Impact Urgent Care

This week we take a look at a rare vocal dis­or­der called Spas­modic Dys­pho­nia. It can greatly effect your vocal cords, result­ing in a strangled-sounding or hoarse voice. For some, it seems like they have lost their voice. It can be treated with a com­bi­na­tion of speech ther­apy and Botox, but there is cur­rently no cure.

My name is Mark and I am 36 years old. I have always relied heav­ily on my com­mu­ni­ca­tion and peo­ple skills to get me ahead of every­body else. I never would have thought that I would strug­gle with some­thing every­body takes for granted.

I can’t pin­point the exact moment where my life changed but I know for a fact that it hap­pened in early 2006 while I was work­ing for the San Anto­nio Express News in their call cen­ter as a Cus­tomer Ser­vice Rep­re­sen­ta­tive. I was strug­gling to speak and was hes­i­tat­ing with cer­tain words and phrases. It was extremely embarrassing!

I kept ask­ing myself: Why is this hap­pen­ing? Will it ever go away? Will I lose my voice? Could it be stress related? Is it psychological?

There were cer­tain words and let­ters that I really strug­gled with. The let­ter “h” was the hard­est for me and to this day still is. The open­ing phrase at the San Anto­nio Express News was: “Thank you for call­ing the San Anto­nio Express News, this is Mark, how can I help you?” Two “h” words! So, I changed this to: “Thank you for call­ing the San Anto­nio Express News, this is Mark, what can I do for you?” A sim­ple change but this really helped me on the phones.

Despite my speech issues, I never got any com­plaints or ques­tions from cus­tomers or co-workers who couldn’t under­stand me. I thought it would even­tu­ally go away, but it never did. It was get­ting more dif­fi­cult every day for me to speak clearly and be under­stood and I was embarrassed.

On May 1, 2006, I saw Dr. Yvonne Page, a Speech Lan­guage Pathologist.

As I soon started talk­ing, Dr. Page knew exactly what I had. She asked me a lot of ques­tions try­ing to pin­point my prob­lems and took a lot of notes. She even­tu­ally had me read these phrases: “Early one morn­ing, a man and a woman were ambling along a 1-mile lane, run­ning near Rainy Island Avenue” and “He saw half a shape mys­ti­cally cross a sim­ple path, at least 50 or 60 steps in front of his sis­ter Kathy’s house.”

I read the first with ease but really strug­gled with the sec­ond sentence.

Dr. Page referred me to Dr. Blake Simp­son, an Oto­laryn­gol­o­gist, who works at the Uni­ver­sity of Texas Health Sci­ence Cen­ter. He would be able to get a bet­ter look at my vocal cords and ver­ify my speech problems.

Dr. Simp­son also wanted me to read those phrases. With the sec­ond phrase, it felt as if I for­got how to read. I couldn’t even say the word “house.” My mouth opened but noth­ing came out. It took a few sec­onds for the word “house” to finally come out and it didn’t sound good at all. By using a fiber optic Laryn­goscopy, Dr. Simp­son showed me what was hap­pen­ing with my vocal cords.

In May of 2006, I was offi­cially diag­nosed with a rare voice dis­or­der called Abduc­tor Spas­modic Dys­pho­nia. Accord­ing to the Dys­pho­nia website:

Spas­modic dys­pho­nia (SD), a focal form of Dys­to­nia, is a neu­ro­log­i­cal voice dis­or­der that involves invol­un­tary “spasms” of the vocal cords caus­ing inter­rup­tions of speech and affect­ing the voice qual­ity. SD can cause the voice to break up or to have a tight, strained, or stran­gled qual­ity. There is no cure. It is treat­able by speech ther­apy and Botox injec­tions in the vocal cords.

I started speech ther­apy with Dr. Page imme­di­ately after I was diag­nosed. Our ses­sions were weekly for 12 weeks. For the first four weeks, we met twice a week. I was very lucky that my work sched­ule allowed me to have two con­sec­u­tive days off dur­ing the week. Oth­er­wise, I would have had to use all of my sick and vaca­tion time.

