Wednesday, December 13, 2017

December: Happy Holidays!

Hi everyone,

Stopping in for a moment to say hi! Hoping to post more videos than blog posts when I get the chance to. I've been busy with my private lesson business, my fiance's woodworking business, and teaching in Castle Rock. I have great news! I will be flying out to Missouri in early January to participate in a research study on FTSED. I'm very excited to be a part of this and can't wait to go! Wish me luck. I am happy to contribute any way that I can. I'm not sure when the research will be completed, but whenever it is, I will share the article when published. For now, happy holidays and hope everyone gets to spend time with family and/or friends! :-)

- Katie A. Berglof

Monday, August 28, 2017

August 2017: New Video and Photo Updates!

It's been a while since I've updated my blog! A lot has been happening so I'm mainly going to explain it all in photos!

First of all, I have posted a new video of my current horn playing on my facebook page Living with Embouchure Dystonia, and in the Focal Task Specific Embouchure Dystonia facebook group. You can see it here: https://www.facebook.com/embouchuredystonia/videos/1415994998449828/  . I filmed this at one of the music schools I teach at. I am warming up before my students arrive for the day.

Next.....surprise! I got engaged!!! David proposed to me in early May. We'll be getting married here in sunny Colorado. It most likely will be a little bit of time before we can get married because we are in the process of starting David's furniture refurbishing and refinishing business. He named it after me, even though I won't have that last name very long. Check us out at www.berglofpremierfurnishings.com :-)  




I got to see an awesome friend, mentor, and professional horn player - Thomas Jostlein and his family again this summer! Like I've said in previous posts, I don't get to experience being in the horn playing world anymore since I'm not in an orchestra, and can't really speak to other horn players because I'm never around them. I can't explain how refreshing it is to speak to a horn player that doesn't look at me like an injured or diseased/cursed person, but instead still supports my success and boosts my confidence by reminding me that I can do it!...I can play and keep improving, and that what I am doing is good! Here are a few pictures from all the times we've got to catch up over the years.



 

I also got to meet Julie Landsman this year who is another huge inspiration to me. She said that she actually just recently donated to Dr. Itlis's Embouchure Dystonia research. It was great to hear her play with that beautiful gorgeous tone. Moved me and gave me so much inspiration.



David and I have been working on so many creative and artistic projects! I love that we have found something that we can work on together. You can see all the work we've done so far at the link below: (I also posted a few below just as examples). Also random tidbit of news: We've been learning Japanese and saving up to travel to Japan someday. It is one of our bucket list items. 

David oil paints!

I draw!

We restore wood furniture too. I am learning wood staining art, and gold leaf. More photos to be added to the album...

I'm also learning wood burning/pyrography.

Safety first. There are so many fumes and chemicals involved in restoring furniture.

This news doesn't necessarily have to do with me. But I wanted to post a picture of my twin sister. She had the opportunity to meet up with her former trumpet section this last year. Here is a photo with her former trumpet section mates: Philip and Natalie Dungey from Seattle. I am so proud of her and miss her trumpet playing! Ally and her husband have a photography business called Sweet Dahlia Photography which you can check out here: https://www.facebook.com/SweetDahliaPhoto/?pnref=lhc . They are based in Washington state and her husband also manages a music store! :-)


Example of Ally and Mario's photography work! :-)

Finally, last but not least. I've started my private lesson teaching again and concentrating on doing it full-time this time. I absolutely love it and wish I would have focused on solely private lesson teaching ages ago! Check out my website at https://berglofmusiclessons.wixsite.com/berglofmusiclessons

However, I haven't completely given up teaching in schools!...I also teach high brass at Douglas County High School/DC Downbeat band program a couple times a week!In my spare time i'm helping Danny refurbish furniture and learning more wood working techniques such as pyrography, stain art, and inlays.

