I've sprung a leak...

SOTSDO

SOTSDO

Old King Log
Staff member
CE/Moderator
...and it is one of the most frustrating problems that I have ever faced.

First, some background. I've been playing horns since I was a young sprout, and can claim no less than fifty seven years horn time on the bass clarinet. Most of my playing time has been on the larger instruments (bass clarinet, baritone sax, a misguided year on tenor sax, bassoon here and there), so filling up a larger airstream has been almost second nature. I've done five hour plus New Year's Eve gigs without a problem, and in the past have only experienced problems with lip injuries as far as playing is concerned.

Medically, I've had to deal with a host of muscular skeletal problems (mostly head wounds and leg wounds), and long term conditions (diabetes, hearing loss, arthritis), but (until a month ago) they were all under control and well managed.

Due to my extensive service related conditions, my health care has been managed (for the past fifteen years or so) by the medical side of the Department of Veterans Affairs. Many will fault the DVA, but as a former employee (five years as an adjudicator back in the 1970s) who is quite familiar with what they do, you won't get a complaint from me.

...Until I was called in to an appointment at something called the "Sleep Lab". There, i was told that I was to be evaluated for sleep apnea. After a night spent with an odd monitoring rig at home, they fitted me for a sleep apnea machine (called a "C-PAP", for some odd reason). It's a clever little contraption, using a face mask like appliance to maintain positive pressure into your airways, allowing for airflow freely throughout the night's sleep.

Wearing it is a bit of a nuisance, but having spent a lot of time in respirators (we wore them over in RVN when using tear gas generators to clear tunnel complexes - mine was built into the tank and quite convenient, and during my many years with OSHA I wore them so much that I had special glasses built so as to allow me to see while using them) it wasn't that great of an imposition.

However, it was at this time (about two months ago) that my problems began to "thicken". First to occur was what I call a "thickening" of my powers of speech. Although I can form the words and speak them clearly enough (so much so that my wife cannot perceive a difference), my mouth feels "thick", like the walls of the oral chamber are all swollen. I'm not tongue tied, I have no trouble expressing myself - it's just that the mouth "feels funny".

I have suspected a stroke, but haven't been evaluated for such a problem yet. Yet.

Concurrent with the C-PAP use and the thickening sensation, I have also experienced two other issues:

The first is the odd, yet not all that important of the two. I have largely lost my ability to whistle. In the past, I could whistle stuff from Rimsky Korsakov or Ippatov-Ivanov with gay abandon, but now I can no longer even manage simple bugle calls, much less Russian Romance era stuff.

The second is the BIG problem. I have started experiencing what is technically called Stress Velopharyngeal Insufficiency. This is when your soft palate starts lacking the ability to seal up the nasal passage when talking, eating, or (more importantly) playing a wind instrument.

Have you ever snored, or made the sound that people make when they snore? When that sound is formed, you are experiencing a version of the Stress Velopharyngeal Insufficiency, albeit one that you bring on yourself. In effect, the seal between the parts of your throat/mouth/nasal cavity is failing, and your air is leaking from the oral cavity into the nasal one.

Trying to play for too long can cause this to happen, although I've never experienced it in the past. As I said, the long five hour NYE gigs were like rolling off of a log for me. Now, a mere half hour of practice on the soprano clarinet is enough to bring the problem on, and the buzzing in my head as the leak occurs is a horrible feeling, as apparently the "seal" swells from the repeated impacts of the "closure flap".

Treatment? Well, it ranges from speech therapy (repeatedly saying the "chuh" (K) sound) through plastic surgery (injection of body fat behind the seal area) through out and out surgery (a purse string through the critical area, or other revisions of the area). Apparently, none of these measures seems to be definitive, and a published author on the problem seems to think that it's all a toss up. His comments can be found at https://www.clarinet.org/clarinetFestArchive.asp?archive=30 .

And, trying to play the baritone, bass clarinet or bassoon is pure torture. With a couple of band jobs in the offing, plus a pit orchestra spell ahead, I am not looking forward to the agonies I am about to experience.
 
