Tag Archives: health

The Coronavirus and Its Rapid Spread

The coronavirus, according to the World Health Organization (WHO), as of March 23, has spread to 187 countries and tallied over 294,000 confirmed cases, with more than 13,000 deaths. In the US, all 50 states as well as the District of Columbia, Puerto Rico, Guam, and the US Virgin Islands are affected, with over 15,000 confirmed cases and over 200 total deaths, according to the Centers for Disease Control (CDC). In Canada, 11 provinces or territories are affected, with over 1,400 confirmed cases and at least 20 deaths, according to the Canadian government.

The virus was first confirmed on December 31, 2019 by officials in Wuhan, China. According to a timeline of the virus prepared by The New York Times, the first known COVID-19-related death occurred 11 days later in China. By January 20, the WHO declared the virus had spread to other Asian countries. The first US case was confirmed on January 21, where a man in his 30s in Washington state developed symptoms after returning from a trip to Wuhan.

On January 30, the WHO declared a global health emergency, and the Trump Administration restricted all travel from China to the US. On February 2, the first virus-related death outside China was confirmed in the Philippines, and less than two weeks later the first fatality occurred in Europe after an 80-year-old Chinese tourist died in Paris. By this time, about 1,500 people had died from the virus, mainly in China.

By February 20, the number of global cases had risen to nearly 76,000, according to the WHO, with cases in Iran and Italy seeing a major surge just days later, followed by confirmed cases in Latin America and sub-Saharan Africa.

On February 24, the White House asked Congress to allocate $1.25 billion in new emergency funds to bolster its preparedness. Four days later, the first US death occurred in Seattle.

The CDC lifted all federal restrictions on testing for the coronavirus on March 3. By this point, the coronavirus had infected more than 90,000 around the globe and killed about 3,000, according to the WHO.

On March 11, the World Health Organization declared the coronavirus a pandemic. That evening, in a prime-time address, President Trump issued a travel ban from all European countries other than Britain for 30 days. Three days later, he included all countries within the United Kingdom.

On March 12, Broadway theaters closed their doors through April 12.

On March 13, Trump officially declared a national emergency and said he was making $50 billion in federal funds available to states and territories to combat the coronavirus. The next day, the US House passed its first coronavirus response bill on a bipartisan vote to expand access to free testing, provide $1 billion in food aid, and extend sick leave benefits to vulnerable Americans. The Senate passed the bill five days later.

On March 16, Canada closed its borders to foreign travelers—with US citizens exempt—in an attempt to limit the spread of the coronavirus. Multiple US states also announced that day they would reduce allowed crowd capacity at any location to 50 people maximum, and all gyms, casinos, and movie theaters would be closed, while restaurants and bars would offer takeout only.

On March 17, the European Union banned all travelers from outside the bloc. This applied to 26 EU states as well as Iceland, Liechtenstein, Norway, and Switzerland. UK citizens were unaffected.

On March 18, the Canadian government unveiled an $82 billion aid package to provide direct support to Canadians forced from work—including freelancers—and for businesses facing hardship due to the shutdown of public life caused by the coronavirus outbreak.

On March 20, 44 unions, companies, and organizations representing the entertainment industry sent a united letter to Congress seeking emergency financial help and unemployment insurance to all workers in their industry as a response to the work lost due to the coronavirus pandemic.

As of March 23, The provinces of Ontario and Quebec had both declared a state of emergency and ordered all non-essential businesses to close.


The AFM and its Members Respond to COVID-19 Effects on Musicians


While our union officials have been monitoring the COVID-19 outbreak and potential impacts on musicians since it first became a global health emergency in late January, once music events began being canceled and restrictions on large gatherings were announced by both US and Canadian officials in early March, that is when the impact on musicians and their livelihoods became stark.

On March 3-4, President Hair was in Washington visiting legislators on union-related legislation. Although the coronavirus was still in its infancy as far as its North American presence, Hair says the people in the nation’s capital were beginning to panic, and it immediately got him thinking about the AFM’s response.

On March 5 and 9, respectively, the AFM’s two largest locals—Local 47 (Los Angeles) and Local 802 (New York City), which cover Hollywood and Broadway musicians—began posting updates and information on their websites to offer their members guidance on health and emergency relief resources. The Local 802 Executive Board began working in conjunction with the 802 Emergency Relief Fund and Musicians Assistance Program to get musicians help as quickly as possible, while the Local 47 Executive Board established an Emergency Relief Fund for members who have lost revenue due to work stoppages, as has the Music Fund of Los Angeles.

Also on March 9, all employees at the AFM headquarters in Times Square who could do their work remotely were allowed to work from home, and any essential employees who needed to work at the office were given limited schedules to avoid being in rush-hour crowds. The office was also supplied with hand sanitizer, cleaning wipes, and gloves to help prevent contagion. (The New York office closed, with all employees working from home, starting March 19, as did the West Coast Office on March 20.)

On March 12, the day Broadway theaters closed their doors, President Hair issued a statement in response to limits being placed on public gatherings: “Union musicians in the United States and Canada are committed to doing everything possible to limit the spread of COVID-19, but this will have a disastrous impact on musicians and so many others who live gig to gig. It is critical that both national and local governments take immediate action to provide economic relief including expanding unemployment benefits and an immediate moratorium on evictions, foreclosures, and utility shut-offs.”

Actors’ Equity Executive Director Mary McColl also released a statement, in which she said the decision to limit public gatherings, “means tremendous uncertainty for thousands who work in the arts, including the prospect of lost income, health insurance, and retirement savings.” International Alliance of Theatrical and Stage Employees (IATSE) International President Matthew D. Loeb also called on the federal government to take decisive action and issue a relief package to entertainment industry workers. “Entertainment workers shouldn’t be collateral damage in the fight against the COVID-19 virus,” he stated. “Film and television production alone injects $49 billion into local businesses per year, and the overall entertainment industry supports 1.2 million jobs in municipal and state economies.”

