Transcript Summary
Feeding of the brass player.
And this lecture actually arose out of the many calls
that Claude and I have gotten over the last years or so
that we've been working together, various brass players,
mostly tromba players, about things that have physically
gotten in their way.
I mean, not just bad practice methods
or not playing the horn right, but I'm
talking about physical disabilities
that have disturbed them.
And Claude has it easy out with me now.
Instead of having to think it out himself, he just says,
he writes down my number or calls him and says, call him.
And I get these calls at 2 in the morning
with guys on the Basie band with chest pain.
And I got a fellow that I couldn't
be sure he wasn't having a heart attack from the symptoms
he was telling me.
I didn't think he was, but 2,000 miles away,
I wasn't about to take the liability.
So I sent him to the emergency room there.
I think it was someplace in Indiana.
And indeed, he was having angina.
So tromba players, brass players can
get health problems that keep them from being able to play.
And since our body is the real instrument,
the trumpet just magnifies what we produce,
the frequency that the lips vibrate at and the air speed
and all the intimate changes within our body
are really the instrument.
And so that's why a player's sound is so characteristic,
because it's really he is an instrument made differently
than anybody else and has his own individual sound
and feel and play.
So you need to realize that tromba playing
is really an athletic endeavor.
It's work.
Those of you who've played long, hard jobs
know that when you're done, you're not only psychologically
fatigued, but you are physically fatigued.
You have muscle pain in the back and the chest
and some in the wrist.
I've had patients call with problems in their wrist
from holding the horn so long and so strangely.
And when you've played hard and arduously,
you are fatigued and you're worn out.
That's because it's like going out and bailing hay
or trucking cement in a wheelbarrow.
It's hard work and it burns calories.
But the problem with trumpet playing itself
is that it's not aerobic for a festival.
I thought you started so early.
It's not my time.
We couldn't get in there.
We couldn't, so we just put it in here.
No key.
Tom's getting cookies like that.
She was celebrating her birthday.
Remember, she told us she was going to come.
Oh, that's right.
OK, well, I'll sit right there then.
OK.
Or you can sit up here.
All right.
What do you mean by that?
This is my specimen.
Instead of going over to the biology lab,
I asked him to bring him in.
So anyway, we want you to know how
to take care of this instrument that you were born with
because it's all you've got.
If you break this instrument, you
can't take it down to the repairman
and have him take the dents out very effectively.
You can't have yourself relacted.
You can't have the mouthpiece changed or whatever.
When you have damage to your body,
if it's irreparable, like some of the things we'll talk about,
you're stuck with it.
And it'll affect the way you play.
It'll affect your ability to play.
You can say that.
Trumpet playing is not aerobic.
And that's where the problem gets in because most trumpet
players neglect the right kind of exercise
because they get a lot of work, but they
don't get aerobic exercise.
And so some of the things we're going to be talking about
is, what can you do to get physically in shape?
That means that right down to a muscular level,
at the cellular level, when you're physically in shape,
the biochemistry of that cell utilizes oxygen
better if you're physically fit.
There's lots of stuff in research and sports medicine
now that, based on actual muscle biopsies from patients
before they began a fitness program
and after they were on the fitness program,
that shows the cell is more efficient in producing energy.
So for your overall well-being, these things are really important.
The benefits of an aerobic exercise program,
which we'll talk about, are that they decrease your blood pressure,
decrease your weight, decrease the risk of cardiovascular disease,
which is still the number one killer of Americans
despite all the other diseases, although AIDS is coming up quick.
There is a decrease in the cholesterol and the fats in the blood stream
which cause hardening of the arteries.
In fact, exercise and red wine have been the two things in the literature
that are described as having an ability to decrease the lipids,
and actually found that sexual activity increases the good fats.
So I used to say, you know, jog between bars,
and now I'm not sure what you should jog between bars or other places.
Anyway, we know for sure you need to jog.
It's like the guy that came in and the doctor said,
you know, you're just burning out.
You've played this trumpet at all these low-life places,
and you've been drinking this wine, women, and song.
It's going to kill you.
And the guy says, well, I guess I could give up singing.
But we can't give up trumpet playing.
I went into chiropractic the other day.
I'm not even going to listen.
And the nurse, you told me you were going to chiropractic.
I will play.
Anyway, the nurse said, how do you feel?
I said, I don't understand.
I said, I feel good, but I am so tired all the time.
She says, I said, I can't understand it.
She says, I know what's wrong.
It's that young woman you married, and I'm going to have a talk with her.
I'm not going to even touch that.
He's been...
No.
You heard about a wind sock?
Oh, don't touch that.
I don't fly.
Oh, I know.
OK.
There's a thing called endorphins that are produced in the brain,
and they have to do with our pain threshold,
and they have to do with our level of well-being.
Endorphins in people who are depressed are low,
and so it's been found by kind of serendipitous changes.
By that I mean just by happenstance in medicine
that when we administer antidepressants to people,
they have less problem with pain,
because the endorphins responsible for our mood
are closely related to the chemical in morphine,
and morphine makes you feel great,
and morphine raises your pain threshold so you don't have pain.
And so we can produce our own natural endorphins by exercise.
So psychiatrists now across the board encourage their patients to exercise
during their problems with depression.
So we want to increase these endorphins,
and that's another benefit of aerobic exercise.
I'd like to talk just quickly before we get into specifics
about the risk for cardiovascular disease,
because that's the one that I see the older musicians all turning up with,
and Claude is no exception.
He had his coronary bypass 10 years ago.
Oh, that doesn't seem possible.
I was skiing in Oregon,
and I got a call that Claude was in the emergency room in Los Angeles
with chest pain,
and he went on to have to have a coronary bypass to prevent heart damage,
and that was accomplished, and he did amazingly well with that.
But coronary artery disease is a real problem
for people who abuse their diet, their exercise, and their way of life.
And it's real easy for musicians to do that,
because you're on the plane, and you're in hotels,
and you're eating out most of the time.
It's very difficult to eat correctly.
I understand. I always ate good Trump.
I know.
I know.
Steak and eggs, I can't understand it.
Seven grams of cholesterol every morning.
The problems are that trumpet players develop the risk factors
for blood vessel disease.
Strokes and heart attacks are from narrowing of these coronary arteries,
and the risk factors are these five.
These are the top ones that you need to remember.
Obesity is the most common thing.
