Posted By: David2 Botox for swallowing problems - 09-26-2019 07:13 PM
So a week ago my ENT injected Botox into my upper esophageal sphincter to relax the muscles. For a few years following my treatment in 2009, like many of you, I had numerous dilations. Those seemed to do the trick for awhile, but in recent years nothing has worked. The procedure was done in the OR under full anesthesia. He'd done a dilation a couple of months ago - in his office fully conscious (me, that is; well, he was too) - but it only lasted a couple of weeks. This was the next step. The one after this would be permanent: surgery to cut the muscle. So this was kind of a test drive.

He'd told me the Botox would take 3 days to kick in, and last 3 months, after which we could evaluate to see if I wanted to go ahead with the surgery.

Well... there have been complications. Specifically, it seems as though the 'tox has spread out to some of the surrounding airway, the result being a 50% drop in my airway opening. Imagine my surprise. I'm having to make a conscious effort to draw in breath all the time and really never feel as though I have a full lungful of air. The effect is most pronounced when I'm standing and a bit less sitting and less still lying down, which is fortunate. Having to work to breathe would be detrimental to sleep, to say the least. I can expect this to continue until the Botox wears off in mid-December.

There are two other things though that are possible in relief. One is a drug normally prescribed for myesthenia gravis and that my doc had never in fact used and had to look up. Apparently the SEs are significant though, and he advised me to use it only if things get worse. Which he could not predict but certainly didn't seem to rule out. Finally he could do surgery to attach part of my vocal cords to the side of my larynx. Let's hope this isn't necessary.

He did allow as that he had never seen this before in a patient treated in the OR. It's only been an issue with in-office procedures and their lack of precision. Nice to know, but doesn't help me breathe.

Bottom line: if your ENT offers Botox for swallowing difficulty be sure to bring this issue up!

Thanks for listening.
Posted By: gmcraft Re: Botox for swallowing problems - 09-26-2019 10:12 PM
Oh dear, David! That’s most unfortunate. It’s a surprise that the Botox has caused constriction of the airway when its effect is supposed to dilate. I’m so sorry that you have to go through this.

Thank you for the warning to others who might have the treatment suggested. This is how this forum is valuable — where those who have experience shine the light for those following in their footsteps. Thank you so much.
Posted By: David2 Re: Botox for swallowing problems - 09-28-2019 05:30 PM
Thanks, Gloria. I really appreciate the good words. The crazy thing (well, it's all crazy actually) is that the whole deal really didn't help the swallowing issue and probably made it worse, adding episodes of acid coming up into my throat to everything else going on.

Oh well. Caveat emptor!
Posted By: PaulB Re: Botox for swallowing problems - 09-28-2019 07:21 PM
David2,

Thanks for the heads up! I saw several years ago Botox, and others being used for the head and neck, and vocal cords. I actually saw a top ENT for the vocal cords who did this with another agent, but I declined at that time due having other things going on.

Thanks!
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