Tuesday, September 16, 2008

Spasmodic Dysphonia

I'd never heard of it before today, but I think I may have a relatively mild (and undiagnosed) case of Spasmodic Dysphonia.

I first noticed it while working at Active Imagination. Whenever I was calling a customer, my voice would crack, and I would get short of breath. The first calls I did there were practically cold calls - I was calling Magic players to remind them about upcoming tournaments. Despite supposedly doing them a service, I always felt bad about it, so the fact that I'd be hoarse before the end of the first call didn't strike me as terribly odd. But it did make me very self-conscious, and I tried to hide it from those jerks I worked for. I'm fairly certain they interpreted my reluctance to make the marketing calls in their presence to mean that I wasn't making the calls at all, or was badmouthing them to their customers, or something. Over time, they insisted more and more on being present in the offices when I was making the calls, and they'd "listen in" frequently.

Later, I ended up working more retail shifts for them. These went fine, I rarely had trouble interacting with people face to face. But on days when shipments would come in, I'd have to call everyone who'd placed special orders and preorders. I knew that I was calling them with good news. I was calling to say "your game is here, and waiting for you!" It wasn't a cold call, it was at their request. Yet, my voice would shatter like I was terrified. I could never explain it. I'd have to take the phone calls slowly, and take deep breaths between each call. At first, I was calm but a little puzzled. Eventually, it made me fear making those calls, especially if co-workers or customers were in earshot, and it got worse after that. The fear made it more pronounced.

Often, I was calling someone that I gamed with casually and personally, but calling to say the book they asked me to order for them was in would make me breathless. Seriously, I could call James or Jeremy and gab all friendly from home, but if I called the same friends from work because the new expansion was in, it hurt to talk. Every word was like fighting for oxygen.

I'd been raised largely without a phone, so I assumed it was psychological, and phone-related. *

But then, I started judging Magic tournaments. All went well for the first few months, until one day, in the midst of giving my opening announcements at a Pro Tour Qualifier, my voice cracked and went up nearly an octave. Everybody laughed at me, Cameron made a snide joke and I felt like I was back in junior high. It happened again during opening announcements at my next couple tournaments, and then sporadically at tourneys thereafter.

I have no stage fright. I'm happy to be in the spotlight. I ran a 40-player LARP for several years without anything like this happening. But for whatever reason, the opening ceremonies of Magic tournaments made my throat constrict and wheeze. Sometimes I could control it, but generally, once started it would last the rest of the event. My boss somehow hadn't noticed until one time when I was in the process of giving out a unsporting conduct penalty to a guy who well deserved it. She dressed me down in front of the whole tournament, and said I was too emotionally invested to give out that penalty. She could tell, so she said, because of the way I sounded. I was calm (but yes, sounding hoarse as I often did at tourneys) until she said that.

That's the point where I started hating her. (There were lots of reasons to do so, but that was the straw that broke the camel's back. Her behavior that day will never be forgotten, and probably never forgiven.)

I resolved at that point to overcome my problem, since I assumed it was all in my head, and somehow anxiety-related. I taught myself to breathe through my nose before talking, and take long pauses, to control the tone of my voice. This worked for a while, till one day Level 4 Judge John Shannon mentioned that the pauses made me come off as uncertain or stupid, instead of thoughtful. That kinda hurt. Unfortunately, by this point, the pauses were part of how I talk. I only manage to totally avoid them when in-character RPGing. When in-character, nothing like this affects me at all. By the end of my time at Active Imagination, I was a basket case. I still pause, and my voice now cracks nearly any time I call anyone for any reason. Just typing about it has made my nose clog up and my neck constrict for the last 20 minutes.

*: An aside about my "it's psychological, and us not having a phone from 1987 to 1995" notion. I've always had a distaste for telephone conversations, because they were not part of my life at all for those years, and minimal before that. I once made a really cool video poem called "I Hate Telephones". So it seemed 'obvious' to me that all my trouble (prior to Magic tournaments) was somehow related to fear and unfamiliarity.

At the same time I was blaming it on that, I had doubts about it, too. I'd done all the movie times on the recording at the theatre for a few years because I had such a good phone voice. I also did the recorded message at Page One, Too for a while for the same reason.

Come to think of it, the only hint before Active Imagination that I might have actual problems with phones was the nightly call from my office at the movie theatre to the 3rd party theatre-polling company that we reported box office grosses to. I always got "choked up" calling in things like "Brave Heart: $7,235; A Very Brady Sequel: $3,128;" to the answering machine of some corporate suit I'd never interact with. My voice would crack, and my breath shallow. I couldn't explain that, but I was always very glad to be making those calls alone in the office late at night.

I've done a lot of soul-searching and healing in the year+ out here in Seattle. Despite that healing, I've been terrified to get back into the job market, because what guarantees did I have that these problems wouldn't just remanifest as soon as I was in a workplace? I was also worried my voice would crack while interviewing. Or that I'd pause a little too much, and they'd write me off as dumb. Even scarier was the notion that I'd get through the interview process, get a job I loved, and then have my problem manifest again.

This wasn't entirely unjustified. During this year i got back in touch with some old friends, and when that finally resulted in a phone conversation with Daved, my voice sounded like I was calling customers about special orders again. Getting away from work reduced the frequency of my triggers, but did not cure it the underlying problem.

I left Magic / quit judging tournaments, despite moving to the city that Magic: The Gathering is designed in, largely because of the things judging did to my voice, and the insecurities that the Godards instilled in me over that voice issue.

That's context. That's what went before. I thought it was psychological, and that I was probably unique in my troubles.

Today I read an article about Economists and the Election on CNN. The article was by Scott Adams, and that reminded me that I really like The Dilbert Blog back before Jeremy and I had that weird little argument that resulted in months of silence between us. (Why that would result in even more months of me not reading Dilbert is hard to explain. Out of sight, out of mind, I guess.) So I clicked on Dilbert's blog today, and started reading back posts.

Turns out, Scott Adams has Spasmodic Dysphonia. It's symptoms sound very close to my problem. People with SD have acute hoarseness while speaking, but the situations that trigger it vary widely. Frequently, it involves talking on the phone. One example that's given is people who's voice cracks or falls apart on the phone, but have no problem talking to their cats. Adams claims his has progressed to the point where the only time his voice sounds normal is when he's talking about Spasmodic Dysphonia. Any other topic of conversation makes his voice go falsetto or scratchy.

From what I've read, there's no cure. There's a form of speech therapy that might help, but it's also possible that to overcome it I might need quarterly botox injections to my throat or surgery every couple of years. Neither of those last two options are appealing unless my condition gets a lot worse. It's also quite possible that I might not have Spasmodic Dysphonia, but Dilbert's descriptions sound very much like what I experience. I'll need to see a doctor to know for certain.

Knowing that it might be this actual physical disorder is actually very comforting. When I thought it was just me being a phone-fearing wuss, I scared me. But I pwn diseases and disorders. I beat DermatoFibroSarcoma Protuberans (aka cancer), I can sure as hell beat a little thing like Dysphonia. I'm even seriously considering getting back on the judging horse.


r_b_bergstrom said...

Or, I could have an anxiety disorder, with a touch of hypochondria. :)

r_b_bergstrom said...

A friend of mine who is a nurse said I should also have my thyroid checked out. Apparently an enlarged thyroid would be an alternate explanation of some of my issues.

That seems less likely to me, though, as it wouldn't explain why it kicks in on the phone and Magic tourneys, but not elsewhere. Part of why Spasmodic Dysphonia seems likely to me is because of the weird triggers that bring it on.

Anyhow, it doesn't hurt to be armed with additional info and multiple possible things to have them check.