They did a study with a city in Massachusetts called Framingham,
and they've studied this city now for about four generations,
and they have seen what people had in common that had heart disease.
And the number one thing they had in common was obesity, overweight.
We define obesity by being 20% over your ideal weight.
So it's not just a little bit.
Heavy 20% is a major amount of overweightness,
but that's the most common thing that people who have heart attacks
and blood vessel disease have.
The other thing is high blood pressure.
So you want to make sure that you do everything to keep your blood pressure down.
The other thing, the third factor, is smoking.
Smoking increases the rate of cardiovascular disease about eight times.
Little drummer boy.
The guy's got rhythm, doesn't he?
What was the name of that?
I would do playing facilita.
It's a good thing he's my friend.
So anyway, smoking is something that if you stop within a few years,
your risk returns to normal.
And it's not that way with your lungs.
You stop smoking, your risks pretty much stay where you were when you stopped smoking.
But the effect that smoking has on blood vessel disease is reversed really quickly,
at least statistically.
So you want to do all you can to eliminate those five risk factors.
And the reason I talk about an aerobic training program is that
that's an important part of doing that.
Really what we're doing with breathing exercises is trying to improve
not only your wind power, but your cardiovascular system by regular exercise.
I don't have a blackboard.
I usually write out all the formulas that I give to patients when I prescribe an exercise program.
There's a specific way to do that, but we won't do that because we don't have the blackboard.
I'd like to talk to you a little bit about the lungs,
since the lungs are really the prime organ of respiration,
which is very important for playing brass instruments,
we need to protect the lungs.
I can't imagine it, but I still play jobs where trumpet players smoke.
It just doesn't make a bit of sense.
And I don't like to play jobs with them because the statistics now show
that my risk is worse than theirs just being around them.
So I don't have any qualms about saying to people,
hey, would you mind putting that cigarette out?
And I think that we need to all be that assertive in this society.
It's changing.
It's no longer acceptable to have to be around that sort of thing.
Most smokers will deal with that without much trouble.
There are some other exposures that you need to know about that can be lung problems.
Over a period of time, if you have problems with allergies,
your nose gets stuffy and it runs,
and you get a thing we call post-nasal drip,
that can cause chronic problems with your lungs in the form of chronic bronchitis.
I see a lot of patients who have had chronic allergies all their life,
and they end up with chronic bronchitis and some of them with emphysema
and never smoke today because they've had this low-grade infection in their lungs.
They don't really notice it when they're young.
When they get into their 50s and 60s and older,
it begins to affect the lung capacity.
So you want to stay away from allergy problems.
If you have that kind of problem, you want to get treated.
You want to get your doctor to prescribe some things to dry that up and take care of it.
Dust exposure.
When I go on a Jeep ride or any place where there's going to be dust,
I like to wear a mask if I can because your nose filters a certain amount of that.
But if you look at lungs over a period of years,
they're scarred by what we take into them.
And if you breathe a lot of dust, it'll coat the lungs and cause problems.
We see tremendous changes in farmers who ride their tractors,
and their lungs are unprotected.
It actually will end up causing a thing that actually almost calcifies the lungs.
So you want to be very careful about that.
Post-nasal drip.
People with asthma.
Claude had asthma.
Trumpet playing actually is a good way to open up the airways of an asthmatic
because we have patients who are asthmatic.
By that I mean their bronchial trees constrict for various reasons,
allergies and inherited tendencies and other things.
And we have them take some breathing treatments to blow that open.
And it's the resistance that keeps those airways open.
A lot of people who are not asthmatic at rest
will have what we call bronchial airway obstruction
or end bronchial obstruction with high exercise.
Just walking up a hill, you may feel yourself kind of...
Those airways collapse.
Nice cookies, but no keys.
The airways collapse,
and so we teach patients to do what we call first lip breathing.
That adds some resistance to the expiration,
so the back pressure opens up the lung, opens up the bronchial tubes.
So trumpet players, and Claude I think is a good example of a guy who had asthma
but was probably protected by playing his trumpet.
But if you don't take care of your asthma,
if you've got asthma continually,
it leads to chronic destruction of the bronchial airways,
the bronchial tree,
and so you want to make sure that you get that treated.
There are lots of good ways to treat bronchial spasm or asthma.
And if you're one of those people who gets it just with exertion,
you may not recognize it unless you're watching for it.
You certainly don't want to develop a pneumonia,
because when you get a pneumonia, the lungs have part of them destroyed.
You may heal, but there's always a little bit of scar in that lung.
When we open up a chest, we see those scars from pneumonias that have even healed.
Patients feel fine. They've got enough respiratory reserve.
They don't really realize there's much difference.
But if you get down the line as you get older, it can make big differences.
I see patients who get pneumonias repetitively.
People tend to be what we call chronic lungers.
If they get one infection, it tumbles to the next one,
and they lose lung volume, and that affects their playing.
It affects their ability to take in air and to move air.
A little bit about some of the diseases that we've seen affect trumpet players.
We've seen trumpet players with mononucleosis, hepatitis,
problems with strep, infections in their throat, all basically from sharing trumpets.
I used to enjoy going to the trade shows and playing all the trumpets.
But have you ever watched who plays all those trumpets?
It's really pretty scary.
I took a sample to the lab just out of my horn before I cleaned it,
the stuff that comes out of the lead pipe.
I cultured it, and within 24 hours I got this what we call panic-stack call from the lab guy saying,
I don't know what this patient's like, but he's got every organism, no demands.
We basically treat infections based on the culture from the lab.
The worst of the bug, the worst of the disease, this one had pseudomonas, which is a bad one.
It had a lot of strep and a lot of E. coli, it had Klebsiella, it had you name it.
The kinds of things we see in seriously ill patients are growing in your horns.
We can't culture viruses, but we know that viruses can be passed in a trumpet section.
Carl called me some time back, and there was a fellow in his section, I believe, that had mono,
and I think he shared his horn with Carl.
He was caught in a tankard and all our water glass was down by our feet.
He was caught in a tankard and he never folds.
I wasn't playing this morning.
Well, it's an easy thing to pick up through sputum particle transport,
and most infectious diseases, including maybe AIDS, despite the publicity from all the politicians
that they don't want us to know, probably are passed by droplets, sputum droplets.
So this harmless sputum that we release through the spit key is something to be considered.
I don't like to let people play my horn.
