How long until I can play again after a PE

Discussion in 'The Rehearsal Room' started by Eb_Alex, Apr 10, 2018.

  1. Eb_Alex

    Eb_Alex Member

    Any doctors in the room or anyone that's suffered similar? I was hospitalised recently with a bi-lateral/saddle PE and I want to know how long before I can realistically get back to full throttle on Eb Bass? Hospital said it'd be at least 6-weeks but I'm not sure she knew the specifics of playing bass.

    Any advice gratefully received.
  2. Jack E

    Jack E Well-Known Member

    Alex - I don't know the first thing about PE, but here's my suggestions based on the aftermath of a quad heart by-pass.

    Almost certainly, the person you spoke to didn't know anything about playing brass, so what I'd suggest is that you go back, see her again, and talk her through exactly what your body has to do in order to play. After my op, the first physio who looked after me said that it would really help my recovery if I did regular deep breathing, using my diaphragm.

    "Like this?", I said, and took a baritone lungful.

    Her eyes popped, and she said "Where did you learn to do that? Most of my patients don't even know what or where their diaphragm is, let alone how to use it!"

    So I explained the mechanics of how you play a brass instrument, and she said:

    "Right! Get back playing as soon as you can, and keep playing as long as you can; it will really help your recovery, and keep your whole chest area in good shape."

    She also said she'd be passing this advice on to every patient she dealt with in future!

    Another piece of advice which might prove helpful; last year, after a very nasty chest infection in January, my breathing went totally to pot. By April, I had to stop playing baritone altogether, as I couldn't even get a decent bottom C out of it; I seriously wondered if I'd ever be able to play again. Fortunately, I had to go down south to see an old friend who plays brass, and told him about my situation. He dug out a ratty-looking tenor horn which he'd picked up for peanuts on E-bay, and suggested I try it, saying:

    "It needs more air pressure, but a smaller volume of air - and you might be able to manage it."

    To my surprise, I could, so when I got back home, I borrowed a tenor horn from my band, and switched to that, and found after a bit that I was getting on reasonably well with it - though adapting to the change of key from Bb to Eb really threw me at first!

    But it kept me playing through last summer whilst the docs were sorting out the best inhaler for me to use; it kept me in contact with the band so I didn't just sit at home and mope; it kept my lungs and diaphragm in far better shape than if I'd stopped playing; and it kept my sight reading up to the mark. By the autumn, my breathing problems were under control, and I was able to revert to baritone again. YAY!! :)

    However (again, based on my own experience), please be patient with yourself! What you've been through is pretty traumatic, and bodies take time to heal (even though it's obvious you're a hell of a lot younger than I am!). Talk it through with your physio / surgeon before starting playing again; give them the info about brass, so that they can make informed suggestions, and heed what they say. They mightn't know the first thing about brass, but they do know a lot about lungs!

    And give some consideration to switching to a different instrument, if only for a while. It might help you as much as it helped me - and playing any brass is better than playing none! :)

    HTH, and best regards,

  3. Eb_Alex

    Eb_Alex Member

    Thanks Jack, that's interesting to hear. I will pass on the information regarding the breathing assisting the recovery for heart patients to a player who is awaiting surgery.

    Sound advice, I will contact the consultant and see if there is any further advice they can offer if I describe more clearly the process of filling a bass with air. I have give Euph and Horn a go in the past and I'm not sure I can subject anyone to that again :)

    Thank you!
  4. 2nd tenor

    2nd tenor Well-Known Member

    Playing a Bass is physically demanding, they consume even more air than a Trombone and playing a Trombone often feels like blowing straight into an open pipe.

    In terms of reducing the load on your self one easy compromise is to seek out a smaller bell and smaller bore Eb Bass (eg. B&H Regent). They are noticeably easier to play than a EEb and, in the right hands, very capable of producing decent music. If you do get one then check the valve alignment and, as needed, use a vintage type valve oil.

    Another option would be to ‘have a rest’ on a Tenor Horn for a while. With them being pitched in Eb too at least you haven’t got to worry about a change in pitch to Bb.