I'm sorry to hear about that. I experienced that condition "one time at band camp" when I was playing/practicing for 6 hours a day. Luckily it went away after cutting back on the playing time. It is disconcerting to say the least. If no other solution presents itself and you have to play at upcoming events, may I suggest trying small plugs inserted up out of sight in the nasal openings. This would maintain the air pressure required to play even if the air is not completely being routed out of the mouth.

I too have been on C-Pap for about 8 years now for sleep apnea. I require a full face mask or else the air goes in my nose and out my mouth and doesn't help my lungs to fill with air. Getting old sucks, but it is not so bad when one considers the alternative. :)
 
I had the same problem with the partial mask that they urged on me as "most comfortable". It certainly was less of a burden on the face, but the pressure was blowing by my mouth in a most uncomfortable fashion. The elastic mouth seal wasn't a solution either.

The C-PAP machine that they gave me is clever as hell. Humidification provided, levels adjustable, and all sorts of bells and whistles. Both of my alto players use them, and they have to pay big money for a replacement mask.

(The DVA watches over me like a hawk, and they are willing to spend your money like water in doing it. In the effort to help me cope with my horrible tinnitus, the therapy and assistive devices provided have reached into the high five figures - even though it hasn't really worked, I sure appreciate the effort.)

(However, I used to do the same. Some of the cases of disabled veterans that I worked through would break your heart if you knew all of the details. The very worst of these follows:

Back in 1973 or so, I had the honor (as did several before me) of dealing with a disabled veteran who was shut out of the system by a flaw in the law. The facts of the case were as follows:
• US Army service during the 1920s - a non-war period
• Military specialty - truck driver
• Stationed at Fort Lewis, up in the notorious damp northwestern United States

The veteran in this case was working on a Saturday, driving a truck to haul dirt to fill in a bit of terrain so that the post officers could have the pleasure of a polo field to wile away their idle hours. As it was a day of nasty, drizzling rain, the drivers were quite cold as they waited for the shovellers to empty their trucks. So, a line of fire barrels were prepared to keep them warm while they stood about.

The truck driver in question had been tending to a carburetor issue when he stopped, but he soon walked over to the barrel line to warm up. While standing there, one of the barrels flared up, catching his clothes (which were moist with gasoline from his carburetor adjustment) on fire.

This was before the days of stop, drop and roll. The fire, before they tore his clothing off, consumed both of his ears, most of his eyelids, and substantial portions of his facial tissue. This being the 1920s, the medical treatment for burns probably did about as much harm as it did good.

Now, the then-VA spend money just as liberally on its veterans as it does now. But, it does so for conditions that arise out of the veteran's military service. Not so in this case.

For you see, the duty that the veteran was involved in was "voluntary" in that it was being done on a Saturday, and outside of normal military orders. (The men were "encouraged" to volunteer by the polo loving officers, a type of volunteering familiar to most who have been in the military.) The panel that met to assess "line of duty" status on this poor guy followed the rules to the letter. Was the man in the Army? Certainly. Was he involved in official duties? No. Legally, all that they could do was to term his injury "Line of Duty: No", and that was the final finding.

He was therefore immediately discharged from service for the injury that arose from his "misconduct", and had been appealing it ever since. The man's case file was over two feet thick, and every VA employee who ever came across it did their bit to try and get the ruling reversed. It had been up to the Board of Veteran's Appeals in Washington at least six times, but each time the government's efforts in his behalf were defeated by the rigid code that stated "If the injury was ruled "Line of Duty: No", then the VA's hands are tied."

He was a pathetic mess physically, and his long-suffering wife (who married him in the 1930s) was beside herself with the totality of it. And, through it all, he bore his suffering (breathing through his filthy silver tube in his throat) with amazing grace. His monstrous medical expenses, all borne by him and his wife, were dragging them down into penury.

Only one story, and certainly not the most gruesome that I encountered over the years. But, very illustrative of how "the system" could screw someone over, and all of the best intentions of all concerned couldn't do a damn'd thing about it.

