Wednesday, November 27, 2019

Dystonia Film about James Wong - Director Julian Stamboulieh, Producer Benjamin Warner



Check this out! Is someone making a film about musician's dystonia (hand dystonia)???? If so...wow!!! Can't believe it! What a huge first step in awareness (this has got to be the first film about it ever). <3

Would be cool if someone did one over Robert Schumann since he was the earliest known case of musicians dystonia in history thanks to his detailed journals/writing (Robert Schumann's Focal Dystonia by Dr. Altenmuller: https://www.karger.com/Article/PDF/85633)....but I digress. Wish I could have seen the premiere. <3

Update: Found more information on it. Posted below.

Dystonia is a short film about a violinist named James Wong (played by Kenny Wong) who, while studying at McGill University, is diagnosed with Focal Hand Dystonia: a neurological movement disorder causing the muscles of a player’s hand to involuntarily contract.

Dystonia Film director Julian Stamboulieh and producer Benjamin Warner Interview:

https://www.hbeonline.com/single-post/2019/11/01/Benjamin-Julian-Montreal-Listen-Collaborate?fbclid=IwAR2rBuXkzGnJpW9k4LJz89FUtpW_rqhdbzuBhEg6btzlXSBCv1HJPHGqcJo

Sunday, November 24, 2019

(Video) Timeline: My Embouchure Dystonia Rehabilitation Over The Years

Time Stamps of Tests
0:04 - December 2011 - A year before this first clip, I couldn't get a sound out
2:15 - January 2012 - Tonguing Mid-to-High Register, Slowing Things Down
6:39 - August 2013 - Transitioning between Low and Middle Range Gap
10:43 - August 2014 - Downward Movement and Large Interval Control
12:18 - March 2016
13:11 - August 2017 - Fluidity in Slurs, Paced Arpeggios, Held Notes
17:09 - April 2018 - Crossing Multiple Registers, Descended Landings.
19:44 - August 2018 - Melodic Passages and Descending Landings
21:52 - January 2019 - Crossing Multiple Registers, Descending Landings, Ascending Landings, Dynamic Control, and Tongue Control
23:28 - May 2019 - Upper Register; Ascending Landings and Grasp, Stability in Dynamic/Sound
24:42 - September 2019 - Holding Out Notes; Testing Length of Grasp

By FAR one of the most embarrassing videos of my face....lots of closeups, while having dystonia over the span of several years, while aging, while rolling out of bed, while gaining and losing weight, while going into my mid-30's, and crazy life stuff in general.

Wanted to post this for those who have Embouchure Dystonia. Keep up your efforts...I know it may seem like a long journey, but you can do it! <3 I'm new to editing videos even though I post videos on my blog all the time ....so have patience, will get better over time with practice.

This is the first timeline video I've done of my playing....approx 30 minutes. Please understand, even though I'm comfortable with showing my playing because I feel it's important and for a good cause, it doesn't mean I'm not vulnerable.

There's a reason musicians don't show this disorder upfront and why it's rarely documented thoroughly as such. Auff! 📯💔 Feel free to share though! I hope to spread Musician Dystonia Awareness.

Thursday, November 21, 2019

Flautist Leslie Thompson: Determination to Continue Playing Music After Overcoming Car Accident


I love that they mention body mapping. Many music departments at universities are now offering courses or summer seminars in Alexander Technique, Feldenkrais, and Rolfing.

Happy to see a news article spreading awareness of musician injuries/disabilities, explaining how common injuries are, the importance of health education, and how adaptation is a key component in recovery (this also applies to dystonia).

Last, but not least, it's more than inspiring to see flautist Leslie Thompson share her journey of surviving a car accident and her determination to continue playing music.

She was fortunate to have Andree Martin as her professor during this time, who understands disabling setbacks all too well. Andree is not only trained as a body map clinician (Andovers Educator), but has recovered a great deal herself from focal hand dystonia and has a remarkable journey to share too.

Believe It's Possible

💕

Wednesday, November 20, 2019

Have No Fear and Embrace Life

"I am not afraid of difficulties. It is perhaps easier, and certainly safer, to follow a beaten path, but it is also dull, uninteresting and futile." --Dmitri Shostakovich

 

Saturday, November 16, 2019

Dr. Keller: Large Study Finds Predictors of Musician's Dystonia



I saw my friend Richard Ware share this insightful article, so wanted to pass it on....hit "continue reading" in order to see full article.

