- Teresa Fream, violin
First, Do No Harm
Over the last few months, we have written a lot about the physical needs of musicians, with an emphasis on the special circumstances of working in a crowded orchestra pit. Why are we spending so much time on prevention and non-traditional therapies? To begin with, our careers depend upon extremely fine motor skills, concentrating on, but not limited to, the face and hands. These are full of small muscles and bones which are repeatedly being asked to perform and exactly reproduce the finest of motions. To be clear, if you are facing surgery, and are told you can get 98% of your usage back, that’s not good enough. The tiniest loss of control is enough to change everything. When surgery is absolutely necessary, even for something small, it interrupts work. Removing a ganglion cyst usually requires two to six weeks of recovery time – and the cyst might come right back. If tendon repair is required, that could mean up to 12 weeks of recovery, and perhaps 6 months to regain full range of motion. If you can safely avoid surgery, it makes sense to do so. And that often means extra attention on the non-traditional, less invasive therapies. After all, the risk of doing actual harm is smaller, so it makes sense to try something less invasive first, right? Of course, what looks to you and me like a sensible, safe option for treatment might make no sense at all to an insurance company. Protocol often requires certain tests in a certain order before something even as mainstream as physical therapy. Some therapies never will be covered, and some things take a good fight. I have a TENS (Transcutaneous Electrical Nerve Stimulation) machine that I have used a lot over the years – it was first given to me by a physical therapist who treated me for shoulder issues. And I use the word “given” loosely: after telling me it would be covered under my plan at the time, my insurance company chose to reverse course after I already had the machine (which was legal, btw), and $1000.00 unexpectedly flew out of my pocket during our off season when there are no regular paychecks. That was hard, but worth it: it has helped me to avoid shoulder surgery, unlike so many of my colleagues.
Of course, sometimes the only option that makes sense is more traditional, like surgery. When that is the case, it becomes very, very important to have choices of surgeons and facilities. And we must do our research and exercise our rights to second opinions (and sometimes third opinions!). All of this is to say one simple thing: when being a musician is your life’s work, the love of your life, the way you pay your bills and put a roof over your head, you have to sweat the details. Traditional medicine often does a great job with this, but sometimes not, and sometimes the risks are just too high. That’s why acupuncture, massage, physical therapy, chiropractic, yoga, weight training, Feldenkrais, and many other options sometimes make sense. And that’s why we have been talking about these therapies so much. Health care in America is a constantly changing system these days. We are fortunate to live in an area with so many choices for care, and it is our sincere hope that the information we share with you through this newsletter is helpful. We all need to understand our options if we are to find the treatment appropriate for each unique situation.