Well I would say my main problem is with slurring, which can make it very difficult for me to be understood sometimes (sometimes I just get humming noises because my lips won't move at all!). But I also sometimes have problems controlling the pitch of my voice and recently I was given some cinnarizine by my GP, which I had extremely bad reaction to, and which made my speech very high pitched and wavering. I could do nothing to control it. Other times I stutter or use completely the wrong words - again, no control over how it comes out. Now I am scanning my speech a lot, the words are very broken up and my voice quite sort of croaky and slow sounding. Making any effort to inflect the voice is tiring, so it makes sense that it would sound monotone. Well that's how it is!

wild_cat

When I am having a bad day, my voice becomes hoarse and raspy. I can get so that I can't talk. My tongue feels think and it makes me sound funny. My overall voice sounds nasally. I have noticed problems controlling pitch.

Yet when I am well rested and have enough mestinon, I can sing like I always did. I haven't tried long sessions. About an hour at a time is what I am doing now.

I haven't had any issues with my speech since getting on the Mestinon. But prior, I would get the feeling of a knot in the back of my throat that would prevent me from speaking properly. I'd start to slur and get a real nasal sound to my voice. And then there would be the occasional word I just couldn't get out. It would feel like a combination of not being able to get my mouth/lips/tongue into the right positioning to form the word correctly, and that feeling in the back of my throat preventing me from getting any sounds out.

Voice is the combined effort of numerous muscles.

So, why should it surprise you that it fluctuates like that in an illness whose hallmark is fluctuating muscle weakness?

If the respiratory muscles are the prominently weak muscles you will sound breathless (=anxious) when you talk, if the laryngeal muscles are effected more it will change the pitch of your voice, if it your palate it will become nasal etc etc.

For me it was very embarrassing that my occupational physician has a name I find hard to pronounce
With time I have found the solution for that-I call him by his first name.

The only thing that surprises me is that the doctor´s secretary keeps winking at me and saying it´s probably the menopause! Oh! And what also surprises me is that my good mood does not necessarily deteriorate along with my symptoms!

When I read ´nasal´ 20 times relating to the voice in MG on the internet I just want to be like everybody else or not have it at all!
So, myasthenia affects respiratory, palatial AND laryngeal muscles
I guess I should know that, but sometimes you just need someone real to tell you it
Great to hear everyone´s descriptions....

Thank you,

Anacrusis

Thank you wild_cat - I´m borrowing these lines! Hope that´s OK