Large Study Finds Predictors of Musician's Dystonia
Daniel M. Keller, PhD

October 09, 2019

NICE, France — A new review suggests musician's focal task-specific dystonia (MFD) often occurs subsequent to a triggering factor, such as a change in technique or increase in practice, and that many patients have concurrent ipsilateral neuropathy, particularly ulnar neuropathy, suggesting it may be an important risk factor, researchers report.

MFD affects 1% to 2% of professional musicians, is an important occupational disability, and can be career-ending. The most common form is musician focal hand dystonia (MFHD), with onset in adulthood at the peak of performance careers.

Less common is embouchure dystonia, which affects woodwind and brass players. Typical treatment with botulinum toxin injections and retraining are most often unsatisfactory.

A review of 2649 case records of performing musicians from health clinics treating performing artists at the University of California San Francisco (1984-1989) and Partners HealthCare in Boston (1989-2015) identified 240 consecutive cases (9.1%) of MFD. Cases were compared with a cohort of 532 nondystonic patients with ulnar nerve entrapment.

Speaking during a group poster tour here at the 2019 International Congress of Parkinson's Disease and Movement Disorders, Christopher Stephen, MB ChB, Massachusetts General Hospital and Brigham and Women's Hospital Performing Arts Clinic, Boston, Massachusetts, reported that "ulnar nerve entrapment had increased prevalence in focal hand dystonia — 30% as opposed to 22% in our whole musician's cohort of 2649 musicians."

In addition, of the 66 patients with MFHD and ulnar nerve entrapment, all but one were ipsilateral. "It's quite a striking finding," he said.

Predictors of MFHD versus ulnar nerve entrapment included male gender and playing professionally (both P < .0001). Predictors of worse outcome included the number of fingers involved with dystonia (P = .0009) and being an amateur musician (P = .0138).

Ten percent of the dystonic cohort had a family history of movement disorders, whereas this was very rare in patients with ulnar nerve entrapment only.

The MFD population was about 70% male, consisted mostly of professional musicians but also 30% amateurs and about 8% conservatory students. The age of onset was about 36 years but with a wide range of 10 to 67 years. About 72% performed classical music, 16% jazz, and 12% other genres.

A side predilection depended on the kind of instrument, for example, piano or plucked strings. MFHD was rare in brass and percussion players.

Of the 215 cases with MFHD, 160 (74.4%) had a pure flexion dystonia, most of them with flexion of the ring and little fingers. Extension-only dystonia occurred in 25 patients, and most of them played woodwinds.

The majority (72.2%) of MFHD patients had reported an associated event prior to developing the condition, whether musical (eg, increased practice, new technique, or a new instrument) or nonmusical (eg, concurrent neuropathy, overuse injury, or emotional stress or trauma).

Fifty-two patients (24.2%) received botulinum toxin injections, with 30% of them having substantial improvement, but most discontinued this therapy due to lack of benefit. Oral medications were minimally effective in treating dystonia in MFHD but sometimes helped treat tremor.

Of the 66 patients that had ipsilateral ulnar nerve entrapment and MFHD, 27 underwent surgery for the entrapment. Most had substantial improvement in symptoms and signs of ulnar nerve entrapment, and a minority had improvement in dystonia.

"So it could suggest that having surgery, if you do find an ipsilateral ulnar nerve entrapment with dystonia...may help some patients have a substantial improvement after surgery, but not in general," Stephen said.

He noted that changing to a different instrument helped some patients, but even then over time dystonia developed with that instrument as well. Just over half of MFHD patients continued to play but were impaired.

After Stephen's presentation, a lively discussion ensued between him and Alberto Albanese, MD, Catholic University, Milan, Italy, one of the leaders of the poster tour. Albanese raised the possibility of better training in technique to avoid dystonia.

"I was thinking that probably appropriate training to some extent prevents future dystonia because I follow the director of the conservatory in Milan, and I discussed with him many times about how to train musicians from the very beginning to try to prevent dystonia," he said.

Although an interesting idea, Stephen said the study involved people who already had dystonia and explored what were predictors of worse outcome. But he agreed that better training may help avoid dystonia. "It may also give them the expertise to be able to still play to a decent level and adjust the repertoire," he said.

