Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
If you heard my interview with RobertF. Kennedy Junior on Friday, you
might have been one of the peoplehitting my text line saying please give this
guy doctor Opperman's phone number because hehas a condition. Not doctor Opperman.
Robert F. Kennedy Junior has acondition, a hereditary condition. His mother
had it as well, called spasmodicdysphonia. And I will say, though
(00:22):
I found his content very interesting,his voice quality is very hard to listen
to. So I thought I wouldgo straight to the man who has all
the answers, doctor David Opperman,and bring him on the show. He
is my voice doctor, He's Ross'svoice doctor, He's Dave Logan's voice doctor.
He should be RFK Junior's voice doctor. But they didn't ask me for
(00:42):
his phone number. So doctor Ropman, first of all, good to see
you, my friend. It's goodto see you as well. I'm happy
to help out here. So youare the man who handles all sorts of
voice issues, and I mean youreally cover everything that could possibly happen to
the vocal courts. I think that'sfair to say. Have you covered pretty
much every kind of case? Yeah, I specialize in laryngology. So it's
(01:04):
treatment of disorders of the voice box. And I was lucky enough to do
fellowships in UCLA with Jerry Burke,who pioneered one of the treatments for spasmodic
dysphonia that's currently used. We usebotox on a daily basis to treat this.
In my practice, we have aboutone hundred and fifty patients with this
(01:26):
that are local and or fly into be treated. Wow, what is
this? What is spasmodic dysphonia?What is the situation? So the best
way to understand spasmodic dysphonia is thescientific explanation. We believe it has something
to do with the basal ganglia andnot functioning properly in the brain and leading
(01:48):
to eight abrupt either stop of talkingor phonation as we call it, or
a pulling a part of the vocalcords to create a breathy sound. There's
two classic types we call them ADdoctor add doctor spasmodic dysphonian ab AB doctor
spasmoic dysphonia AD doctor sounds strangled andstrained and abrupt very tight breaks in the
(02:15):
voice abductor you get spontaneous breathy breaks, so it says if your chord stopped
touching and they actually produce this almostair burst during speech. The most common
type is ad doctor, which iswhat RFK Junior probably has a note I
(02:37):
have not taken care of him,so this is off of what we hear
and what he has prior said toother interviewers. The issue with spasmodic dysphonia
is it can be hereditary. It'snot always hereditary. It's more common in
women than men. It can beprogressive, or it can be stable from
(03:02):
when it onsets, typically on setsforty year old plus. And we see
a common pattern in patients a lot. They tend to be successful people,
Type A individuals, and stress definitelyseems to be a common onset trigger for
this. That's interesting. Yeah,I mean, so if you've lived a
(03:25):
low stress life, if you werea type A personality who decided to become
a Buddhist monk and you know,sit around and meditate all day, then
perhaps you wouldn't have it kick in? Is it? I mean, does
it have to do with endorphins?Do you have any idea what that connection
is? We actually don't know,And this is one of the hot areas
of research. And you can reallythank a celebrity for interest in neurodegenerate diseases,
(03:52):
Michael J. Fox and his unfortunatediagnosis at early twenties or mid twenties,
I believe with Parkinson's disease has ledto I believe it's just over six
billion dollars worth of contributions now tothe research and treatment of that disease.
Well, what's happened is all ofthese neurologic disorders that affect people are gaining
(04:16):
information from this, and we're gettingmore and more ideas on how to treat
these conditions. And it's it's youknow, you're throw enough money at it,
I think we'll eventually get it.We've done MRI studies around the country
trying to locate is there a specificarea in the brain, and they have
not been as clear as to acause as we had hoped. But we
(04:39):
do have ways to treat people,the gold standard of which is botox.