As challenging as last year was to us, I know this year is already starting off better than ever! I am looking forward to all the creative and artistic work I'm doing and haven't been this happy in a long time! Please keep sending positive energy our way. I will do my best to keep my blog updated, but am pretty busy!....until next time....happy 2017-2018! May everyone be blessed! :-)


- Katie Berglof

Monday, April 3, 2017

April: Important Embouchure Dystonia Research Articles, Information, and Videos

MRI Horn and Brass Repository Project (MBRP)
Dr. Peter Iltis is currently directing this research project in collaboration with the Max Planck Institute for Biophysical Chemistry (Gottingen, Germany) and the Institute for Music Physiology and Musician's Medicine (Hannover, Germany). The goal of the project is to research and find ways to restore function in musician's with Embouchure Dystonia, and also find ways to prevent FTSED in general. If you are interested in more information, please click on the link and scroll to the bottom of the page for Dr. Iltis information. Also if you would like to donate to this important research, there is a link on his webpage as well. Currently the International Horn Society executive committee encourages fellow musicians and horn players to support this research if can!

Here is a video of Dr. Iltis speaking in a new video posted on facebook about the research project. And here are further informative videos over his current research below:












American Academy of Neurology Podcast: Sensorimotor Overactivity as a Pathophysiological Trait of Embouchure Dystonia
An interview with Dr. Bernhard Haslinger about his paper published on sensorimotor overactivity in embouchure dystonia.

Activity and Topographic changes in the Somatosensory System in Embouchure Dystonia
I believe I've posted this before! But here is a more condensed overview of this research publication by Tobias Mantel MD, Christian Dresel MD, Eckart Altenmuller MD, Claus Zimmer MD, Jonas Noe MD, Bernhard Haslinger MD ( <-- Who was speaking in the previous podcast link above).

Allegro: Foundation is Created to Assist Musicians with Dystonia
This is an article from the year 2000 when Glen Estrin and Dr. Frucht founded the Musician's With Dystonia Foundation. It has Dr. Frucht's contact information, and talks about how they assist musicians with information on how to get health care coverage, and where to go when they need a diagnosis. "Dr. Steven Frucht of the Columbia Presbyterian Medical Center Movement Disorders Clinic may be reached at (212) 305-5277...for further information regarding Musicians with Dystonia Foundation, send e-mails to musiciandystonia@aol.com."

Clinical and Epidemiological Correlates of Task-Specific Dystonia in a Large Cohort of Brazilian Musicians
This is a general study on focal task-specific dystonia in musicians around Brazil. The study was conducted by Rita C. Moura, Patrcia Maria de Carvalho Aguiar, Graziela Bortz, and Henrique Ballalai Ferraz. 49 individuals were diagnosed with FD (mean age 26.4 years; 92% male). The instruments most associated with FD were acoustic guitar (36.7%) and brass instruments (30.6%). They concluded that Brazilian FD music players were mainly male, classical music professionals, around 30 years of age, with arms, hands, or oromandibular muscles affected. They end their study by stating that Musicians Focal Dystonia should receive more attention from musicians, teachers, and health professionals.

Worlds First Focal Hand Dystonia Patient in Japan Treated with Focused Ultra-Sound (FUS) Enabling Musician to Play Again
I was quite interested in this and contacted Nadia Scantlebury at SunnyBrook about a current focused ultra-sound study that was going on in Canada. Unfortunately they are only letting Canadian citizens participate. However, she did mention that there is a focused ultra-sound research study or trial going on at University of Virginia. Here is a list of all their current trials going on with focused ultra-sound! If interested, you can contact them directly.

From Embouchure Problems to Embouchure Dystonia? A Survey of Self-reported Embouchure Disorders in 585 Professional Orchestra Brass Players
This research was conducted by Anke Steinmetz, Andreas Stang, Malte Kornhuber, Marc Rollinghoff, Karl-Stefan Delank, and Eckart Altenmuller. "The final publication is available at link.springer.com.

Music and Medicine: A Research Model
These are slide presentations by professor Karendra Devroop of the School of Music and Conservatory at North-West University that cover a variety of music performance-related injuries, disorders, research, knowledge, and statistics. I highly recommend reading it, as it covers a wide variety of very important information we can all benefit from as musicians. Raise awareness!

