Antigua Winds
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  1. #1

    Default Nasal pressure, loss of air support

    I have been experiencing a rather odd and debilitating problem with my playing off and on for the last several years. As I play I will begin to feel pressure in my nasal cavities, as if my nose was plugged by mucus. When I try to blow my nose, there is no mucus present. This pressure will build and build as I continue to play. At some point, a “break” occurs – I suddenly lose air support and experience a quick and sharp exhale of air through my nose. After this occurs, I am unable to maintain a constant air stream for more than a few seconds. If I speak very soon after this occurs, my voice sounds nasal, as if my nose is plugged. Since I cannot keep a steady air stream, I am unable to play for several hours after this occurs.

    I have consulted with both my general practitioner and an Ear, Nose and Throat specialist regarding this issue. My ENT diagnosed the problem as a swelling of tissues in the nose called the turbinates. These tissues are responsible for humidifying the air entering and leaving through the nasal passages. An x-ray of my nasal cavities showed one of the turbinates to be enlarged. At the ENT's recommendation, I started on prescription nasal decongestant spray. This did not have any definite effect. I then had a procedure called a “somnus reduction.” In this procedure, an electric current is run through the turbinate, temporarily shrinking it. This too has had no discernible effect. My ENT says that the next step would be to partially remove the turbinate tissue, which I am hesitant to do.

    Sometimes I can play for hours without experiencing this problem, while at other times it occurs after only five or ten minutes. I have not been able to relate it to allergies or environmental conditions of any kind.

    My question is thus: has anyone experienced anything similar to this, or are there any saxophonists with medical training who may be able to provide any insight?

    I am 18 years old and have been playing saxophone for 8 years. I play mostly alto and soprano. I am also a bassoonist (for four years) and experience the exact same problem when playing bassoon. I do not have asthma or any other respiratory condition. I will be a double music performance major next fall on both horns (school starts in a month) and need to be able to play without this occurring.

    Thanks in advance for your time and consideration.

    Ben Opp

  2. #2
    Minatar12's Avatar
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    The symptoms you described happened to me extensively starting the end of my freshman year in high school, and lasted till about my junior year. But it's very strange...the problem went away eventually on its own accord. I wish I could help you, but my only experience was really just a wait and see...I waited and it went. I hope the same happens for you. Best of luck.

  3. #3

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    Thanks for your reply. I have since determined that the turbinate swelling diagnosis was incorrect. I have self-diagnosed myself as having velopharyngeal incompetence. This is an inadequacy of the soft palette most common in children with cleft pallete (which I did not have). I am attempting to find a doctor in my area who has experience with this issue to confirm or reject this diagnosis.

    If you would like more information, run a Google search for the condition with "wind player" also as search terms. You will find several brief articles describing this condition being brought on by the stress and intraoral pressure of wind instrument playing.

  4. #4

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    My 15 year old son is having symptoms similiar to what you described. This condition started about 4-5 weeks ago and it takes him about 10-15 minutes to reproduce the air loss problem.

    I found that standard ENTs are not trained nor have experience in treating issues such as these. I then contacted Julliard college to find out where they send their wind students that are having problems. They refered me to a group of doctors in NYC which specialize in treating performing artists called the Miller Institute http://www.millerinstitute.org/.

    I spoke to one of the doctors there who described conditions related to the soft palette which could contribute to this issue. They of course can't diagnose the problem over the phone, but want you to come in with your saxophone for an evaluation. The doctor also said that this condition is more common in double reed players than saxophonists.

    I am considering making a trip into NYC to see what they say.

  5. #5

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    Good to hear I'm not the only one experiencing this. Since I am located in California, NYC is a bit far to travel, but I appreciate the information; perhaps they can recommend someone on the west coast.

    I would very much appreciate any information you could share after you visit the Miller doctors, if you decide to do so. Information is our best weapon in the war against this condition. Thank you.

  6. #6
    Vader's Avatar
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    I have had this, as well as other sinus problems over the years. It's so hard to predict what will set it off. I'm glad to hear that other people are having similar issues, as I ws worried that I stood alone.
    Thanks for posting that link to the doctors in NYC.
    That's excellent. I might go down what I get some time.

  7. #7

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    I have a potential work around (not a fix) to this problem which has helped out some clarinet players. While playing you will need to change the way you take a breath, just exhale the rest of the air from your lungs before inhaling again. This apparently helps relax the throat which should avoid undesirable air releasing through the nose.