It happens all the time.
People want to try different horns and those sorts of things.
It's scary to me, especially knowing what's in those horns.
Enough said about that sort of situation.
The AIDS thing is really scary.
It's so much more scary than we're allowed to even go on about.
May I ask a question?
Concerning the AIDS thing, you definitely feel that it can be passed like trying mouthpieces and that sort of thing?
Well, you know, they tried for a long time to say that AIDS was not transferred by sputum particle,
but only by blood injection like a scratch or a transfusion.
But there are now several proven cases of AIDS transferred by sputum particle.
And there was an elderly couple.
He got AIDS from a blood transfusion, and she got AIDS from him,
and the only contact they had was living together.
So it was sputum particle transfer.
And there are several other of those sorts of things.
So it leads you to wonder about sputum of any kind,
whether it be in your mouthpiece or in the lead pipe or where it might be.
The AIDS thing is tremendous.
It's so scary that our nation does not want to face it.
It's the first disease that we have treated politically.
We have tuberculosis, which has been around for a long time,
but we isolated tuberculin patients and still do in wards,
even though we have drugs that will cure it because we know that it's a devastating kind of thing to get.
Routinely, when I was first in practice, every patient that walked into the hospital got a test for syphilis.
He didn't get asked.
He just got a test for syphilis if he was going to be operated on especially.
And even though we had good drugs that cure syphilis, we don't have a cure from AIDS.
It's the first disease that we've ever had where everybody that gets it dies.
And yet we don't even quarantine like we used to quarantine for measles.
And we don't allow blood testing.
We don't test to know who has it.
We don't do any preventive medicine techniques.
And the disease, if it follows its exponential multiplying change,
according to the CDC, the Center for Disease Control, a lecture that I attended,
a fellow drew a graph and a slide and he said,
if we don't do something to stop this AIDS exponential development,
the whole country, the United States, could be wiped out by the year 2010.
That's really scary.
And luckily we are having some effect with the, particularly the homosexual group,
are becoming a lot more monogamous.
And that sort of thing has declined the incidence in that one group.
But the incidence in other groups, drug users, teenage girls, is rising.
And it's really scary.
I think that it's just a tragedy that we don't have the fortitude to stand up and say,
you guys can't play politics with our lives.
It's going to wipe out Africa.
Ninety percent of some of the people in the smaller countries in Africa have AIDS.
It's a scary thing.
So anyway, enough of that.
At this point I usually go into how to prescribe an exercise program.
But since we don't have that blackboard to work with,
I'm going to talk with Claude about some of the other things that we see.
One of the things that Claude really wanted to make sure you all understood is
what the problems are with your hearing if you are a trumpet player or a brass player.
You're around loud noises just like people who run jackhammers and shoot firearms
and work in foundries where there are loud noises.
Many of you, I'm sure, have played in a trumpet section with a group of loud playing trumpet players,
especially if they play into their stand and it comes back at you and your ears ring after the job
or even during the job and you may get a little bit dizzy.
That kind of chronic exposure takes away the high frequency response of the timpani membrane,
the eardrum, and it no longer can respond to that.
It actually causes nerve damage to the nerve that conducts the sound to our brain
so that people begin to lose their hearing.
I've seen a lot of trumpet players that have been around for a long time
and most of them have hearing loss.
So I've gotten to the place where if I'm going to be in that situation for a long period of time,
a big band job for a long time, I put cotton in my ears.
I can still hear, but it takes away the tremendous amplitude of the noise.
I often think, what about the trombone player who's sitting right in front of me
or the second trumpet player who's sitting right in front of the cymbal?
You know, that's a tough one.
You keep hearing that ride cymbal going all night long.
If you go to an audiologist now, they have a special hearing protector
that's made just for musicians. It only cuts out certain frequencies.
They've had those and they've used them in airplanes.
Pilots have used them for a long time because of the noise there.
They're pretty effective. I've tried them.
They cut out more than I want to cut out.
Well, I don't know.
I may not know that.
I'd like to have more information about that.
Larry.
Great.
I have a young student. He's in his 20s up north in the San Francisco area.
He's been playing for several years in a rock band.
The amplifier is on both sides of him, just full volume.
It's not the trumpet that's getting it. It's the amplifier.
All of a sudden, his ears ring all the time.
He went to the doctor and there's nothing to do about it.
They give him things to wear to stop the sound from coming in.
But every time he hears like he did a show a few weeks ago,
and they had a gun on stage and they hacked.
When the gun went off, his ears started ringing,
and they haven't stopped for several days.
And he is really frightened because he's only in his early 20s,
and his ears are about shot.
And that won't come back?
No.
That won't come back?
I think rock things are this idea that everything has to be so loud that it shakes the building.
I think that's terribly detrimental.
I went into one club one night and they had an 18-piece orchestra.
They had an amplifier on every instrument.
It was all mic'd.
Can you imagine that?
When the soloist came out to play, he came out to do a jazz solo,
and everything was amplified so loud that even he had the mic right in his belt,
you still couldn't hear anything.
That's not necessary.
No.
It's not just a problem with bands.
He used to play a lot in salsa clubs.
The band was a level of pain threshold.
The DJ is in between sets.
So we were walking on and off stage.
We didn't have a back floor, and we had to walk right in front of that stage,
right in front of the house mains.
And that's what got me started on Airplane.
It wasn't the band level that was going between sets.
So not to belabor the point, but you really need to protect your ears,
because if you don't have ears, you're not going to be the musician you want to be,
because your ears are the key to hearing what you're playing
and changing what you're doing, because you hear something you don't like.
Our whole appreciation of music is dependent on your ears,
and you've got to protect your ears,
especially the kids now that have a chance to do it before it actually happens.
Another thing that we see fairly frequently is the common cold sore.
This is really a virus called herpes simplex,
and it's relative, very close relative,
maybe even the same thing as the chicken pox virus.
Chicken pox we all get when we're kids.
Usually by the time we're two or three, we've all had chicken pox.
The virus stays in our system, and for some people it affects the mucous membranes.
Some people it's right on the lip, others it's inside the mouth,
and it usually happens or comes out when the body's resistance goes down,
for one reason or another.
Some it's stress, some it's exposure to sunlight, a sunburn on the lips.
It can be a sign that there are other infections or other problems in the body,
so you need to pay attention to what's happening.
