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974281 Posts in 64708 Topics- by 15829 Members - Latest Member: Lutscher
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1  Creation and Performance / The Healthy Trombonist / Re: Prostate cancer? on: Dec 12, 2014, 08:55AM
The one thing that I can offer as a perspective is this: Prostate Cancer is quite common in older males and becomes more common as you become older. Perhaps 80%  of 90y/o were found on autopsy to have prostate cancer. Most prostate cancers are indolent and slow growing. If they are discovered many of them can just be observed and monitored and really require no treatment. There are some tumors that can be aggressive, those are often found in younger men (as in 40-60yo) Therapy in these cases is dictated by the biopsy and tumor histology. Often even this is not fully predictive. I have a good friend with an histological "aggressive" profile who is doing very well currently.    Much of the screening recommendations have been modified recently, because there were many low grade prostate tumors found which were more indolent and these were subject to things like total prostatectomys, radium implants and external beam radiation that frequently caused more morbidity than the disease itself. Additionally, causing intense emotional distress to patients and families. In my experience, the people I know that have had prostate cancer treatment have done very well most of them die of something else. The small percentage of very aggressive prostate cancers seem to do poorly is spite of how you treat them. It is difficult to predict these. The people who need to be screened are primarily Blacks and those individuals with a 1 degree relative with cancer of the prostate. The chances are, your brother-in-law will do well. I wish him well, Hope this helps.
2  Creation and Performance / The Healthy Trombonist / Re: Uh-oh. Hair loss. on: Nov 19, 2014, 07:41AM

If I can't take either sort of medication (proton pump inhibitor or histamine antagonist), what else can I do?

:( :( :(
Christine, I think that with all of the problems that you're having, It's time to have a discussion with your doctor/gastroenterologist about treatment options. What you might try is the "Gaviscon" that I mentioned earlier. But aside from that, given the limitations of a forum-like format, I can't offer any other meaningful recommendations. On the forum, I don't have the ability to get an adequate history or examine you, but I'm happy to provide a general overview. It sounds like your doctors are doing a great job, and your "reaction/side effects" problems need to be discussed with them sooner rather than later. Best of luck, and keep us informed.
3  Creation and Performance / The Healthy Trombonist / Re: Uh-oh. Hair loss. on: Nov 17, 2014, 02:14PM
I took it with a glass of water, as prescribed. It felt like it was still in my throat. I've had another glass of water. It still feels as if it's there. Is this usual?? :(
Most people don't have that problem, but often it can happen with any tablet. It sticks at the back of the tongue, partially dissolves and irritates the tissues making it feel like it hasn't gone down. It should go away after a while. Try drinking a small amount of water at first, then take the tablet then immediately swallow an additional 4oz or so of water.
4  Creation and Performance / The Healthy Trombonist / Re: Uh-oh. Hair loss. on: Nov 17, 2014, 10:21AM
Doug, et all. H Pylori testing is more or less specific for Duodenal Ulcer and Gastric ulcer detection. It doesn't correlate with esophagitis or reflux at all. It sounds as though RHM has had a pretty thorough evaluation.
5  Creation and Performance / The Healthy Trombonist / Re: Uh-oh. Hair loss. on: Nov 17, 2014, 07:37AM
Christine, the manometrics and pH monitoring sounds like a good next step. As far as the Ranitidine is concerned, the 150mgm twice daily is actually a good starting point. I wouldn't half it without discussing it with your prescribing doctor. Best of luck with the reflux, hope they can help with it.
6  Creation and Performance / The Healthy Trombonist / Re: Uh-oh. Hair loss. on: Nov 14, 2014, 11:27AM
In addition to my discussion previously, This article may be of interest:

Note I am not saying that excessive alcohol intake is the cause of your hair loss, thought it may be a factor, but to point out that it would be reasonable to try a remedy even though hair loss is listed as a possible side effect.
7  Creation and Performance / The Healthy Trombonist / Re: Uh-oh. Hair loss. on: Nov 14, 2014, 11:14AM
It works to take the tarnish off of brass...
I also makes great pickles!  Good!
8  Creation and Performance / The Healthy Trombonist / Re: Uh-oh. Hair loss. on: Nov 14, 2014, 11:13AM
One thing about Ranitidine (Xantac) - it comes in 75 mg tablets which are very expensive, and 150 mg "extra strength" which is much cheaper.  I buy the 150mg tablets and cut them in half.  If I feel stronger symptoms I'll take a whole one, but normally the half dose is enough and it saves a lot of money.  Probably less side effects too.

