DECLINE AND FALL
In the late 1990’s I began to experience some response issues below the staff. I thought it was because I couldn't open my jaw enough due to Temporomandibular Joint Disorder (“TMJD”). Therefore, in 1999, I consulted Dr. Steven Graff-Radford, DDS at Cedars-Sinai. He was unable to help. In September 2000, I began a two-and-a-half-year run of The Lion King at The Pantages Theatre. How I got through it I still don’t know – I had about 12 different embouchures going to get through that show. Walking in to the first rehearsal I overheard, “I don’t know what it is about this show; we usually have to fire somebody, usually one of the drummers.” It was a more than a little nerve-wracking! Inderal helped with the nerves.
Fortunately, no one was fired, but I was on edge for five or six months. Lion King led to several more years of shows at the Pantages, but what turned out to be Focal Dystonia eventually made that tough to do. I recorded The Orators, Tommy Pederson's duo concerto with my friend, Bill Booth in 2003. That was tough – and scary – but we did it.
In 2003, I got an NTI-tss® device for TMJD from Dr. James Boyd of the Neurology and Headache Center of Southern California. I recommend it. In 2004, I also consulted Dr. Joseph Schames, DMD, regarding TMJD; who said, "Sir, I think you should see a neurologist." To be clear, I did have TMJD in addition to (and because, I think, of the stress from) the dystonia. The NTI-tss® device in combination with the Trigeminal Pharyngioplasty procedure, performed by Dr. Paul Guerrero, D.C. at Muscle Works in Glendora, CA, eliminated the TMJD. (The procedure is quite uncomfortable and required several visits.) But the dystonia remained – and progressed.
In late 2004 I saw Dr. Steven Frucht at the Neurological Institute, Columbia University, New York, who diagnosed task-specific focal embouchure dystonia. Dr. Frucht is, perhaps, the leading expert on musicians' dystonia and embouchure dystonia. However, diagnosis is NOT treatment. There are several treatment options – more now than then. There were few applicable to embouchure dystonia at that time. I suggested to Dr. Frucht that a colleague had some success with Klonopin. He thought that might work and prescribed it. It helped me get through the next decade.
In early 2005, I went to Texas to work with Jan Kagarice. She was very helpful and supportive. However, she thought the Klonopin would likely inhibit the brain’s plasticity and therefore it's ability to heal under her regimen. Perhaps she was right – but I had to go to work – I had a mortgage.
The problem was in the bass bone "money register" – F below the staff to "pedal" Bb on the valves – true pedal Bb in 1st was fine – go figure. (Frequently . . . maddeningly . . . dystonia affects a player's "strong suit" the most.) Not knowing for sure when . . . let alone if . . . a note's gonna start makes it real tough to pIay in time – or stacatto. Sometimes I needed to play a little louder than was completely appropriate. Swing? Fuggedaboutit! And constant worry about response led to poor concentration and occasional embarrassingly stupid mistakes. It became no fun to go to work.
I was able to keep things going until around 2014 – for live, orchestral, concert work – most of which is 3rd trombone – not much below the staff. Studio work had started to fade for me around 2010. Both music directors for the orchestras I primarily worked for, John Mauceri and Carl St. Clair, were very supportive while I wrestled with dystonia – as was James Horner – and most of my colleagues. More gratitude!
Despite the support I received, I never felt like I ever "hit one out of the park" at work. Running out infield dribblers, bunting, and occasionally striking out (to run this metaphor right into the ground) was not satisfying. I resigned/retired from performing in 2014. From then on, my relationship with the bass trombone has been as a teacher. I had a pretty good run – with a little luck and a lotta help. I am grateful.
I discontinued the Klonopin and did not touch the horn for about 2 years. Then I started to play a couple pitiful minutes a day – then 5 – then 10 – then 15 – then 30 – and so on. Things slowly got less and less pitiful. I appear to be in "remission" (for want of a better word). I can play below the staff again. However, I no longer have the "fire in the belly" – or the economic necessity – to spend the time and energy requisite to get – and stay – what I'd call "good" again. But I can make a little music from time to time, here and there; and provide an occasional demonstration for a student – with the caveat: "things ain't what they usta wuz."
If you want to see the rest of my story . . .
Fortunately, no one was fired, but I was on edge for five or six months. Lion King led to several more years of shows at the Pantages, but what turned out to be Focal Dystonia eventually made that tough to do. I recorded The Orators, Tommy Pederson's duo concerto with my friend, Bill Booth in 2003. That was tough – and scary – but we did it.
In 2003, I got an NTI-tss® device for TMJD from Dr. James Boyd of the Neurology and Headache Center of Southern California. I recommend it. In 2004, I also consulted Dr. Joseph Schames, DMD, regarding TMJD; who said, "Sir, I think you should see a neurologist." To be clear, I did have TMJD in addition to (and because, I think, of the stress from) the dystonia. The NTI-tss® device in combination with the Trigeminal Pharyngioplasty procedure, performed by Dr. Paul Guerrero, D.C. at Muscle Works in Glendora, CA, eliminated the TMJD. (The procedure is quite uncomfortable and required several visits.) But the dystonia remained – and progressed.
In late 2004 I saw Dr. Steven Frucht at the Neurological Institute, Columbia University, New York, who diagnosed task-specific focal embouchure dystonia. Dr. Frucht is, perhaps, the leading expert on musicians' dystonia and embouchure dystonia. However, diagnosis is NOT treatment. There are several treatment options – more now than then. There were few applicable to embouchure dystonia at that time. I suggested to Dr. Frucht that a colleague had some success with Klonopin. He thought that might work and prescribed it. It helped me get through the next decade.
In early 2005, I went to Texas to work with Jan Kagarice. She was very helpful and supportive. However, she thought the Klonopin would likely inhibit the brain’s plasticity and therefore it's ability to heal under her regimen. Perhaps she was right – but I had to go to work – I had a mortgage.
The problem was in the bass bone "money register" – F below the staff to "pedal" Bb on the valves – true pedal Bb in 1st was fine – go figure. (Frequently . . . maddeningly . . . dystonia affects a player's "strong suit" the most.) Not knowing for sure when . . . let alone if . . . a note's gonna start makes it real tough to pIay in time – or stacatto. Sometimes I needed to play a little louder than was completely appropriate. Swing? Fuggedaboutit! And constant worry about response led to poor concentration and occasional embarrassingly stupid mistakes. It became no fun to go to work.
I was able to keep things going until around 2014 – for live, orchestral, concert work – most of which is 3rd trombone – not much below the staff. Studio work had started to fade for me around 2010. Both music directors for the orchestras I primarily worked for, John Mauceri and Carl St. Clair, were very supportive while I wrestled with dystonia – as was James Horner – and most of my colleagues. More gratitude!
Despite the support I received, I never felt like I ever "hit one out of the park" at work. Running out infield dribblers, bunting, and occasionally striking out (to run this metaphor right into the ground) was not satisfying. I resigned/retired from performing in 2014. From then on, my relationship with the bass trombone has been as a teacher. I had a pretty good run – with a little luck and a lotta help. I am grateful.
I discontinued the Klonopin and did not touch the horn for about 2 years. Then I started to play a couple pitiful minutes a day – then 5 – then 10 – then 15 – then 30 – and so on. Things slowly got less and less pitiful. I appear to be in "remission" (for want of a better word). I can play below the staff again. However, I no longer have the "fire in the belly" – or the economic necessity – to spend the time and energy requisite to get – and stay – what I'd call "good" again. But I can make a little music from time to time, here and there; and provide an occasional demonstration for a student – with the caveat: "things ain't what they usta wuz."
If you want to see the rest of my story . . .