    This technique was given to us by my son’s last saxophone teacher who has successfully used it with some of his other students. It is too early too tell, but my son thinks it is helping him. He started playing without using this technique and air was escaping through his nose, then his ex-teacher came by worked with him on it, they had an hour lesson and my son played another ½ hour without any problems.

  8. #8
    Vader's Avatar
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    There may be something to that. I find myself exhaling in that manner when things are bad. It doesn't cure me, because by the time i'm doing that, it's usually too late. But, maybe results wil be diffirent if I try it all the time.

  9. #9
    Distinguished Technician & SOTW Columnist
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    Quote Originally Posted by js99
    ...The doctor also said that this condition is more common in double reed players than saxophonists.
    .
    I guess that is because oboe requires higher air pressure than does sax.
    Therfore I wonder if using a mouthpiece/reed combination that requires lower air pressure would be helpful.

  10. #10

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    js99: This is, unfortunately, not a very practical solution. It is very often impossible to exhale completely before inhaling again, especially during a lyrical movement (things like the Bozza Aria or even the slow movement of the Glazunov). It is a lead, however, and I thank you very much for sharing the information you have. I will try this out and report my results.

    Gordon: As a bassoon player, I can speak to this. Double-reed playing involves "back pressure" - a feeling of pressure, or resistance, against the reed when playing. There is very little back pressure on saxophone, somewhat more on bassoon, and a ton when playing oboe. This pressure seems to exacerbate the inadequacy of the soft palette, or even cause it.

    Thanks to everybody for their responses. As for me, I am attempting to make an appointment at the Cleft Pallete center of the University of California, Davis Medical Center. I am in contact with an ENT there who has experience with this condition and should be able to help.

  11. #11

    Default and I thought it was just me....

    i'm late as hell on this thread, but reading it almost gave me goose bumps--'cause it's the only time someone mentioned something that I'd been quite disturbed by.

    In the past I'd experienced very similar symptoms, but for me they seemed directly related to the rigor of my practice schedule. If I'd been slacking on playing and then tried to blow for a couple hours straight, my sinuses would blow a leak and goodbye air pressure. But when I practiced consistently (and WARMED UP---gotta love those long tones...) it didn't happen at all.

    Please keep us updated on your progress. For a long time I had a deep fear that I'd have to retire my horn permanently because of some bizarre physical woodwind handicap. Thanks for posting this and letting me know it's not just me.

  12. #12

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    Thanks for your message! It's comforting for everybody here I think to know we're not alone.

    I will try your advice concerning long tones, etc, but I normally warm up pretty well before practicing. As far as my situation, I will be visiting UC Davis Medical Center within a few weeks for a motion MRI and consultations with a few doctors. I will of course report back with any information I receive.

    Thanks again to everybody who has posted on this thread.

  13. #13

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    Earlier this week I had a appointment with a speech pathologist at UC Davis Medical Center regarding my nasal problems. The pathologist conducted an x-ray, which was enlightening to some extent.

    She first had me say a number of syllables and short sentences while watching the live motion x-ray display. My soft palette closed and opened normally, sealing lightly against the back of the throat. I then played bassoon while being x-rayed. Here, my soft palette sealed very tightly and very forcefully against the back of my throat. The pathologist said it is likely that because the palette is sealing so forcefully, it is becoming fatigued quickly and is unable to maintian the seal for long periods of time.

    I have another appointment with an ENT in three weeks to discuss treatment options, etc. At this time they will also stick a camera up my nose while I play for further observation.

    The pathologist confirmed my self-diagnosis of Stress VI (velophyringial incompetence), and the x-ray seems to suggest the same.

  14. #14

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    I recognized the same problem (and on the weekend there are 3 important gigs ) with me and now I'm interested in getting to know how you overcame the problems for gigs ? Did you close your nose with a kind of clip ? What can I do ...

    I sometimes (seldom) had this problems but it never disturbed my playing but now I'm afraid.
    The last week I've bought a new mouthpiece (it's the same model as before) and I could not warm up very good before practising ... I hope that this is the only problem ...

    Please tell me what has happend to you !

  15. #15

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    Like Hannes said, definitely keep us posted on how things develop. In the meantime I'll be wishing you well and pulling for a spontaneous miraculous full recovery!