Helping Traveling Musicians

The cancellation of Broadway shows includes all the travelling shows, and many union members were left out on the road with employers offering only partial payment for their final week of work, says AFM Touring/Theatre/Booking Division Director Tino Gagliardi. Gagliardi has been in constant contact with all the AFM touring musicians to keep them informed of the situation.


He also has been meeting with other entertainment industry union officials and the Broadway League to sort out the issue of worker benefits and compensation. “Some companies have given notice to musicians they will only be paid a partial week for their last week. The union’s position is full payment of course,” he says. “The League’s got to do the right thing here. What we’re looking for is full compensation through the rest of the week that was canceled plus additional financial relief for the musicians through additional wages based on the type of production and health care benefit contributions until April 12, with a commitment to resume discussions on the possibility of additional health contributions the week of April 6.”

An agreement was reached on March 21.

Side Letter to Integrated Media Agreement

On March 13, the day President Trump officially declared the COVID-19 outbreak a national emergency, the AFM announced it had signed an agreement with the Employers’ Electronic Media Association (EMA) to enable livestreaming of concert performances by a signatory employer that has been adversely affected by the spread of COVID-19. This side letter to the 2019-2022 Integrated Media Agreement guarantees no disruption in compensation or benefits for any musician for a 30-day period following the date of posting of the first streaming content.

“What the side letter does is to allow the employer to maintain an online presence when maintaining an in-person presence (for either audience or musicians) is either impossible or imprudent in the limited context of the COVID-19 pandemic,” explains SSD Director Rochelle Skolnick. “An employer must elect to use the side letter and the musicians of the orchestra must vote to approve its use. It is not automatically applied to any orchestra.” She says the use of the side letter also does not interfere with the ability of a local, orchestra committee, or musicians to make their own decisions about gathering together to rehearse or perform. “In short: agreeing to use the side letter does not create any new obligation for you to show up to work,” she explains.

Online Resources

This COVID-19 side letter was the first document to be placed in a newly created folder in the SSD section of the AFM.org website called “Corona Virus Resources.” The folder also contains legal guidance on force majeure (“Act of God”) aspects of collective bargaining agreements and a Q&A document regarding musician attendance and COVID-19 concerns; it will also be continuously updated and augmented as conditions change.

In addition to the new SSD digital resource, there is now a COVID-19 resource page with information and helpful links at www.afm.org/covid-19/.

Lester Petrillo Fund

Union officials also have announced reminders that any members who contract COVID-19 and lose work because of it can apply for limited emergency financial aid through the Lester Petrillo Memorial Fund. The Fund was established to assist members in good standing who become ill or disabled and are unable to accept work. A member would qualify for assistance if he/she is diagnosed with coronavirus and/or he/she tests positive for coronavirus and is quarantined.


Members and local officers may download Petrillo Fund applications from the AFM website. Go to www.afm.org and type “Petrillo Memorial Fund” into the search bar. Completed applications together with supportive medical documentation should be submitted by members to their local unions, which will then submit them to the Federation.

Across the northern border—which the Canadian government closed to foreign travelers on March 16—the Canadian office of the AFM, located in Toronto, started putting emergency office measures into place on March 13. These measures included allowing staff to work from home if possible, having reduced office hours to avoid peak travel times in transit, having a maximum of three staff members in the office at one time, offering hand sanitizer around the office, and practicing increased cleaning of common surfaces in the office, says Alan Willaert, Vice President from Canada. The Canadian office closed until further notice on March 24 after the Premier of Ontario and the Mayor of Toronto both declared a state of emergency and ordered all non-essential businesses to close for two weeks.

The Canadian Office of the AFM, in coordination with the Canadian Actors’ Equity Association and the Toronto Musicians’ Association, also started the Save Live Arts in Canada initiative (www.savelivearts.ca) in response to the COVID-19 pandemic. The initiative encourages all who work in the live arts to sign a petition addressed to all elected officials in Canada, which urges certain health and financial actions be taken to help members of the entertainment sector in the face of unemployment.

Urging Federal Response

Also on March 13, Willaert sent an open letter to the Government of Canada, urging support for musicians due to an unprecedented loss of work caused by reaction to the Coronavirus. “The CFM is requesting that government adopt emergency measures in this exceptional situation, to provide security to counteract this critical loss of revenue, through whatever means necessary,” Willaert wrote. “These steps may include a waiver of the one-week waiting period for Employment Insurance (EI) benefits (in the case where the musicians are entitled), to expanding the benefit to include freelance workers who provide their services as self-employed contractors, to ensuring that compensation is made available for musicians who have had gigs or tours canceled for both lost revenue and other expenses, such as the hundreds of dollars, or thousands paid to USCIS as petition fees for P2 visas for US entry. Consideration must be made as well for proper funding to help musicians and symphony/theatre organizations recover, as well as assistance to stimulate and revitalize the industry once the virus has been contained and/or eradicated.”

Willaert also signed on to a letter from the seven Canadian entertainment unions to the Canadian minister of heritage and multiculturalism urging him to extend income support to workers not eligible for EI sickness benefits. Many workers in the Canadian entertainment industry are not classified as employees under Canadian laws, and therefore are not eligible for EI benefits for any loss of work due to the coronavirus pandemic. 

“We are concerned the government may forget the importance of our industry and the need to also protect the workers who rely on it for their income,” the letter states. “We are already seeing cancellations of screen-based productions and live performances with more anticipated. Workers who are signed to productions rely on those contracts, which can range from several days to several months. The loss of that expected income will be devastating to these precarious workers. Production insurance is not covering cancelltions related to COVID-19.”