I sure hope that the officers enjoyed their polo field...one man's price that was paid sure made the finished product an expensive one.

Enough of that, though. One of many tragic cases of someone caught outside of the bounds of the system, so bound up in law that right got left at the station.)

Back to music.

When we did our arrangement of Twist And Shout a couple of weeks ago, I could not make it through the extensive baritone figure at the start of the piece. When we did the repeat of same after the DS, I handed it over to my lead alto, who did the best he could. It sounds weird on the recording - normal the first time through, then up an octave the second.

If it can't be resolved, I'll probably just have someone else cover my part. Spread the wealth, and cut down on the hassle at the job.

To make things even more interesting last time around, my friend from down in Corpus Christi to play the part of band boy. Unfortunately, he came down with a horrible intestinal affliction, and spent most of the evening in the can. He did help out with the loading, but passed his bug onto me. Bummer..
 
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Approaching my 60s I truly dread the day that I will not be able to play in band anymore. I distinctly remember having to stop playing basketball in my 40s because of my knees, plus no one as old as me was playing so I became the slow guy on the floor. I went into a depression for years after that. I grew out of the depression by picking up the sax after a 30 year hiatus. I had to take almost ten years of lessons because although I played solos all the time in concert band in high school, I really didn't know how to sight read. So overcoming that challenge made my entry into music very interesting.

Terry, I hope you can find a cure or fix for your challenges. We learn from your travails. Hang in there.
 
I think we need a new group: C-PAP users. "Hi. I'm Pete." "Hi, Pete." "I've been a C-PAP user for almost 5 years ...."

I also have a humidifier C-PAP. I generally get a new mask, tubing and filters every three months. I get a new water chamber for the humidifier every six months. I'm fairly sure that the price for the full monty is about $150, although I haven't checked in the new Obamacare world. Heck, one of my medications went up by 1000% (yes, it's 10x more expensive). I get that one filled in Canada, now.

FWIW, you can get the tubing and masks even on Amazon.com, if you want to pay for them yourself. The C-PAP, itself, is a different animal. If you have a prescription in-hand, you can go just about anywhere. If you don't, there is a grand total of ONE website. Here ya go. When my old C-PAP died a year ago, I was told that I had to go back in to get a new prescription, which meant that I'd have to do another sleep study ... when the room was available in about 6 weeks. My wife pleaded with the respiratory therapist for mercy. The therapist found the same make/model C-PAP I had on a shelf somewhere. New, in-box, but 5 years old. Some people find brand new SMLs still in the box, I find a C-PAP. Sigh.

Anyhow, I use a full over-the-nose mask. There is the kind that goes over your nose and mouth and the kind that sticks up your nose. The former is very expensive, even with insurance, and the latter makes me feel like someone's constantly picking my nose. I'm fairly sure that all of them can be used with oxygen, too, if you're also prescribed that.

The thing that helped me most, after getting an appropriate mask, was to get the right webbing to go with the mask. There are some with different strap thickness and different padding. Kinda like sax neck straps.
 
During my visit to the ENT doctor today, he squirted stuff up my nose to deaden the tissue, then shoved a fiber optic scope up one nostril and examined every square centimeter of my soft palate. There was some irritation there from my time spent on the clarinet last night, but other than that no trauma of any kind.

I'm due to go to a speech therapist in the near future, and I've been given some nasal spray to clean up a sinus drainage problem. He also suggest that I get screened for the potential of a tumor in the pituitary gland (oh, joy!), and that I continue the C-PAP machine.

(The loss of whistling ability and the "thick tongue" feeling pointed him to potential for a tumor in the gland. Certainly, not the sort of news you'd like to hear, but it's only to screen out the possibility, not because he expects it to be found.)

Last night, I played for about a half hour before the leakage got so severe that I had to stop. I then picked up a wind synth stick and was able to play for the rest of the night without any symptoms at all. Not quite the same thing as a Selmer full Boehm, especially the "finger everything like a saxophone" nature of the thing. But, I was able (for the most part) to keep up with the extreme key signatures without too much difficulty. The four octave key bit was the worst of it.
 
