December 6, 2000
Cured of SD
If you have Spastic Dysphonia (SD) and are looking for relief from this awful and debilitating condition please take a moment to read this letter in it's entirety. I also had SD, and this is my account of how I recovered my voice through Dr. Cooper's Direct Voice Rehab program. I want to share with you not only my personal victory but also offer encouragement that you can do the same. There is real hope!
If you want to skip over the details of my personal history with this and get right to the "recovery" go right to the section titled "The Process and the Right Stuff".
My Search: I am a mid 40's aged male and I work in the field of Commercial Property Finance. I use my voice a great deal, much of which is on the phone. I had never considered myself as having voice problems prior to developing this condition. I would occasionally get a slightly raspy voice but thought it was due to allergies. For me the onset of SD was fairly rapid as I went from having what I thought was a normal speaking voice to a very strained "strangled voice" in about 3 weeks. From that point it got progressively worse. This was the summer of 1998. When it became evident that this was not a temporary voice loss for me I went to a local ear, nose and throat specialist and he determined that the voice loss and soreness in my throat was possibly due to allergies or perhaps reflux. Allergy medicine was prescribed. It did nothing for my voice. I then went to a gastroenterologist who determined that I did have reflux, and prescribed appropriate medicine. Again, no improvement to my voice.
Spastic Dysphonia? Botox? Huh?: At this point I was told by a friend about a TV special they had seen on the use of Botox shots to treat a condition called Spastic Dysphonia, which they thought sounded like what I had. This was the first time I had heard about SD after having visited several MD's. I did some research on the net on SD and became pretty discouraged by what I read, which said there was no known cure for SD. I found a local Otolaryngologist who was treating SD with Botox shots who diagnosed me as having an "early form" of SD, called Muscle Tension Disorder (MTD). I as told that MTD presents the same type of "strangled voice" symptoms but is intermittent. In my case I was usually able to speak in a less strained voice early in the morning sometimes up until 9:00 to 10:00 AM at which point I would slip into the strangled voice and by the end of the day I usually had almost no voice at all. I had also developed pretty severe reverse breathing. I was told that I should undergo a regimen of speech therapy and that if that was not successful then I would be a candidate for Botox shots. I kept up the appointments with the speech therapist for several weeks, with no real improvement. I had also done some reading on Botox and was becoming less convinced that I would want to be injected with a toxin of that strength without knowing whether there would be any long term side effects.
By the grace and kindness of God, I found Dr. Cooper through one of the speech therapist I had come across. I was able to visit Dr. Cooper's office in LA in February 1999. He diagnosed me as having SD, I was not very surprised but I was skeptical when he told me confidently that "my prognosis was excellent". He told me that it would take three and preferably four weeks of Direct Voice Rehab to recover my voice. The cost of the program looked high given that Dr. Cooper estimated that I would need to spend several hours per day if I was going beat SD. Three to four weeks of DVR equated to thousands of dollars out of my own pocket. as the prospects for getting the insurance company to cover this looked very unlikely, I decided to try other approaches.
I continued on with the speech therapist for a little while longer, trying to follow that program, which consisted of throat massages some resonance exercises, and some relaxation breathing exercises. There were a couple of visits where I found I could briefly speak small sentences after doing the relaxation exercises in the therapists office, but the moment I tried to resume normal conversation doing something as simple as making the next appointment, I would revert right back to the strangled voice. My frustration was increasing, as I was making no progress with the therapy, and the SD seemed to be getting worse. I was also disturbed by what I had read that SD was neurological and incurable. There seemed to be confusion and speculation in the medical community about what SD is or isn't and what causes it. From what I had read, I was presenting all the symptoms of SD and yet I was being told I did could not have full blown SD.
I was open to alternatives and through a friend I happened upon a singing teacher who claimed to have had some success helping people with SD. I spent close to $800 on intensive lessons with no result. I gathered that my SD was more severe than the other people this teacher had seen. The one thing of value I gained from that experience was a sense for resonance and placement of the voice which would become useful in my DVR experience with Dr. Cooper. This teacher was knowledgeable and understood some of the variables in the problem, but couldn't put it all together.
By the fall of 1999 it was very clear to me that SD was completely ruining my life. I then made the decision to do Direct Voice Rehab in January 2000.
The Process & the "Right Stuff": If you are going to seriously consider DVR, you must understand the following: The foundational elements of DVR are deceptively simple; Pitch, Tone/Focus (placement), Breath Support and Voice Image. Taken individually, in a person who has a healthy normal voice these are easily demonstrated. A person using their voice properly will have all these components in the right balance without being the least bit conscious of doing so. A person with SD, though cannot without competent clinical guidance identify how to make these variables work individually, let alone discern how these variables fit together to make a functional voice. In short, DVR requires the trained (and gifted) ear of clinician such as Dr. Cooper who can listen to the SD voice and know what approach and exercises are needed and how to apply them. Dr. Cooper had told me that for people with SD it typically takes three to four weeks to recover a functional voice. The specifics of my case fit this pattern pretty well.
Over the course of the past several months I have made a consistent effort to talk with numerous SD sufferers (many of whom have been patients of Dr. Cooper) I have observed that there are two related primary factors that greatly affect a persons ability to recover their voice through DVR, they are Desperation and Personal Responsibility. Patients must have reached the point of desperation where they are willing to put in the intense effort and closely follow Dr. Cooper's instructions and they must accept personal responsibility for completing the program. No one can do it for you. Dr. Cooper can give you the tools and instruction to recover your voice, but the reality is, the only one who can implement it is you.
