Joined: 13 Nov 2001 Posts: 9830 Location: Chicago, Illinois
Posted: Mon Jun 15, 2015 9:39 am Post subject: The Hernia Report
Hi all,
Given the past history on the TH pertaining to the topic of hernias, it's time for me to contribute to the fund of knowledge...
I was diagnosed with two inguinal hernias around age 18 or 19 (circa 1980). The doctor back then said I might have been born with them, and that playing trumpet and pushing long lines of grocery carts at my part time job as a grocery clerk probably contributed to them. Other than the protruding lumps in my lower abdomen (in the V areas between my abdomen and thighs), they were benign for many years. I did a lot of very heavy playing for many years with no ill effects. But then in 2013 when I was on "The Color Purple" they stared acting up - especially the right side. I also found that I could no longer run or jog any significant distance without pain, and walking my large Malamute was becoming a problem (though finally, I've managed to undo 16,000 years of sled dog instincts breeding and he no longer tries to yank one forward when on a leash). I was a bit nervous during The Addams Family run this past year but got through it okay. Now that the theater I work for is doing a show that doesn't have a trumpet book, and no school until the end of August, I knew now was the time for the surgery.
I am very blessed that one of my students is a great anesthesiologist working in Milwaukee (just a few hours away), and with his experience both as a doctor of anesthesiology and a trumpet player (20 years playing trumpet in the Army), he had the knowledge and experience required to hand pick whom he thought would be the best surgeon for the job, Dr. Anthony Linn Sr. I had the surgery this past Friday, June 12th. It turned out to be a triple hernia procedure, as there were two hernias on the left side. Ouch! I'm glad it was possible to do them all at once, because though the recovery is going to be a bit longer and more painful, I don't want to go through this over and over!
Due to the size of the hernia(s) on the right side, and my being a trumpet player and hence generating high levels of thoracic pressure when playing the upper register, open surgery rather than laparoscopic was deemed best, as the chances of success are higher with open surgery on larger hernias. And instead of mesh, gore-tex was used to bolster the repair (mesh has a history of complications years down the road after surgery with among other things, intestines sticking to it causing chronic pain). With that gore-tex in me, maybe I can get a sponsorship from Nike or the North Face or someone...
I'll keep you all posted on my recovery and return to playing, along with any tips and suggestions my experience allows me to share. Yesterday, 55 hours post op, I did play a few very quiet notes on my horn. I could play up to middle C softly with no discomfort whatsoever. And now that I know I can do at least that, I am perfectly content to have put the horn back in its case and bid it farewell for at least a few weeks. I've got plenty of time to recover and then rebuild my strength and endurance and I intend to make use of that time to its fullest!
Thanks goes to my Anesthesiologist who shall remain anonymous here as long as he wishes to be (he's a member of the TH, but like most, tends to intelligently stay out of the many fracases here and watch and enjoy from the sidelines). Thanks goes also to the rest of the team that worked on me, from the Surgeon to the Nurses to the Techs. It's a rare surgical team that can make triple hernia surgery fun!
Cheers,
John Mohan _________________ Trumpet Player, Clinician & Teacher
1st Trpt for Cats, Phantom of the Opera, West Side Story, Evita, Hunchback of Notre Dame,
Grease, The Producers, Addams Family, In the Heights, etc.
Ex LA Studio Musician
16 Year Claude Gordon Student
Speedy recovery to you John! I had two hernia ops a year a part right above my belly button. Luckily this was before I started playing again 6 years ago. So far so good, not issues.
When you do start playing again, I would like to know how long you were off the horn and what you do to get back in shape. I am struggling with a number of issues right now that are preventing me from practicing every day like was was (about 3 hours). Now sometimes I am going 3-4 days with no practice at all. Thankfully Bruce Haag taught Claude's method well in playing correctly, but man this is miserable trying to come back feeling like I just started playing again! _________________ “Breathe and play the first note with a beautiful sound.” –Allen Vizzutti
“Don't stop where I have, but go further." –Claude Gordon
Joined: 13 Nov 2001 Posts: 9830 Location: Chicago, Illinois
Posted: Tue Jun 16, 2015 11:22 am Post subject:
jbeights wrote:
Speedy recovery to you John! I had two hernia ops a year a part right above my belly button. Luckily this was before I started playing again 6 years ago. So far so good, not issues.