I've had patients who get cold sores so frequently
that they continually have a cold sore some place in their mouth.
There are some things you can do that are real painful.
Those of you who have had them, they're real painful.
I happened to see one of the trombone players that was playing up at the jazz festival in Sacramento
had a cold sore the first day I saw him.
The second day he had a big bleeding gash out of his lip.
He continued to play on that thing for the whole time,
and he should have had it taken care of.
There are some things you can do.
We use a silver nitrate stick, which is caustic, and it will cauterize that spot.
I don't like to do it out here on the vermilion border of the lip,
because it does leave a little bit of a scar,
and inside the mouth I use it fairly effectively.
If it's near a tooth where there's going to be pressure,
particularly if it's a bottom tooth where there's going to be more pressure,
sometimes you can effectively treat that with a silver nitrate stick.
The other thing that I've given some brass players information about,
there are anesthetic creams that you can buy with a little xylocaine in them,
like viscous xylocaine, that you can put on there,
and if you have to play it will deaden that discomfort.
Things will go away if you don't chronically irritate them,
but if you have something important that you have to do,
and you've got to deal with it, these viscous things will help.
Through the experience that I've had,
L-I-Z, which is a food supplement or a vitamin, whatever you want to call it,
actually handles that, because I get whole sorts of things,
especially when I eat lots of fruit.
For some people, the citric acid seems to do it.
Yeah, and so I refuse to get out of the fruit.
I mean, it's like when I get that, I just take the L-I-Z,
I take a wild vitamin A, it's not going to kill the cells,
and I deal with it that way.
I can't get this used in a refinery,
when they like that movement, stuff like that,
because that has a carotid effect too, and I use that too,
but if you do that, you actually have to deal with it.
I'm starting to yell on the screen.
Well, there are some other things.
I had a food store when I was at the studio.
It went from here to here,
and on the lower lip, it went from here to here,
all at the same time,
and there's no way I could get out of the way of playing that job.
It was a show called The Whistler,
a murder mystery,
and the trumpet parts were much more frightening than the show.
I wanted to play that show,
and I said, can you play with that?
And I said, sure.
And when I pulled the mouthies off my mouth,
the skin would come with it off of both, either one.
That was the most painful evening,
and it finally healed up.
Unfortunately, I put camphor phonique on it,
which I think sterilized it,
and that's probably all it did.
But you know the thing,
unless I don't want to step on your mouth,
a dangerous thing about that is the trend today
to playing on open brass, no plating.
And you see that advertised?
Like I tell you, you get a brass mouthie,
it sounds better.
That's baloney.
That has nothing to do with the sound.
And what do you do?
If you've got a bracelet on your lip,
it'll pick up brass poisoning.
And brass poisoning is very serious.
Even if your horn is brass
without some kind of a covering or a lacquer,
you can get it right from your hands or anything.
And tell us about brass poisoning,
what it does and what it is.
Well, brass is a metal, a heavy metal,
and it's taken into the bloodstream
and metabolized in the liver
and in the kidneys to a certain degree.
And it deposits in those areas,
and so you begin to have abnormalities
with the function of those organs.
You can have actually even a bronzing of the skin
and a cirrhosis of the liver type thing will occur
if it's chronic exposure to it.
It's a tough thing to treat.
There are some radical treatments
with things that bind heavy metals,
but they don't really work very well.
Frank?
Yes, getting back to this coal saw business,
I guess I spent a fortune on coal saws over the years.
Just about the time I was getting discharged from the Army
and I already had the contract to play first trumpet
with the Dallas Symphony,
I got my first coal saw.
I had never had one before.
And I was at absolute shock about it.
And from then on, I used to get about two or three a year.
Believe me, I've seen dermatologists
from one end of this country to the other.
I've had x-ray treatments on my lip.
I've had all kinds of things.
I've had the silver nitrate that you mentioned.
That left a burning scar here on the side
that I could feel for years and years later.
But the thing that I find,
and I'm sorry to interrupt you,
the thing that I find helpful
as a preventive measure, lysine,
500 milligrams of lysine,
sometimes two, three times a day.
I don't know what the side effects of lysine,
there is a side effect of lysine
and I don't know what it is.
Lysine is an amino acid.
And like Carl said,
there are what we call statistical evidence
that it does make a difference.
We don't really know how it works or why it works,
but there's no question that it does make a difference.
Amino acids are a little bit scary now.
Tryptophan is another amino acid.
Yeah, that's not bad.
And those things, they can cause problems.
I don't know of anyone with lysine.
But the medical prescription now
that's the most helpful is Zovarax.
Yeah, that's a good one.
I'm glad you reminded me.
That works like dynamite.
I mean, if you get a cold sore,
and you get, there's also, I understand,
a side effect to large doses of Zovarax,
but you'd have to take huge doses.
But the dosage of Zovarax,
five capsules a day for like two or three days,
and it really knocks it out.
I had one experience in Chicago many years ago.
I had a bad cold sore.
I had a terribly big concert to play.
And it was a famous Negro dermatologist in Chicago.
This guy was world famous.
And I went to see him about this cold sore.
And he gave me the kind of medicine
that they used to give for arthritis.
Famous though?
I beg your pardon?
Motrin, Naprosyn,
one of the non-steroidal anti-inflammatories?
No, there was a name for those
that they fell into a big group.
Non-steroidal anti-inflammatories?
I think so.
They cause your simplex to come out.
Yeah, but he gave me only once.
He said, I'll never give it to you again,
because I could rearrange your whole system with this.
And sure enough, I went playing the concerts on it.
So I don't mean to interrupt your thing,
but cold sores are really nothing to monkey with.
And just like I have to reinforce what Claude is saying,
so many trumpet players these days
have been bitten by some kind of a titsy fly
that tells them that a horn plays better without plating of any kind.
And they rub their hands on this raw brass.
You can see their hands are green.
And then they wipe their mouth with it.
And if they got any kind of a sore there,
those I've seen guys with lips that look like a mess.
What cold sores I think for trumpet players are deadly.
What he's saying is exactly right.
There's a drug called Zobrax, or acyclovir is the generic name,
developed for genital herpes,
which is a relative of the herpes simplex.
And it comes in a cream, and it comes in a tablet.
And the tablet is now approved just recently for herpes simplex.
But you have to take it five times a day in real high dosages.
But that is something that if you really have chronic problems
with recurring herpes simplex, you ought to take that.
