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 Oboe and emphysema or COPD
Author: Caroline Bloss 
Date:   2006-10-20 21:20

Dear Oboists and Bassoonist,

This week I was diagnosed having lung emphysema (or COPD). This is
when your
unable to exhale as much as you've inhaled before. The result is that
the
bad air in your lungs stays and that you don't have enough oxygen in
your blood. The cause is a destruction of the alveoli in the lungs
which
results in bigger lungs and weak lung tension to push out the bad
air.Normally it's a condition linked to smoking (80-90% of the victims
are
smokers).

I never touched a cigaret but I'm an oboist... playing the oboe seems
the cause to me but it's difficult to find any literature about it. It
seems logic to me that te pressure in the lungs and the difficulty of
getting rid of the bad air while playing, causes a pressure in the
lungs
which damages the alveoli.

My lung specialist didn't see this before, because I'm just 33 years
old and it occurs normally at the age of 50... and that after smoking
during 10 years 1 package of cigarettes a day... and that when you are
unlucky to belong to those 16% of smokers who develop this disease.

A search on the net learned me also that this disease supports
itself...: the more alveoli are damaged, more alveoli will follow that
path...

It doesn't sound very good.... But I like the sound of the oboe...
:-(

Is there anybody (or any windplayer) with the same experience? Does
it mean that I have to stop playing the oboe (sounds reasonable to me,
but I'm in love with that instrument)? Is every oboist suffering from
this disease and just ignoring it? The specialist told me to stop
definitely with smoking if I was. But he didn't have any information
about
oboe....

I'm curious about your reactions!

Thanks in advance,
Caroline

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 Re: Oboe and emphysema or COPD
Author: JRJINSA 
Date:   2006-10-20 21:33

I'm not a doctor, but I'm willing to give my opinion. Fortunately for oboe players, the oboe is not a permanent thing attached to our bodies forcing us to breath unnaturally 24 hours a day, 7 days a week. Rather it's something we have total control over. Even when playing, there are plenty of opportunities to breathe normally. Sure, you breathe rather unnaturally while you're playing but the time one does this per day/week I wouldn't think is enough to cause long term problems. Thank God we sleep at night and allow our bodies to take over, replenish us, and make us feel rested. Plus, our bodies build up an endurance. I wouldn't worry about this. I bet there is another culprit to your illness.

I'm sorry to hear this and I sincerely wish you the best of luck.



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 Re: Oboe and emphysema or COPD
Author: ohsuzan 
Date:   2006-10-20 22:40

Sorry to hear of your illness.

The only thing I have ever heard about oboe playing vis-a-vis pulmonary function is that it tends to IMPROVE it -- that playing the oboe is tantamount to respiratory therapy.

I don't know if this is true or not, but I've heard it alleged more than once. Long ago, when I had allergic asthma, I underwent a course of respiratory therapy. One of the exercises was something that, for all intents and purposes, was similar to what we do when we play the oboe. It involved taking a big breath, and then expelling it very, very gradually but steadily for as long as possible, while trying to keep a ball floating inside a tube.

I am aware that we have to more-or-less hold our breath (or at least, hold it back) while we play, but I can't think that means that mean we "trap" the air in the same way that you mean. If that were true, then it seems to me that many professional oboists would experience chronic COPD.

Susan

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 Re: Oboe and emphysema or COPD
Author: Dutchy 
Date:   2006-10-21 04:36

If holding your breath caused COPD, then not only oboists, but also deep sea divers, scuba divers, snorkelers, and those Weeki Wachee mermaids would also have COPD as an occupational hazard. And I've never heard of anything like that. Playing the oboe didn't cause your COPD.

Actually, pulmonary rehabilitation therapy for COPD often includes breathing while deliberately causing back pressure in those alveoli:

From here:
Quote:

Pursed-lip breathing is a type of exercise that may be helpful when people who have chronic obstructive pulmonary disease overinflate their lungs during attacks of airway narrowing, panic, or exercise. It also can function as an additional breathing exercise for people undergoing respiratory training. The person is taught—or often discovers by himself—to exhale against partially closed (pursed) lips, as if preparing to whistle. This measure increases pressure in the airways and helps prevent them from collapsing. The exercise causes no ill effects, and some people adopt the habit without instruction.


And more on it here.
Quote:

Exhalation must be 3-4 times longer than inhalation, so do not force the air out.

That's exactly what you're doing when you're playing an oboe--you're exhaling very, very slowly against resistance.

Playing the oboe isn't going to make your COPD worse, and it might actually help it.