We did a lot of breath­ing and relax­ation exer­cises. We worked on the voice­less sounds. Every few weeks we would try words that began with the let­ter “h.” Dr. Page wanted me to have a soft voice; no yelling or talk­ing loud on the phones. She had soft­ware that mea­sured how loud my voice was and how much rough­ness I had. It was really inter­est­ing to see these changes before, dur­ing, and after a ses­sion. I was also able to hear my voice; it was good some­times, bad some­times, and some­times just plain laughable!

I was relieved that the Speech Lan­guage Pathol­o­gist knew what I had as soon as I started talk­ing.  Unlike other peo­ple I have met with Spas­modic Dys­pho­nia, I didn’t have to wait months or years and see sev­eral other doc­tors to get the cor­rect diag­no­sis.  After lots of research, talk­ing with Dr. Page and Dr. Simp­son, and con­sult­ing with my par­ents, I decided to try the Botox injec­tions. I was aware there could be side effects. But I was ready to take the plunge.

On August 14, 2006, I was in the wait­ing room at Uni­ver­sity Hos­pi­tal in San Anto­nio, Texas. I was extremely ner­vous.  My mother came with me and her sup­port really helped me get thru the antic­i­pa­tion of get­ting my first Botox injection.

Dr. Simp­son sprayed my nose to numb it.  It didn’t taste like any­thing, but it really made my nose runny!!  He then inserted a nee­dle into my neck to numb it.  The numb­ing med­ica­tion tasted really gross and made me cough a lot; but that means the numb­ing was work­ing.  A Neu­rol­o­gist, Dr. Car­layne Jack­son, put some sen­sors on my stom­ach; this helps locate the proper spot for injec­tion.  A res­i­dent from the hos­pi­tal was also in the room and he was the one who inserted the fiber optic Laryn­go­scope from my nose to my vocal cords.

I coughed a few times and said the let­ter “E” for a few sec­onds.  I even read these phrases again “Early one morn­ing, a man and a woman were ambling along a 1-mile lane, run­ning near Rainy Island Avenue” and “He saw half a shape mys­ti­cally cross a sim­ple path, at least 50 or 60 steps in front of his sis­ter Kathy’s house.”  

Dr’s. Simp­son and Jack­son located the cor­rect spot for a uni­lat­eral injec­tion and I didn’t even feel the Botox. Wow!  After­wards, I was cough­ing a lot, had some dis­com­fort in swal­low­ing, and my voice was very strained.  But, those side effects wore off quickly and I was very glad.

I went back for my 2nd Botox injec­tion on Octo­ber 23, 2006. I was more eager this time and was look­ing for­ward to how my voice would fare. It was the same pro­ce­dure for the treat­ment. I had the same side effects but again they van­ished quickly.

Since my diag­no­sis, I have had 17 Botox injec­tions and I am get­ting fan­tas­tic results and do notice a HUGE dif­fer­ence in my voice.   I always have the dis­com­fort in swal­low­ing, a strained voice, and lots of cough­ing.  But, they go away quicker each time.  My last 3 Botox injec­tions have lasted about 6 months. I will prob­a­bly sched­ule another Botox injec­tion toward the end of the year.  Each injec­tion I get lasts longer than the previous.

If you heard me talk, you prob­a­bly wouldn’t even know I have any issues.  I do strug­gle at work occa­sion­ally but nobody notices it. I am kinda curi­ous to see how my voice would do with­out Botox?

I made my first pod­cast to share recently.  I gotta admit, I was extremely ner­vous when I recorded this last night in my car on the way home from work.  Yes, my record­ing stu­dio was my car; hey, it was quiet and nobody both­ered me.

At least I thought it was quiet…when I replayed it after­wards, I heard my keys jig­gling and my turn sig­nal click­ing.  Next time, I will unhook the car key from the mis­cel­la­neous keys and find a straight path to nowhere in par­tic­u­lar.  Other than that, I am very excited  to debut my voice and hope you enjoy it.

This post was repro­duced with per­mis­sion from Mark at mdlblog.com.