Review: Music, Motor Control, and the Brain. By Eckart Altenmuller, Mario Wiesendanger, and Jurg Kesselring. 
You have to have a Jstor account in order to read this! Easy to sign up, and easy to access this article, as it is a free read. I highly recommend a Jstor account anyways!...so many articles and quality information.

Carmine Caruso Method Adapted and Taught by Julie Landsman
Last, but definitely not least!!! These are some of my favorite videos to watch. I actually use the freebuzzing/mouthpiece buzzing exercise video in rehabilitation, as it helps me a ton!!!

The Recovery
Freebuzzing and Mouthpiece Buzzing
The Six Notes
The Harmonic Series

Carmine Caruso Method: Introduction with Julie Landsman

Note Tasting

Noodles

Spider

Intervals

Dynamic Studies

Low Register

Snakes

Sunday, October 23, 2016

October: Monthly Shared Articles



First article is titled: "What DOES it take to be a Professional Orchestra Musician?" 
This blog post also points out something that is a significantly huge part of preparing for focal dystonia rehabilitation! Changing your mindset from a performance technique mindset to an exploratory mindset full of love, creativity, and adaptability. 

Everything taught to you haas to go out the window. Foget it all (i.e. all knowledge and practice of technique, embouchure formation, setup, proper breathing...). Literally have to deprogram everything so you can start over and start physical rehabilitation from a healthy mental place. Not easy because musicians instruments and reputation are woven tightly into their identity.

What a great article! If you're like others who lean more towards this side, do whatever it takes to regain even a little ownership of your own voice/sound and expression in music. This is why guitar has always been my secondary instrument. It allowed me to feel creative and free of many limitations at times, or when demands got tough. 


A glimpse at part of the article:
 "We get similar effects in blind people who read Braille with several fingers at once: they develop a single representation of all these fingers on the somatosensory cortex, but are not able to determine which part of the information received in the brain comes from which finger. Psychologist Thomas Elbert further points out a parallel of this in all of us: our toes are generally stimulated only simultaneously as we walk, and most of us have trouble telling which of the middle toes has been touched upon application of a light pressure stimulus. Indeed, our toes are not individually represented on the somatosensory cortex as our fingers are."

"Dr Merzenich of the University of California San Francisco calls focal dystonia of the hand a “learning-based catastrophe” and a “failure of the brain’s learning processes”. Consequently, he focuses on developing techniques that will help to “re-normalize the learning system”, in helping to newly distinguish the areas on the somatosensory cortex that have become blurred. Although this approach is very new, Merzenich claims some good results in training children with linguistic impairments, such as dyslexia, which show similar blurring of representations in the brain."

Friday, October 7, 2016

More Alternative Medicine/Therapies (Part 3): Body Movement Awareness Methods (Somatics), Modifications, and Musical Exercises for Focal Embouchure Dystonia

(PART 3) External Modifications to Playing

A couple of external modifications have helped me with my dystonia. As I progressed the modifications changed over time. Here are some examples...
  • Playing with the bell on the leg or off the leg...
    As a horn player (pre-embouchure dystonia) I had always played off my leg. But with embouchure dystonia, it was the complete opposite. I started rehabilitating on my mouthpiece only, and later on in the processes moved onto my horn and found that playing on my leg made things significantly easier. It was as if I had more control and my embouchure didn't have to adjust to any slight external movement that I would have had to deal with if I played off the leg. As I improved over time and regained more abilities, I found that switching back and forth between playing on the leg and off the leg was both helpful, but it just depended on the way my embouchure was feeling that day. With embouchure dystonia, you're highly sensitive to what helps you and what doesn't (even if it is just the slightest tiniest modification).