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 Re: Oboe and emphysema or COPD
Author: d-oboe 
Date:   2006-10-21 12:39

Regardless. You have to go see your health professional, with your oboe and reeds, and let them make a good judgement as to if it's safe.
Better safe than sorry!

D

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 Re: Oboe and emphysema or COPD
Author: vboboe 
Date:   2006-10-22 00:05

Oh, what a terrible shock to your system this health diagnosis must be, eh?
To be, or not to be (with oboe & career?)
... this must be heart-rending situation for you ... unless part of you is ticking away on another more desirable agenda and this is The Time?

... echo d-oboe's caution, but please don't rely on docs & medicines like god, use your own god-given IQ, a lot! DIY research to inform yourself ...
this seems a opportune moment -- a sea-change or epiphany -- to make a serious and committed long-term effort to pro-actively help yourself get better

IMO -- Here's what i think might help you right away -- enrich your daily diet ASAP -- you can do something for yourself, starting with your very next meal -- is it really nourishing, replenishing, rebuilding and replacing those poor devitalized degenerated lung cells, or is it just a carb-rich tummy filler that fuels the brain but doesn't nourish your body?

I'm sure i'm not the only oboe player who has to play on tummy close to empty, and busy, hungry, upcoming oboists often eat on the run paying little attention to nutrition

Prolonged periods of time without full solid meals shrinks the stomach's capacity to contain food in quantity, and one snacks only enough to feel comfortable. Over many months and years, this lifestyle may lead to borderline malnutrition. You've got a degenerative disease.
Evaluate how your eating habits have been these last 7 years or so.

Consult a licensed nutritionist to inform you what you might have been missing, chronically, and how to change that

Other things you probably could do right now if these situations apply to you:

1. get a blood iron test -- find out if you might be anemic. Even if not by medical standards, make sure you have the figures from doc so you can calculate your percentage of blood iron; if less than 93%, get busy on your own, enriching your diet ASAP (liver, herbal iron). This is much, much higher than medically accepted OK range for female blood iron, that is, not considered to be anemic enough for medical treatment. Female wind instrument players need all the iron-rich hemoglobin they can muster

2. getaway from city fumes at least once a week to a fresh-air location, and just doodle-play oboe in a relaxed organic fashion

3. Consider this one very carefully -- plead pleasantly with any smoking member of your family to quit cold turkey, or at least agree not to smoke, ever again, inside your residence anywhere

4. identify other possible sources of toxic-to-you-in-your-condition airborne particulate & gaseous fume exposure in your habitat, for example, low levels of carbon monoxide, or perhaps those air-freshener sprays, or the summer heat on asphalt, or maybe just too much dust?

5. identify possible sources of aluminum or heavy metal poisoning (lead, mercury, etc) in things you're eating, drinking, contacting your skin or mucous membranes ... or ditto with any pets in the house ...

6. If you don't understand basic principles and laws of chemistry & biochemistry, now's the time to get informed, you'll need it to better understand how your body works at a cellular level, which is where life-style changes need to be focused

Hope some of these suggestions lead to something helpful and positive for you

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 Re: Oboe and emphysema or COPD
Author: sylvangale 
Date:   2006-10-22 05:48

Always get a second opinion for major health problems. Doctors are human... to err is human.

It's the inhaling that causes emphysema, not the exhaling.

When emphysema web sites mention the over inflation of the lungs, this isn't something that happens with breathing that you control. Think of your lungs as a great big balloon with little balloons inside. When you inhale the little balloons inside inflates a great deal and the outside balloon not so much, but when the little balloons cannot take air, the big balloon inflates beyond its normal size pushes against the diaphragm.... and then breathing problems ensue.


Take a look at the breathing excercises at the emphysemafoundation:
http://emphysemafoundation.org/pulhthex.jsp#BREATHING

Self-Care info from the Mayo clinic:
http://www.mayoclinic.com/health/emphysema/DS00296/DSECTION=9

Regards,
Stephen

Reply To Message
 
 Re: Oboe and emphysema or COPD
Author: lucyw 
Date:   2006-10-22 20:10

I'm so sorry to read about your problem. I think that the advice to inform your doctor of the oboe playing is good. The advice to always get a second opinion is excellent.

My only other suggestion would be to follow Tabuteau's suggestion to exhale before you begin to blow into the horn. This helps with a multitude of things, including expelling a lot of the carbon dioxide that is in your lungs.

Good luck and please keep everyone posted on the board.