It's the same drug that everybody knowscommonly used to reduce wrinkles on the forehead
and around the eyes. And theironic thing is botox was not designed to
do that. Botox was developed totreat a very small muscle in the eye
(05:02):
in a condition that causes double visionin children primarily, and with the side
effect of it, How does somebodygo from let's make an injection for the
eye to I can take care ofthose elevens between your eyebrows, no problem,
Like how do you get How didsomebody go, let's put this into
our faces and see what the answeris? Well, what you end up
(05:26):
seeing is when they were treating this, one of the side effects is it
relaxes muscles. That's what botox does, and it happens to have the side
effect of if you get it inthe muscles in the skin around the eyes
that control the contracture of the skin, all of a sudden the wrinkles go
away. Well, once that wasknown, the cosmetic world erupted with we
(05:48):
have a way to treat wrinkles inpeople. And that's why it's a multi
billion dollar drug for the companies whohave made it and the competitors that are
now out for brand name box.So how effective is botox treatment for people
with spasmodic dysphonia. It's incredibly effective. It is a treatment, it is
(06:10):
not a cure, so it hasto be repeated approximately every three months.
It's injected into the muscles that areprimarily causing the symptom. So for adductor
add we injected into the actual musclethat wraps around the vocal ligament, called
the thyroriytenoid muscle. For abductor thebreath e break type, we inject the
(06:35):
PCA or poster cricoortenoid muscle in thelarynx, and what we're trying to do
is blunt the speed of the contractionsto smooth out the voice, and it's
very effective. Most people get aweak or two of some mild breathiness following
the injection for adductor spasimiic dysphonia,and then their voice will near normalize for
(07:00):
a couple of months. Then asthe botox power wears off, the spasm's
return and we get set to repeatthe injections. So, I mean,
I know you have not treated RFKJunior once again, we'll repeat that as
part of this. But he hashad some kind of treatment, because he's
talked about having some kind of treatment, So what else would there be that
(07:23):
he could have undergone that obviously isnot working. I mean to put it
subtly, Yeah, so I'm notsure why RFK Junior has not used botox.
There's some indication he is reluctant touse the botox just due to the
fact that it's a toxin and there'ssome concern on his side of what it
(07:46):
affects the body. On from whatI've read in articles, apparently he went
to Japan at one point and hada procedure done. We don't know the
exact procedure, but there are anumber of surgical procedures that have been tried
for this doctor Isshiki and Japan pioneeredprocedure actually four types that do something called
(08:09):
a thyroplasty, And what you're doingis altering the actual framework of the voice
box or larynx to put the vocalfolds or chords as we refer to him
as vocal folds into proper position andhelp stop the breaks. And what I
understand is he underwent the type inJapan that slightly pulls the vocal folds apart
(08:35):
to help stop these spastic contractions thatare shutting down his voice. The typical
results are kind of what you hear. It's blunting of the spasms, but
a choppy sort of abnormal sounding voice. There are other procedures. Doctor Jerry
Burke pioneered after a modification of alaryngeal nerve section procedure, and it's called
(09:00):
a slayed SLA D dash R orselective adduct or deinnervation reinnervation procedure, where
we actually go into the voice boxand remove a specific branch of the nerve
that controls the muscles that bring thevocal quirts together and are spasming, and
we hook those up to another nervein the neck which allows the spasms to
(09:24):
stop. That is the procedure thatScott Adams of Calvin and Hobbes had Gilbert
about that on Scott Adams is yeah, Scott Albert. Scott Adams is Dilbert,
Bill Waterson is Calvin Hobbs. Yeah, Hey, don't mess up my
two favorites comic strips right there,Doc, Okay, I know that I
don't know about voice start well,I know a little bit. So it
seems that and we do know thathe has been very vocal about his belief
(09:50):
that he was poisoned by mercury,that he had some mercury poisoning, and
that he is uh. And hesaid on the interview on Friday that as
as far as vaccines go, he'slike, look, if you want to
do it, he just wants tomake sure that we're studying all the negative
ramifications and making that information available.So I'm he is not a vaccine fan,
(10:11):
so you are right about that.So it would stand to reason that
he would probably also have concerns aboutthe botox. But dang doc. I
mean, he's out on the campaigntrail and he sounds and I got to
