night before, the morning of the shot, and one later that day. Cuts down on the swelling. The next morning when I start talking, my voice is perfect--no spasms, no hesitations. For two or three days it's that way, then when the pills start wearing off, the breathy stage starts. My breathy voice is soft and whispery, but I can be easily heard. For me, this stage lasts a couple of weeks, then it's smooth sailing for several months. I have a shot about every four months.

Hope this helps. Keep us informed about your progress.

BTW, I just spent Christmas in Anchorage with my son. You live in a beautiful state.

I had my first injection about 3 weeks ago. My doctor anestisized (sp?)my thoat with a shot, waited a few minutes, then put some sort of electrodes on my throat to pinpoint the exact spots for the injection. He injected both sides with a "moderate" or "baseline" dose (2.5 units). I felt the flow of the botox into my cords, but I wouldn't call it pain. It happened very quickly.

He had me stay for 10 minutes to make sure I didn't have a bad reaction. Within that 10 minutes I became naseaous and felt faint. They placed a cool towel on my brow and within 10 minutes it passed. I went to my car and drove home.

I am still very breathy - which I think means the baseline dose was too high for me. But I went back to my normal routine immediately, including facilitating a 3 day seminar out of town (with the help of a voice amplifier).

I am hopeful that a normal (or near normal) voice will eventually emerge. One thing I learned from this -- botox is not like an on/off switch where one day you have SD and then you don't. The effects are gradual. I gradually became more and more breathy, and now I am gradually becoming less and less breathy. But I do think it is different for everyone, so try to be comfortable with the ambiguity!

Best of luck and Happy New Year!

I do think sitting in an upright position is better than flat of your back (some doctor have you in that position). I tried both and had better results after having injections in the upright position. Then again, it could have been the doctor giving the injection did a better job of hitting the right spot.

The earlier shots made me breathy for a few days and then my volumn began to come back. I did have to be careful swallowing water following the earlier injections. Later I had no problems with the swallowing. Most of my injections were about four months apart.