When you do start playing again, I would like to know how long you were off the horn and what you do to get back in shape. I am struggling with a number of issues right now that are preventing me from practicing every day like was was (about 3 hours). Now sometimes I am going 3-4 days with no practice at all. Thankfully Bruce Haag taught Claude's method well in playing correctly, but man this is miserable trying to come back feeling like I just started playing again!
I played a little today. Gave my first Skype lesson post-surgery this morning and I demonstrated a few things during it. I'm fine up to Middle C at a soft volume. Played once up to the E above Middle C, but pain came on so that was that. I don't have another lesson commitment scheduled until next Saturday, so I won't need to pull the horn out until then. When I do start up again with a regular practice routine (perhaps 2 to 4 weeks from now), I'll keep out of the range where the increased blowing pressure causes pain. Keeping the "feel" of it up is more important to me than maintaining the strength - the strength will come back fairly quickly once I am able to play more challenging material.
As for your having to take days off at a time, that is a problem, especially for a player that is developing more ability and not just interested in maintaining what he or she has. If there is someway you can get at least a little time on the horn - even just 3 to 5 minutes - each day, it'll do a lot to get rid of that "starting over" feeling you describe. I know that feeling well - if I take too much time completely off, it feels like someone else's mouth when I first put the mouthpiece up to my lips!
That is exactly right! Its very frustrating because I play based on "feel" as well. Yes, I can do more and will. I was playing at a pretty high level a couple of years ago (solid working range to G above high C, flexibility like butter, great endurance playing some demanding 2-3 hour programs with relative ease, reading very well it was all great) and due to a number of set backs I have lost a great deal of what I had. This simply compounds the frustration. Patience, right? _________________ “Breathe and play the first note with a beautiful sound.” –Allen Vizzutti
“Don't stop where I have, but go further." –Claude Gordon
Joined: 03 Nov 2011 Posts: 2322 Location: Beavercreek, OH
Posted: Tue Jun 16, 2015 11:54 am Post subject:
Gone through two hernia repairs myself.. each with somewhat different experiences and I'm sure you will have your own pace, success and setbacks in your recovery.
My advise is to go slow, when practicing stay in the "mids" (mid dynamic, mid range, mid duration).. some pain is telling you that you've been injured, a little more means you're injuring yourself - knowing when to stop=damn difficult.
In my case, I'd say it was 4 to 6 weeks to feel average - maybe 3 to 6 months to feel 100%..
best wishes _________________ Freelance Performer/Educator
Adjunct Professor
Bach Trumpet Endorsing Artist
Retired Air Force Bandsman
Joined: 13 Nov 2001 Posts: 9830 Location: Chicago, Illinois
Posted: Tue Jun 16, 2015 2:08 pm Post subject:
jbeights wrote:
That is exactly right! Its very frustrating because I play based on "feel" as well. Yes, I can do more and will. I was playing at a pretty high level a couple of years ago (solid working range to G above high C, flexibility like butter, great endurance playing some demanding 2-3 hour programs with relative ease, reading very well it was all great) and due to a number of set backs I have lost a great deal of what I had. This simply compounds the frustration. Patience, right?
Yes, patience. But note also that you'll recover what you had much quicker than the time it takes to develop it in the first place.
Joined: 13 Nov 2001 Posts: 9830 Location: Chicago, Illinois
Posted: Tue Jun 16, 2015 2:12 pm Post subject:
zaferis wrote:
Gone through two hernia repairs myself.. each with somewhat different experiences and I'm sure you will have your own pace, success and setbacks in your recovery.
My advise is to go slow, when practicing stay in the "mids" (mid dynamic, mid range, mid duration).. some pain is telling you that you've been injured, a little more means you're injuring yourself - knowing when to stop=damn difficult.
In my case, I'd say it was 4 to 6 weeks to feel average - maybe 3 to 6 months to feel 100%..
best wishes
Thanks for the input. I'm not going to push it as I have plenty of time to recover. "Ring of Fire" the (no trumpet book) Johnny Cash musical currently playing at my theater has now been officially extended until August 30th. I think if it keeps selling they'll run it right up to when "Christmas Schooner" (their annual Christmas Musical) begins in late November - and that runs through the end of the year.
When I do return to normal practice, as soon as I feel pain, I will stop.