    When I started playing on the leg, it formed a type of  crutch for me. That's what all these external modifications are...everything is a crutch (i.e. something you rely on or lean on for support) in the beginning of rehabilitation. As I regained more control of my embouchure, I didn't need the crutch as often, so I started switching back and forth between playing on the leg and off the leg depending on how my embouchure felt. Some days it felt easier to play off the leg, and other days I couldn't play at all unless I balanced my horn on my leg.
  • Using a mouthpiece with a good amount of back-pressure...
    When I first started rehabilitating, I didn't even play my horn. I focused on mouthpiece buzzing ONLY for several months, maybe even a year? and NO tonguing, and NO breath control. In one of my previous posts I wrote about how I basically had to deprogram that feeling of automatic "playing-mode" because once my body was aware that I was physically playing, it completely tensed up or locked up. Therefore, I had to forget about everything and just focus on breathing out normally (without thinking about it and without preparing my lungs through breathing exercises...just let it all go!), and also focusing on just buzzing through very loose lips, even if it meant frowning or scrunching the chin...just playing with the flabbiest most loose lips possible. But sometimes my muscles needed to stretch and squeeze...so I started doing stretches, because sometimes I had to give into the tension I felt and just squeeze my facial muscles into contorted expressions just to relieve the tension...kind of like trying to get rid of a huge muscle cramp. So later on I realized how important it was to do facial muscle stretches first, and then focus on flabby lips in buzzing.

    About needing a mouthpiece with back-pressure. It was necessary for me to play on a mouthpiece that provided a little more resistance than normal, because again, it provided a crutch for me. It was much easier for me to buzz and get a sound out. I had less spasms and more control. It may have not been that much more control given, but it was significantly noticeably more efficient than playing on a free-blowing mouthpiece.

    Lucinda Lewis does something very similar called blocked-buzzing. This is the best analogy I can think of to describe why the resistance or back-pressure is necessary in rehabilitation. She said that one day when blowing into a soda bottle and looking into a mirror, she realized that because the air wasn't being allowed out of the bottle, it resulted in air resistance against the lips. This air resistance made her embouchure muscles form into a natural embouchure because there was no room for the muscles to relax, they had to fight the air resistance.

    It's like jumping on a trampoline. If you are jumping on flat ground, your leg muscles have to carry a lot of your weight, and it takes a great deal more muscle strength to jump on flat ground and it's a lot harder on your joints. But if you are on a trampoline, you are still using your leg muscles to bounce in the air, but it is significantly easier because the trampoline-springs provide that extra back-pressure or support. You push your legs against the trampoline mat and it pushes back, and it's the trampoline's resistance that shoots you off into the air. It's the same with mouthpiece back-pressure! You push up against the resistance and it helps by pushing back, and it's as if your embouchure muscles don't have to try that hard to function.

    This only works in the case of embouchure dystonia, because of course if you don't have embouchure dystonia then more back-pressure or resistance just gets in the way. You feel the opposite; like you're trudging through mud and having to work harder to play higher and louder because there is no flexibility. But with embouchure dystonia, we are just focused on trying to hold onto a note without our muscles giving out, spasming, or fighting back. So the back-pressure of the mouthpiece helps us hold on to the note(s) for a split second.

    Later on when I didn't need my heavy back-pressured mouthpiece as much, I kept switching back and forth between one that was less resistant and the one that was more resistant. It's like learning how to walk again. Sometimes you get to a point where you don't always need a crutch to walk, but sometimes you do! Some days you feel great, and other days you fall back on your crutches because you're exhausted or the stamina just isn't there from working so hard.

    Eventually I reached a point where I felt my muscles actually start to work or that feeling of "kicking in". If that makes sense? I started to see my muscles try to form a stable embouchure without me even trying. It was never forced. But when it did happen, it grabbed my attention.
  • Using your right hand to hold your mouthpiece and closer to your mouth when buzzing...
    As a horn player I'm so use to holding my left hand up when I play, that actually buzzing with the mouthpiece in my right hand helped me lessen that "automatic horn-playing mode" that I was working so hard to get out of my body. In a way it is kind of like a sensory trick (neurologist use sensory tricks to help trick the brain into thinking that it is doing something different). It may not seem like it makes a huge difference at first, but over time I found that buzzing out of my right hand helped lessen my spasms.