tell you, like talking to him, my voice hurt for him, right,
It was like, I have somuch sympathy for that. But is
it a painful condition or is itjust it doesn't come out the way he
(10:37):
wants it to kind of conditions Itcan be both. One of the most
disheartening parts of this disorder is forthe normal public, it leads to social
isolation because they're so self conscious oftheir voice and rightfully so, that they
start to isolate away from friends andfamily and groups. And it's very unh
(11:00):
healthy. Obviously, we want peopleto interact with people and enjoy life,
and if your voice is so badthat you're insecure to go out, it's
incredibly damaging to one's person. Inthe case of a presidential candidate, where
it's so critical he get his messageacross to potential voters. He could be
(11:20):
the best person in the world,and people will judge him by how he
sounds exactly exactly right. I waslike, are people going to go do
I want to listen to this forfour years? I hate to be,
you know, like petty and small, but a lot of voters are petty
and small, so it's like,you have to sort of get this stuff
taken care of. But it soundslike he's done what he's going to do
(11:43):
and he's just going to let thechips fall where they may. I actually
saw an article where he made acomment that his voice sounded terrible and he
felt bad for everyone listening to andit's not surprising he's developed some humor to
deal with us. But the sadthing is, I you know, botox
has been misunderstood in this condition.We deal with it a lot when people
(12:07):
come in and they're starting therapy thatthey're concerned you're putting botulism in their vocal
courts, which is not what wedo. It's a purified, very scientific
toxin derivative where it's very dose tospecific on what kind of effect we get.
It's not consistent in a linear curvewhere one unit versus two units is
(12:31):
you know, half the effect oftwo units. It's but it is consistent
within the person and you can finetune it to get a very good result.
The problem is that people hear thingsthat it's botulism toxin and they assume
that it's dangerous. Done properly,botox is extremely safe. It's used in
(12:54):
wrinkles worldwide daily thousands and thousands oftimes, and it's been tested in so
many people. We know what itdoes, and in the voice, it
can be effective to give somebody anear normal voice for a period of time.
Right, So we try and educatepeople what it is, talk with
them on it, and at leasttry it because it is a less destructive
(13:20):
way of dealing with the disorder thandoing a surgical procedure for it that may
or may not work and does haveother side effects. Yeah, but it
all wants surgery on their vocal cords, trust me on that. That sucks
anyway, Doctor David Opperman, thishas been very informative and I wish that
you know, I wish OURFK Juniorall the best, but it's unfortunate that
(13:43):
he's not willing to give this atry, just to see how it would
work on the campaign trail, becauseI do think his voice in a campaign
is a very big liability. Welive in a video and audio culture,
and it is challenging to listen tohim for a long period of time,
(14:03):
and it's difficult sometimes to understand whathe's saying. And that's death for a
politician. So I appreciate you makingtime for us today to kind of go
over this. I just thought itwas super interesting. So many people commented
on it, and they talked aboutwhy I love what he's saying, but
boy, listening to him is sohard while he says it, you know.
(14:24):
So it's tough politics, and Ithink he's making it probably worse on
himself. But if it's a principledstand, who am I to criticize?
You know? Who am I tocriticize? He thinks he's taken a principled
stan doc you know, well,it says something about his character. He's
willing to go out there and dothis even with this condition where it puts
(14:45):
him at a disadvantage. Hopefully hewill look into some treatment options as time
goes on a little bit more tohelp it be more clear. But everyone
has to make their own decision ontreatment, and and there are lots of
options, and that's the key here. But I hope he considers something because
(15:07):
his message is strong, and asa third party candidate, he really needs
to be able to get his pointacross clearly to the voters if he has
a chance of making a dent inthis two party system. Exactly. That
is doctor David Opperman for the ColoradoVoice Clinic. If you're having any kind
of voice issues, I give doctorOpperman two thumbs up. Ross gives him
(15:31):
two thumbs up. Dave Logan giveshim two thumbs up. Everybody that goes
to him give him two thumbs up. So if you need any help at
all, he's the guy to goto. Doc. It's good to see
you, man. I'll talk toyou again soon. It's good to see
you as well. Look forward toit.
