Diane Rehm has been a radio figure since 1973, and in 1998 she was diagnosed with Spasmodic Dysphonia (SD). If you have ever wondered why she sounds the way she does, it is because of this rare neurological condition. Some people don't know she has SD, and wonder why she talks so slowly and shakily. I want to remind folks what spasmodic dysphonia is and how Diane utilizes Botox treatments to keep her radio career alive.
Diane has written books and has created a YouTube video through the National Spasmodic Dysphonia Association (NSDA) to help others better understand Spasmodic Dysphonia. Her condition began with a cough which impacted her ability to speak. Tremor also affected her and she went off the air for 4 months to deal with the emotional and psychological impact of the disorder. Diane was diagnosed with SD and began receiving Botox injections bilaterally (into both vocal folds) to reduce the impact of the spasms on her vocal quality.
Spasmodic Dysphonia is a type of focal dystonia in the central motor system. The two types of SD differ in the abnormal involuntary movements. Adductor SD spasms the vocal folds inward causing a strained, strangled sounding voice and Abductor SD spasms the vocal folds outward causing a very breathy sounding voice, usually on voiceless consonants.
Spasmodic Dysphonia does not favor a specific gender, nor does it have a pattern of onset that stays consistent. Treatment success varies, and usually consists of Botulinum toxin (Botox) injections paired with voice therapy to prolong its effects. Botox usually lasts from 3-6 months before the spasms return. Voice therapy centers around increased pitch, breathy voice quality, /h/ onsets and relaxation. Great care is taken to decrease the hyperfunction some patients have developed as a compensatory measure to their condition.
A nice article by the Washingtonian describes the spitfire confidence that Diane exudes despite her diagnosis and voice troubles. She is an inspiration to all people, especially those who share her diagnosis. SD can easily send a person in to a deep depression and cause reclusive, anti-social behavior and even thoughts of suicide. Rehm doesn't let SD define her, instead she uses her position of influence to help educate listeners about SD and its treatment options.
Diane says that some listeners cannot stand to listen to her, and others feel vulnerable and more human after listening to her on the air. Whatever your position, it is interesting to note that this condition could affect any one of us. The more we understand it, the more accepting we can become.
Sources: Clinical Voice Pathology:Theory and Management 4th Edition. Stemple, Joseph; Glaze, Leslie; Klaben, Bernice.
Check out our Mobile Videostroboscopy and FEES Clinic: Voice Diagnostix.