Posted by: Laurie ®
09/22/2006, 21:02:04
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Hi, Fred,Sorry to hear of your inconsistent results. I'll try and answer some of your questions with my experience: 1) No, I do not have bad days among the good voice days after a botox treatment. If Botox is working, you really shouldn't have a "bad day" unless it's wearing off. My voice is initially breathy, then normal for a couple months, then it wears off. I would not consider having some bad voice days a successful treatment. 2) Yes, it's possible to miss the mark. They do use an EMG but it's my understanding that other muscles can fire activity or the needle can be right at the tip of a muscle and thus the actual injection can miss. Perhaps they're just off the mark a bit. 3) Not sure why you have to wait 6 weeks. It's not medically necessary. While the general idea is to space injections about 3 or more months apart, if one or two don't work, there's no harm in going back w/in several days to a week. You wouldn't want to do this endlessly as there is an extremely remote chance of developing an immunity to Botox, but for unsuccessful injections here and there, I don't think you have much to worry about. Overally, while two semi-unsuccessful shots can be frustrating, I'd say to keep at it since you had such good results with the first one. Have faith that you can get that back! I'd also say to increase the dose of Botox and/or eventually try out another MD if your shots continue in this fashion. Good luck and please let us know how it turns out next week. Laurie
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Posted by: mdubovick ®
09/25/2006, 08:02:11
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Fred, I agree with everything that Laurie said in her response to you so I'll not repeat all the same responses.I would be very concerned about a doctor who says it is impossible to miss the mark because they use an EMG. There have been dozens if not more of instances where people on this bb report misses during botox injections. I attended the NSDA Annual Patient Symposium this past April and asked one of the country's foremost authorities on Botox shots how it is possible to miss while using an EMG device? He said there are situations where the EMG guided needle touches the very outer edge of the muscle. The doctor receives a signal they are in the correct area but when the injection is given, it is a "near-miss" not hitting the center of the target muscle. He said for those with AD/SD, the muscle is roughly the size of a pencil eraser on the tip of a pencil; and for those with AB/SD, the target is even smaller and less accessible. In rare situations where the botox shot did not work, I have personally had the doctor perform a redo, at no additional cost within one or two weeks of the first shot. Your doctor's comments and actions should make you think about finding another doctor. I suggest you go to the NSDA web site and look under HealthCare Referrals to see if there are any doctors listed in your area. The web site address is:
http://www.dysphonia.org/ If you wish to discuss this further, my email address is
meldubovick@comcast.net
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Posted by: Fred Hosier ®
09/26/2006, 06:35:59
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Thank you both for the replies. This has been an anxious time for me with thoughts of such things as "did I build a resistance to Botox?" going through my head.
Just having this forum has provided me some relief until I get this settled, medically.
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Posted by: nan g ®
09/26/2006, 17:40:16
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I am not sure if I can help but I can share my experience. I have had three treatments to date with varying results. With the first one, I experienced the classic breathy phase, which lasted for about a month, but as my voice got stronger the spasms came back as well, I don't think they ever subsided. Very disappointing, as I was hopeful with such a strong reaction to the botox, I would experience a good result. I experienced good voice days and bad voice days, which I suspect is just SD. My doctor tried a different approach with the second shot and administered the botox into a different muscle than he had the first time, the interarytenoid muscle. I had a much better result, I would say almost 80% of normal voice function returned. The third round of botox was somewhat different yet again. As the botox started to wear off, I went in for an EMG and my doctor took a close look at all the muscles of my larynx to see which were most involved/causing the SD. As it turned out, the interarytenoid muscle was the main muscle involved but other muscles were affected as well, (sorry, I wish I could remember the name of the muscle but it's the pair of muscles usually involved with AD/SD). Based on the results of my EMG, he administered the botox this last time a little differently, most of the botox (5.0) going into the interarytenoid muscle but he also put a small amount (1.25 each side) into the other muscles (the usual bilateral injection sites for AD/SD). Anyway, I have my best voice yet, almost 90-95% function. I should mention that I did have a lengthier than I would have liked breathy phase (three weeks)but I will request less the next go round. We are still fine-tuning. I tell you this because there are botox failures which might be due to the fact that different people have different muscles or multiple muscles involved in their case of SD. Try doing a google search, I remember I found some very interesting articles about this. Sorry if I haven't made myself clear. Good luck.
Modified by nan g at Wed, Sep 27, 2006, 11:36:22
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Posted by: Gigi ®
10/03/2006, 14:57:32
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Fred, I've had some inconsistent results also. My first 3 shots worked, but I found that I can only go 2 months. My fourth shot didn't work at all. When I went back for the fifth shot, I had the beginnings of a sinus infection. I asked the doc if having an upper respiratory infection could affect the results of the shot. She said it could. Sure enough - I would say that it's only working about 50%. That may be all in my mind, but I know for sure how much better the first 3 worked. I am going to miss her clinic on Oct. 20 to get another one as I have a trip planned out of town. I really dread having to wait until Nov. I hope you are having better results with your most recent shot.
Regards, Mary Chrisanthis "Gigi"
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Posted by: Kim Lee ®
10/04/2006, 19:59:20
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I've been getting Botox injections for the last 3 years. Each time I've had a different experience. My last injection was at the end of May and it did not work. The doctor injected almost 10 units. After the injection, I had severe pain in my forehead. They don't know why that happened. During the summer, I was in limbo because of insurance red tape and I had a blood test done to see if I have developed immunity to Botox. The test finally came back negative. So my next question, is the doctor missing the mark or what is going on? I was wondering if I was getting too many treatments. I was getting them every 2 months or so. I never got breathy, my voice would get high pitched, like Minnie Mouse and then I would go into a normal voice, then the voice breaks would start.I want to try it again, but I'm a little reluctant since I have to meet my insurance deductible again and the treatments are pretty expensive. Kim ADSD Florida
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