I really had only two complaints about my old Yamaha WX-11 wind controller: the key action was way too light and I really didn't have a decent tone generator. Well, my intonation was pretty much dead on, so I at least had that going for me.

I've just finished my antibiotics from being sick for the last couple of weeks. One of the problems I still have is that my ears plug up something horrible when I blow my nose. Other than taking decongestants -- which tend to wire me up more than a half-dozen cans of Coke -- there's not much I can do but ... chew gum. Which really does help. It just takes awhile. And hearing the air leak out of my ears is kind of an off-putting sensation.
 
After quite a bit of calling the insurance company, the referring doctor, and the speech therapist, I finally am on board with her for the (hopefully) curative therapy. Time will tell.
 
Tonight's pit crew rehearsal (with the cast) went well, with only some minor leakage during "Got A Lotta Livin' To Do". The amp I'm using (our piano amp) has a volume control that is extremely sensitive, so it is hard for me to boost the volume when I need to blow less.

On the other hand, playing the rhythm parts (with the bass clarinet patch) sound pretty good, as long as I don't forget to use the #&%%! saxophone fingerings...
 
SOTSDO said:
(...) The amp I'm using (our piano amp) has a volume control that is extremely sensitive, so it is hard for me to boost the volume when I need to blow less.

(...)
Click to expand...

Why not use a guitar volume pedal ? I do when I have to amplifiy my flute (between flute mic pre-amp and main amp). Works pretty well.
J
 
All that I currently have is a lash-up of borrowed equipment (the controller and synth) combined with a foot pedal box (to switch "horns") and my group's piano amp. If I move to doing this permanently, I'll rig up something more permanent, but for now what I have will have to do.

Volume of the tone is governed by the wind stream, of course. In this case, it's probably the amp's fault, as my pianist has no trouble with his volume levels. With the synth, it's either low level or VERY LOUD, this when moving to one dot on the scale to halfway up to the second dot.

Run all the way up to eleven, I could crush the rest of the group. I can see why electrified people so enjoy advancing their gain settings. The thought of an all-conquering bass clarinet tone is tempting, but I have some self control.
 
SOTSDO said:
Run all the way up to eleven, I could crush the rest of the group. I can see why electrified people so enjoy advancing their gain settings. The thought of an all-conquering bass clarinet tone is tempting, but I have some self control.
Click to expand...
The bass trombonist, in a group I played a long time ago, sat directly in front of me. He really didn't like it when I bought a Berg Larsen (read: jazz/rock) hard rubber mouthpiece for my bari.

Power corrupts absolutely is meant to be used!
 
Used, perhaps, but used wisely. I too play Berg Larsens (metal in my case), and could move walls when the chart merited it. However, most of what we play is ensemble work, and very little of it is jazz-oriented (i.e., about 85% of the charts are vocals, with limited soloing across the sections).

But, I could blast out Punkin, Punkin or our Twist and Shout with the best of them.

Emphasis there on the could...
 
The initial visit to the therapist went very well indeed. Right off the bat, she told us that it appears that I have had a minor stroke affecting the speech areas of the brain (which would explain both the soft palate issues and the "thick mouth" and complete failure of my formerly formidable whistling ability). She is making a referral to my friends at the DVA for a MRI to see if any damage can be found.

Even if that is not apparent, she said that it is relatively simple to "remap" the functions of "voice control" (as opposed to the ability to speak in the first place, a much more serious problem). Through vocal exercises, the normal speech movements can be retrained and speech returned to former proficiency.

(I can (with some minor difficulty) still run through the "One hen, two ducks, three squawking geese..." radio announcer mantra. So, it's obviously not the mental aspect of speaking, just the operation of the mouthparts.)

I was worried that she might not be familiar with the instrumental music aspects of the problem, but nothing could be farther from the truth. As it happens, she used to play alto, tenor and baritone (but not soprano) back through her college days, and she was pre-acquainted with the 'condition' outlined in the article quoted above.