    Also holding the mouthpiece around the cup or closer to the rim with my fingers/hand allowed me to have more control. Usually we are taught by our teachers to hold the mouthpiece with only two fingers near the end of the shank so that way we use more of our embouchure muscles and air to control the buzz, rather than relying on pressure. But with dystonia, the opposite is necessary....we need to help our embouchure out by holding the mouthpiece in a secure way. If we try to buzz while the mouthpiece is loosely set upon our lips, it's a million times harder/worse and brings out the spasms and dystonia symptoms even more. At least this was the case for me! So I absolutely had to do whatever was most comfortable for me and allowed me to work with my dystonia symptoms....none of the traditional methods of playing or pedagogy could help me...I really had to completely ignore or unlearn every so called "good" habit ingrained, and instead had to trust my body and allow it to tell me what to do. I had to be highly in tune with my dystonia symptoms and how they functioned.

    Again, as I improved, the less I needed the sensory tricks and crutches to help me play. But these steps were absolutely necessary for my recovery when my dystonia symptoms were at their worst.
    ....same goes for when transferring over to your horn. Try playing your horn with the right hand, and no use of tongue! 
  • Playing Stop-Muted
    Playing with a straight mute or practice mute in the bell made my symptoms worse. But stop-muting the bell with my hand actually helped. I don't know why the sensation of the stop-muting helped, but I believe it helped physically and also with my sound. I always sounded much better stop-muted, so I practiced this way about half-way through the second year of retraining.
  • Playing With or Without a Mirror
    Before I was diagnosed, I was constantly looking in the mirror at my embouchure when I practiced because it looked as if all of my muscles were melting or becoming distorted. I became too obsessed with trying to correct my dysfunctional embouchure at first; by trying to flatten my chin and straighten my corners, but nothing was working.
    So throughout the first part of retraining after diagnosis, I had to focus more on feeling things, rather than looking at my embouchure in the mirror. However, I eventually did need the mirror, because it did help me become more aware of what my symptoms were; I could see where every little twitch/spasm occurred and on which note. I could see when the left side of my lower lip started to droop, etc.
    It was important to use a mirror, but in moderation, and only when I became less analytical about trying to "fix" my embouchure. It wasn't until I started to focus more on "feel" that I could start using the mirror more often to observe my symptoms.
  • Playing other instruments
    At first this didn't help me. Actually it didn't help for quite a few years. But after regaining some abilities. playing other instruments started to help. They helped condition my muscles in a different area or way, and this allowed me to transfer those adapted muscles and use to my horn playing.
  • Changing Mouthpiece Angle
    Constantly changing my mouthpiece angle to find a more comfortable position helped greatly. Even though the angle and position of my mouthpiece changed almost every 2 minutes or every day, it still helped to experiment and seek out a spot on my lips and angle that helped me regain more of a grasp on my notes.
  • Sensory Work
    This should actually be logged under body-movement methods, because it deals more with retraining your sensation  - sensory tricks or body mapping.

    Practicing using non-focused air is key! If you can get either a small windmill to blow on, or a feather, this will help. Practice blowing with loose, wide, and unfocused air coming out of your lips. Think of the type of air you huff and puff when angry....if your lips and your cheek/facial muscles are truly loose, then you should feel the air fill up both cheeks a little, or the air will fill up and puff out near the corners of your lips, or even lower near your chin.

    Practice putting things up to your lips; like a spoon touching the surface of your lips, or practice blowing through a really wide straw (like the ones that they give you for bubble tea). It sounds silly, but it's a way of desensitizing your body and brain from constant "mouthpiece/automatic horn playing mode." When your brain realizes that not everything you put up to your lips is a horn, it helps. Because that's basically what it is doing. I had so many problems with drinking from a water bottle or even a coffee cup with a cap on it, just because my spasms would kick in as if I were playing the horn.

    Holding bubbles of air in my cheeks and mouth helped a lot to (just don't fill them up too much because it can actually open or damage a gland in your cheek, so be careful). 
There weren't too many external modifications, but the ones that I listed helped me. The exercises that I will write about next are what helped me tame my dystonia symptoms the most.