"Well, it depends on the severity because they try as much as they can because they love music. So for them to stop is really a problem," Albanese concluded.

There was no funding for the study. Stephen has reported no relevant financial relationships. Albanese has received speaker's honoraria from Allergan, Ipsen, Merz, Medtronic, and Zambon.

International Congress of Parkinson's Disease and Movement Disorders 2019. Presented September 24, 2019. Abstract 1345.

Tuesday, November 12, 2019

Musicians Well: Flautist Julianna Nickel on Focal Dystonia and Brain Surgery


So happy to see you featured Julianna Nickel!!! What I have always looked up to most about you is your straightforwardness when it comes to pointing out the truth/facts about focal dystonia, and for always seeing both sides of an issue clearly. Thank you for continuing to share your journey! 🎶💕

Friday, October 25, 2019

Philip Smith: On Upbringing, Trumpet, and Focal Embouchure Dystonia


Thank you to Alison Pesacreta (my twin sister) for sharing this! I can't tell you how many recordings I had to listen to of Phil Smith while growing up because my sister started playing cornet in the 4th grade in 1993 and loved playing along with a tape cassette of duets where he played the bottom part on side 1 and the top part on side 2. This was way before his concert studies series or hymns...don't think they publish it anymore. She actually got him to autograph the music years later through a friend and he was surprised to see it. Anyways, from then on she listened to practically every recording he came out with and I continued hearing him throughout college on a daily basis as well. His sound definitely influenced her and I hear so much of his style in her playing.

That's why it was very saddening to hear of his diagnosis with Focal Embouchure Dystonia 5 years ago. He is a legend and one of the greatest of all time.

I wanted to share an excerpt from this interview where he speaks a little about his journey. I definitely can relate here as so many with FTSED do too.

He is correct when saying to be honest there is no easy or simple explanation of what causes focal dystonia. It doesn't only occur in musicians but other fields that require high levels of repetitive accuracy, repetitive practice, and refined skill over a long period of time.

It really does feel like it happens over night and as much as you try to re-trace your steps, nothing adds up. That's because it has to do with our brain signals/wiring....you just never see it coming or crashing, especially when you're at the top of your game.

Everyone wants a simple explanation, but those of us who have lived with it for more than 10 years or even 5 years will tell you it's not like some light bulb hasn't turned on or like we're missing the answer staring us in the face or like we haven't tried everything.

Just like trying to regain the ability to walk after a stroke, knowledge does not equal understanding. Knowing how to play your instrument like a pro does not help or mean you're immune. It's not a "mental issue" or "emotional issue" or "bad habit/lack of healthy playing issue" ....it's a loss of a highly refined motor skill/brain pathway. Knowing how to walk your whole life doesn't mean you understand how to walk after losing that ability, nor even grasp how much work rehabilitation is. Some do regain close to full control, while others recover to varying degrees, and some struggle with it severely, and you can't put a time limit on recovery. However, the new pathway dug is not as natural as the original.

Phil says: Four years ago, I got hit with it, and I basically couldn’t play a note. I have had to re-teach myself how to play over the last four years, and quite honestly it has been hell.

I wish I could say what triggered it, but I don’t know. I have had people say to me “I can’t believe that you lost your lip” or “I can’t believe you lost your nerve”, and it was neither of those things. Something happened that took what I knew and wiped it off the map.

I have had to re-teach myself what to do, and in some ways, I have needed to be more ‘fundamentally’ focused, and in other ways I have had to erase everything that I thought I knew as an experienced trumpet person and approach the instrument like I am 7 years old. That has been difficult!

Tuesday, October 22, 2019

Monette Mouthpieces: Brother-in-Law visits the Monette Factory

Glad someone finally captured Mario Pesacreta's playing on camera! Now just need to capture Alison Pesacreta (my twin sister)...I know she tried some mouthpieces too! Happy Birthday to the best Brother-in-law. Miss hearing you guys play! 🎶🎺🎂🍻 (Go bears 🐻 and hi Jason) #UNCO



Here's Mario from Centralia WA visiting us on his birthday! Mario went to school back when with Jason in our office... we hooked him up with new PRANA RESONANCE mouthpieces today... he was all over them! Thanks for the visit Mario... have fun with the new mouthpieces!