Joined: 13 Nov 2001 Posts: 9830 Location: Chicago, Illinois
Posted: Wed Jun 17, 2015 8:09 am Post subject: Today's "Hernia Thought for the Day"
Today's "Hernia Thought for the Day" has been inspired by sneezing.
In the past few days, I've unfortunately had a few sneezing episodes. Due to the intense pain currently brought on by a sneeze, God and/or Nature's wondrous design has insured each time that each episode is just one sneeze (it seems even the autonomic nervous system thinks and reacts quickly once in a while!). If you have a "Schadenfreude" streak in you (and we all do), you'd really get off on the sound I make when I sneeze. I can't help it - the pain makes me sort of "yelp" like a 150+ lb. puppy dog as I sneeze. It's hilarious. I guess I suffer from Self-Schadenfreude.
Several research projects have been done over the years comparing the capabilities of non-trumpet players to trumpet players in terms of the maximum level of air pressure achievable by each group. The results have been predictable. Trumpet players can generate significantly higher levels of air pressure than non-players, usually around 40% more, depending on the study. Here's an abstract from one of those studies:
And though it has not been done yet (though it SHOULD be), I am certain that if a study were done comparing the air pressure generation capabilities of trumpet players who struggle to get past High C to trumpet players who can play into the Double High C range, the results would show again, a significant difference between these two groups. The players in the studies I've read were not "Double High C" players; they were for the most part, amateur players with an average of four years experience on the horn.
When we sneeze, for a moment, our bodies generate their maximum levels of thoracic air pressure. This is not good when recovering from hernia surgery. The more developed we are, the more pressure will be generated. This is not good when recovering from hernia surgery!!!
Up until the time of my surgery, I was very concerned with the surgery itself, and the time after when I would start to recover my playing ability. I purposely practiced a fairly heavy routine right up to the day of my surgery, emphasizing that which I would lose after the surgery (the ability to generate a lot of air pressure and play high notes), figuring that the more developed I was at the time of the surgery, the more I'd still have after taking weeks to months off post-surgery. I did not take into account what I will call the "sneeze factor".
Had I known (or thought of) then what I know now, I would have stopped all heavy developmental practice at least a month before the surgery, purposely weakening my blowing muscles. Because I do not want to sneeze my way back into the operating room! (Though everyone there was quite nice and I got a free shave).
My recommendation to anyone who will be having hernia or other abdominal or thoracic surgery is to lay off the heavy practice a while before surgery - especially the Systematic Approach type Pedal and High Note arpeggio exercises, and anything else that develops Air Power. Let your body return to the level of the (mamsy pansy) non-trumpet players out there for a while. You can get it all back and more post-surgery, with the proper playing routine (and I can help with that).
Or, just say no to sneezing post-surgery. I think the former will prove less difficult.
Posted: Wed Jun 17, 2015 8:17 am Post subject: Re: Today's "Hernia Thought for the Day"
John Mohan wrote:
Had I known (or thought of) then what I know now, I would have stopped all heavy developmental practice at least a month before the surgery, purposely weakening my blowing muscles. Because I do not want to sneeze my way back into the operating room! (Though everyone there was quite nice and I got a free shave).
It doesn't matter. I was not playing at all when I had hernia surgery and I still experienced this. Even non-musicians have hernia repairs, you know.
I felt like I had done a thousand ab crunches for a couple weeks afterward.
Joined: 13 Nov 2001 Posts: 9830 Location: Chicago, Illinois
Posted: Wed Jun 17, 2015 9:22 am Post subject: Re: Today's "Hernia Thought for the Day"
oxleyk wrote:
John Mohan wrote:
Had I known (or thought of) then what I know now, I would have stopped all heavy developmental practice at least a month before the surgery, purposely weakening my blowing muscles. Because I do not want to sneeze my way back into the operating room! (Though everyone there was quite nice and I got a free shave).
It doesn't matter. I was not playing at all when I had hernia surgery and I still experienced this. Even non-musicians have hernia repairs, you know.
I felt like I had done a thousand ab crunches for a couple weeks afterward.
Kent
Hi Kent,
I know what you mean about that Ab crunches feeling! It's getting easier every day though. I can play now, but anything above a quiet middle C hurts, so I don't go there (and I'm only playing a little during lessons).