Also, Omeprazole is normally a 14 day course and then you stop, so it seems to me the hair loss would probably reverse when you stop taking it.

Good point, Doug.
9  Creation and Performance / The Healthy Trombonist / Re: Uh-oh. Hair loss. on: Nov 14, 2014, 11:11AM
Galen, you know RHM as well as I do.  Alcohol is rather central in her life.  Giving it up may not be very easy.
I understand full well that RHM has a problem with alcohol. It may well be exceedingly difficult to manage it. My family on my father's side is rife with alcoholics. In addition to my brother, my oldest sister is in a "memory unit" with alcoholic dementia. My Father, a tee totaler, had 10 siblings of those 7 were alcoholic. My son is a recovering alcoholic, Thankfully!! I was a physician at a VA Medical Center. Alcohol treatment was a big ticket item there. So yes I am completely aware of the difficulty RHM faces. But, she did ask for advice on it and it would be dishonest if I did not address it. I do not think the less of Christine for her struggle, but Alcohol has impacted my life to a huge degree. I am not inclined to bury it as little consequence in a discussion of an illness where it probably plays a significant role.
10  Creation and Performance / The Healthy Trombonist / Re: Uh-oh. Hair loss. on: Nov 14, 2014, 08:36AM
One other thing that was mentioned as aggravating the reflux is alcohol.  I know that will be a lot less negotiable than coffee or tea :/

Bruce, it should be negotiable because Alcoholism is a prominent risk factor in the development of cancer of the esophagus and a major cause of reflux symptoms. My older brother, who died several years ago of carcinoma of the esophagus was a serious alcoholic, although he functioned at a very high level and denied his alcoholism vehemently until the day he died. Alcohol and reflux esophagitis were his risk factors. It was a tragedy. Alcohol creates a huge amount of damage to exposed esophageal tissue, it causes reflux symptoms.  So, my advice is to stop drinking. Period. That will be the last I say about it but it's something that needs to be addressed in ANY discussion of gastric reflux.

Christine, you have not tried the Ranitidine. I would do so. Drug companies put every side effect imaginable on their package insert profiles. Hair Loss is a prominent listing for many drugs, but keep in mind it is a different molecule entirely and acts through a different mechanism than the proton pump inhibitors. It probably won't cause hair loss at all. If it appears to, THEN stop it, but give it a trial. If Ranitidine causes problems, then you might try Gaviscon (if it is available in the UK) It is an antacid with foaming properties that will get into the esophagus and not just run down into the stomach. The other things that were mentioned, elevating the head of the bed; not eating for 2-3 hrs before retiring; avoiding foods which cause reflux (these may vary) and caffeine are all good suggestions. The Apple Cider Vinegar thing is a "folk" remedy the effectiveness is based entirely upon anecdotal evidence and scant, if any, empirical findings. I could not recommend it one way or the other.  I hope you find this information helpful.
11  Creation and Performance / The Healthy Trombonist / Re: Carpel Tunnel possibilities on: Nov 07, 2014, 07:52AM

Go and see someone who can make a diagnosis! The internet is no place for medicine. Even if you 'just want an idea' of what it may be - well, for any given symptom I can rattle off at least a dozen causes, with widely varying treatments.

COI - practising physician.

Best wishes for a speedy recovery!


I wholeheartedly Agree!
12  Creation and Performance / The Healthy Trombonist / Re: time off after cataract surgery on: Oct 23, 2014, 10:11AM
I just got home from having a cataract removed from one of my eyes. I have blocked off the week to lay off the horn. But I overlooked a 3 hr top 40 call on Saturday. I am wondering if I should sub it out just to be safe.