    Good luck and I hope that you get some better advice / comments soon. As I recall pbirch is a Tuba player and has medical knowledge, and David Evans is a Baritone player and was (if my suspicions are correct) an expert Anaesthetist.
    Last edited: Apr 10, 2018
  5. Jack E

    Jack E Well-Known Member

    Alex - re. what 2nd Tenor said about the B & H Regent instruments (which were B & H's student range when their top models were the Imperials - made up till the early 70s); my baritone is a Regent, and when I bought it I showed it to my MD.

    He told me that the price of the Regent range was kept low by them not having compensation - and not because they were poorly built; and secondly, when he tried it out he said he was surprised at how nice it sounded. He also pointed out that as the Regents had smaller bores than modern instruments (mine is .500 inches bore, most modern ones are .540 inches), they are easier to fill properly, even if your lungs are not that strong.

    I think 2nd tenor's suggestion is well worth considering.

    Best regards,

  6. David Evans

    David Evans Active Member

    Hello Alex, a couple of assumptions that you’re a healthy man in his early 30s with a recent significant PE so my advice is based on this.

    1) Specialist nurses are adequate for routine matters but nothing else, similarly with registrars and below. You may get sensible advice from a Senior Registrar or Consultant but almost certainly they are most unlikely to know anything about brass playing. For this you need to speak to people like BAPAM who specialise in Musicians’ problems.

    2) Unfortunately the problems of heart and post op heart patients are not the problems of PE and DVTs. Despite only being an inch apart the whole pathophysiology is very different and you cannot just transfer what works in one to the other.

    3) your PE was caused by a clot forming almost certainly in your leg 10 days before your admission to hospital which may have coincided with a journey by car or plane or a period of inactivity. Whatever the cause it shows that your blood system in your legs need radical improvement otherwise the same thing may happen again with fatal consequences.

    4) So, you should be exercising already and oddly enough the best exercise is walking, 20-30 minutes most days. This is to improve the blood system in your legs. Walking will open up new channels, recruit new venous systems and train the calf muscles to pump blood back up against gravity into the body and then into the heart. This isn’t one of those medical homilies to exercise and lose weight which are always spouted out, in your case it is vital and like a shark, if you don’t move you will die.

    5) As far as your chest is concerned, you need to practice deep breathing for a few minutes several times a day. Not when you are doing anything important as it may make you a little light headed for a minute or so. But don’t take it easy, your body is young and mostly healed by now and if you don’t get your lung alveoli back to normal you will succumb to a chest infection and die.

    6) Do NOT change to a smaller instrument. The problem is high Intrathoracic pressure and the highest is recorded in Oboists, Soprano players and trumpet screamers. It effectively stops the blood going through the brain and more importantly stops blood returning to the chest so the blood ‘pools’ and stagnates in the lower limbs. You can see where this is going. Large instruments have progressively lower pressure although high notes, like constipation, will still raise the intrathoracic pressure, predispose to pooling and ...

    7) I suggest that you play your bass with nice big breaths but perhaps avoid high notes for a month or so, just put them down an octave and gradually build up but avoiding sustained high notes. Most PEs will be put on blood thinners for 3 months or so so if you aim to be back to normal then it is probably a sensible option.

    8) your lung function will be slightly vulnerable for a few months so I would suggest cleaning your bass in the bath every few weeks as you don’t want a mould or fungal infection to cause a pneumonia and kill you.

    9) Then the usual sort of stuff, don’t cross your legs, make sure you don’t sit for more than 2 hours without getting up and walking around, wear DVT socks if flying or even long car journeys, consider laxatives to avoid constipation for a few months, reduce the alcohol and coffee as these have been linked to DVT, similarly with weight, try and reduce it.

    10) All good stuff but it needs active means to avoid it happening again, you’re young with potentially 50 years ahead of you, -and basses are in short supply.


    2nd tenor and Jack E like this.
  7. Jack E

    Jack E Well-Known Member

    Whew!! HEAVY stuff, David - but thank heavens you were a poster on here, and able to give Alex the benefit of your advice.
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