Regarding whether it matters (laying off for a while to weaken things down a bit before surgery), I didn't mean to imply that stopping heavy playing for a while before surgery would eliminate the risk of a relapse caused by sneezing or something else - but I think it certainly makes a difference if one person's sneeze exerts 40% or more force against a repair site than another person's sneeze.
Joined: 28 Feb 2006 Posts: 379 Location: Lancaster, PA
Posted: Wed Jun 17, 2015 10:15 am Post subject: Re: Today's "Hernia Thought for the Day"
John Mohan wrote:
Today's "Hernia Thought for the Day" has been inspired by sneezing.
In the past few days, I've unfortunately had a few sneezing episodes. Due to the intense pain currently brought on by a sneeze, God and/or Nature's wondrous design has insured each time that each episode is just one sneeze (it seems even the autonomic nervous system thinks and reacts quickly once in a while!). If you have a "Schadenfreude" streak in you (and we all do), you'd really get off on the sound I make when I sneeze. I can't help it - the pain makes me sort of "yelp" like a 150+ lb. puppy dog as I sneeze. It's hilarious. I guess I suffer from Self-Schadenfreude.
Several research projects have been done over the years comparing the capabilities of non-trumpet players to trumpet players in terms of the maximum level of air pressure achievable by each group. The results have been predictable. Trumpet players can generate significantly higher levels of air pressure than non-players, usually around 40% more, depending on the study. Here's an abstract from one of those studies:
And though it has not been done yet (though it SHOULD be), I am certain that if a study were done comparing the air pressure generation capabilities of trumpet players who struggle to get past High C to trumpet players who can play into the Double High C range, the results would show again, a significant difference between these two groups. The players in the studies I've read were not "Double High C" players; they were for the most part, amateur players with an average of four years experience on the horn.
When we sneeze, for a moment, our bodies generate their maximum levels of thoracic air pressure. This is not good when recovering from hernia surgery. The more developed we are, the more pressure will be generated. This is not good when recovering from hernia surgery!!!
Up until the time of my surgery, I was very concerned with the surgery itself, and the time after when I would start to recover my playing ability. I purposely practiced a fairly heavy routine right up to the day of my surgery, emphasizing that which I would lose after the surgery (the ability to generate a lot of air pressure and play high notes), figuring that the more developed I was at the time of the surgery, the more I'd still have after taking weeks to months off post-surgery. I did not take into account what I will call the "sneeze factor".
Had I known (or thought of) then what I know now, I would have stopped all heavy developmental practice at least a month before the surgery, purposely weakening my blowing muscles. Because I do not want to sneeze my way back into the operating room! (Though everyone there was quite nice and I got a free shave).
My recommendation to anyone who will be having hernia or other abdominal or thoracic surgery is to lay off the heavy practice a while before surgery - especially the Systematic Approach type Pedal and High Note arpeggio exercises, and anything else that develops Air Power. Let your body return to the level of the (mamsy pansy) non-trumpet players out there for a while. You can get it all back and more post-surgery, with the proper playing routine (and I can help with that).
Or, just say no to sneezing post-surgery. I think the former will prove less difficult.
Cheers,
John Mohan
John, I considered it almost miraculous that I didn't sneeze one time until twelve days after my surgery, and that was just one quick sneeze. I forget how long, but it was a few weeks until I had one of my "sneezing episodes (up to ten sneezes)." Thankfully I had recovered enough that it didn't hurt.
I actually did what you recommend; the last time I played was a gig on November 29th. Surgery was January 6th and I stated playing on January 30th. As I also didn't do any weight-lifting, riding the exercise bike or bowling, I got REALLY mamsy pansy by surgery time.
Good luck with your recovery John and be careful with the sneezing. I was lucky too like Tim and only sneezed and coughed a few times and it hurt. I held my stomach muscles with my hands to keep them from expanding. I was in the living room recliner for the first two weeks after surgery. I had left and right inguinal and umbilical surgery on 5/13/15. It was laparoscopic robotic surgery and Bard 3D max mesh was used. There were two needles that were misplaced inside of me during surgery which extended my surgery to four hours. They had to get an x-ray machine to find them. The doctor assured me that no other debris was left inside of me. Other than this minor mishap everything went fine.