Further action by her awaits her submission to the reviewing board of an appraisal of the initial contact. Stay tuned.
 
Today, we did the traditional two show "Final dress rehearsal with an audience" that the director at the school performs every year before putting it on for real for the paying public. A total of about six hours of time in the pit, with perhaps half of it spent playing, if you will.

The synth aspect of the setup was the most frustrating part of it all. Having to stab the correct foot pedal to call up the correct patch is a real bother, and I still find myself looking to set down "one horn" to pick up one of "the others", instead of reaching for Pedal 1, 2 or 3. (Hit number 4 by mistake, and the synthesizer takes off into hand clap territory - I haven't figured out how to disable that without screwing up the whole setup.)

Apart from that, most of the other problems have been addressed, if not perfected. The saxophone tone still sucks big time, but since most of the sax work on Bye Bye Birdie! is in the nature of string or trombone fill stuff, it works well enough. The clarinet patch is way too fluty for my tastes, but it mixes well enough with the other clarinet tones. The bass clarinet is the best of the three, and it works well for the rhythm parts as well as the choir arrangement of "Talk To Me".

However, the fingering is still as frustrating as you can get. The basic saxophonic setup functions well for the sax parts - until you have to descend to low Bb and A, at which point it all falls apart. My ham hands do not handle the spacing of the stupid "octave crescents" strewn around the LH thumb rest, and I am constantly tripping up two octaves or down two octaves when all I want is one in either direction.

(The touchy keys are another issue. Bump one while reaching for another and you take off into squeak territory, not usually a problem with a EWI. There is simply no resistance on the key touches, and you have to calibrate your finger velocity to match the characteristics of the 'horn', much moreso than shifting from (say) clarinet to bassoon.)

But, where things really fall apart is with the bass clarinet patch. Since the EWI is stuck with saxophonic fingering, there's no way around the clarinet break problem (with regard to the fingerings used). You can't "finger" any of the twelfths in a normal fashion, and are stuck with the single octave span of the Sax designed fingerings. Unfortunately, bass clarinet parts often range through more than a full octave, and very often on adjacent notes.

As a result, I find the stick (with its poorly conceived thumb rest and key layout) twisting in my hand as I attempt to handle a series of tough intervals at speed. If I ever end up buying one of these things, the first thing I'm going to do is to tear off the thumb "hook" and put a real thumb rest on the thing. (Yamaha apparently considered this when they built the thing, as the hook is held on by but a single screw.) And yes, I tried it with a neck strap - no better with than without.

Other than these issues, the main objection that I have to the setup is that it takes a good long while to set up, what with the cords, the stomp box, the stick, the synth and the amp, plus the tangle of wiring all around my feet. I was able to route the cables a bit more logically today, and I think that I have a schema where I'm not constantly getting hooked into the tangle. However, the two that dangle from the end of the stick are a major league irritant, only partially overcome by the lack of a need to swap out horns.

I'm still waiting on both the approval of the therapist and the MRI from the DVA. To add insult to injury, my lovely wife experienced a couple of episodes of eye shutdown in her left eye that prompted a trip to the emergency center. Not a stroke, per the ER physician, and not a serious eye problem according to the opthamologist, but the remaining choices include one that really causes us concern - myasthenia gravis. Joyce Ann has a sister and two other relatives who are so afflicted, and while it usually manifests itself far earlier in life, the threat has always been there. Fortunately, none of the other common symptoms are there, but the fear lingers regardlessly.

So, I've gone through a four hour technical rehearsal, a five hour trip to the emergency center, four hours of sleep, a five hour trip to the eye doctor, four hours of moving furniture back into the house (we've just had it all carpeted), a short nap, and two full shows, plus assembling another eighteen instrumental arrangements for the six horn group and setting up and tearing down the wind synth setup twice. Not a bad showing for two and a half days.
 
Well, I'm still waiting on the approval by the medical insurance. They don't seem to have a sense of urgency about it at all.

Last night, I made it through the three-hour performance with only a very minimal amount of leakage (although this was with the low air volume wind controller, not a "real" horn.
 
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