If you heard my interview with RobertF. Kennedy Junior on Friday, you
might have been one of the peoplehitting my text line saying please give this
guy doctor Opperman's phone number because hehas a condition. Not doctor Opperman.
Robert F. Kennedy Junior has acondition, a hereditary condition. His mother
had it as well, called spasmodicdysphonia. And I will say, though
(00:22):
I found his content very interesting,his voice quality is very hard to listen
to. So I thought I wouldgo straight to the man who has all
the answers, doctor David Opperman,and bring him on the show. He
is my voice doctor, He's Ross'svoice doctor, He's Dave Logan's voice doctor.
He should be RFK Junior's voice doctor. But they didn't ask me for
(00:42):
his phone number. So doctor Ropman, first of all, good to see
you, my friend. It's goodto see you as well. I'm happy
to help out here. So youare the man who handles all sorts of
voice issues, and I mean youreally cover everything that could possibly happen to
the vocal courts. I think that'sfair to say. Have you covered pretty
much every kind of case? Yeah, I specialize in laryngology. So it's
(01:04):
treatment of disorders of the voice box. And I was lucky enough to do
fellowships in UCLA with Jerry Burke,who pioneered one of the treatments for spasmodic
dysphonia that's currently used. We usebotox on a daily basis to treat this.
In my practice, we have aboutone hundred and fifty patients with this
(01:26):
that are local and or fly into be treated. Wow, what is
this? What is spasmodic dysphonia?What is the situation? So the best
way to understand spasmodic dysphonia is thescientific explanation. We believe it has something
to do with the basal ganglia andnot functioning properly in the brain and leading
(01:48):
to eight abrupt either stop of talkingor phonation as we call it, or
a pulling a part of the vocalcords to create a breathy sound. There's
two classic types we call them ADdoctor add doctor spasmodic dysphonian ab AB doctor
spasmoic dysphonia AD doctor sounds strangled andstrained and abrupt very tight breaks in the
(02:15):
voice abductor you get spontaneous breathy breaks, so it says if your chord stopped
touching and they actually produce this almostair burst during speech. The most common
type is ad doctor, which iswhat RFK Junior probably has a note I
(02:37):
have not taken care of him,so this is off of what we hear
and what he has prior said toother interviewers. The issue with spasmodic dysphonia
is it can be hereditary. It'snot always hereditary. It's more common in
women than men. It can beprogressive, or it can be stable from
(03:02):
when it onsets, typically on setsforty year old plus. And we see
a common pattern in patients a lot. They tend to be successful people,
Type A individuals, and stress definitelyseems to be a common onset trigger for
this. That's interesting. Yeah,I mean, so if you've lived a
(03:25):
low stress life, if you werea type A personality who decided to become
a Buddhist monk and you know,sit around and meditate all day, then
perhaps you wouldn't have it kick in? Is it? I mean, does
it have to do with endorphins?Do you have any idea what that connection
is? We actually don't know,And this is one of the hot areas
of research. And you can reallythank a celebrity for interest in neurodegenerate diseases,
(03:52):
Michael J. Fox and his unfortunatediagnosis at early twenties or mid twenties,
I believe with Parkinson's disease has ledto I believe it's just over six
billion dollars worth of contributions now tothe research and treatment of that disease.
Well, what's happened is all ofthese neurologic disorders that affect people are gaining
(04:16):
information from this, and we're gettingmore and more ideas on how to treat
these conditions. And it's it's youknow, you're throw enough money at it,
I think we'll eventually get it.We've done MRI studies around the country
trying to locate is there a specificarea in the brain, and they have
not been as clear as to acause as we had hoped. But we
(04:39):
do have ways to treat people,the gold standard of which is botox.