On March 14, President Hair issued a statement on the pandemic’s impact on musicians and other gig economy workers:

The SKYXE Juno welcome stage was shut down by Canadian government order at 10:30 a.m. on March 12, with only two of the 19 scheduled Local 553 (Saskatoon, SK) musical groups over the March 12-16 event having performed. The Starry Night Quartet kicked things off at 8 a.m. Thursday morning. The quartet features four members of the Saskatoon Symphony Orchestra. Pictured from left: Joan Savage (violin), James Legge facing away from the camera (viola), Nova Wong (violin), and Scott McKnight (cello).

“As events related to the fast-moving coronavirus pandemic evolve, emergency declarations in many locations have banned all but small-sized public gatherings in an effort to protect families, save lives, and prevent the spread of the disease. These actions have led to the shuttering of large, medium, and small venues, sporting facilities, and the preemption of live media production involving studio audiences. This has prompted the widespread cancellation of concerts, shows, theatrical productions, festivals, and musical performances of every kind—all of which have inflicted disastrous economic effects upon performers who often live gig to gig and who bring joy to the world wherever groups are gathered.

“Tens of thousands of musicians and others have suddenly found themselves without income, without the means to feed and protect their families, and who may lose healthcare coverage during these shutdowns. Today, a state of national emergency has been declared which frees up $50 billion in federal funds for use in response to the accelerating surge of infections. When considering funding assistance and relief for working people, Congress and state and local lawmakers should pay particular attention to those who work and perform in the entertainment industry, whose gigs have gone dark, and who are bearing the financial brunt of these shutdowns the most.”

Like their Canadian counterparts, the major US entertainment industry union leaders are also coordinating to protect their members from the effects of the coronavirus and the governmental response to it. These leaders—part of the coalition comprising the AFL-CIO Department for Professional Employees—had a teleconference on March 16 during which they discussed all aspects of the situation, particularly how to ensure that our elected officials in Washington DC stand up for creative professionals.

They drafted a letter to government officials in which they advocated for emergency economic support for entertainment industry professionals. Specifically, they urged legislators to create a special Emergency Coronavirus Economic Support Benefit geared toward entertainment workers who have a bona fide, good faith work offer that gets canceled due to the coronavirus, as well as the creation of a benefit similar to the Emergency Paid Leave benefit included in the first Coronavirus Response Act legislation (signed into law on March 18) but available to those who cannot work due to production shutdown rather than due to illness, quarantine, or family caregiving needs.

“We are working closely with the Arts, Entertainment, and Media Industry (AEMI) unions through the AFL-CIO’s Department for Professional Employees (DPE) to speak with one voice urging Congress to include musicians and other arts and entertainment workers in any subsequent bill to help our members,” says AFM International Secretary-Treasurer Jay Blumenthal.

While President Hair and the rest of the AFM leadership and staff are working around the clock with other national entertainment unions to protect their members, they are encouraging members to stand up and speak out as well. “Musicians need to directly contact their congressperson and senators to urge them to protect entertainment workers during this unprecedented crisis,” President Hair says.

All AFM members are encouraged to visit www.afm.org/covid-19, scroll to the bottom, and fill out the “Emergency Action – Contact Congress” form to let Congress know that they need to protect entertainment workers, thousands of whom are unable to pay for rent or food and are finding their healthcare coverage in jeopardy.

mental health

Advice for Taking Care of Your Mental Health as a Musician

by Roz Bruce, Guest Contributor

When you’re a musician, be it in a rock band, jazz ensemble, or a classical orchestra, it’s likely you have a schedule that’s tough on your body and your mind. Even if you’re not a full-time musician, those late nights and the fast-food meals can take their toll.

mental health

For many people, listening to music or playing an instrument is a way of dealing with problems and can help improve mental health. However, many musicians struggle with mental illness, which in some cases ends in tragedy.

As a songwriter and musician, I know how easy it can be to let your health slip when you’re gigging, touring, or even just heavily involved in a creative process. I remember, in the early days of my songwriting, sacrificing sleep, food, and relationships as I allowed myself to be possessed by the creative process that would end up taking its toll on my mental well-being as I suffered depression and anxiety. Later albums, which I recorded more healthily, were undoubtedly better as well as more enjoyable to create.

It’s so important to look after your mental health as a musician; it’s what helps you create, interpret, play, and enjoy music. Here is some advice for how you can help to take care of yourself both at home and on the road.

Take Some Time for You

This one is the hardest to stick to for musicians. You rehearse, prepare, play, get home tired, sleep in the next day, or go to work and repeat. It can be so exhausting and draining. You need to remember that music is a gift and you’ll burn out if you only ever give, give, give.

Take some time to do things that have no purpose other than for yourself. Read a book, have a bath, do whatever you enjoy, but do it just for you. This is an essential aspect of mental wellness. Two books that I have found particularly enjoyable and helpful are Destination Happiness: 12 Simple Principles That Will Change Your Life, by Mark Reklau, and The Little Book of Self Care, by Mel Noakes.

Take some time for yourself, by yourself. You’ll thank yourself.

Don’t Compare Yourself to Others

This really is a psychological one. Performing makes you sensitive. Yes, even you, tough guy. After you’ve performed, you’re much more likely to see the potential negatives in anything anyone says to you. Didn’t they like the songs? They hate us. Or if nobody says anything, oh my gosh! The worst. They were all embarrassed. They thought we were awful.

mental health

Then the next band goes on, and everyone is cheering *because they know them*… and you’re thinking, “Nobody did that for us … we must have been terrible.”

When reflecting on your performance, reflect on your performance. What did you do well? What could have gone better? How? Comparing yourself to other bands or performers will never lead you to anything helpful or insightful.

