Posts made by Dr GO

OldPete,

Moshe brings out an important point regarding advising a trumpet component to rehab. Data and research are helpful and even more the most important information comes from the question: How are you doing?

What rehabilitation has been arranged for you?
Is the sternum pain (surgical site of chest wound) a significant problem?
If this is a problem, what makes it better; what makes it worse?

Please understand that this is an open forum with many readers reviewing our discussion. Patient privacy is ABSOLUTELY paramount. Only post what you think you may want others to experience to keep this on a user friendly learning curve. Any further advice will only come further should you want to update your experience. If you would also to communicate through personal message, I would be glad to advise.

@moshe said in Triple by-pass reocvery:

I had triple-bypass heart surgery right after Christmas, 2011... I remember that the hospital forced me to do breathing exercises that I hated.

But forcing air against trumpet resistance is quite different.

I would say that buzzing a mouthpiece would be OK since it is no different from the recommended breathing exercises,
but playing an actual trumpet would be too much strain while body is trying to heal.

moshe

I would agree that the soreness to the sternum is to be your guide. But I would not be afraid to use the trumpet as you can control and gauge the resistance. Actually buzzing a mouthpiece can increase resistance as opposed to letting in open into a leadpipe where blowing through a fixed opening will relax the expiration of air.

Here is an excerpt from a cardiology brochure the discusses home care recommendations:

While I appreciate personal experience, ignoring actual studies that demonstrate respiratory function can enhance rehabilitation is important. I do agree with Moshe, let soreness be your guide as to how much trumpet playing can be done, but playing the horn as soon as you can, will provide benefit to the road to recovery.

@Kehaulani said in A great cleaning breakthrough:

I order Roto-Rooter once a year. Works for me.

I have considered having a gastroenterologist to whom I refer my patients perform quarterly endoscopic evaluations of my horns and to perform bovie electrocautery to eliminate any plaques if found within the lumin of the horn. Perhaps I can use my American Federation of Musicians instrument insurance program to reimburse these expenses through a novel ICD-10 coding scheme.

@oldpete said in Triple by-pass reocvery:

...I came home last week [post CABG] and have already been told twice I was pushing it too hard. Slow for me, henceforth! I only play for self-satisfaction nowadays..

So there are many studies reported in the literature as to the best timing of Stage 1 Cardiac rehabilitation. The range is from 11 days to 4 weeks. What I found on reviewing the literature was an interesting Evidence-based randomized study that demonstrated that beginning a respiratory enhanced program to a routine Cardiac rehabilitation actually ENHANCES rehab and outcomes in participants:

So my interpretation of this (even though trumpet playing was not the respiratory intervention chosen) is that any activity that will improve respiratory muscle function, will improve oxygen flow to a newly re-vascularized heart, which in this study was found to increase the exercise capacity by an additional 35% in the respiratory enhanced intervention group compared to the standardized cardiac rehab group.

I would think that these studies would support trumpet playing as soon as 2 weeks post surgery and that trumpet playing may in fact enhance the 12 week post CABG rehab programs that are typically recommended. My only caution is to avoid any valsalva maneuver (grunting down to hit high notes) which may trigger a reflex cardiac arrhythmia. If any palpitations (racing or funny heart beats) or fatigue that is noted while playing, I would then recommend contacting the cardiologist to report these sensations to get direct feedback as to when playing can resume.

@barliman2001 said in Easter Services:

@Dr-GO Over here in Austria, Easter services tend to be a) Catholic and b) orchestral masses.,,,I'm booked into St. Peter's in Vienna

This is so classic, AND so amazing! I wish I could attend. This sounds so inspirational!

In the US we have some non-traditional venues and I experienced a rather interesting "praise" Easter Service where an area church rented out the University of Dayton Arena (where they play the first four NCAA tournament). They filled the arena with over 7,000 people and I was again hired by our AFM to play lead trumpet (there were 3 trumpets) and essentially a "Big Band" section, that was choreographed to a Hard Rock Band, that was choreographed to a very large choral group. The orchestra's book was filled with very contemporary music that sounded like it was written and arranged by Earth, Wind & Fire. It was energetic, highly IT integrated with video's, lights, and yes, mass baptism! This was highly non-traditional, and maximized sensory overload. This was several years ago, and has not been repeated since. There must be a reason for that, and I have my theories.

THEN there was the question as to what to charge. I believe many on this forum may do this for gratis; however, the Union got me this gig and requires a contract and a 10% finder charge. So I looked all over the internet. I found a wide array of charges for Easter Services. The steepest was in NYC; however, I chose a more regional contract that came out of Illinois. I decided to use that fee recommendation, broken down between rehearsal fee, performance fee (fist 3 hours) and travel expenses. Here is the contract to give you an idea as to how this can be put together:

Hope all this is helpful to our readers, as for me, the first time arranging this (Songs and Fees) took a lot of time and research. So for those of our member venturing out for Easter, I am hoping this makes your Hippity a bit easier to Hop... I Hope!

This is the Prelude tune chosen by the Organist.

The Trumpet Shall Sound. Again a C instrument part, with notation as to when the Trumpet is in with the melody, and when the Trumpet comes out to give some melody lines to the Organ. It really adds to the piece as we found in rehearsal to break the song up between Trumpet and Organ Leads.