  16. #16

    Default Loss of air pressure through the nose

    Thank you for posting your information about the your problem with loosing air pressure while playing your sax. I have the same problem. I am 55 years old and played with a jazz group on the road for 17 years and never had this problem until I was 53 years old. I was just thinking it was an age thing, but then I saw your post and found out this is not just an age thing. I have not totally overcome the problem, but have made a lot of progress dealing with it. It helps me a little to use snore spray before I play. Also I have practiced many hours at blowing softer into my horn, and amazingly was able to reach good volume at a low blowing pressure. Thankfully, now I'm only playing 45 min. - 90 min. concerts and my gig is over. I just don't know how I could make it through a 4 or 5 hour gig without loosing my air pressure. Please let me know how things have turned out for you.

    Thanks
    Les Blalock

  17. #17
    Distinguished SOTW Member Saxland's Avatar
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    Default Throat

    Here is my two cents.....I had nasal leaking at about age 18. It turns out that my wisdom teeth came in pushed my bite off and then the muscles in my face were scrunched up . As well I learnt at 26 that I needed a chiropractor. I was leaning forward to compensate for bad posture and was pinching the drainage tubes for the ears to the throat. Causing allergies and sore throat. So the muscles were enflamed as well. Need to fix my bite, so I wear a biteguard at night to put the jaw in the right position. I wear orthotics and go to the chiropractor and it works most of the time. I have no idea if this helps you. But I'm glad you posted your challanges. Many many doctors misdiagnosed me for 14 years until I figured out the bite problem on my own. My own dentist I had since I was 12 missed my TMJ completly.
    Last edited by Saxland; 04-26-2005 at 05:35 AM.

  18. #18

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    I'm not sure is this is related to the problem you guys have, but sometimes after I've been playing a while, air seems to leak out from the passage in my mouth up to my nose. It tickles/irritates my throat and is very audible. I don't feel air coming out my nose when I play, just on the inside of my mouth. It sounds like I am trying to clear my throat, but with a more constant and faster sound. It started about a year ago. It doesn't happen often, but when it does, I have to stop playing and rest for a while before I can play normally again. I'm not sure what to do about it.

  19. #19
    Distinguished SOTW Member Saxland's Avatar
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    Default Nose throat

    Never an easy task to self diagonose, even for doctors. Part of the problem in describing a symptom is that it may or may not be the source cause of the symptom. As well, since the wrist bone is connected to the arm bone...... if one thing is out then it can lead to a few other things being out. Take your thumb and hold it accross your palm and try and write your signiture. You might see that as a problem of your writing instead of the true source of the problem. When something is not right with the body it is like your pinky being pulled 2000 times a day just slightly that you do not notice it. The whole arm and shoulder will eventually go numb and pain will happen. Think carpel tunnel with using a computer at the wrong height.

    I have tmj that has been painfull at times, AND a few weeks ago I discovered that the house I was in had a mold problem in my room, leakey water pipe. Well I moved out and the TMJ pain is next to nothing but there is pressure there because of a bite being off. The allergie to the mold had really jacked up the symptoms of the TMJ.

    The best thing that anyone can do is to find a Doctor that is also a professional level woodwind or brass player. For years my dentist, family doctor, and many many specialists thought that my body would re adjust and the problem would go away, I was diagonosed with a week imune system because of all the stress in my life, and my mother has systemic lupus.

    That one doctor who was a dentist/trumpet player knew exactly what the problem was. Period. Bite is off and my world falls apart. Hard to believe and true. . And he lead me to other Doctors that dealt with musicians that understod how important this is for me and the ability to play.

    I have had my fair share of family members tell me they think its "All in your head" that "mabey you are not as good a sax player as you think" . "Let go if it, you will be happier" "Chasing windmills will destroy you" Turns out it was caught in time before my jaw became arthritic. I could not play for years like I used to, then with the right Doctors I can. Even made a very very good friend out of a chiropractor that spotted I need orthodics for posture, that improved my sax playing.

    Even with a proper diagonise my family is in denial and some friends think that this can't be, to them they can not grasp how inportant a proper bite is. Carefull who you turn to for support because the way they support you is an emotional investment that they may resent being challanged by medicial facts.
    Last edited by Saxland; 05-06-2005 at 04:49 PM.

  20. #20

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    I have to agree with the speech pathologist who said the problem comes from fatigue. I sometimes experience this after a couple of hard sets with the R&B band I work with.

    My solution? Change reeds! As reeds get waterlogged or worn out--and therefore become too soft--I found I try to compensate by blowing harder to get the same volume. It all happens so gradually that I'm not aware I'm doing this until my embouchure blows out.

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