Eat and Drink

It sounds so obvious, but this is a big one. We need to eat to stay alive, right? But when you have to be at a venue at 4:30 p.m., sound check at 6 p.m., play at 8:30 p.m., leave the gig at 11 p.m., where’s the time for food? It’s really worth taking some food with you to a gig. Look after your body and your mind will flourish. Just get past the uncool-ness of it and prepare a packed lunch. Alternatively, try getting a healthy meal at least some of the time, rather than burgers every time you’re gigging. It’s so much better for your mood.

It’s also easy to forget to hydrate yourself when you’re out and about. Performing takes a lot of energy, and it’s not unusual to sweat when you’re on stage. This makes you more dehydrated. Make sure to keep water flowing. It hydrates your brain as well as your body, and you’ll find your mood improving as a result. Best of all, water is free.

Reach Out

If you do find yourself struggling, don’t forget that help is out there. The worst thing you can do is to keep stuff bottled up inside. Try speaking to someone close to you and getting that fear, anxiety, anger, or whatever off your chest. If you don’t have health insurance, you can get free help and look for mental health resources online. For example, the SIMS Foundation in Texas helps to provide musicians with mental health resources, as does the New Orleans Musicians’ Clinic. In Canada, the Canadian Mental Health Association has a presence in more than 330 communities across every province and one territory. You should also save your state’s mental health crisis line, just in case you need it.

Roz Bruce is a professional musician, songwriter, and teacher based in Nottingham, UK. She has personal experience with depression and anxiety and has a commitment to helping others in mental distress. www.guitaristroz.com.

dental checkups

Keep Your Chops and Get Dental Checkups

Teeth grinding. TMJ. Muscle cramps. Dry mouth. Cold sores and calluses. These are all potential problems for wind and brass musicians, who can often suffer from pathological conditions that are aggravated by their occupation. Repetitive movements, excessive practice, and stress can cause a number of dental and orofacial problems.

It is not uncommon for musicians to experience TMJ (temporomandibular joint pain), muscle strain, or focal dystonia (failure of a muscle to respond). As the result of continuous playing—and with age—tooth and mouth structure can shift. Tongue position and muscles of the lip and cheek are vital for embouchure. Dentures and dental implants, soft palate pain, cracks in teeth caused by vibration, and loss of feeling or sensitivity in the lips all can interfere with performance level.

Know Your Dentist

Eventually, controlling pitch and tone can become problematic. The slightest change in the position of the tongue or shape of the teeth (which occurs over time and with age) can alter airflow and change embouchure. Clearly, regular dental visits are highly recommended, but it’s important to entrust dental care and treatment to dentists with expertise in conditions that specifically affect musicians. With consistent care, they can provide relief and help prevent further problems. Bring your mouthpiece for a better overall assessment.

Teeth that are sensitive to cold become more sensitive from inhaling air. Desensitizing toothpastes will help manage the problem, but your dentist may also discuss applying bonding resin to sensitive root surfaces. To strengthen enamel, fluoride treatments may be recommended.

Over time, mouthpieces can also cause irritation. To slow down wear and tear, appliances can be made to help cover the upper incisors and evenly distribute the pressure. For teenagers under the age of 15, playing for several hours a day may cause the upper teeth to protrude, which may require orthodontia. Keep your dentist or orthodontist informed of any changes you feel in playing technique.

In Sync

Science and technology have come a long way in crafting advanced, precise mouthpieces. Likewise, adaptive mechanisms may include lip shields, treatments to improve occlusion (bite), or customized mouthpieces for trumpet players. In fact, some practitioners recommend taking the instrument to the dentist’s office at the time of consultation. This allows the dentist to better assess problems and, if necessary, to create a prosthetic appliance tailored to your specific need.

Wind players should consider having a model made of their dental arches every year. It’s an inexpensive way of safeguarding their sound. A specialist would know that wind instrumentalists display complex neuromuscular activity during performances. For instance, an exam would be complemented with the aid of technology to better understand orofacial structure and the embouchure mechanism. Any prosthetic rehabilitation would provide minimal changes to the musician’s performance.

Warm Down

For single reed players, where much of the weight and pressure is on the lower jaw, the biting surface of your lower teeth may slowly wear away and/or chip. In double reed players, there is increased risk for pain and calluses. The increased pressure in the mouth may increase the risk of infection within the ducts that release saliva.

The pressure on teeth for double-reed and brass players forces teeth inward. Brass players can also suffer from trauma to the upper lip. A long night of playing, when teeth are in direct contact with the mouthpiece, can lead to dental wear and tooth fracture, and lip trauma. Experts recommend not only warming up before a gig but also “to warm down” afterwards—playing long tones, scales, and lip slurs—to prevent chop problems. Playing puts pressure on the embouchure, which may become inflamed. The warm-down helps a musician regain that pliability. Above all, if there is an injury, practice the three Rs: Rest, Recuperation, and Rehabilitation.

carpal tunnel

Piano Playing and Preventing Carpal Tunnel Syndrome

by Brent Wells, D.C.

For piano players, the possibility of developing carpal tunnel is a real concern. Most people who play the piano, professionally or as a hobby, play every day or multiple times per week. While this is a great way to get better at the craft, it also means that your chances of suffering from this syndrome increase. That is because carpal tunnel develops when you use your hands in the same repeated motion.

However, just because you are at an increased risk for developing carpal tunnel syndrome, it does not mean there aren’t things you can do to prevent it. While there is no surefire way to ensure it does not happen, you can reduce the likelihood.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is both a simple and complex issue. It occurs when your median nerve squeezes and compresses at your wrist. This nerve is located in your forearm and connects to your hand’s palm.

carpal tunnel
Carpal tunnel develops when you use your hands in the same repeated motion. If you begin to develop carpal tunnel, the ligaments in the area grow thicker, which causes a narrowing of the tunnel. When it narrows, your median nerve will begin to compress and squeeze, creating pain and other symptoms.

The carpal tunnel is made of different bones and ligaments that creates a narrow tunnel at the base of your hand. This tunnel helps bend your fingers and allows sensation in your palm and fingers—except your little finger. It also controls some smaller muscles in your thumb.

