Cold Sores from playing?

[tbn.al]

My bass trombone playing has been restricted as of late due to some ensemble changes. I don't get in but a couple of hours a week in addition to orchestra rehearsal. We have been slugging away at Tchaik 4, FFFF, for 2 1/2 hours each Monday night for the last 4 weeks. Every Tuesday morning I wake up with a honkin' fever blister. I'm playing tuba every day and that doesn't seen to affect it. I've never been in a position to blame playing for my fever blisters, which I've suffered off and on for 60 years, until now. The evidence is mounting. Any one else ever have or hear of this?

[djwesp]

My bass trombone playing has been restricted as of late due to some ensemble changes. I don't get in but a couple of hours a week in addition to orchestra rehearsal. We have been slugging away at Tchaik 4, FFFF, for 2 1/2 hours each Monday night for the last 4 weeks. Every Tuesday morning I wake up with a honkin' fever blister. I'm playing tuba every day and that doesn't seen to affect it. I've never been in a position to blame playing for my fever blisters, which I've suffered off and on for 60 years, until now. The evidence is mounting. Any one else ever have or hear of this?

I have this problem. BUT, only if I eat raw tomatoes.


I will get all kinds of sores, especially if putting a lot of pressure on the lips if I eat them.

[tbn.al]

Aren't you the same guy that was hacking Ben the other day? Thanks so much for the comments. I do so appreciate all the good advice I can get.

[sinfonian]

How is the plating on the rim of the MP you use on Mondays? Maybe you are having a reaction to the plating or the base material under the plating.

[Dr. Dave]

It sounds like the sores you're getting after playing (and have had most of your life) are Aphthous Ulcers, or what people commonly call a canker sore. IF the sore appears on the mucosa/tissue inside the lip, that's an Aphthous Ulcer and the likely cause is trauma/irritation to the tissue from the heavy playing session(s).

On the other hand, if the sore appears on the outside of your lip (and often appears/re-appears at the same place) that's a "cold sore" (or also called fever blister) caused by the Herpes Simplex 1 (HSV-1) virus.

I'm an Dentist and a tuba player, and am the Director of Education for Dental1.org, a consumer dental information website. Here is a link to a lot more info on Aphthous Ulcers, that I wrote on Dental1: http://www.dental1.org/edu_ctr/clinicaloverview.cfm/5

You can treat Aphthous Ulcers very effectively. Contact and/or visit your Dentist or Physician and ask them to write you a prescription for a topical corticosteroid called Triamcinolone Dental Paste 0.1% (also called Kenalog in Orabase). Apply a thin coating of the paste on the ulcer at least 4 times per day as soon as you feel the ulcer appear, and this should help the ulcer resolve in a matter of days. Apply the paste every day as needed (at least 4 times/day) until the ulcer disappears.

If the ulcers are due to HSV-1 you will need antiviral medicine to help resolve the "cold sore". The medicines prescribed for this are called Valtrex and Zovirax (you take one or the other, not both) and this needs to be taken at the first sign of the cold sore ("prodromal" symptoms such as itching, tingling or burning at the site where the cold sore will soon appear). Zovirax also comes in a topical ointment and some studies have shown that taking the antiviral pill and applying the antiviral ointment at the same time will heal the cold sore more quickly.

Unfortunately, we don't know exactly what causes Aphthous Ulcers, (they may be related to changes in immune system function) and they usually last a lifetime. They're really painful, but can be effectively treated with the right medicines. HSV-1, that causes cold sores, is a virus, that once acquired, resides with the person for life, as the virus "sits" or "hibernates" along a nerve, for example, a cutaneous nerve that supplies the lip. When something triggers the virus, the virus sheds to the skin where that nerve is located and the ulcer/sore apears.

While the ulcer/sore is healing, if it's still painful to play the horn or eat, etc, you can get a 20% benzocaine gel over the counter at your drugstore to apply to the sore to temporarily numb the pain, or your dentist or physician can give you a Rx for topical lidocaine.

Aphthous Ulcers are not contagious but cold sores caused by HSV-1 are. People who have an active cold sore need to know that they can transmit the HSV-1 to others (ie, infect others with the HSV-1 virus) if they come into contact with the sore. Common sense needs to be followed so as to not infect others with the virus.