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 Re: Oboe and emphysema or COPD
Author: Caroline Bloss 
Date:   2006-10-24 16:08

Hello,

I'm sorry I took so long to reply. I was completely taken by reading medical articles about that subject and doing research on the topic of breathing. I finally did find an article which supports my view. It's the only profound and recent study I found on this topic. Here you can see the summary:

Reduced pulmonary function in wind instrument players.Deniz O, Savci S, Tozkoparan E, Ince DI, Ucar M, Ciftci F.
Department of Pulmonary Medicine, Gulhane Military Medical Academy, Ankara, Turkey.

BACKGROUND: Wind instrument playing requires a strenuous respiratory activity. Previous studies investigating effect of wind instrument playing on pulmonary function are equivocal. METHODS: In the present study, 34 male, non-smoker wind players in a military band were compared with 44 healthy non-smoker males by pulmonary function testing. RESULTS: All spirometric values including forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow rate, forced expiratory flow in 25, 50, 75% of FVC, and during the middle half of the FVC were found significantly diminished in wind players. The class of wind instrument, brass or wood, showed no significant differences. FVC was significantly and negatively correlated with duration of practice. CONCLUSIONS: It was concluded that pulmonary function in wind players might be diminished probably due to development of asthma or constant barotrauma during their playing. This fact should be considered in clinical evaluation of wind instrument players.

I was able to read the complete article in the university library for medicine. I try to put it on internet later this week when I go back.

What you are saying makes sense to me too. And I think that we are lucky that we rest and don't play all the time. Probabley one's constitution is also a big factor that influences the damages to your alveoli.

Whether this is really emphysema or not, I don't know yet. My blood is tested now for alpha-1-anti-trypsine deficiency, which could also be a cause. Maybe, I'm a victim of both...

I'll wait for my bloodresults and the scan and I'll tell you more when I know more.

Thanks a lot for your mail! It made me calm down!

Reply To Message
 
 Re: Oboe and emphysema or COPD
Author: Caroline Bloss 
Date:   2006-10-24 16:25

Dear Susan,

I did a very big search this week, studying about every reaction I got on the net. Because I was so focused on it, I didn't find the time to answer alle the mails, since I also had to work during the weekend and I wanted to come with some real meaningfull results of the search.

I found out that asthma is actually the opposite from emphysema. You have astha because your lungs are in a spasm and too tense... Emphysema is because of the loss of the tension out of the alveoli caused by the breakdown of the walls between several alveoli.

Having asthma, playing oboe seems a good idea to me too. Because of the extra airpressure the lungs expand and the tension and the spasm in the lungs are relieved.

Having emphysema... It seems logic to me that playing oboe will worsen it because of the loss of the tension in the alveoli...

Best regards and thanks for your info,
Caroline

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 Re: Oboe and emphysema or COPD
Author: Caroline Bloss 
Date:   2006-10-24 16:34

Hello Dutchy,


I did find in the medical literature that divers are unfortuntely also suffering from barotraumas (lung damage caused by pressure).

Best regards,
Caroline

Reply To Message
 
 Re: Oboe and emphysema or COPD
Author: Caroline Bloss 
Date:   2006-10-24 16:38

Hi,

Thank you for your detailed mail. You're right and I already started taking care of my diet. I keep you posted about the findings.

Regards,
Caroline

Reply To Message
 
 Re: Oboe and emphysema or COPD
Author: sylvangale 
Date:   2006-10-25 15:43

Quote:


The Secret Weapon for
Respiratory Health

by Kathy Wechsler

Did you know that singing or playing a musical instrument is good for your respiratory system? Don’t get me wrong: I’m not talking about the drums, piano or guitar.

From the trumpet to your vocal cords, any instrument that takes lung power may help you maintain or improve breathing.

If your respiratory muscles are strong enough to let you speak, you can probably sing or play a horn, say respiratory therapists who work with people served by MDA. Plus, it’s fun, easy, and it beats the heck out of any other form of exercise. And you don’t even have to be musically talented to receive respiratory benefits from this type of exercise.

“Anything that I can do to get my patients to take a good sustained breath is good for them,” says Jerry Reynolds, a respiratory therapist (RT) at Ohio State University in Columbus who’s seen people with neuromuscular diseases benefit from singing or playing an instrument that requires lung power.

“That’s a known, proven fact,” Reynolds says.


Quote:


How Much Is Too Much?

Don’t overdo it, Reynolds cautions. With most forms of exercise, there’s a fine line between doing too little and doing too much. With a neuromuscular disease, too much exercise can actually weaken your muscles, but you need enough exercise to keep them active. Singing or playing an instrument is no different.

