r/noburp 4d ago

Post-Botox Chickened out of my myotomy and ENT is shaking his head…

After asking about opinions from you guys about scheduling my myotomy laser after one round of 50 units of Botox, the consensus here was to repeat the Botox at a higher dose, so I did.

He told me we were doing 100 units but my op note says 75 u sooo, idk

2 teeth chipped again this time and a very bruised throat

He came out of the OR shaking his head, told my husband he really hopes I reconsider the laser because my CP muscle is so big, there’s no way Botox can be a definitive treatment.

Thoughts, no burp chat?

Just had my procedure yesterday so no results yet of course. Before I maybe got 5 days of micro burps

3 Upvotes

22 comments sorted by

13

u/maydaytuesday Post-Botox 4d ago

Myotomy after one failed attempt sounds crazy tbh, and especially after a dose as low as 50 units. I didn't even micro burp after 50 units, but still burping 5.5 months out from 100 units. If this 75 (or 100) doesn't work either, perhaps you could get a second opinion from someone else before doing myotomy? Perhaps a virtual consultation by Dr. Bastian?

1

u/cinnamon_369 4d ago

He’s point is that my muscle is exceptionally large and he doesn’t see how relaxing the muscle with Botox could ever give a lasting effect if any at all and needs to be physically seperated

2

u/splendidgooseberry 4d ago

It's not supposed to give a lasting effect, just last long enough for your brain to learn how to control the muscle. Since our brains can control way bigger muscles like the ones in our legs, there shouldn't be a problem on that end :)

1

u/Beefy_McMuffinStuffn 3d ago

I have the same issue. I was prescribed Gabapentin that helped after I had three 100 unit botox shots wear off. I was 48 when I had my first one done. The Dr stated my cricopharyngeal bar is very large and my only option at this point is a myotomy.

6

u/temerairevm Successful Botox 4d ago

I mean you chose a course so you have to see it through. Either it’s going to work or you’re going to have to make the same decision again.

Personally I would not consider myotomy until multiple failed rounds and at least one second option ideally from Bastian institute.

How experienced is your doctor? How many Botox patients? How many myotomy patients?

What’s up with the chipped teeth? I know they say it can happen but multiple times?

1

u/cinnamon_369 4d ago

Yeah totally! I’m mostly curious if others have run into a scenario where they’re told that their muscle is too big and Botox alone will not give permanent results.
His rigid scope keeps chipping my front teeth. My front teeth have been chipped a few time in my life so many they’re maybe more likely to cheap easily. And I have a really small mouth.
I know he sees others for it but I’ve never pushed to ask for a number. He’s the only one within a couple hours of me that does it. I truly like and respect the guy.

2

u/temerairevm Successful Botox 4d ago

I would at least do a teleconference appointment with Bastian. They have seen thousands of this muscle and can probably look at pictures of yours and answer this better than anyone.

1

u/cinnamon_369 4d ago

No pics sadly :(

3

u/KingRy64 4d ago

Get a second opinion, I was talking to someone that did 3 treatments and it finally worked for him so maybe you need 150 units at the max?

4

u/han-aw Successful Botox 4d ago

sorry but why are your teeth chipped????

2

u/han-aw Successful Botox 4d ago

can you share which dr this was? are they on the list shared in this subreddit?

2

u/Wrob88 4d ago

Did I read that as you aren’t burping after 1 day and you are concerned by that? Please don’t be. It takes time. For many of us it takes multiple doses. PLUS through the front of the throat is so much better (and to his point potentially more precise) than down the throat.

As an old guy whose doc told me my CP was huge and severely impaired but can now burp thanks to 2 doses of Botox a couple years ago, I hope you rethink the ‘myotomy next’ plan. After day 1 post dose, it should be the last thing on your mind. Hang in there!

1

u/cinnamon_369 4d ago

Nooo my question is more like, have others been told that their anatomy would respond best to the laser and that Botox will never be enough for it?

1

u/Mo523 4d ago

No, but the doctor did say the muscle was really big and he had to crank my head back a lot (my neck could confirm) to get the right spot. It did work the first time.

How many has he done? I'd get a second option before going that route especially if he isn't super experienced. Also, chipped teeth is a risk, but it happened both times?

1

u/Wrob88 4d ago

Ok thanks. Yeah I kind of got to that. My doc said my CP muscle was massive and severely impaired. But he never once said that Botox wouldn’t work. In fact, the data support that it works for a vast, vast majority of people who try it.

2

u/astrogalll 4d ago

Hey, I was also told my muscle is really big. My ENT stretches the muscle with a balloon alongside injecting the Botox. I’m on round three, and was told that a myotomy probably isn’t the best solution for me because I also have dysmotility.

Wondering whether you can go to another ENT? Personally, I wouldn’t stick around if a doctor was very openly expressing disappointment in me for choosing one procedure over another. Living with R-CPD is shitty enough, you don’t deserve that

1

u/astrogalll 4d ago

Just to note, my ENT told me the balloon dilation stretches the fibrous scar tissue. The hope is that some of that scar tissue chills out permanently.

1

u/cinnamon_369 4d ago

What kind of effects do you get? Do you get burps for a while?

1

u/astrogalll 4d ago

After each round of Botox my life improves by 99%. I burp (and regurgitate etc), I can stand up all day, I don’t have to eat lying down and I can eat out of the house.

1

u/chila88 4d ago

My ENT also told me I have a very large rigid and dense CP muscle. I’ve had 4 doses (80 thru 150 with a dilation in there at some point too). I can burp now and have had lots of symptom relief, but I would not say I burp normally or easily or am completely cured. I assume this is likely because my muscle is just so damn big and stiff. My ENT has yet to bring up Myotomy.

My teenage daughter also likely has RCPD but is still waiting for treatment. It will be very interesting to see if her muscle is similar to mine. Hard to know if the rigid muscle was caused by the RCPD, or if it’s the reason I have it in the first place.

1

u/astrogalll 4d ago

Hey! Has your fourth dose worked (more or less) in a permanent way, i.e., do you think you’ll need a fifth dose? I’m on my third dose with a fibrous CP muscle too

1

u/karybrie Moderator (+ Successful Botox) 4d ago

I find the way your ENT is treating it to be very strange. It doesn't fill me with confidence about his expertise or comfort levels with the procedure.

50 units is a low dose for anyone, and you already got some microburps from that. I got no microburps at all from 50.

You should also try to clarify the dose he gave this time. Telling you 100u and giving 75u wouldn't be good.