Songs the Pastor has chosen for next Sunday's Easter Service:

Now All the Vault of Heaven Resounds. Again, a C instrument manuscript, with trumpet calls written in.

Songs the Pastor has chosen for next Sunday's Easter Service:

Jesus Christ Is Risen Today. Again, Pastor requested a Trumpet Intro which is scored at the bottom of the page which IS written for C instruments as is the printed manuscript. Again, as with the first song, I scribbled in trumpet calls to accent the organ lines.

Songs the Pastor has chosen for next Sunday's Easter Service:

Christ the Lord has Risen Today; Alleluia! This is the C score I play from (as I typically prefer transposing) AND Pastor requested I play a Trumpet intro before the organ joins, so I have written in the Trumpet Intro at the bottom of the manuscript... AND that intro IS written for Bb horn. I have also scribbled in trumpet calls to complement the organist in the main manuscript.

I thought it would be interesting to hear from all performing Easter Services. Would like to hear regarding the venue (Church, Cathedral, Coliseum) and denomination. Lists of songs to be performed would be of help as well.

The reasoning behind this posting is last year I received a call from my Local AFM that a Lutheran Church in the area wanted to hire a trumpeter to play their Easter Service last year. I had to pass a fairly rigorous interview by the church elders (seriously) to get the gig. I had to provide references, and was asked directly, do I know the Lutheran Hymnal? I was honest and said that the services I played in the past were Methodist and Baptist. So I posted on TM for some help from members as to traditional Lutheran Easter Service Hymns, and got an AMAZING response. It really helped my credibility to get the job, and it was a great success! Since last Easter, the same church hired me to play their Christmas Services, and I am again hired to play next week's Easter Service.

While this thread may not be of much help for this year, perhaps our members testing the waters for an Easter performance may want some advice in preparing for next year. Hope this is helpful.

If anyone wants to get to some of the classic TM Posts for there archives of amazing advice, use this link:
https://web.archive.org/web/20190119162733/http://www.trumpetmaster.com/

I can truly support that Ivan from Jaeger Trumpets and Austin Custom Brass (who I believe is already authorized) are amazing. It appears Flugelgirl also has an affiliation with selling horns. From her posts and amazing trust an intellect, I would strongly support authorizing her as a Seller as well.

Somehow, "without the" [ohne die] resonates with me.

Dr. Onady

@BigDub said in Oder Deutsch?:

@Kehaulani said in Oder Deutsch?:

I speak some German - Scheiss egal.

Me, too. Farfegnuten.

Or constipation: Farfrompooten

@moshe said in Dr. GO? My back's been bothering me...:

If a person has a knife sticking out of his back, it should be removed immediately, even if it is not causing any symptoms at the moment.

moshe

Moshe, for the important reason of staying in context, a knife sticking out of the back is a different clinical situation and a separate guideline. In medicine, we treat the specific etiology behind a problem. Nerve root etiology to pain is a very difficult and risky etiology to treat. IF the knife is the cause, (even true if not symptomatic) the knife should not be removed immediately in this situation!* In fact, if a knife wound is the etiology to nerve root pain (a very deep penetration), if the patient is found at the scene with the knife still in, EMS will stabilize the knife until the patient can have it removed at a trauma center where surgeons are available if other structures (major blood vessels) may be compromised.

We take an oath in medicine to first do no harm. The evidence I presented above weighs heavily for physical therapy first, which minimizes the risk for potential harm of unnecessary surgery.

I kindly recommend for the sake of the readers reviewing this discussion that we understand to keep the situation in context.

*https://www.jems.com/articles/print/volume-36/issue-6/patient-care/use-caution-impalement-injuries.html

@moshe said in Dr. GO? My back's been bothering me...:

If a herniated disk is crushing the spinal cord, the patient might not notice any pain.

The patient might slowly lose sensation and lose fine motor skills without realizing it.
moshe

If we did this, 80% of patients with anatomical abnormalities would have unnecessary surgery of which the majority of these causing lower extremity symptoms are in the Lumbar distribution. Moshe, were you having neck pain?

Typically FIRST physical therapy may be attempted then the nerve conduction can be re-tested to see if rehab alone is taking the pressure of a nerve.

My question to you, is did you have rehab first? If you did and this failed, then I can see surgery as being the next step. I must admit, the C5 region would have been more difficult to manage conservatively. And now I have a better appreciation for your special situation. There was so much missing from your personal presentation prior to your above post that I want to re-assure our other readers that "One Size Does not Fit All".

Just want to make sure Vulgano Brother is UNDERSTANDING THIS:

It goes on the WRIST (Read first word for priority!)

An informed patient is a happy patient

I don't know... what's wrong with a good ol' catcher's mitt? It protects against any wood that strikes it as a result of foul tips, AND can handle the balls that fall into the pouch!

And how does this relate to back pain... less strain [during the activity], less pain on the axial skeletal system; just to make sure we are all keeping on track with this thread!

You know, I used to get this as well, but I remember something Rowuk recommend on TM and this works well. Before each oiling after I remove the valves, I use a paper towel and wipe clean the valve, even tuck a bit inside the bore if I see any hint of deposit. I do the wipe even if I see no sing of residue. After doing this, my valves have stayed amazing debris free, which never use to happen between my typical three month cleaning.