That didn't really happen. For the first year, maybe even several years after that one shot, my voice was very good. I'd have some occasional spasms, but they were minor, more of a nuisance than a real detriment. I also figured out a few techniques that were helpful in avoiding the spasms, the most helpful being to speak at a higher pitch. At times I convinced myself that maybe I never really had SD to begin with.
Eventually, however, the spasms started to become worse and harder to control, even with my compensatory techniques, so I sought a solution. I tried a variety of things: voice therapy, traditional Chinese medicine, thyroid supplements -- none of it helped in the least. The only reliable trick that did work was alcohol. After a few drinks, the spasms would disappear. The problem with this approach of course was that being drunk all the time is not much of a solution. And I would always pay by having worse voice spasms the next day.
In September 2011, I was re-diagnosed in New York City by two different SD experts -- Dr. Chandra Ivey of New York Presbyterian and Dr. Michael Pittman of the New York Eye and Ear Infirmary. Dr. Ivey described my SD as mild, and Dr. Pittman described it as moderate. Indeed, the severity of my SD did vary. Sometimes I could more or less hide it, but other times I couldn't.
By then, since I was living in Shanghai (I'm from New York and was there on a visit), Botox wasn't a good option because it's simply not available in China. I was also hesitant to try Botox again given my initial experience in 1994, and in any case did not favor a temporary solution.
It was around this time that I learned of Dr. Gerald Berke and his team at UCLA, and the SLAD/R procedure. Here's an introductory video on Dr. Berke and his team and the SLAD/R (aka "DE RE") procedure:
After I read extensively on Dr. Berke's procedure, and spoke or emailed with at least a dozen patients, I decided that this was the procedure for me. The rest of my experience is detailed in my blog.