It's the same drug that everybody knowscommonly used to reduce wrinkles on the forehead
and around the eyes. And theironic thing is botox was not designed to
do that. Botox was developed totreat a very small muscle in the eye
(05:02):
in a condition that causes double visionin children primarily, and with the side
effect of it, How does somebodygo from let's make an injection for the
eye to I can take care ofthose elevens between your eyebrows, no problem,
Like how do you get How didsomebody go, let's put this into
our faces and see what the answeris? Well, what you end up
(05:26):
seeing is when they were treating this, one of the side effects is it
relaxes muscles. That's what botox does, and it happens to have the side
effect of if you get it inthe muscles in the skin around the eyes
that control the contracture of the skin, all of a sudden the wrinkles go
away. Well, once that wasknown, the cosmetic world erupted with we
(05:48):
have a way to treat wrinkles inpeople. And that's why it's a multi
billion dollar drug for the companies whohave made it and the competitors that are
now out for brand name box.So how effective is botox treatment for people
with spasmodic dysphonia. It's incredibly effective. It is a treatment, it is
(06:10):
not a cure, so it hasto be repeated approximately every three months.
It's injected into the muscles that areprimarily causing the symptom. So for adductor
add we injected into the actual musclethat wraps around the vocal ligament, called
the thyroriytenoid muscle. For abductor thebreath e break type, we inject the
(06:35):
PCA or poster cricoortenoid muscle in thelarynx, and what we're trying to do
is blunt the speed of the contractionsto smooth out the voice, and it's
very effective. Most people get aweak or two of some mild breathiness following
the injection for adductor spasimiic dysphonia,and then their voice will near normalize for
(07:00):
a couple of months. Then asthe botox power wears off, the spasm's
return and we get set to repeatthe injections. So, I mean,
I know you have not treated RFKJunior once again, we'll repeat that as
part of this. But he hashad some kind of treatment, because he's
talked about having some kind of treatment, So what else would there be that
(07:23):
he could have undergone that obviously isnot working. I mean to put it
subtly, Yeah, so I'm notsure why RFK Junior has not used botox.
There's some indication he is reluctant touse the botox just due to the
fact that it's a toxin and there'ssome concern on his side of what it
(07:46):
affects the body. On from whatI've read in articles, apparently he went
to Japan at one point and hada procedure done. We don't know the
exact procedure, but there are anumber of surgical procedures that have been tried
for this doctor Isshiki and Japan pioneeredprocedure actually four types that do something called
(08:09):
a thyroplasty, And what you're doingis altering the actual framework of the voice
box or larynx to put the vocalfolds or chords as we refer to him
as vocal folds into proper position andhelp stop the breaks. And what I
understand is he underwent the type inJapan that slightly pulls the vocal folds apart
(08:35):
to help stop these spastic contractions thatare shutting down his voice. The typical
results are kind of what you hear. It's blunting of the spasms, but
a choppy sort of abnormal sounding voice. There are other procedures. Doctor Jerry
Burke pioneered after a modification of alaryngeal nerve section procedure, and it's called
(09:00):
a slayed SLA D dash R orselective adduct or deinnervation reinnervation procedure, where
we actually go into the voice boxand remove a specific branch of the nerve
that controls the muscles that bring thevocal quirts together and are spasming, and
we hook those up to another nervein the neck which allows the spasms to
(09:24):
stop. That is the procedure thatScott Adams of Calvin and Hobbes had Gilbert
about that on Scott Adams is yeah, Scott Albert. Scott Adams is Dilbert,
Bill Waterson is Calvin Hobbs. Yeah, Hey, don't mess up my
two favorites comic strips right there,Doc, Okay, I know that I
don't know about voice start well,I know a little bit. So it
seems that and we do know thathe has been very vocal about his belief
(09:50):
that he was poisoned by mercury,that he had some mercury poisoning, and
that he is uh. And hesaid on the interview on Friday that as
as far as vaccines go, he'slike, look, if you want to
do it, he just wants tomake sure that we're studying all the negative
ramifications and making that information available.So I'm he is not a vaccine fan,
(10:11):
so you are right about that.So it would stand to reason that
he would probably also have concerns aboutthe botox. But dang doc. I
mean, he's out on the campaigntrail and he sounds and I got to