I'm glad you brought that up.
Is that a prescription?
It's a prescription.
Zobrax.
Zobrax.
Z-O-B-I-R-A-X.
And you've got to be careful, too.
We were doing a clinic out of Chicago.
And like just for a second on the ears again,
the youngsters don't want to listen to that for some reason.
They think, well, I'm all right.
And I hear them come down the street in a car,
two blocks away you can hear this thump, thump, thump, thump coming out of their car.
And when they pass you, you can't even hear your own car.
And so they don't want to listen until it gets so far,
now they become afraid.
We did this clinic out of Chicago and we were talking about brass,
like Frank mentioned, raw brass.
And you can see them hold and they play hard and it's hot and they get sweaty.
And they put their horn down, their hands are green from the brass.
And then they do it, rub their skin and wipe their mouth off, you know.
And we mentioned that in this clinic.
And oh, there must have been 300 in the clinic.
One guy raised his hand and said, well, I read in Downbeat that this
and that the horn plays better in brass and it sounds right to me.
And he said, what do you think about that?
And I said, well, do you believe everything you read in Downbeat?
And of course everybody laughed because that's true.
They say some stupid things in those magazines.
Like I've had them come out in the magazine and one writer said,
if you want to get a good grip on your mouthpiece,
take a wood rasp and rough it up a little bit and stick better.
And that was in the magazine.
And it's amazing the things they do.
And the advertisements, don't believe the advertisements.
They want to sell you something.
And the advertising now, the dip this horn, there's no waiting on it.
It's better in raw brass.
It's not better.
There's a whole lot of interesting things that we can talk about.
The thing with chest pain is real, especially in developing players
who are working hard at it.
We see chest pain in the front of the chest,
irritation of the cartilage where the ribs meet the chest,
spasms of the pectoralis muscles.
But most of the pain I see people complaining about is back here in the back,
right in the middle of the back, right medial we call it, to the scapula.
And often in the left hand, often in the left hand,
on the left side from the left hand holding the horn like that so much,
they get knots back there.
I've seen lots of trumpet players have big, hard, chronic,
fibrotic cysts of muscle that are just spasms and actually turn to calcium
because the body is trying to calm that inflammation down.
And it's muscle spasm.
So you need to do things to release that muscle spasm as much as you can.
Massage is a great way to do it.
Ultrasound is a great way to break that down.
But basically, if you can find a good Swedish masseuse that gets to that muscle
before it spasms chronically, it really makes a big difference.
I know one.
Good.
I smoke a little too.
This is a non-sexual massage.
Another little thing you've probably noticed is little puffs
or the upper lip, little tiny puffs of actually infection
that we call folliculitis that will come.
You're playing with your lips wet and your mouthpiece is up there all the time.
The mouthpiece brings bacteria constantly to this spot.
You get a little infection of a hair follicle.
There are a lot of hairs on everybody just right over that lip.
And that little tiny follicle will cause a little puff to kind of form.
I've had a lot of players ask me what to do about that.
One of the things that seems to aggravate it is people that use lots of salve on their lips.
Trouble players try all different kinds of salve, but the salve plugs up these pores.
And if you're not careful, you'll have chronic little infections in these little tiny puffs.
If you leave them go and you don't use any salve, usually in 24 to 48 hours,
they're going to be gone on their own and you don't have to do much about it.
I've treated a couple with actually antibiotics orally.
They were so bad they kept coming back.
I've found that in people who have chronic reoccurring infections,
if you just use the salve on the lower lip, it will transfer enough to the upper lip
that it keeps the vermilion mucous membrane from drying out,
but does not affect the edge of the lip above that vermilion border that contains just above that,
the little hair follicles.
Blisstecs won't help that. It's an infection.
It's got bacteria in there and it's actually got a little bit of pus inside it.
Frank, any specific things you've done for that? Have you ever experienced that?
Oh, I've had all kinds of nonsense on my lip.
Pimples, ingrown hairs and scars and all that sort of thing.
I guess I've tried about every kind of medication you can.
I haven't found anything that would work the magic.
I used to get in and grow hair right here.
When I was younger, as I got older, it disappeared.
I had one so bad one time and that's when I could put the mouthpiece up like a needle.
And it really hurts when you put that mouthpiece in.
And I didn't know what to call, so I called Herbert Clark.
And it always seemed to happen when I had something important to play.
I eventually figured that stress had something to do with it.
So anyway, I called Herbert Clark one day.
Gee, it's minimal. It just hurts so bad to play.
And I said, what will I do?
He says, go play the job, of course.
And that's all I got from him.
But it finally got so bad, I went to this doctor in Hollywood.
This was years ago.
He couldn't get it out. He couldn't make it out.
So finally he said, well, I'm going to have, I'm not going to tell you what I'm going to do.
He says, I'm going to try something.
And he took a little bit of lead, you know.
You know, Larry, excuse me for interrupting.
I think that the best thing that we can do, all of us, as far as what you call these little puffs,
or any of those things, is a very clean mouthpiece.
I use like Hagerty's silver polish on my mouthpiece,
because you can use that on silverware.
You know, it's safe to use.
I wouldn't use any other kind of silver polish.
And I regularly wash that mouthpiece inside and out,
and keep that mouthpiece well polished.
It's bacteria, it's contamination coming out of that mouthpiece onto your face.
So if you keep your face clean and...
Oh, that's true, yeah. A lot of washing.
Yeah, that's right.
I like to play with gold on my mouthpiece.
I don't know if it makes any difference or not in that respect, but gold sure feels good.
Well, we treat it kind of like we treat acne or pimples on a kid.
You want it to dry out as much as you can, and if you keep it...
So we're constantly licking and moistening.
The lips are wet, and that contains bacteria.
So if you keep the lip dry during the period that you're trying to get this healed for 24 to 48 hours,
I think that helps a lot.
Now, don't go trying to play with a dry mouthpiece.
No.
It doesn't work.
It doesn't help your playing, that's for sure.
Let's...
I'm sorry.
If you go back to the first question, I was wondering, what are the symptoms of that?
If you have it.
Yeah.
Well, it can cause all kinds of things.
It can cause nervous system changes, what we call neurological abnormalities,
where you get a little fine tremor.
It can cause you to have failure of your liver, where you turn jaundiced.
I mean, these are bad things that can happen.
It can affect your kidneys in the same way your kidney function stops.