These areas of the hand are exceptionally important for playing the piano since you need fine tune motor skills to play effectively.

If you begin to develop carpal tunnel, the ligaments in the area grow thicker, which causes a narrowing of the tunnel. When it narrows, your median nerve will begin to compress and squeeze, creating pain and other symptoms. Some of the most common symptoms of this syndrome are:

  • Burning
  • Tingling
  • Itching
  • Numbness
  • Swollen feeling in the fingers
  • Useless feelings in fingers

Even though your fingers may feel swollen, they are not swollen in appearance. Symptoms develop over time and get worse gradually. You will begin to feel the above issues in the fingers and the palm and symptoms may appear in one hand or both.

As the condition progresses, you will find it challenging to grip objects and move your hands normally. Since playing the piano almost solely relies on your ability to move your fingers, hands, and wrist in a precise and graceful way, developing carpal tunnel can be devastating to your career or hobby.

How to Prevent Carpal Tunnel Syndrome

Before any symptoms start, you can incorporate
the following into your
weekly routine:

  • Keep your wrists straight.
  • Sit up straight.
  • Shake out your hands.
  • Stretch your hand, fingers, and wrists.

For more stretches and strengthening exercises to help prevent carpal tunnel, read the helpful article at WebMD, “What Exercises Help for Carpal Tunnel Syndrome?

What to Do When You Feel the First Symptoms

carpal tunnel
Some of the most common symptoms of Carpal Tunnel Syndrome are burning, tingling, itching, numbness, swollen feeling in the fingers, and useless feeling in the fingers.

According to a 2009 study in the International Symposium on Performance Science, which analyzed both men and women pianists with carpal tunnel, the authors found that a delayed diagnosis of carpal tunnel resulted in two ways. Either surgery was needed or the fear of diagnosis and possibility of surgery lead to late diagnosis and prohibited early treatment. 

This study suggests that the fear of diagnosis and the potential for surgery means many people do nothing about symptoms when they first appear. If you let your symptoms progress without intervention it will become worse, hence surgery is more often necessary. However, with early intervention, less invasive treatments often were administered and doctors were able to effectively treat symptoms without surgery.

These findings show us that early treatment is imperative to quick recovery and stopping the progression of the syndrome. The key to preventing carpal tunnel syndrome is to immediately seek treatment when you feel symptoms.

In the end, remaining in-tune with your body will be the best tool for preventing carpal tunnel. At the first signs of an issue, speak with your doctor in an effort to stop symptoms before they even start. Maintaining proper form and doing stretches and exercises will also go a long way for prevention. 

Dr. Brent Wells, D.C. is the founder of Better Health Chiropractic & Physical Rehab and has been a chiropractor for over 20 years. His practice has treated thousands of patients from different health problems using various services designed to help give you long-lasting relief.

Dr. Wells is also the author of over 700 online health articles that have been featured on sites such as Dr. Axe and Lifehack. He is a proud member of the American Chiropractic Association and the American Academy of Spine Physicians. And he continues his education to remain active and updated in all studies related to neurology, physical rehab, biomechanics, spine conditions, brain injury trauma, and more.


Our Brains Appear Uniquely Tuned for Musical Pitch

In the eternal search for understanding what makes us human, scientists found that our brains are more sensitive to pitch, the harmonic sounds we hear when listening to music, than our evolutionary relative the macaque monkey. The study, funded in part by the National Institutes of Health, highlights the promise of Sound Health, a joint project between the NIH and the John F. Kennedy Center for the Performing Arts, in association with the National Endowment for the Arts, that aims to understand the role of music in health.

“We found that a certain region of our brains has a stronger preference for sounds with pitch than macaque monkey brains,” says Bevil Conway, Ph.D., investigator in the NIH’s Intramural Research Program and a senior author of the study published in Nature Neuroscience. “The results raise the possibility that these sounds, which are embedded in speech and music, may have shaped the basic organization of the human brain.”

The study started with a friendly bet between Conway and Sam Norman-Haignere, Ph.D., a post-doctoral fellow at Columbia University’s Zuckerman Institute for Mind, Brain, and Behavior, and the first author of the paper.

At the time, both were working at the Massachusetts Institute of Technology (MIT). Conway’s team had been searching for differences between how human and monkey brains control vision only to discover that there are very few. Their brain mapping studies suggested that humans and monkeys see the world in very similar ways. But then, Conway heard about some studies on hearing being done by Norman-Haignere, who, at the time, was a post-doctoral fellow in the laboratory of Josh H. McDermott, Ph.D., associate professor at MIT.

“I told Bevil that we had a method for reliably identifying a region in the human brain that selectively responds to sounds with pitch,” says Norman-Haignere. That is when they got the idea to compare humans with monkeys. Based on his studies, Conway bet that they would see no differences.

Tuned for Musical Pitch: NIH-funded scientists found that our brains may be uniquely sensitive to pitch, the harmonic sounds we hear when listening to speech or music. Image: Courtesy NIH

To test this, the researchers played a series of harmonic sounds, or tones, to healthy volunteers and monkeys. Meanwhile, functional magnetic resonance imaging (fMRI) was used to monitor brain activity in response to the sounds. The researchers also monitored brain activity in response to sounds of toneless noises that were designed to match the frequency levels of each tone played.

At first glance, the scans looked similar and confirmed previous studies. Maps of the auditory cortex of human and monkey brains had similar hot spots of activity regardless of whether the sounds contained tones.

However, when the researchers looked more closely at the data, they found evidence suggesting the human brain was highly sensitive to tones. The human auditory cortex was much more responsive than the monkey cortex when they looked at the relative activity between tones and equivalent noisy sounds.

