Spasmodic dysphonia: ADductor injection

• The initial wait
• The weak-breathy voice phase
• The talking is golden phase
• The spasms are back phase
• Early laryngitis

The initial wait

For a day or two your voice will usually be unchanged. Approximately 24-72 hours from the injection the spasms begin to diminish and the voice may be very good. Within a few hours the voice may become weak and breathy. Many wonder why this weakness develops. As the medicine begins to take effect, just a part of the muscle in the vocal folds is weak, while a short time later, when the injection has taken complete effect, most or all of the muscle will be weakened, thereby weakening your voice. In a few uncommon situations, the effect has come on over a week or two rather than right away.

A few of my patients, who have had many injections, have noticed that if they rest their voice on the day of the injection, the medication works better. Conversely, if they have a lot of coughing on the day of the injection, it does not seem to take as well.

The weak-breathy voice phase

This phase lasts as little as a few days or as long as 8 weeks. During this phase, you will notice that your voice is weak and cannot be heard in competition with background noise. You may find that you have to take a breath frequently when you talk, because you run out of air so quickly.

• whispery
• airy
• helium voice
• hilarious sounding cough
• “Mickey Mouse” voice
• I'm exhausted after I talk
• my breathing seems harder (they are referring to the need to take frequent, deep breaths in order to keep up talking at a normal rate)
• I feel a burning in my throat when I talk (the other normal muscles are working harder and getting achy)

A few people will also tend to cough on liquids, a side effect that tends to resolve faster than the breathy voice. If this swallowing problem happens to you, use extra care when drinking liquids, utilize thick liquids when possible, and try tucking you chin towards you chest when you drink.

The talking is golden phase

For 1-3 months after the weak - breathy phase has passed, the voice often seems virtually normal. Talking is a pleasure, and some forget they even have spasmodic dysphonia during this time.

The spasms are back phase

Typically, during the second to fourth month after your injection, just when the voice seems at its best, a spasm may occur. It may not be necessary to return immediately for another injection, because you may still have several to many weeks of reasonable vocal function. As spasms become more noticeable, you should consult your calendar and arrange another injection appointment.

Early laryngitis

Some persons experience what seems more like hoarseness than weakness during the first few days after an injection.