Has anyone in here had similar surgery between gigs?

I intend to play some low/mid register long tomes around the house in the meantime, but nothing above D above the staff.

Just wondering....

I would to be on the safe side. When I had cataract surgery in 2011, I was off of the horn for over a month; not because of leakage or glaucoma issues, but because I couldn't see straight until I had my second eye done and a proper reading prescription. You shouldn't require a long time off, but I would ask the opthalmologist who did the surgery to be sure.
13  Creation and Performance / The Healthy Trombonist / Re: Uh-oh. Hair loss. on: Oct 13, 2014, 08:33AM
Rogaine?  It's for Male Pattern Baldness and you're not male, though :/

Rogaine would be worth a try, and would probably work. It has to be used continuously, though.  Other PPI's MIGHT be worth a try though they work through the same mechanism.
14  Creation and Performance / The Healthy Trombonist / Re: Dead lip recovery on: Oct 06, 2014, 01:37PM
"Dead lip recovery"

"expiring through the mouth"

I'll pass, thanks.

Sort of a Zombie embouchure? Good! I'll pass as well, except to recommend "lip bends". That is what I do as well as long tones.
15  Creation and Performance / The Healthy Trombonist / Re: Carpel Tunnel possibilities on: Oct 04, 2014, 08:45PM
Going to a doctor is ok, but if what you have is something related with tendons, muscles or stuff like that you should visit a neuromuscular massage therapist. Doctors will give you drugs and in the cases mention above that's not going to help in the long run.

That was my experience with tendonitis anyway.

Pardon me but that is a cluster of glittering generalities. I speak from experience as a practicing physician (now retired) who has treated many musculo-skelital problems in the past. Yes, we do use medications depending on the situation, but we also use physical and occupational therapy for these conditions. I have used them personally. Massage therapy can help in some conditions, but you really need to have an evaluation to, for instance, rule out a neuropathy or a metabolic bone disorder. Massage therapy may not be appropriate at all, or it may be just the thing. You need an evaluation to begin with, and the OP did not give a comprehensive enough history to make any kind of definitive call. I know you are writing with good intent, but I could not let these misconceptions pass.
16  Creation and Performance / The Healthy Trombonist / Re: Carpel Tunnel possibilities on: Oct 02, 2014, 11:02AM
If this persists or gets worse, what you need to do is have a medical evaluation of the issue. If the problem is only there when playing the trombone, then perhaps a support or changing your grip might help, but if it continues to be a problem then an evaluation is necessary. This could be a nerve problem, ligament inflammation or arthritis.
17  Creation and Performance / The Healthy Trombonist / Re: Recovering from Pneumonia on: Sep 17, 2014, 10:14AM
I found that I had pneumonia and spent three days in the hospital.  It was in my lower left lung.  Two weeks after leaving the hospital I finally felt up to trying to play my trombone.  I was shocked to find how little breath support I had. It is not that I could not blow and play the notes but the automatic changes in pressure and volume of air as I played higher and lower was not there.  Does anyone have experience with playing after recovering from pneumonia?
I'm not surprised at your symptoms. You need to remember that the lung tissues are not completely healed. This may take an additional week to two weeks at least. Start slow, play long tones and gradually build up your endurance. If you have discomfort or start coughing, back off a bit. Soon you should be back to your former self.
18  Creation and Performance / The Healthy Trombonist / Re: Nighttime dry eyes? on: Aug 31, 2014, 06:58PM
Grah, (and others) I reviewed your comments in the thread, and you had many good suggestions. "Dry eye" can be very difficult to treat especially if it is caused by Sjogren's Syndrome or other auto-immune condition. It can also be inconvenient and aggravating to treat because of the need for frequent drops etc. But it could also be an allergy that could be amenable to treatment or do to "air conditioning" or infrequent blinking. I think it's valuable to have an evaluation at least to let you know what you are dealing with. I have included a URL that I picked up on a brief search of the internet that gives some suggestions to start with: http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/dry-eye?sso=y . Some of you folk might find it enlightening. It's a place to start anyway.