The symptoms don't really show up in a major way until you're pretty sick.
I think we got to be careful, too, that we don't get the idea of...
Larry is bringing out to you that we have to take care of ourselves.
And that's the potential against anything.
Brass playing is not a dangerous endeavor.
And some people may get that idea.
And the only thing is that we have to take care of ourselves.
And cleanliness comes first.
Now, this goes in everything, you know.
And it's...
We should clean the mouthpiece every time we play it.
And it wouldn't hurt to even spray it without alcohol, you know.
And the main thing is keep it clean.
Keep the bacteria off of it.
And I had another thought in mind there.
Oh, yeah, we even had a professor at the brass camp one year.
And he's talking about how dangerous...
I'll bet some of the kids left and never played again.
And he was talking about how dangerous...
He said, you can blow holes in your neck.
And things like that.
And he's a professor.
So some people listen to that.
I got a kick out of...
Dave Evans was there.
And this guy was talking for a while.
And I could see Dave out of the corner of my mouth.
And I wanted to go...
Oh, my eyes are like...
That was a Freudian scene.
And I wanted to go over there and see that Dave just...
You don't see anything.
You just get dizzy.
And Dave says...
Finally, he stood up so long already.
He said, you mean to tell me that you can blow holes in your neck?
And he says, yeah, it's been proven.
And it was ridiculous.
But just that one statement will affect somebody.
We're basically just trying to tell you ways to prevent problems.
And they're unlikely to happen.
Let's take another question or two, and then we'll move on.
Bruce?
You didn't make it clear.
Is it dangerous in a way?
Let's say you're wearing some black, you're wearing off.
Should you cover those spots in the ear, like there,
that you would have to call someone?
Well, I think it's probably a good idea.
It probably takes a pretty good dose of chronic exposure to brass
to get it high enough blood levels to make a change.
But I would certainly not want to have any exposure if I could help it.
So...
It could go through your skin?
Well, especially if you have an open sore or a cut
or some of that sort of nature,
it's less likely to penetrate the skin as opposed to,
let's say, a cold sore or an open cut on your hand or something.
One more question?
Todd's saying that drum playing is dangerous.
I read an newspaper article on an Italian drum player
saying that the last parts of a man do a monster
and his head explodes.
LAUGHTER
That's what happens if you're Italian.
LAUGHTER
That wasn't because he was a trumpet player,
that's because he was Italian.
OK, before this deteriorates any further.
LAUGHTER
Thanks a lot, Dave.
One of the things that we've seen in trumpet players
is some problems with wrists from holding the trumpet tensely.
And there's a band of tissue in the back of the wrist
that pulls the tendons down
and keeps them from bowing like a bowstring
that often becomes inflamed around the tendons that hold the horn.
Sometimes that responds to a little injection of some xylocaine
and even sometimes a little steroid.
But it's from chronic use.
I know several people that we've injected in that area
and they've gotten relief fairly quickly.
I've seen it in bass players with their hands,
particularly the wrists that are cocked around like that all night long.
Another thing that you need to watch out for,
and trumpet playing does not necessarily cause,
but if you have a congenital hernia
or already have a hernia in the groin,
increasing the pressures that you develop with trumpet playing
may cause some pain.
Actually, Jerry Kinney, who we know as a trombone player
and has been at our camp several times,
we just operated on him last week.
He had a large hernia that he had for years and years
and he began playing a lot more in recent months.
And the discomfort from that herniation with part of the bow
actually being pushed through this little hole in the abdomen
caused enough pain when he played that he had to get the thing fixed
so he could continue to play.
So those are things to be aware of.
Trumpet playing is not going to cause hernias
if you breathe correctly and play correctly.
I want to bring that up.
If you breathe incorrectly, like if you try and use a diaphragm,
you start pushing out your stomach,
you have a good chance of getting hernia.
If you get that chest up, you won't.
If you squeeze that tooth with toothpaste,
Bruce?
What's happening in players like Dizzy Gillespie and others
where there's actually a stroke there
as opposed to the same as cheeks?
What's happening in the necks?
Well, certainly in his cheeks and in the muscles around his face,
he has weakened those things so that they have dilated,
the muscles have actually dilated so much from constant pressure,
probably playing incorrectly, I would say.
Who's that, Dizzy?
Dizzy Gillespie.
Someone interviewed him recently.
He didn't always play like that.
And they asked him what was wrong, why he did that.
And he said, oh, he didn't have to play that way.
It's just that when he was younger, it was easier for him.
And that's probably true because he just let everything go.
But he said he could have stopped it,
but he's just done it that way all his life.
But I've had students that their neck came out like this,
one went to the specialist and asked him about it,
and he said, well, does it bother your plane?
He said, no.
He said, does it hurt?
He says, no.
He says, well, what are you worried about that?
And he said it's probably from a weakness there somewhere,
and it just comes up.
And he says, yeah, but it looks bad.
He says, fine, put a neckerchief around it.
And that was the answer.
I've had students that did that.
I've had students that when they went up to a high register,
like above high C and up, you could see the teeth.
And I'll bet you've seen that too, Frank.
They'd play that.
And actually, they're playing for that
because the air is coming right down the center of that tongue.
It's not coming out into, oh, there's always an excess,
but it's not, and when they do it,
well, you can just see their teeth right inside.
The mouth opens up that much on the side.
The first time you saw that, you kind of went...
Smiling at me.
No, I thought, boy, that's interesting.
And then the more I looked, I thought,
that's like he's whistling.
And that's what he was doing.
So someone would say, oh, you've got to stop that.
I've had a player just play wonderful,
and a professor come up and say,
yeah, but you're doing that wrong.
Well, let me see you do it.
You know, he was doing it,
and yet the professor said, you're doing it wrong.
Well, how could he be doing it wrong if he's doing it?
Yeah.
Well, one other quick thing that we might just talk about,
and then our time is up,
and I'm sure that Frank and Claude
will have some advice for us here.
With nervousness and getting ready to perform,
oftentimes the mouth goes dry,
and that can spell the death knell for a brass player.
And some of the things that you've seen performers do
is to use a glass of water.
Some people find that a diet drink
somehow stimulates the salivary glands.
And the salivary glands,
if you chew on the back of your tongue,
you can get them to actually spurt out
mucus into your mouth,
and that will create some wetness.
But what kind of things have you encountered?
