Klarinet Archive - Posting 000205.txt from 1996/09

From: David Blumberg <reedman@-----.COM>
Subj: Re: Further advice response
Date: Sat, 14 Sep 1996 23:36:03 -0400

Neil,
The timing of taking Advil does also help. Take it 1 hour before playing. Two
are not enough for a real inflamation problem. Typical prescriptions are for
600 Mg. (3 OTC pills) or 800 Mg.(4 OTC) for the really tough cases. The doses
of Advil can and should build up in your system- Thats why you need a Doctors
advice as to what level of Anti-inflamatory the Doctor wants in your system.
The effect of the Advil may take a few days to build up enough to give you
relief. But you have to have a stomach like iron to handle 4 Advil. It bothers
some, not others. The year I took off was not at all by choice. It even hurt
to watch someone play during my stint with wrist pain. Don't get to the point
where it is too painful to brush your teeth with that wrist.
Zostrix is another thing you should try. It is a capsaicin creme (red pepper)
that feels hot when you put on (use a tissue-Don't touch it -if you rub your
eyes, the creme that got in your fingernails will BURN). This stuff is quite
good for reducing pain of Arthritis, and tendonitis. There is Zostrix HP (high
potency with enough red pepper to go mexican) also. Use it before going to
sleep.
David C. Blumberg- Phila. Pa.
Reedman@-----.com

----------
From: Klarinet - Clarinettist's Network on behalf of Neil Leupold
Sent: Monday, September 02, 1996 2:53 PM
To: Multiple recipients of list KLARINET
Subject: Further advice response

On Mon, 2 Sep 1996, David Blumberg wrote:

> Go see an Orthopod who specializes in Hand/ Wrist
> injurys. He will give you several tests to determine whether it is Carpal
> Tunnel syndrome ( constriction of the Median Nerve ) or tendonitis, etc.

Thank you for this. If I seek medical attention, now I can at least
start a couple of squares forward of the initial consultation with a
general practice physician. I'll speak with an orthopod specialist to
begin. Hopefully there are some decent ones in the Dallas area.

> Get on an anti-inflamatory soon!! Tylenol is not an
> anti-inflamatory. Advil, and Aleve are. Make sure that you drink a full
glass
> of water when taking high doses of them ( I take 4 at a time of Advil)

Good to know. Question: this may seem silly and obvious, but is timing
an issue when taking the medicine? Is it more effective to take it 30
minutes before practicing? Immediately prior? Not until the pain arises?

> .Another thing you could do is use a neck-strap. That would reduce the
> pressure of the weight of the Clarinet on your hand.

Agreed. I've mentioned starting with a Claricord. Any other brand or
style recommendations?

> tendonitis made me take a year off of playing back in 1989.

I think that may be part of my problem. I'm practicing and performing
more now than I have consistently over the past four years. This sudden
increase in activity, and concurrent sudden increase in the stress upon
my wrist, probably has a lot to do with the onset of pain. It's like
going running after taking a break for a year. That first day after
running, the legs are really sore and need to be stretched and allowed to
recuperate until the muscles are reaccustomed to the activity. But I
certainly don't want to take a year off, although I know others who had
to do precisely that in order to fully heal from tendonitis.

> The Doctor may
> also reccomend Physical Therapy to learn stretching.

I'm trying to avoid that - 'try some of the "home remedies" before
turning to conventional medicine. But if it becomes necessary, I won't
hesitate, of course.

Thanks David Blumberg.

Neil

>
> I haven't taken Advil or anything for it yet. Those of you who are
> experienced with this - or better yet, physicians on the list - please
> refresh my memory: does Advil diminish..or aggravate..the probable
> inflamation in my wrist? Should I consider one of the other OTC
> products, i.e.; Tylenol or Aleve or Bayer? Should I avoid aspirin? What
> is the effect of acetominophen?
>
> Beyond this, I know from the many others I've spoken to that icing the
> wrist will very likely help, so I plan to give this a try. My gut
> instinct tells me also that a well-chosen wrist brace will help a great
> deal, serving to bolster the wrist and afford it greater stability when
> supporting the instrument for the long periods that I practice. So I
> need another piece of authoritative information, either from a physician
> on the list, or from somebody who has experienced this and has been
> successful with a wrist brace: is there a specific kind, brand name, or
> model which is known to have the right effect - perhaps one which has
> been used successfully by one of you on this list? I remember from
> conversations with Ricardo Morales and Sean Osborne that their braces are
> custom made, but I've misplaced my contact information for them. Could
> anybody provide me their contact info again? Hopefully there is something
> available commercially which will alleviate my problem. Should it be
> something loose-fitting but rigid? Should I be concerned about restriction
> of blood flow from a brace which fits snugly?
>
> I know that what I should do is consult a physician directly, but I'm
> exploring this avenue first because I suspect very strongly that the crux of
> the problem rests in the area of physical relaxation. My body is too tense
> from personal stress, and I'm seeking ways of minimizing the harmful
> side-effects of that stress while I alter my mindset and lifestyle...in
> order to effect greater relaxation during practice and performance.
>
> The increase in practice time is concurrent with the increase in my
> performance activities. I'm teaching more. I'm gigging more. I've got
> an audition for yet another orchestra in 4 days. Thus, with the increase
> in music to be learned, I'm putting in many daily hours on both Bb and
> bass clarinet (bass has problems of its own related to neck angle, but no
> wrist problem since I'm not supporting the instrument). I don't
> anticipate a decrease in activity or practice time over the next four
> months, so I desire to take quick and effective action. Please respond
> genuinely with whatever you've got.
>
> Sincere thanks,
>
> Neil
>
> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
> Neil Leupold
> Southern Methodist University
> Meadows School of the Arts
> nleupold@-----.edu
> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
>