Grah, you seem to have a plethora of medical practitioners who have difficulty communicating. I have probably had patients who had the same problem with me. My only suggestion with that is to be persistent in getting answers, and if a particular practitioner doesn't know, he probably knows someone who does. Don't let them blow you off.   Hemochromatosis is a real problem. It's not common, and a lot of practitioners, most in fact have had little experience with it. I've seen cases where it has gone undiagnosed for a long time. Some are probably never diagnosed.  But any rate, better luck in the future with your medical encounters.
19  Creation and Performance / The Healthy Trombonist / Re: Nighttime dry eyes? on: Aug 31, 2014, 12:58PM
Doctors seem to be baffled that the general population doesn't run to a doctor for every question.  Here's why I, personally, don't do that...

- I didn't grow up with that mindset. The only time, after infancy, my parents took me to a doctor was for a required physical to enter junior high. 

I couldn't breathe through my nose for most of my teenage years... my parents never considered consulting a doctor about that.

I fell out of a tree when I was about 12... my parents never considered taking me to a doctor.

I never got into that habit of doctor visits that some other people have.

- It's expensive. Without insurance, just the appointment to ask a question is $200-$300. Now with Obamacare I have insurance again, but it's still going to be $35 for a GP and $55 for a specialist.

- It's slow. Insurance or not, you can't get a quick appointment for a non-emergency.

- About 14 years ago I HAD insurance and DID GO to a doctor about what seemed to be a significant problem. I ended up with a spectacular misdiagnosis and unnecessary operation. If I had ever thought of doctors in god-like terms before that, I don't now.

- They aren't always eager to help. About 10 years ago i was working on my house and my electric drill jumped out of my hand, swung down on the cord and put the drill bit three inches into my leg. Four hours later it was still bleeding so I went down to the ER at Baylor here in Dallas. They were quite indignant that I was troubling them with my petty bleeding problem. "This is AN EMERGENCY ROOM!" scolded the front desk lady. They would not see me no matter how long I waited. I went home and "stitched" the skin flaps together with duct tape and that did work.

- Most things get better without even doing anything about them. Colds, flu, cuts, bruises, nausea, backaches... doctors don't have much for that stuff anyway.

- You CAN find useful info on the internet. I've previously related my "tennis elbow" experience. The problem persisted for many months, then I found an article on the NY Times about some exceedingly simple rehab exercises for it. Six weeks later, pain gone. Solution found on the internet!

If someone here had mentioned something simple for dry eyes that I had not already tried... it would have been silly not find out about it just because it was "on the Internet."

I will make a doctor appointment this time around, largely because I have about four other maladies I need to ask about and I haven't had a physical in 15 year either, so I'm overdue.

That said, over the course of my life, "See a Doctor!" isn't something that has been radically more effective than not seeing them.

Sorry about your bad experience with the medical community. I, too, believe that many minor complaints do not need to be brought to the attention of a medical professional.( Disclaimer: I am a physician by training.) In this case, you solicited opinions from the trombone community for advice. This, after you had already tried many the OTC remedies available without success. There have been several worthwhile suggestions made which could be useful in the general. However, my point is this: 1) The numbers of folks on this forum who have the expertise to render a competent diagnosis are very few. 2) Without actually seeing you in person, examining you and then following up any rendered treatment even those persons would be at a total loss to provide satisfactory advise. 3) There are MANY reasons for a "dry eye", some of them are serious and require significant intervention, many, perhaps most are not. 4)You have already tried and failed many of the quick remedies available. Anything more will obviously require an evaluation. I suggested earlier that you seek medical advice because that would be the logical next step. Since you like to look things up on the internet, you might research the Mayo Clinic public site or WebMed for suggestions they might have. If you have a primary care provider, that would be good place to start. You could also visit an optometrist they could give you a thorough eye exam. I applaud your decision to seek advice. It would seem to be the logical next step. I hope that helps. 
20  Creation and Performance / The Healthy Trombonist / Re: Feeling lost. on: Aug 27, 2014, 07:14PM
We'll keep this topic where it is. That is the general consensus.
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