Have you had any special things, Claude, that you've done?
No, I would...
If you're in a tension, you can...
You never got nervous.
You can have a dry mouth,
but generally I have found out that the tenseness
or any nerves would come right at the start of your performance.
And the minute you start playing a few notes,
it all went away.
And I've seen, up until I had this radiation,
I never encountered real dryness.
And there's lots of, well, a little, like you say,
a little soft drink once in a while,
because you get thirsty, and that's probably from that.
A little soft drink.
And not any vodka.
Just a little soft drink.
Frank, do you need anything else?
Harry James used to have a quart of...
Gin.
Gin, yeah.
And he'd kill a whole fifth during a performance.
Why let it go to waste, right?
Yeah.
That wasn't necessary.
The most bizarre thing I ever saw dealing with this dry mouth business,
the famous trumpet player Adolf Scherbam,
who started this whole piccolo trumpet craze in the late 50s.
I'm sure you know his name.
He's not a German.
He happens to be a Czech,
and I used to translate for him when he would come around Chicago.
And he, like all of us, would get nervous
and dry mouth and everything.
He would chew on a nail.
He actually had a nail,
and he'd stick it in his mouth.
You know, he'd have a finishing nail without the head,
and he had the point cut off so that there was no sharp point,
but he'd stick the finishing, the head of the nail in his mouth,
and that helped him salivate
so that he would not have dry mouth.
That was the most bizarre thing I ever saw concerning that.
I mean, I'd be afraid, what the hell happens if you swallow it?
He didn't keep it in there when he was playing.
Larry, can I go back a minute here?
Sure.
I think this is, I don't know if everybody realizes,
this is an unbelievably fascinating lecture,
and I can't think of too many places that have it.
And I think it's very, very necessary
because Americans are becoming suddenly more aware
of stress factors in performance.
There have been all kinds of government studies done now.
But getting back to your risk factors and the heart disease,
you mentioned there were five.
Those are the top five.
Well, I only got three.
Did I only give you three?
Obesity, high blood pressure, smoking.
That's as far as we got.
Diabetes and increased lipids, cholesterol, triglycerides.
A quick course on cholesterol and the facts.
You've heard a lot about good facts and bad facts.
Let me give you an illustration that I tell my patients
that makes it real easy to understand.
If you think about your arteries as if they were a Velcro tube
and you have little balls of Velcro,
which are the cholesterol products,
and we have small, lightweight, low-density, if you will,
lipoproteins, which is another term for fats,
or in this case cholesterol, little lightweight cholesterols.
They come rolling down through this Velcro tube,
and they stick because they're a real lightweight.
Then we have the high-density or the heavy weight,
the big Velcro balls that come rolling down through,
and they're too heavy to stick,
and they actually pull the small little Velcro balls
of low-density fat off the wall.
That's how you can remember high-density and low-density fats.
We need lots of what we call HDLs,
high-density lipoproteins, the good fats.
These are some of the things that exercise increases.
Exercise increases HDLs, lowers LDLs.
We need to control the lipids in our diet
probably closer than almost anything else.
We're finding out that the fats in our diet are related to malignancies.
There's a higher incidence of cancer, particularly in the bowel,
in high-fat diets and this sort of thing.
The risk factors for blood vessel disease,
mainly strokes and heart attacks,
which are the number one killer of Americans still,
even though we've made tremendous strides in this,
largely through educational programs,
not through miracle cures or anything else,
but largely through the exercise craze and the diet consciousness,
the willingness of the American people to make a lifestyle change.
So you need to remember these five risk factors.
Obesity, high blood pressure.
High blood pressure by that, we redefine the numbers on that.
It used to be that we'd say, as you got older,
we allowed you to have a little higher blood pressure.
But there are good studies recently done that show that
you need to keep the blood pressure below 140 on the top and below 90 on the bottom.
Anything greater than 140 or greater than 90 on the bottom is too high.
I do Air Force physicals, and the Air Force is way behind.
They will allow you to have a blood pressure of 160 over 110
and not reject you for a pilot's license.
But they're not up to date on the latest statistics.
So blood pressure needs to be kept 140 over 90 or less.
The smoking you can handle.
The diabetes, there are two types of diabetes.
The type of diabetes that we see most often is one that comes on later in life
called secondary or adult onset diabetes, type 2 diabetes.
And it's genetic.
But it simply happens when people gain some weight
and their pancreas is designed to put out enough insulin for their ideal weight.
As they get older, they can't kick out any more.
And so they become diabetic.
Their blood sugar goes up and stays up.
We can fight diabetes by ideal weight and exercise.
It's amazing that lifestyle change can really affect most of the things that we do.
But in fact, if you look at the top 10 things that kill Americans,
which auto accidents rank way up there, number one above almost everything else, above diseases,
we don't wear seat belts.
A lot of the cancers that we deal with, especially cancer of the lung, can be prevented.
So it's not so much that we die, it's that we kill ourselves
because we aren't willing to live a lifestyle that makes sense.
We're slowly converting the nation, but we're not dealing with everything very effectively.
So I think... Do you have something to add?
Yeah, people's attitudes, players' attitudes.
Larry was giving a lecture on health.
Not near this in detail, but he was hitting and smoking.
This was one of our early brass cats.
And we had a player there, and he was listening, and he raised his hand and asked several questions.
And Larry really laid it down.
This could kill you, this constant smoking.
Do you know that the minute Larry's lecture was through,
this guy was out that door as fast as he could go lighting up a cigarette.
It's amazing, the attitudes.
Well, nicotine addiction has been shown to be the worst addiction there is.
I have had opportunity to deal with drug and alcohol rehabilitation.
I directed for a year the facility at our hospital,
and I saw patients that could get off alcohol, that could get off heroin,
but they couldn't stop smoking.
You go to an AA meeting, and most of them still smoke like mad.
And it's a tough addiction. I've had patients do all sorts of things.
They go through the stop smoking programs, and some of them raise right through it.
It's just really easy, but it's got to be, from what I've seen in 20 years of practice,
about the toughest addiction, and I think most of the statistics support that.
So any of you that have stopped smoking probably know that was one of your toughest to do.
Okay, Claude, do you have anything else?
Well, that's hard for someone to understand if they didn't smoke, I suppose.
But, of course, I was fortunate. I never, ever smoked.
So I can't say, well, why don't you stop?
Because I don't know what it is. I'm glad I don't.