“We found that human and monkey brains had very similar responses to sounds in any given frequency range. It’s when we added tonal structure to the sounds that some of these same regions of the human brain became more responsive,” says Conway. “These results suggest the macaque monkey may experience music and other sounds differently. In contrast, the macaque’s experience of the visual world is probably very similar to our own. It makes one wonder what kind of sounds our evolutionary ancestors experienced.”

Further experiments supported these results. Slightly raising the volume of
the tonal sounds had little effect on the tone sensitivity observed in the brains of two monkeys.

Finally, the researchers saw similar results when they used sounds that contained more

natural harmonies for monkeys by playing recordings of macaque calls. Brain scans showed that the human auditory cortex was much more responsive than the monkey cortex when they compared relative activity between the calls and toneless, noisy versions of the calls.

“This finding suggests that speech and music may have fundamentally changed the way our brain processes pitch,” says Conway. “It may also help explain why it has been so hard for scientists to train monkeys to perform auditory tasks that humans find relatively effortless.”

Earlier this year, other scientists from around the US applied for the first round of NIH Sound Health research grants. Some of these grants may eventually support scientists who plan to explore how music turns on the circuitry of the auditory cortex that make our brains sensitive to musical pitch.

lyme disease

Summer is Coming, Remember to Protect Yourself Against Lyme Disease

When it comes to health, the fear of any musician is contracting a disease or condition that impedes or even prevents the ability to make music. Imagine suffering from severe fatigue or anxiety, chronic muscle spasms or joint pain, constant headaches and sensitivity to sound and light—and having no clue where it came from, what it is, or even how to effectively treat it. Unfortunately, this happens all too often with the continued rise in Lyme disease cases throughout North America.

With the arrival of summer, it is a good time to review and remember the threat that Lyme disease poses to anyone who steps outside. For musicians who may spend hours at outdoor rehearsals and performances, the risk is important to keep in mind.

lyme disease

According to the U.S. Centers for Disease Control (CDC), the incidence of Lyme disease in the United States has approximately doubled since 1991, increasing from 3.74 reported cases per 100,000 people to 7.95 reported cases per 100,000 people in 2014. An estimated 300,000 people are infected with the illness annually.

Lyme disease is a bacterial illness transmitted through the bite of a deer tick. Most people are infected through the bites of tiny, immature ticks called nymphs, which most commonly bite during spring and summer. In the majority of cases, the appearance of a rash resembling a bull’s eye or solid patch, about two inches in diameter, appears and expands around or near the site of the bite.

According to the CDC, early stage symptoms of the disease include fatigue, chills and fever, headache, muscle or joint pain, and swollen lymph nodes. People treated with oral antibiotics such as doxycycline or amoxicillin for early Lyme disease usually recover quickly. If Lyme disease is unrecognized or left untreated during the early stage, however, more serious symptoms may occur including acute fatigue, a stiff aching neck, tingling or numbness in the arms and legs, or even facial paralysis. The most severe symptoms of Lyme disease may not appear until weeks, months, or years after the tick bite. These can include severe headaches, painful arthritis, swelling of the joints, and heart and central nervous system problems. This requires a longer duration antibiotic therapy treatment.

lyme disease

Unfortunately, one of the major battles of Lyme disease sufferers is first getting the right medical diagnosis. Doctors often are not looking for Lyme disease and patients may not realize they have it by either not recognizing the rash for what it is, or by masking the usual symptoms through the use of over-the-counter pain and anti-inflammatory medications.

One of the more well-known cases of celebrity Lyme disease in recent years was that of songwriter and actor Kris Kristofferson of Local 257 (Nashville, TN) who suffered ailments for years—and was given a diagnosis of Alzheimer’s—before he was tested and diagnosed with Lyme disease. Other musicians who contracted Lyme disease and have gone public with their suffering and how the illness has affected their career include Deborah Gibson of Local 802 (New York City), Shania Twain, Avril Lavigne, Daryl Hall, and Pete Seeger.

The best way to prevent Lyme disease is to take precautions when spending time outdoors. Ticks favor moist, shaded environments, especially leafy wooded areas and overgrown grassy habitats. If you are recreationally moving about in tick-infested areas, the most common advice from health organizations such as the CDC and National Institute of Allergy and Infectious Diseases is to wear light-colored clothing to spot ticks more easily, walk in the middle of designated trails, wear closed-toed shoes, avoid low-lying brush or long grass, and tuck pant legs into your socks to prevent ticks from crawling up your legs.

But what if you are a musician performing at or attending an outdoor venue where you have a stricter dress code, and perhaps long grass or other potential tick habitats are unavoidable? The CDC also recommends using insect repellents containing DEET or Icaridin on skin and clothing and be sure to check your body for ticks when you get home (under the arms, in and around the ears, inside the belly button, back of the knees, in and around the hair, between the legs, and around the waist). It is also important to shower or bathe within two hours of being outdoors to wash away loose ticks. According to medical experts, if a tick is attached to your skin for less than 24 hours, your chance of getting Lyme disease is extremely small.

For more information about Lyme disease and preventing Lyme disease, visit www.lymedisease.org.

better hearing month

Prick Up Your Ears: May Is Better Hearing Month

better hearing month

May is National Better Hearing Month and the American Academy of Audiology encourages everyone to make an appointment with an audiologist if they suspect hearing loss for themselves or their loved ones. The American Speech-Language-Hearing Association (ASHA) designated May as Better Hearing and Speech Month in 1927 with the goal  of raising awareness about speech and hearing challenges and encouraging people to treat their hearing and speech problems.

According to the National Institutes of Health, National Institute on Deafness and Other Communications Disorders (NIH NIDCD), approximately 20% of American adults aged 20 to 69 (48 million) have some trouble with hearing and approximately 28.8 million could benefit from the use of hearing aids. Among adults aged 70 and older with hearing loss who could benefit from hearing aids, fewer than one in three has ever used them.

