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Doublereed Archive - Posting 000050.txt from 2006/12

From: herb fawcett <herbgosia@-----.net>
Subj: Re: [DR-L] When focal dystonia strikes musicians
Date: Mon, 18 Dec 2006 15:29:43 -0500

I don't recall hearing of such difficulties when professional musicians did
not work as much as they do today. Focal dystonia is terrible, but so is
carpal tunnel syndrome and other body malfunction. Music was lovely as a
hobby and an avocation, even as a profession, but when orchestras moved fro=
m
a 32-36 week season model into 45-50 week seasons, one could hear more of
these problems emerging. Sure, concert artists like Fleischer and Graffman
or an aspiring soloist on flute could expect to experience some trauma, but
a player in an orchestra! What sense is there in that? I often think the
demands are just too much for our current bodies, and we need a little more
time to evolve into musical machinery.
Herb=20

On 12/18/06 11:33 AM, "D Bogan" <dblrddonna@-----.com> wrote:

> I found this interesting, considering Alex Klein's
> affliction with this condition. dgb
>=20
>=20
> =20
> =20
> Last update: December 15, 2006 =96 2:48 PM
> =20
> When focal dystonia strikes musicians, careers end
>=20
> Dystonia, a=20
> perplexing neurological affliction, is the
> third-most-common movement
> disorder in the United States, behind Parkinson's
> disease and essential
> tremor.
> =20
> By Kay Miller, Star Tribune
> Flutist Alison Young was rehearsing Mozart's
> "Requiem" for a Houston
> Ballet Orchestra concert in 1999. She lifted the flute
> to her lips --=20
> something she had done thousands of times -- but
> couldn't remember where
> to place her fingers."My hands felt like they weren't
> my own," she=20
> said.
> Over time, as the movements in Young's left hand grew
> more erratic, she
> blamed herself. She must be slacking off. So she
> practiced more. Things
> got worse.
> Four years ago, Young was diagnosed with focal
> dystonia, the perplexing
> neurological disorder that ended the careers of
> pianist Gary Graffman,
> Tokyo String Quartet violinist Peter Oundjian and
> Chicago Symphony=20
> Orchestra oboist Alex Klein. Pianist Leon Fleischer
> played one-handed for
> 40 years until starting Botox injections, famously
> reviving his=20
> two-handed career at age 75.
> Young saw a neurologist, rebuilt her flute, changed
> her technique,=20
> practiced slowly, underwent physical therapy and had
> Botox injected into
> her hands. She'd fix one problem, only to have another
> creep in. Three=20
> years ago, she quit her 20-year career as a soloist,
> recording artist and
> principal flutist of the ballet orchestra, where she
> had been for 13=20
> years.
> Now, at 41, she's putting her knowledge and love of
> music to work as a
> classical music host at Minnesota Public Radio in St.
> Paul.
> "I didn't think I would want to have anything to do
> with classical=20
> music. The heartbreak was too extreme. It was like the
> baby had died and I
> didn't want to be around children anymore," she said.
> "But I discovered
> you can't get away from the exhilaration of music."
> Like a death in the family
> Focal dystonia is one type of dystonia in a huge
> family of movement
> disorders that affect 300,000 Americans who can't stop
> their eyes from=20
> closing or keep their feet from dragging. It can
> appear anywhere in the
> body: eyes, lips, head, jaw, vocal cords, neck, hands,
> back or feet.=20
> After Parkinson's Disease and essential tremor,
> dystonia is the third most
> common movement disorder, said Dr. Steven Frucht,
> assistant professor
> of neurology at Columbia University Medical Center and
> a leading expert=20
> on focal dystonia. An estimated one in every 200
> professional musicians
> will develop a potentially career-ending focal
> dystonia.
> "The emotional impact on these patients is akin to the
> death of a=20
> first-degree relative," Frucht said. "It threatens
> their livelihood, their
> sense of self-worth, their career, which is all tied
> up with their=20
> psyche, their social life and who they know --
> everything about how they
> define themselves."
> No one knows what causes dystonia. Researchers believe
> it is due to=20
> abnormal functioning of the basal ganglia, deep brain
> structures where=20
> movements are planned and executed. Normally, when a
> set of muscles=20
> tightens, an opposing set of muscles should relax, if
> only for a=20
> micro-second, said Dr. Jennine Speier, medical
> director of Sister Kenny
> Rehabilitation Institute. "Often in people with
> dystonia those muscles don't
> relax," Speier said.
> Instead of extending, Young's fingers would flex. She
> would put one=20
> finger down and another would pop up. Trying to
> control them was=20