“Overdoing it” causes your respiratory muscles to weaken. To prevent this from happening, Reynolds suggests that you pay attention to how much you can do before you start feeling fatigued. When you start to tire, it’s time to stop.

http://www.mdausa.org/publications/Quest/q123sing_out.aspx



Quote:


the claim that the playing of wind instrument might predispose to the development of pulmonary emphysema has never been confirmed (Bouhuys, 1964; Lucia, 1994). Rather, emphysema has been proved to be connected to smoking habits, to chronical respiratory disease and to genetically-related disposition (Snider, 1994). On the other hand, patients with respiratory problems who have music as an occupation are more likely to experience symptoms triggered by the demands imposed by performance. Similarly, wind players will tend to notice more clearly the physiological modifications associated with aging.

Arend Bouhuys probably contributed most importantly to the present knowledge on physiology of wind instrument playing. He studied pressure, airflow, sound power, efficiency, CO2 variations, heart rates, and other aspects (Bouhuys, 1964, 1965, 1968). Using a pneumograph he assessed qualitatively lung volume variations and also discussed some respiratory techniques, such as circular breathing (Bouhuys, 1964).

Based on the fact that blowing pressure in the observed brass instruments presented wider ranges than in woodwinds, Bouhuys hypothesised that mouth pressure control would be more important for those instruments than in any other type of winds. It must be borne in mind, however, that in brass instruments, where the lips serve as the oscillating reeds, the lip tension control is as important as the expiratory pressure. In woodwind, the embouchure, i. e. the link between the player’s mouth and the instrument (see below), is also very relevant, although it does not affect the pitch to the same critical extent as in brass instruments.

http://www.speech.kth.se/music/publications/leofuks/thesis/Previous.html




Regards,
Stephen


♫ Stephen K.


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 Re: Oboe and emphysema or COPD
Author: ohsuzan 
Date:   2006-10-25 18:54

Yet another reason not to play on really hard reeds . . .

Susan

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 Re: Oboe and emphysema or COPD
Author: d-oboe 
Date:   2006-10-29 13:23

I agree...x-nay the hard reeds.
Ok so, in the oboe world I think we've been brainwashed (by the single reed world) that the hardness of reed you play is directly related to how accomplished a player you are. Tsk Tsk Tsk, I say.

Get this: a hard stuffy reed, while it may allow one to feel that they have a nice dark tone, is only fooling the player. A hard reed vibrates *less* right? So to the listeners in the hall, it just sounds like an oboe player who can't attack properly, and whose tone doesn't project.

In my opinion, one should play on a reed that is *almost* vibrating too much. In other words, a complete (stable) 3-octave crow, that has just, just been cleaned up, so that it doesn't rattle. That way, one can play loud and soft, with complete ease. There's no restriction on this type of reed. You can do anything.

...and it's good for your sanity too. The feeling you get when you forget that you're playing a reed, or even the oboe, and that you're making m-u-s-i-c.....is priceless.

D

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 Re: Oboe and emphysema or COPD
Author: oboist 
Date:   2006-10-29 17:12

Bravo,d-oboe

Reply To Message
 
 Re: Oboe and emphysema or COPD
Author: oboemelli 
Date:   2006-11-09 15:28

I am very sorry to hear this news. Now it's got me thinking, we could all be at high risk with it!

"People imagine they can reach one another. In reality they only pass each other by"- Schubert.

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 Re: Oboe and emphysema or COPD
Author: Duduk Player 
Date:   2019-12-20 00:42

Dear Caroline,

I have been diagnosed with COPD after using C-PAP for sleep apnea for six months. A second opinion was that I did not have COPD, but did have lower lung dysfunction. My inspiratory volume is twice what my expiratory volume is. I agree with JRJINSA that you might look for another culprit. What is the air quality where you live? Is there a family history of lung disease? I wouldn't give up the oboe that you love until you are sure that is the culprit. My research also has lead me to believe that double reed instrumentalists have lower rates of lung disease, and that playing a double reed instrument mimicks the breathing exercises recommended for COPD lung diseases, i.e. pursed lip breathing.

I would like to get off C-PAP for sleep apnea, since it does cause air trapping. (The science is in its infancy.) One of the recommended natural treatments is learning to play the Didgeridoo, an aboriginal double-reed instrument. Not crazy about the sound. So I purchased a duduk, which is an ancient Armenian double-reed instrument made of Apricot wood that has a lovely deep mellow sound.

The other posts are also helpful, in that it is possible that certain techniques in playing may exacerbate inflammation, the major culprit. So use of softer reeds may be helpful.

I am neither a doctor or musician, but am looking for natural treatments that do not end up exacerbating one condition or the other, in my case sleep apnea and lower lung dysfunction.

But look further for a culprit, and for how you can continue to play your oboe in a manner that would not increase inflammation, the culprit in COPD.

Best, Suzanne

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