As the baby boomer population ages, more Americans are forced to face hearing health challenges. Growing numbers of younger Americans (including millennials and Gen Xers) are also reporting hearing problems. The NIH NIDCD also states that five in 10 young people listen to music or other audio too loudly and that four in 10 young people are around “dangerously loud noise during events like concerts and sports games.” 

Occupational noise is another factor impacting hearing in people of all ages who work outdoors, in factories, fulfillment centers, and in music.

Professional musicians are almost four times as likely to develop noise-induced hearing loss (NIHL) as the general public, and they are 57% more likely to develop tinnitus—incessant ringing in the ears—as a result of their job, according to a 2014 study published in British Medical Journal. NIHL can be caused by a sudden loud noise, such as an explosion or gunfire, but it may also develop gradually as a result of repeated exposure to loud noise, according to the authors of the study. Over time, loud sound will irreparably damage the hair cells of the inner ear, which are sensory receptors responsible for sending sound to the brain.

Musicians need to remember to pay attention to their surrounding sound levels, not just during performances, but also during practices and rehearsals. Not only does every instrument have a different decibel level, but it is important to understand that certain instrumental sections tend to produce higher sound levels. Sometimes these levels relate to the piece of music being performed and to notational requirements (fortissimo); other times, these levels naturally resonate from the instrument. According to information from the Eastern Kentucky University School of Music, string sections tend to produce decibel levels on the lower end of the spectrum, while brass, percussion, and woodwind sections generally produce decibel levels at the higher end of the spectrum. It is important to be mindful of the overall volume of your instrument and of those around you.

Signs of hearing loss include:

•   Having to turn up the volume of the television, radio, or stereo and having other family members complain that the volume is too loud.

•   Difficulty understanding people speaking to you and asking people to repeat themselves.

•   Difficulty with phone conversations and understanding the other person.

•   Sudden inability to hear the doorbell, the dog barking, and other household sounds.

•   People telling you that you speak too loudly.

•   Ringing in the ears.

The American Academy of Audiology suggests that musicians, especially, should get a hearing test to establish baseline hearing levels because they are exposed to loud music on a regular or semi-regular basis. Ask to be tested on a range of 125 to 20,000 hertz, as the highest frequencies often show loss first. If you’ve had ringing in your ears, consider including a tinnitus assessment.

According to the Center for Hearing and Communication, continued exposure to noise above 85 dBA (adjusted decibels) over time will cause hearing loss. According to the National Institute for Occupational Safety and Health, the maximum exposure time at 85 dBA is eight hours. At 110 dBA, the maximum exposure time is one minute and 29 seconds.

Points of Reference measured
in dBA or decibels
Sound Levels of Music in dBA
(Courtesy of Eastern Kentucky
University School of Music)

0 Softest sound a person can hear   
with normal hearing
60-70 Normal piano practice
10 normal breathing70 Fortissimo singer (3 feet away)
30 soft whisper75-85 Chamber music, small hall
40 quiet office, library84-103 Fortissimo piano
60 normal conversation82-92 Violin
80 alarm clock85-111 Cello
110 shouting in ear95-112 Oboe
120 thunder92-103 Flute
125 pain begins90-106 Piccolo
140 firecracker (peak)85-114 Clarinet
90-106 French horn
85-114 Trombone
106 Tympani and bass drum
120-137 Symphonic music peak
120 Amplified rock (4-6 feet away)
150 Rock music peak
performance stress

Dealing Effectively with Performance Stress

Don Greene
Peak performance psychologist and author Don Greene, PhD.

by Don Greene, PhD

During my 35-year career as a peak performance psychologist, I have helped countless performing artists learn how to perform their best under pressure. My clients have won major auditions and competitions all over the world. I have never met a performing artist who has not felt some kind of performance stress. Whether they call it nerves, stage fright, or performance anxiety, the stress comes from fear—fear of how it will go, fear of how people perceive them, fear of not performing at a high enough level, and so on. My goal is to help performers break down this fear and to give them tools to combat it.

When musicians encounter highly stressful situations they tend to react instinctively. It does not matter whether something is really threatening their safety or if it is just a perceived threat (like an audition panel or an angry conductor). The perception of potential harm triggers the part of the brain known as the limbic system or emotional (not rational) mind.

If you are like my clients, you have felt yourself getting nervous at an audition or performance. Your limbic system responds to your nerves by releasing adrenaline into your bloodstream, which triggers physical changes. Within nanoseconds, the heart starts to race and respiration increases. You become very alert and your senses become extra sharp. You start to feel shaky as you scan your environment for danger. Your muscles tighten and you begin to sweat. Sensing the extra energy surging through your system, your mind goes into overdrive. You may begin obsessing about the potential results and feel things like dread, self-consciousness, self-criticism, loss of focus, and confusion.

If a real danger was present, you would be ready to fight for your life or run away at record speed. But for many musicians, the physical and mental changes caused by this flight/fight response deteriorate their normal performance skills. The goal is to learn to use this extra energy to your advantage.

There are several things you can do to prevent your nerves from progressing out of control. First, figure out what your most common symptoms of performance stress are: racing heart, shakiness, butterflies, perspiration, cold limbs, racing thoughts, dry mouth, or unfocused mind, for example. Then, start keeping track of your sleep, food, hydration, and preparation level before stressful performances. Adequate sleep helps quiet and focus the mind. Try to limit or eliminate caffeine, sugars, alcohol, and heavy meals. Proper hydration helps with dry mouth, jet lag, and adjusting to changes in climate for traveling performers. Feeling prepared always boosts confidence and, in turn, helps decrease performance stress symptoms.

Next, learn to accept that you may feel nervous. You can expect to feel a huge rush of energy before important performances or auditions. Instead of viewing adrenaline as a negative thing to overcome, you should use it to your advantage by channeling it into the music. The energy will allow you to deliver exciting, intensely focused, and powerful performances that can move audiences and sway audition panels. Start to practice performing with that extra energy.

