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On Wednesday, 9 December, I played an important concert with a 101 fever. By Friday, the fever was still high, so I went to the local ER. I was admitted immediately with a temp of 103.6 and a pulse-ox that nosedived when I engaged in simple mental tasks. On Saturday, 12 December, things got a bit worse when I went "Code Blue". All hell broke loose at that point, and I don't remember *anything* for more than a week from that point on.

I was on a respirator (two tubes) for more than a week (very interesting ICU psychosis), remained in ICU for another few days, and a more normal hospital room for a few more days.

On 23 December, I was sent home with O2 equipment, and very strict instructions to not go anywhere near a tuba until after my followup appointments (first one is scheduled for 13 January). I've been off the O2 for nearly a week, and everything gets a bit easier every day. Classes begin on Tuesday and I plan on showing up. We'll see if I can still talk for 50 minutes...

My question is: has anyone here come back from double pneumonia? Any hints on how to avoid problems (but still get back up to speed ASAP?) By the time I start back it will be after more than one month off ... and with still-suspect lungs.

Good news for tubists. My wife reports that I was not doing well on the respirator until she told the docs that I played the tuba. They had calculated tidal volume based on height and weight; when they found out I was a tubist they cranked up the volume by about 1/3 and I'm told I did much better. By that time, the only thing I was appreciating was the morphine drip.

I'm planning on being at TUSABTEC with my son the eupher (David), but I won't be bringing a tuba. My second followup (with the specialist) isn't until *after* TUSABTEC, and I'm planning on being a *very* good boy (at least until then)! For those of you who know me, this will be your chance to see me without the long beard. it had to come off to put in a central line (or 3) and the beard is now less than one month old.

Ken,
Short of the ventilator, I went through the same thing 4 years ago. Like you, my 6-1/2 vital lung capacity helped. Sorry to say, it still feels like I am catching a cold every day of my life. If I get behind on sleep and over stressed, I cough up green stuff the next day. I hope you fair better in that regard.
Some things that helped:
1) Change all the air filters in the house with the expensive ones that have a MERV of 11 or better.
2) Wipe down everything with Lysol.
2a) Fresh pillow case every day or two.
3) For now, take the tubas into the Shower stall and dump Isoprophl Alcohol through the leadpipe and out the main tuning slide. That will start killing whatever bug was in the horn. Wipe it down with Alcohol.

Until I got the filters and became OCD about cleaning and wiping everything, I wasn't getting much improvement.

3a) When you think you are about ready to play again, have the horn chemically cleaned out before you use it again. PLEASE WARN THE REPAIRMAN SO HE CAN WEAR A MASK!!
4) Take it easy. You won't get a big breath for about 6 months.

Get well.

Thanks for all the useful replies (and private messages).

The good news is that I'm feeling remarkably good, and regular work on the Airlife toy has me closing in on the "3000" mark (and it only goes to "4000")

I think that the doctors believe that playing the tuba 'stresses' the lungs, and they are also afraid of what might happen to my pulse-ox numbers. Interestingly, there seemed to be hard and fast rules about what oxygen levels were required to leave the hospital without O2, but my instructions for home use were "use it, unless you feel you don't need it - then don't use it; if you feel light headed or short of breath...use it again". I *almost* bought a pulse-ox meter from Amazon (about $200), but it turns out it would have arrived about the same day that I decided to go off the O2 on my own.

I'm going to make the case that long tones are just another way to fill and empty the lungs with deep breaths, and ask about the differences between rapid inhalation (usual while playing) and the slow inhalation typical of using the inspirometer.

I've been wondering - any truth to my suspiscion that playing during the early stages of the infection forced the infection deeper into my lungs (that is, am I paying dearly for that one last gig that I played with a temp of 101)?

sloan wrote:I'm going to make the case that long tones are just another way to fill and empty the lungs with deep breaths, and ask about the differences between rapid inhalation (usual while playing) and the slow inhalation typical of using the inspirometer.

I've been wondering - any truth to my suspiscion that playing during the early stages of the infection forced the infection deeper into my lungs (that is, am I paying dearly for that one last gig that I played with a temp of 101)?

Obviously, I'm no doctor, but I wonder if the temperature of the air makes a difference. When drawn in slowly, it gets warmed up to some extent by its slow passage through the mouth and trachea. But the rapid inhalation wouldn't warm it up at all. I don't think there's anything particularly wrong with the cold, but it might irritate already damaged lung tissues.

As for playing the tuba up to that last concert forcing a worsening condition, I rather doubt that it had as much effect as the general exertion and untreated invasion of bacteria, a colony of which was likely nicely stored in your mouthpiece and leadpipe.

Rick "whose lungs and throat are often sore after aerobic activity in cold weather" Denney

Get a pulse oximeter. You can wear it on your toe while you play to see what happens to it.

You'd be surprised at how low your pulse ox can go down to before you feel any physical signs.

If it dips below 85%, I'd recommend taking a break.

When your buzz gets more efficient, you won't need as much O2.

I'd say practice buzzing (on a mouthpiece that has been boiled and cleaned) for now. GL
farah

Maybe I'm naive or something. Surely, if any conditions were ripe for breeding germs, the inside of a tuba where it is dark and moist, would seem ideal. But, I was told years ago that germs and bacteria cannot survive in or on brass. So, I've always dismissed the idea that my horn could harbor germs and make me sick, or prolong an illness. The holiday season was busy for me playing-wise, and I've felt like crap for 6 weeks, on and off now. Should I consider having my tubas cleaned? Is there a doctor in the forum?

Yeah, germs can't survive on brass. But they can probably survive on the deposits that get into your horn, especially if the deposits have some carbohydrates in them.

Also, some bacteria can lie dormant and some can survive for more than 24 hours out of the human body. I am not a microbiologist or white suit guy at the CDC, but a good cleaning is always useful.

It seems to me that someone, especially the pro guys out there, could get a rough estimate on how many hours a horn should go without cleaning as opposed to the six-month or once-a-year deal. I'm willing to bet that you should clean the horn at least every 150-200 usage hours depending on your tooth-brushing habits. If you are an amateur that doesn't rack up those hours before the year mark, then you can default to the time interval.

To the original topic:

Also, on the deeper breathing affecting the penetration of the pneumonia into the lungs, I'm not too sure that follows. While you may breathe deeper than most, you also cycle in and out more fresh air than the average person, which should potentially help more than harm.

I wouldn't think that playing will hurt your lungs. There is little stress created by tuba playing, especially when compared to aerobic and some anaerobic (weightlifting comes to mind, with heavy stress loads) excercises. Every time I got a broncial infection, playing some nice long tones at the end of the illness period helped to rid my lungs of the last fluids. Take it very easy and you should be fine in the future.

Best of luck for a speedy recovery!

I'm an alternative medicine freak because it is the only thing that has worked for me, most of the time. I'm particularly wary of the after-effects of antibiotics; obviously if you have to take them to save your life, well, then you had to do that. (You didn't say if it was viral pneumonia or bacterial.)

Rather than trying to convince everyone of the benefits available outside the AMA, I'll direct you to one of my favorite educational websites, and if it intrigues you, you can take it from there:

www.primaldefense.net

MA, who thinks the idea of bleach solution down the leadpipe is a good one