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Technique & Instrument Related to techniques, to the instrument, to the components, to maintenance.

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Old 07-17-2017, 05:24 PM   #1
RJET
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Default Post Stroke Bagpiping

All, I am a piper and suffered a stroke last year caused by a dissection (tear in the wall of the artery) in my carotid artery. I am mostly recovered and docs are recommending not returning to pipes because of increased intracranial pressure when playing. I want to listen to docs but also want to get back to pipes. So I am asking you all for input:
1. Does anyone have knowledge of health issues related to increased intracranial pressure while piping?
2. Are there better techniques for playing pipes without creating that much internal pressure?
3. Any suggestions for modifying the pipes with least amount of back pressure, without changing sound?
Thanks very much.
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Old 07-17-2017, 07:47 PM   #2
Jim Fogelman
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Default Re: Post Stroke Bagpiping

Look into a very easy chanter reed and set up your drone reeds to play at that pressure. Should drastically reduce the pressure (assuming you're already playing a medium/easy-medium reed).
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Old 07-17-2017, 08:07 PM   #3
Kevin
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Default Re: Post Stroke Bagpiping

In response to your second question, you might want to consider bellows pipes. SSP have a very different sound than GHB but borderpipes can be made to sound very similar to GHB. It's different than the pipe band world but very enjoyable in other ways. There are a few makers that make bellows big enough to power GHB. I imagine pulling off a clean attack while marching into the circle would be very tough but once you get the pipes going it should be easier. If solo is your thing, this wouldn't be such an issue but then you might find it easier to play borderpipes (it would be tough to tune drones on your shoulder with your right arm strapped into your bellows).

If you do return to playing mouth blown GHB, you might want to seek expert advice from a PT or OT in addition to your doctors. If I was in your situation, I would look for a cardiovascular specialist MD who is also a piper. Maybe you could start by getting your blood pressure measured while playing a PC and gradually work up from there if it goes well.

Best of luck with your recovery.
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Old 07-18-2017, 05:09 AM   #4
CalumII
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Default Re: Post Stroke Bagpiping

The body does elevate blood pressure when blowing an instrument, but it also increases cerebro-spinal pressure, meaning that the pressure difference across arterial walls is relatively stable while playing. Despite the lifestyles of pipers, I've never heard off-hand of someone stroking out while playing.

Obviously I'm not a doctor and this isn't medical advice, but I suspect this is one of these areas where you have to educate yourself as best you can then make your own decisions.

One more thought - it seems likely to me that rigging up a bellows to power a GHB will require enough effort to stabilise your torso that you'll get a similar spike in blood pressure anyway.
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Old 07-18-2017, 03:54 PM   #5
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Default Re: Post Stroke Bagpiping

Quote:
Originally Posted by CalumII View Post
The body does elevate blood pressure when blowing an instrument, but it also increases cerebro-spinal pressure, meaning that the pressure difference across arterial walls is relatively stable while playing. Despite the lifestyles of pipers, I've never heard off-hand of someone stroking out while playing.

Obviously I'm not a doctor and this isn't medical advice, but I suspect this is one of these areas where you have to educate yourself as best you can then make your own decisions.

One more thought - it seems likely to me that rigging up a bellows to power a GHB will require enough effort to stabilise your torso that you'll get a similar spike in blood pressure anyway.
CalumII,

Do you know where the source was that stated CSF production is increased during musical instrument playing? I did a literature review in PubMed and could not find a reference. This trans-vascular phenomenon may have something in it, but I can't prove it.

I did find literature linking woodwind and brass playing to an increase in both blood pressure and intra-occular pressure (eye pressure). This may raise the risk of glaucoma for players.

Interestingly, the increase in BP was greater for high notes for woodwind players and low notes for brass players. I do not know if low notes are more difficult to play on brass instruments.

I assume this is a compensatory increase by the body to maintain constant brain blood flow during Valsalva (strong blowing/ bearing down actions) maneuvers. This is a guess on my part, the article did not state a cause.

The bottom line, in my opinion, RJET, is only your doctor knows the fragility of your carotids, blood vessels and overall health. These articles are all statistics, while you are an individual. You may want to consider a very easy reed or bellows as stated above.

The good news is that the RSPBA (and other sanctioning bodies) has wide allowances for players with a variety of disabilities and ailments. They have stated that they will do "whatever it takes" to accommodate a player, so if it's pipe band you are after I am sure it is doable.

For further information on that subject you can listen to the recent podcast of the Big Rab Show, out of Northern Ireland, that talked in depth about pipers and disabilities.

Good luck!
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Old 07-18-2017, 04:33 PM   #6
Kevin
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Default Re: Post Stroke Bagpiping

Quote:
Originally Posted by CalumII View Post
One more thought - it seems likely to me that rigging up a bellows to power a GHB will require enough effort to stabilise your torso that you'll get a similar spike in blood pressure anyway.
That is a good point. I would think blood pressure would increase most significantly if you use the Valsalva maneuver (closing or restricting your glottis and blowing against it) to stabilize your torso. I have not played GHB with a bellows but a Valsalva maneuver isn't necessary for playing either SSP or BP with bellows.

Best regards,
Kevin
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Old 07-19-2017, 05:32 AM   #7
SweetDrones
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Default Re: Post Stroke Bagpiping

[QUOTE=DRCTL;1316584]
Interestingly, the increase in BP was greater for high notes for woodwind players and low notes for brass players. I do not know if low notes are more difficult to play on brass instruments.

In response to DRCTL I wonder if the difference between woodwind and brass is due to reeding namely single reed double reed and no reed.
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Old 07-19-2017, 09:58 AM   #8
CalumII
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Default Re: Post Stroke Bagpiping

Quote:
Originally Posted by DRCTL View Post
Do you know where the source was that stated CSF production is increased during musical instrument playing? I did a literature review in PubMed and could not find a reference. This trans-vascular phenomenon may have something in it, but I can't prove it.
I can't point at academic sources but you might like to take a look at the exercise literature - my (slight) knowledge of this stuff is through weightlifting. I do know a heavy squat involves a Valsalva with more pressure than I ever apply while piping.

My question is really whether it's reasonable to think that blowing a properly set up instrument involves more stress than other activities of daily life.
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Old 07-19-2017, 12:54 PM   #9
el gaitero
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Default Re: Post Stroke Bagpiping

Quote:
Originally Posted by CalumII View Post


....whether it's reasonable to think that blowing a properly set up instrument involves more stress than other activities of daily life.
...could be the last thought the OP ever has... while contemporaneously wishing he'd heeded the doctors advice.
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Old 07-19-2017, 02:25 PM   #10
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Default Re: Post Stroke Bagpiping

if the pressure of blowing GHB will be a problem, but yo want a sound more akin to the Highland pipes, you might want to try Lowland pipes, AKA Border pipes, Reel pipes- conical bore, bellows blown ( Though you can also find mouth-blown versions). Depending on the maker's particular design, some sound more like Highland pipes- bright and resonant, some more mellow like Continental varieties.
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