What is spasmodic dysphonia, and why did Luchi Cruz-Valdes treat hers with Botox?
Retired broadcast journalist Luchi Cruz-Valdes recently shared a video from her vlog, Usapang Real with Luchi, showing her getting Botox injections—not for cosmetic reasons, but to treat her vocal cords.
"I live with spasmodic dysphonia, a neurological voice disorder that causes my voice to suddenly weaken or disappear while speaking," she wrote in the video caption.
When PhilSTAR L!fe spoke to Cruz-Valdes on Friday, it had been a year since she got her most recent Botox injection—the "fourth or fifth," by her count. Though her voice cracked occasionally, she had the same perky tone audiences knew from her time on the defunct investigative documentary program The Probe Team.
"Normally, the vocal cords are involuntary, meaning it's the brain that...controls it. But in my case, there's a disconnect. My vocal cords move on their own volition outside of the control of my brain," Cruz-Valdes told L!fe. "Even if in my mind I know how to read the script exactly the way it should be read, my vocal cords just do their own thing."
Working through the disorder
Her battle with the disorder began in 1983. Then a 21-year-old anchor for Newswatch, Cruz-Valdes experienced a heartbreak and suddenly lost her voice live on air.
"In the middle of the newscast, bang! I lost my voice," Cruz-Valdes said. "The director turned it over to my co-anchor, Joe Carlos. Then they tried me again in the next [segment]. So I started reading again. And then, in the middle [of my delivery], it happened again."
When the issue persisted, she convinced her boss to make her a reporter instead, even offering to do it for free. "And that's how I became a reporter because of the disorder," she said.
Covering late former President Cory Aquino's US state visit in 1986 with another veteran journalist Cheche Lazaro, Cruz-Valdes was able to do live reporting again. But when it came to recording her voice-over spiels, she still had to do seven or eight tries to get her voice right.
In 1992, a vocal technician from the speech pathology department of the University of the Philippines suggested Cruz-Valdes was just stuttering and taught her some vocal exercises. Those, coupled with her will power, helped her weather her disorder through the 1990s until around 2017, when she experienced another personal trauma.
"I was just at home talking to my parents when my voice stopped working. I felt, 'No, no, no, this can't be happening again,'" Cruz-Valdes said.
"So I started Googling. What is this that I feel? Spasmodic dysphonia," she said.
Treatment plan
"Spasmodic dysphonia is actually a spasm of the laryngeal muscles during phonation o 'pag nagsasalita," explained ENT-HNS specialist Dr. William Lim in Cruz-Valdes' video.
Dr. Lim notes that Cruz-Valdes has the "abductor" type of the disorder, which causes spasms that pull the vocal cords apart and suddenly weaken her voice.
According to laryngologist Dr. Pam Dela Cruz, the gold standard in spasmodic dysphonia treatment involves botulinum toxin A injections, of which Botox is one brand. A Botox injection to treat spasmodic dysphonia relaxes the muscles behind the larynx, or the voice box. The location of the muscles, especially for the "abductor" type, makes the procedure difficult, so a specialist uses an electromyography machine, whose needle electrodes help detect problems in the muscles, per Johns Hopkins Medicine.
Cruz-Valdes pays about P26,000 per treatment, which includes a vial of Botox.
Aside from Botox, Dela Cruz said another option is laser surgery targeting the vocal cord muscles.
"But these treatments will just prolong the interval between vocal cord spasms," Dela Cruz told L!fe.
Cruz-Valdes said as much. "The Botox would help me for a few months, but after a while, babalik 'yung symptoms," she said.
Dela Cruz added that treatment may also involve a neurological approach using deep brain stimulation, but there is need for more studies about this method.
Although emotional trauma apparently triggered Cruz-Valdes' symptoms, doctors have yet to determine the specific cause of the lifelong disorder.
"There are a lot of studies about spasmodic dysphonia, but its cause remains to be established," Dela Cruz told L!fe.
Other famous personalities who suffer from the same disorder are actress Selma Blair and US Secretary of Health and and Human Services Robert F. Kennedy Jr.
Living with spasmodic dysphonia
Now 65 and retired from active journalism, Cruz-Valdes stays up-to-date with her vlog, and spends the rest of her time reading and watching political commentaries, the news, and documentaries.
"Spasmodic dysphonia is the reason why I quit [my job in TV5] but nobody would believe me, not even MVP," Cruz-Valdes said, referring to Manny V. Pangilinan, chairman of TV5.
Since it's a chronic disorder, Cruz-Valdes manages it by "praying, because there are things that could happen that are out of your control," and staying away from high-pressure situations where she needs to project her voice, such as hosting an impeachment annotation program.
"I've become very spiritual on account of it," she said. "You just want to be peaceful and trusting the Lord about it."