Set up your instrument and music, then turn on a recording device in a room. Step out of the room and do something to get your heart rate up like jumping jacks or run a flight of stairs. When your heart is pounding, enter the room and pick up your instrument. Take a slow, deep breath and relax the muscles that are actively involved in your playing. Ignore your racing heart and focus on what you need to do. Shift to your right brain by hearing the first phrase just the way you would like it to sound. Then, without hesitation, let it fly with reckless abandon, riding the extra energy that you feel. Stop after the first few phrases and turn off the recording device. Do not listen to the recordings until you’ve completed the exercise five to seven times. By then, you’ll get the idea and be ready to listen to your progress. You will have practiced performing your best with at least some of the symptoms you feel when you are under real pressure.  

My centering method is another great tool to help channel the mental and physical effects of performance stress into powerful performances.

Author of Fight Your Fear and Win and Performance Success, Don Greene is the first sports psychologist to teach in a music conservatory. He has helped thousands of musicians win auditions and major competitions. Based in Los Angeles, he also works with clients remotely. Visit the website winningonstage.com for information about Greene and his online centering courses.


Fiber Is Key: Diverticulosis Requires Diet and Lifestyle Management

Diverticulosis is a condition in which small bulging pouches form in the lining of the digestive tract, usually in the lower part of the large intestine or sigmoid colon. Occasionally, one or more of the pouches become inflamed or infected—in which case it becomes diverticulitis, indicating an infection. An acute attack can cause severe abdominal pain, fever, nausea, and bowel irritability. Mild diverticulitis can be treated with rest, changes in diet, or antibiotics. Severe or recurring diverticulitis may require surgery. For musicians, whose careers revolve around tours, eating on the road, and sitting for long periods, diverticulosis requires vigilance.

In general, unless they have an attack, many people do not know they have diverticulosis. It is often detected incidentally, through routine colonoscopy. If this is the case, it’s important to know the symptoms of an episode, which include pain in your lower abdomen, tenderness, bloating, and cramps. If you have been diagnosed with diverticulosis, it’s advisable to enlist a gastroenterologist and see a dietitian for food recommendations.

An episode of diverticulitis may start out mild, but left untreated or unmanaged, it can escalate quickly. Subsequent episodes may become more severe. Fever is a clear indication of infection (diverticulitis), which can lead to more serious problems, such as peritonitis (caused by perforations in one or more diverticula); abscess in the abdomen; or obstruction (blockages of the intestine). 

During the active stage of the infection, physicians recommend eating a low-fiber diet and drinking plenty of water. Once the infection clears, and on the recommendation of your doctor, fiber should be back on the menu.

Uncomplicated Diverticulitis

See your doctor if you have any symptoms. If it’s a mild case, she or he is likely to recommend:

•   Antibiotics to treat infection, although new guidelines state that in very mild cases, they may not be needed.

•   A liquid diet for a few days while the bowel heals. Once symptoms improve, gradually add solid (though low-fiber) food to your diet.

•   An over-the-counter pain reliever, such as acetaminophen. This treatment is successful in most people with uncomplicated diverticulitis.

Management of Ongoing Diverticulosis

According to the American Society of Gastrointestinal Endoscopy (ASGE), diverticulosis affects half of everyone over 60 years of age in the US, though it’s rare in people under 40. As a person ages, the pouches (diverticula) in the digestive tract become more prominent. In addition, it is uncommon in certain parts of the world, such as Asia and Africa, where diets are high in fiber and rich in grains, fruits, and vegetables. For this reason, most health practitioners believe the condition is due, in part, to a diet low in fiber. A low-fiber diet leads to constipation, which increases pressure in the sigmoid colon. 


Vigorous exercise appears to help lower the risk of diverticulitis. A low-fiber diet, combined with a high intake of animal fat, will likely increase the risk. While it is recommended that we consume 20 to 35 grams of fiber daily, most people only get about half that amount.

Eating vegetables and whole grains is a starting point for managing diverticulosis. Drinking plenty of water helps the body capitalize on the fiber. Doctors often recommend supplemental fiber. There are plenty of on-the-go options as well. Fiber and protein bars can supplement for days on the road when you cannot work in proper meals or regular exercise.

General guidelines include minimal use of alcohol (which dehydrates), getting regular exercise, and maintaining a healthy weight. A sedentary lifestyle is a risk factor. Desk jobs and sitting for too long are generally unhealthy: stand up every hour—move around, stretch, take a short walk. Try to fit in moderate-to-vigorous exercise during the day, like a brisk walk or a run.

Adopt a High-Fiber Diet

The best sources of fiber are fruits, vegetables, legumes, and whole grains:

•   Beans, such as black beans, kidney beans

•   Brown and wild rice

•   Fruits, all kinds, fresh and dried, raw or cooked

•   Vegetables of all kinds, raw or cooked

•   Whole grain breads, cereals, and pasta


If you have received a diverticulosis diagnosis, your doctor may also recommend that you add the following to your daily diet:

Fiber supplements: to ensure adequate fiber intake and to prevent constipation

Probiotics: as a possible measure for preventing diverticulitis

Should you avoid nuts, popcorn, and seeds?

Historically, the advice for people with diverticulosis was to avoid nuts, popcorn, corn, seeds, and seeded fruits and vegetables for fear that seeds would become trapped in the diverticula, causing inflammation. This advice is no longer considered valid. In fact, these foods are a good source of fiber. Do your research and speak to your doctor about optimal fiber intake. Also, if you have been diagnosed with diverticulosis, consider talking with a dietitian about general food guidelines for management to prevent an attack of diverticulitis.

If you have symptoms of diverticulosis or diverticulitis, you should seek immediate treatment from your healthcare provider.