" You want the truth?.": I have met and spoken over the phone with many people who have recovered their voices through DVR and some who have not. In the majority of the instances where a person failed to get their voice back, the reason can be traced back to their not following through on Dr. Cooper's instructions. I don't want to discourage anyone from Dr. Coopers DVR approach as I believe it works, but the truth of this can be a little bit hard to handle. The simplicity of the elements of Direct Voice Rehab is undeniable, the process of working those elements requires discipline and determination and can be hard work. I would typically average 5 - 6 hours per day in Dr. Coopers office with an hour of what I would call a "working lunch", where the process would continue. I would then go back to the hotel and put in another three to four hours of work on average. Frankly, it wasn't easy, but by the beginning of the third day I started to see some real results, which encouraged me to continue the effort. Between the two weeks I only took Sunday off. My progress remained incremental but fairly steady for about two weeks to the point where I was able to speak in a more normal voice for short periods of time, but I was having trouble "carrying it over" and would revert back to speaking in the lower throat. I did consider stopping at the end of two weeks and trying to continue the program at home, but I was having enough trouble consistently using the new voice and I was still fighting the reverse breathing. That third week made a tremendous difference for me, I found that my progress had plateaued and that more than ever I needed Dr. Cooper's competent guidance and encouragement to keep the progress going. By the end of that week I had a better handle on it and decided to return home. I was at what I would call a 50% recovery. I was still having some trouble holding the new voice, but by then Dr. Cooper had given me the tools to "self monitor" my voice and I felt that I could keep progressing if I continued the exercises at home. The first week I went back to work I continued the exercises when I could during the day, but found that I made significant progress as I spent several hours each night. By the end of that week my recovery became quite rapid and I would say I was up to 75% to 80% restored. The reverse breathing was almost gone and I was consistently speaking in my optimal voice. In the months that followed I have continued to work on it, but I have found that I am putting in much less time doing the exercises. As of this writing in December 2000, I am at about 95% recovery. I also believe at some point in the future that I will reach the point of being cured where I no longer have to think about my voice when I speak. Though nobody can tell that I ever had SD, I am still consciously working on it every time I speak, thinking about the resonance, pitch and breath support. Dr. Cooper counsels that beating SD is a 25 hour per day effort, I can attest to that, but I am also extremely pleased to say that Dr. Cooper's Direct Voice Rehab program worked for me, and I am convinced that it can work for you.
Fear and Loathing in the Medical Community/ Alternatives to Direct Voice Rehab: You have two other options; Botox shots for the rest of your life, or surgery. Both can potentially produce results but both have risks.
I have in my files an article published by Dr. Gerald Burke at UCLA Medical Center in the December 1999 NSDA Newsletter, that he is no longer recommending Botox shots due to observations by himself and other physicians that the use of Botox causes "structural changes in muscle tissue" but rather he is advocating "de-nervation surgery" which is as radical as it sounds. Dr. Berke and others have had some successes in eliminating SD through the severing of specific nerves of muscles that are spasming around the larynx. There appears to be differing statistics on the success rate of the surgery. I have heard anywhere from 50% to 95%. I have personally known and spoken with people who have had the surgery and or the shots and have not been helped.
Dr. Cooper contends quite reasonably that Direct Voice Rehab should be one of the options available to people. People with SD should have a choice. He has no problem with patents choosing to go with surgery, or even Botox. He is a strong advocate of the medical doctrine of "informed consent". The patient should always be given all the options without prejudice.
Tragically, this is not what is happening. What is occurring is the medical community seems to be threatened by the fact that Dr. Cooper has produced numerous cures of a condition that they deem to be incurable. Over time this has developed into quite a conflict. If the MD's admit that Cooper is right, demand for Botox or surgery would be weakened. I am pretty convinced it must be about money. As long as the problem is "medical", then medical solutions are the only appropriate treatment. If the problem is non-medical, the revenue from the medical options is at risk. What makes this truly unconscionable is that the ones who suffer the most are the patients, who are not being given all the options. Medical doctors who know that Cooper's methods work, and yet chose not to refer SD patients to him. To me this is criminal, as are the efforts of the American Speech and Hearing Association (ASHA) to de-legitimize Dr. Cooper's methods. Having witnessed this prejudice against Dr. Cooper firsthand I think that thousands of SD patients suffer needlessly and have endured shots and surgery unnecessarily.
In my own case, I think it is fair to say that the long term Speech Therapy would not have worked and I would have been a clear candidate for Botox or surgery. I make this conclusion logically based on the amount of intense work and skilled guidance that was actually required to recover my voice. A couple of voice therapy appointments per weeks would could not have accomplished what was needed. Elements of DVR are actually analogous to physical therapy for the muscles around the larynx. There are 15 or so muscles on either side of the hyoid extending up the neck and head. In short, Dr. Cooper's holistic methods are retraining the use of those muscles. Improper use of the voice can and does cause distortions in the use and development of that musculature. Abusing the voice over long periods of time magnifies that distortion and it takes time to undo that. What is clear to me is the medical community seems to lack understanding of the voice, as they are only treating the symptoms and not the root problem which I believe is misuse of the voice.
Finally, I conclude by recommending Dr. Cooper and his DVR program without hesitation. I hold him in the highest regard personally and professionally. In my opinion, his contributions to the field of voice are unparalleled. Because of his dogged tenacity to uphold truth in his field, I recovered my voice without surgery or Botox shots. In helping me recover my voice, he gave me my life back, and for that I am extremely grateful.
If you read this letter in it's entirety and you have questions about what I have said or my experience, please feel free to contact me through Dr. Cooper's office, or you can e-mail me at firstname.lastname@example.org.
Update: September 8th, 2006
I am extremely pleased to report that following my three weeks of DVR in January 2000, my voice remains cured of Spasmodic Dysphonia. I credit my voice recovery to the grace of God, and continued application of your Direct Voice Rehabilitation techniques, without which I would never have recovered and maintained my normal voice.