I smoked one day. There was a big fire in Helena, Montana,
and the fire went into these tobacco stores during the fire,
and they just threw out boxes, you know, big boxes of tobacco.
And, of course, little kids, you know, we went down there with our wagons,
and we just loaded them up with cigars.
Then they went home, and the folks were in the house, of course, we went out behind the garage.
We sat there against the garage door, and boy, we were lighting up cigarettes one after another,
and cigars, and all of a sudden, I didn't feel very well.
I went inside, and boy, I have never been so sick, sick.
That couldn't, no more. Never touched another cigarette.
Did you have another candle?
No, you had mentioned that you were going to prescribe an exercise program?
Yeah, I would like to write it out. It's pretty complicated just to describe.
I usually have the blackboard to write it out, but I'll be glad to go through it real quickly.
Can you put it down so we can copy it?
Sure, I can do that. I'll put it down there. I'll give it to you first.
Last year, you talked about beta blockers. Do you think that's important to talk about?
Well, beta blockers is a thing that performers like to use, certain ones of them.
We can talk about that a little bit.
There are drugs called beta blockers, the primary one that you hear about is Inderol,
that block the effects of adrenaline.
For the performer who has particularly a difficult time controlling his nervousness and stress,
they do make a difference.
There have been some interesting studies.
I take a journal that's called The Musician in Health.
I don't know where it comes from, but I have a bunch of neurologists on the editorial board.
One article was on just a test to see how they perform.
They performed without effect of the medication.
My personal feeling is music is important enough to me that I want to do it on my own.
I think that a certain amount of adrenaline is necessary to do that well.
I think that anytime a performer has to turn to something to deal with his stress, it's not reasonable.
Other people may have other opinions.
I think that we need to be drug-free.
There's just no question about it.
Everything we take has its effect on us.
For instance, for those of us who are males with thinning hair,
we don't want to use too much beta blockers because it will cause hair loss.
I don't use them, I guess.
How much do you think?
I only tried it once.
I tried it once, and you know the funny thing, I felt nothing.
The beta block?
Yeah, I felt nothing.
I tried that interval.
I thought, well, let me see if I get calmer.
I felt nothing.
You don't feel any effect from it yourself.
That's the thing about it.
It's not like taking a Valium or a tranquilizer or even a shot of booze.
You don't get that martini high from it.
You don't even know you've taken it.
It slows your heart rate.
I took it once because I wanted to see.
I had a handle thing that let the bright seraphim in front of 2,000 people,
and I was scared less.
And so I took 20 milligrams of Inderol,
and I waited to see what happened to my pulse because it slows the pulse,
and when we prescribe it for heart patients,
one way we watch its effect is to monitor their pulse.
And when my pulse got into the 50s, I knew I had the right dose,
and I knew it was time for me to play.
And I felt like I did play well, but I didn't have the stress.
So I could see where it could get to be something you might depend on
just psychologically, and I think that's bad.
Yeah, way too.
You know, the best thing I've found in my whole life to deal with nerves
for performing, just know that you can do what you're going to do.
Have it down.
Yeah, if you know absolutely you can do this,
then you're not going to be upset,
because unless you're playing for an audience of brass players,
that's a little frustrating.
When you, if you know absolutely you can do that performance,
you can play it, the audience can play it,
but you're anxious to play it because you want it to sound good
and you're interested, but if you know you can do it,
the nerves are going to be much less.
And Frank, you'll bear that out, too, for sure.
When you know what you can do, you might have tension
for the first couple of hours.
I don't think they ever went on a live broadcast of any kind,
that there wasn't that initial tension,
but the minute that stick comes down and you're in, you're all out.
You concentrate on what you're doing.
I know I saw Frank do a thing with the Philadelphia Orchestra
on television one night.
Frank, what was that?
I think it was da-da-da, da-da-dee-da-da, da-da-dee-da-da.
You filmed it. It was with Ormondy.
We did the pictures at an exhibition on national television,
which was an interesting day because that day I had to play
that damn piece from beginning to end five times
before they televised it.
We're watching the show and the conductor goes,
one of you goes, right, and Frank just played it like a bird.
I was scared out of his head.
Everybody gets nervous.
Speaking for myself, playing 200 concerts a year,
there are times when I couldn't play a wrong note
no matter how hard I tried.
I never go into a performance blase.
I've always detested that.
But then there are other times maybe you're mentally fatigued
or maybe there's been some kind of nonsense going on
among colleagues and whatnot,
and you'll go into a performance that will be a ridiculously easy piece,
and all of a sudden you find yourself like this.
I think that the, right, you prepare.
There are people that I know, some very well-known trumpet players,
that are very religious and use their religion to block out
Phil Smith at a New York Philharmonic is a classic example of that.
He even preaches when he gives a seminar.
He even preaches religion and love of God and all this
because he wants to block out all nervousness this way.
And beta blockers.
You mentioned beta blockers.
I'm on the brass auditioning committee.
I want to tell you these kids today auditioning for orchestras
are eating that stuff like popcorn
because they want to go into an audition and they don't want to get the nerves,
and you only got 15 or 20 minutes to impress a whole committee
that you're the one for the job,
and they don't want to take a chance.
So enderal blockadren is another one.
That's not enderal, that's something else.
It's a long-acting beta blocker.
Yeah, these things are being used,
and people in your profession are using a lot of beta blockers.
When they have to speak, which is ironic, they can operate,
but when they have to speak in public or give a paper,
they have to take a beta blocker.
Yeah, it's almost an irony, I think.
I mean, there's been a study done on that,
and I can't remember where I saw it,
but it was brought to my attention by a doctor friend of mine.
But the beta blockers are very widespread today.
My daughter is a violinist,
and she tells me that all her friends that go on auditions
for orchestras are all on that stuff.
Very few of them go to play an audition without taking a beta blocker.
I get hit up all the time by musicians for prescriptions for it.
Pianists normally take a beta blocker,
but they have so much to think about.
Memory lapses, I've had memory lapses.
But isn't it wonderful, Frank, the days that you mentioned
when everything plays itself?
You can't do anything wrong.
But then you can get careless.
You've done that, and ended up playing one extra note on a big shoulder.
Okay, are there any other questions or comments?
Tom, are we going to go down to the area in front of the comms?
What's the plan?
Yeah, right now.
All right, let's do it.
Thank you.