I didn't play three weeks prior to surgery and until three weeks after surgery. When I started played I was able to practice for a 1/2 hour and over the past few weeks have increased to about 1 1/2 hours. High notes caused more pain then lower notes and when I felt pain or fatigue I stopped or rested. High C came back in about a week. Anything past high C caused additional pain and I haven't worked on high D to A yet. Last night's practice was the best yet, over five weeks after surgery. I've been very carefully and softly practicing Stamp, Goldman, Clarke, and a few tunes. I'll be going to rehearsals next week and then gigs in July. I look at my playing as a physical therapy rehab program and continue to be careful and gradual in what I play. I have some three hour gigs coming up in July and I play lead. I don't know if I'll be in top form, but I'll do what I can. Best wishes John!
Joined: 13 Nov 2001 Posts: 9830 Location: Chicago, Illinois
Posted: Sun Jun 21, 2015 9:31 am Post subject:
Thanks for your input. Given you are also here in Chicago, we should get together for "Hernia Duets".
My recovery is going fine. I gave another Skype lesson yesterday with little discomfort.
One thing this is teaching me, is I've now come to see that the "overlap" in blowing pressure between louder lower notes and quieter higher notes is greater than I realized in the past. With my surgical site providing a sort of "pain meter" that correlates with air pressure generation, I know now that I generate about the same amount of air pressure to play a very quiet High C as I do when playing, say a very loud Middle C range note.
While it's always been pretty obvious we blow harder for high notes than low notes, and we blow harder to play any given note louder, in the past I thought there wasn't as much difference in blowing power between a soft and a loud middle range note than there apparently is (according to my "pain meter").
Don't worry - I am taking it easy and every day is closer to pain free than the previous day. I feel very blessed to be mending so quickly!
While I certainly don't recommend doing such things so soon after abdominal surgery, it does show what the possibilities are when one has developed their air power and control of the air power via the tongue level properly as taught by Claude Gordon (and now taught by myself and several others).
Best wishes,
John Mohan
Webcam Lessons Available - Click on the e-mail button below if interested _________________ Trumpet Player, Clinician & Teacher
1st Trpt for Cats, Phantom of the Opera, West Side Story, Evita, Hunchback of Notre Dame,
Grease, The Producers, Addams Family, In the Heights, etc.
Ex LA Studio Musician
16 Year Claude Gordon Student
Ahhhh, pain.
Ain't it a great way to be reminded of just how alive we are.
Seriously though, I've had a few when I was younger, (appendix and gall stones) but, that was a long time ago in my early twenties. Coughing and/or sneezing are some of the most surprisingly painful results of a surgery in abdominal areas. Yet, we get through them. You are doing the right thing by not stopping. The muscles in that area will strengthen as a result and you will improve much faster.
Joined: 20 Jun 2007 Posts: 1264 Location: Kankakee, IL
Posted: Mon Jun 22, 2015 6:24 pm Post subject:
Way to go John keep it up! Remember pain is weakness leaving the body so push but remember not to hard. Injuries are just that. Listen to your body and you'll be yourself in no time.
Great to hear you playing again. _________________ Kanstul Chicago 1001
CG Personal
Schilke 20D2d
Schilke 20D2d 22 throat
Pain is weakness leaving the body????? _________________ Finally Beiderbecke took out a silver cornet. He put it to his lips and blew a phrase. The sound came out like a girl saying ‘yes.’. . . . .Eddie Condon/
Joined: 20 Jun 2007 Posts: 1264 Location: Kankakee, IL
Posted: Mon Jun 22, 2015 9:27 pm Post subject:
A favorite saying of the US Marine Corp.
Laugh a little. Discomfort is ok when working out etc. But injury is not what they refer. _________________ Kanstul Chicago 1001
CG Personal
Schilke 20D2d
Schilke 20D2d 22 throat
Joined: 13 Nov 2001 Posts: 9830 Location: Chicago, Illinois
Posted: Tue Jun 23, 2015 8:00 am Post subject:
corsair wrote:
Coughing and/or sneezing are some of the most surprisingly painful results of a surgery in abdominal areas. Yet, we get through them. You are doing the right thing by not stopping.
Yes! My first sneezes a couple of days after the surgery were painful and embarrassing - I yelped like a puppy being stepped on as I sneezed. If anything was going to rip things open down there, it would have been those damn sneezes. Now just moderate pain when I sneeze (which is pretty rare as I'm taking Claritin per my doctor's advice).
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I'm glad it was possible to do them all at once, because though the recovery is going to be a bit longer and more painful, I don't want to go through this over and over!
