There is Hope

But after graduating from college with a degree in engineering and starting my professional career, I decided to look into my speech problem. I wanted to know, why was talking so much effort and difficult for me? At this point, I knew that I had a medical problem but I did not know that it was called spasmodic dysphonia. My search for an answer started with my primary physician who referred me to many specialists. My search ended at the National Institute of Health (NIH) where, after many tests, they diagnosed me with spasmodic dysphonia.

The original diagnosis was a relief in a way. It confirmed what I had already known - that something was wrong with my vocal chords. They did not work like everyone elses. But while the diagnosis provided some relief, it also produced plenty of anxiety. What was this thing called spasmodic dsyphonia? What type of treatments were available?

While at NIH, I was educated about botox injections and how they were used in the treatment of spasmodic dysphonia. After some careful consideration, I decided to pursue the botox injections. There were only a few places in the country that gave botox injections. I was fortunate to be located near several of them. I decided to get my botox injections at the Ear, Nose & Throat Associates at the Greater Baltimore Medical Center (GBMC) in Baltimore, MD. From 1993 to 2001, I received injections once a quarter (i.e. 4 times per year), alternating between the right and left side of my voice box every other visit. My physicians were Dr. Andrew Goldstone and Dr. Samuel Lumpkin.

The botox injections made a big difference. Before the botox injections, on a scale from 1 to 10, my voice operated on a 1. After starting taking botox injections, my voice improved all the way to a 7 during the peak periods. But as good as the botox injections were, there were some drawbacks such as: the initial breathy period; the continual need for repeated injections on a periodic basis; every dose of botox had a different potency which resulted in different end results; and after a while my vocal chords got use to the injections so that their effectiveness decreased with time.

In 2000, Dr. Andrew Goldstone, M.D. and Dr. Dario Kunar, M.D. began to tell me about a potential surgical alternative to botox injections. Both doctors, who teach on the staff at John Hopkins University, had heard about a surgical procedure called selective laryngeal adductor denervation - reinnervation that Dr. Berke was doing out at UCLA. After traveling to UCLA and seeing the procedure first hand, Dr. Goldstone and Dr. Kunar decided to offer the same surgical procedure on the East Coast at Greater Baltimore Medical Center (Baltimore, MD).

When the doctors explained to me the new procedure, I was more than willing to undertake the surgery. The potential benefits of the surgery were too great to turn down, so I volunteered to be their first patient. On July 12, 2001, Dr. Goldstone and Dr. Kunar performed the 5-hour procedure on me. Six weeks after the surgery, the results are remarkable. For the first time in more than 2 decades, I can talk effortlessly with no straining. The spasms and poor voice quality are gone. Thus far, I am thrilled
with the results.

But there are some downsides to the procedure. First and foremost, there is nothing fun about surgery. Secondly, for the first week after surgery, swallowing food and drinks often results in coughing because it goes down the wrong pipe. Thirdly, there is an extended breathy period after the surgery. Typically in the past with other patients who underwent the procedure on the West Coast, the breathy period lasted from 3 to 6 months. But to shorten the length of the breathy period, Dr. Goldstone and Dr. Kunar injected foam gel into my vocal chords after 6 weeks. This gel allowed for my vocal chords to close together when I talked. Therefore, my breathy period was reduced from the normal 3-6 months to 6 weeks.