tell you, like talking to him, my voice hurt for him, right,
It was like, I have somuch sympathy for that. But is
it a painful condition or is itjust it doesn't come out the way he
(10:37):
wants it to kind of conditions Itcan be both. One of the most
disheartening parts of this disorder is forthe normal public, it leads to social
isolation because they're so self conscious oftheir voice and rightfully so, that they
start to isolate away from friends andfamily and groups. And it's very unh
(11:00):
healthy. Obviously, we want peopleto interact with people and enjoy life,
and if your voice is so badthat you're insecure to go out, it's
incredibly damaging to one's person. Inthe case of a presidential candidate, where
it's so critical he get his messageacross to potential voters. He could be
(11:20):
the best person in the world,and people will judge him by how he
sounds exactly exactly right. I waslike, are people going to go do
I want to listen to this forfour years? I hate to be,
you know, like petty and small, but a lot of voters are petty
and small, so it's like,you have to sort of get this stuff
taken care of. But it soundslike he's done what he's going to do
(11:43):
and he's just going to let thechips fall where they may. I actually
saw an article where he made acomment that his voice sounded terrible and he
felt bad for everyone listening to andit's not surprising he's developed some humor to
deal with us. But the sadthing is, I you know, botox
has been misunderstood in this condition.We deal with it a lot when people
(12:07):
come in and they're starting therapy thatthey're concerned you're putting botulism in their vocal
courts, which is not what wedo. It's a purified, very scientific
toxin derivative where it's very dose tospecific on what kind of effect we get.
It's not consistent in a linear curvewhere one unit versus two units is
(12:31):
you know, half the effect oftwo units. It's but it is consistent
within the person and you can finetune it to get a very good result.
The problem is that people hear thingsthat it's botulism toxin and they assume
that it's dangerous. Done properly,botox is extremely safe. It's used in
(12:54):
wrinkles worldwide daily thousands and thousands oftimes, and it's been tested in so
many people. We know what itdoes, and in the voice, it
can be effective to give somebody anear normal voice for a period of time.
Right, So we try and educatepeople what it is, talk with
them on it, and at leasttry it because it is a less destructive
(13:20):
way of dealing with the disorder thandoing a surgical procedure for it that may
or may not work and does haveother side effects. Yeah, but it
all wants surgery on their vocal cords, trust me on that. That sucks
anyway, Doctor David Opperman, thishas been very informative and I wish that
you know, I wish OURFK Juniorall the best, but it's unfortunate that
(13:43):
he's not willing to give this atry, just to see how it would
work on the campaign trail, becauseI do think his voice in a campaign
is a very big liability. Welive in a video and audio culture,
and it is challenging to listen tohim for a long period of time,
(14:03):
and it's difficult sometimes to understand whathe's saying. And that's death for a
politician. So I appreciate you makingtime for us today to kind of go
over this. I just thought itwas super interesting. So many people commented
on it, and they talked aboutwhy I love what he's saying, but
boy, listening to him is sohard while he says it, you know.
(14:24):
So it's tough politics, and Ithink he's making it probably worse on
himself. But if it's a principledstand, who am I to criticize?
You know? Who am I tocriticize? He thinks he's taken a principled
stan doc you know, well,it says something about his character. He's
willing to go out there and dothis even with this condition where it puts
(14:45):
him at a disadvantage. Hopefully hewill look into some treatment options as time
goes on a little bit more tohelp it be more clear. But everyone
has to make their own decision ontreatment, and and there are lots of
options, and that's the key here. But I hope he considers something because
(15:07):
his message is strong, and asa third party candidate, he really needs
to be able to get his pointacross clearly to the voters if he has
a chance of making a dent inthis two party system. Exactly. That
is doctor David Opperman for the ColoradoVoice Clinic. If you're having any kind
of voice issues, I give doctorOpperman two thumbs up. Ross gives him
(15:31):
two thumbs up. Dave Logan giveshim two thumbs up. Everybody that goes
to him give him two thumbs up. So if you need any help at
all, he's the guy to goto. Doc. It's good to see
you, man. I'll talk toyou again soon. It's good to see
you as well. Look forward toit.
The Mandy Connell Podcast News
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