> exhausting and often futile. She could finger a
> difficult piece on a table top
> or a pencil, but as soon as she picked up her flute to
> play the same=20
> thing, her fingers cramped.
> "You can't fool the brain," Frucht said. "It knows
> you're not playing
> the real thing."
> Somehow the brain learns dystonic behavior,
> hard-wiring it into cells,
> says Dr. Paul Tuite, a neurologist at the University
> of Minnesota. "My
> theory is that in doing a task over and over again,
> somehow you're=20
> stressing the system and it starts developing abnormal
> function."
> Treatment focuses on temporarily immobilizing muscles
> and remapping the
> brain. Speier has patients shorten their practices.
> She uses Braille=20
> and other textures to retrain brain neurons. And she
> uses biofeedback,
> sometimes in combination with Botox or other powerful
> drugs in extremely
> low doses.
> "Sometimes patients will get better," Speier said.
> "It's very hard if
> they have to continue playing a lot."
> One of her success stories, a string player from out
> of state, came to
> her with dystonia so bad he couldn't play. Eventually
> he was able to=20
> return to an orchestra. But it took three years of
> Botox injections and
> hand therapy. He now plays a very limited schedule.
> Musicians often hide the condition until it's
> advanced, struggling with
> the question: "Am I to blame for my loss?"
> They are no more to blame than a person with foot
> dystonia is to blame
> for walking, Frucht said. "I've seen it in people who
> train an hour or=20
> two a day. And I've seen it in people who train
> obsessively for eight
> or 10 hours a day."
> He says that patients have a genetic predisposition
> for dystonia, which
> is then triggered by physical trauma, exposure to
> certain medications,
> toxins, infections or stroke. He suspects that
> dystonia in musicians is
> linked to the complexity of the task they are
> mastering.
> One of Frucht's saddest cases involved a promising
> 16-year-old trumpet
> player who developed dystonia in her lips after a
> trombonist ran into
> her in marching band. She shifted to bassoon, which
> uses a different=20
> embouchure. Within eight months she was playing
> Mozart's Bassoon Concerto.
> "She was a bassoon prodigy," Frucht said. Two years
> later she returned
> with jaw dystonia.
> "I think she was wired to get it," Frucht said.
> Courage to say that's enough
> In her St. Paul duplex, Young pulls out her flute,
> joking that she had
> to blow the dust off, and demonstrates what happens
> with dystonia. Her
> tone is lovely. But as she plays a passage from Bach's
> A-minor Partita,=20
> her third and fourth fingers curl back from the keys
> -- like little=20
> hiccups.
> For a long time Young felt cheated. She had played the
> flute with fluid=20
> technique since she was in fifth grade. After
> graduating from=20
> Interlochen Arts Academy high school in Michigan she
> got a bachelor's degree in
> music from the University of Southern California and a
> master's from=20
> the Cleveland Institute of Music. She toured Europe
> with the Boston=20
> Philharmonic and played with the Atlanta, Memphis and
> Toledo symphonies.
> When the dystonia appeared, she was at the peak of her
> career, having=20
> traveled to Bratislava, Slovakia, to record the David
> Diamond Flute=20
> Concerto and playing concerts across Argentina and
> Brazil before recording
> her tango CD. She can't listen to them now. It's too
> painful.
> "I finally had to say, 'This is my life. I'm not
> defined totally by
> playing my flute. I can talk. I can teach. There are
> other ways I can=20
> engage in the world that have meaning.' I'm a pretty
> strong person. I think
> it takes a lot of courage to know when its time to
> say, 'That's=20
> enough.' "
> Now there's much that delights: her husband, Richard
> Rasch, who=20
> encouraged her in the worst times. Their Cathedral
> neighborhood in St. Paul.
> Morning yoga workouts. Riding her bike to MPR's
> studio. And fan letters
> that already are coming from listeners.
> On a recent show, Young played Ravel's "Daphnis et
> Chloe." She heard
> herself tell listeners how glad she was to have them
> there, listening=20
> with her.
> "I realized that's exactly what I meant. This is one
> of the greatest=20
> pieces ever written. I know what it's like to be
> inside the sound. Now
> I've stepped to the other side of it. There's
> something sort of total
> about being a host."
> Kay Miller =95 612-673-4393 =95 kmiller@-----.com
> =A92006 Star Tribune. All rights reserved.
> =20
> =20
>=20
> Donna G. Bogan
> Double Your Reeds and Double Your Music--
> Oboe, English horn, and Bassoon
>=20
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>=20

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