Hope this helps and hope you get medicine/treatment that will resolve the ulcer/sore and let you play a lot more comfortably, especially since the ulcers will come back again.

Dave

Dr. David Rolf

[pulseczar]

Will playing while the sore's there make it worse?

[tbn.al]

I suspect that the intense vibration of 2+ hours of FFF playing is the trigger. I was really posting to find out if any one else out there has had similar experiences. No, playing doesn't make them worse. The main problem is it affects the efficiency of the embouchure.

[djwesp]

I suspect that the intense vibration of 2+ hours of FFF playing is the trigger. I was really posting to find out if any one else out there has had similar experiences. No, playing doesn't make them worse. The main problem is it affects the efficiency of the embouchure.

Are they where the actual sound is produced or where your mouthpiece meets your chops?


I wasn't dogging Ben, btw.

[Chuck(G)]

I've been plagued with canker sores most of my life and have found that using a mouth rinse of Chlorhexidine Gluconate (Periodex) speeds healing. Get it from your dentist. Don't overuse it--it can stain teeth.

[Mitch]

I use to get those much more frequently. My jaw is slightly misaligned, so on occasion I may bite the inside of my cheek or lip. There was a time when, without exception, no matter what I did (saltwater rinses, Listerine, etc.) it would turn into an ulcer. G-d forbid I bit it in such a way that there were two punctures; they would eventually morph from two ulcers into one really big one.

A couple years ago I was doing the Atkins thing. Looking at my weight gain, I saw my diet was really carb-heavy. Not from candy bars or soda, but too much pasta, bread, etc. I was on Atkins for about a month when I bit my cheek. No ulcer. I waited for it, but it never came. Ever since then, I've noticed a correlation between whether a puncture turned into an ulcer and how it related to my diet. If it turned into an ulcer, I changed my diet. The next time, no ulcer. As the good Dr. pointed out, nobody really knows why some people get them and some don't, but I figure it may somehow relate to body chemistry and whether your mouth is an environment favorable to the development of the ulcers. Experimenting with diet worked for me. Just a suggestion.

Unless it's due to HSV-1. In which case, refer back to Dr.'s post.

[Chuck(G)]

The good news is that as you get older, canker sore outbreaks tend to decrease in frequency and severity.

[tubatooter1940]

I play tuba bass and solos in a jazz-rock trio-along with some trumpet.
After four hours of high-energy music, my lips swell up and then develop zits on the outside in the area covered by the mouthpiece. I also am allergic to raw tomatoes.
I have been happily married to one lady for 45 years and I'd like to know what I did to catch herpes.
I switched to a lexan mouthpiece (Kelly 24AW) on tuba but still have a silver-over-brass Olds 3 in my trumpet.
I use Origins to burn the zits and dry the red out and apply hydrogen peroxide 3 times a day. I apply Bactroban Ointment (perscription) and A and D Diaper Rash Ointment (over-the-counter) to keep things moist and soft until healing occurs.
Problem is, us Creekers keep getting busier and healing time between gigs is getting too short. We have a tour of Parrot Head Club functions in Texas, Arkansas, and Missouri ( seven nights in a row) coming up soon. I'm gonna be a bloody mess coming home from that.
Help! help!
Dennis Gray
tubatooter1940
www.johnreno.com/

[Mark]

I ... develop zits on the outside in the area covered by the mouthpiece.

Try Bikini Zone on the zits. And yes, I'm serious.

[tbn.al]

[quote="tubatooter1940"] my lips swell up and then develop zits on the outside in the area covered by the mouthpiece.


If they are small blisters full of clear liquid then they are probably fever blisters (cold sores) and not zits. See your Dr. preferably while they are present. There are medications that can help. Most of the population of the world is carrying the herpes virus that causes cold sores, HSV-1, it just affects some folks more than others. At my age it is more troublsome than the genital variety because it affects my playing every day. The other kind would only mess me up a couple of times a year.

[SplatterTone]

I'd like to know what I did to catch herpes

No doubt from kissing the wrong toilet seats.

I got my first "cold sore" back when I was about 5 years old. And I know I wasn't smooching around on no girls back then (or toilet seats).

[tubatooter1940]

Try Bikini Zone on the zits. And yes, I'm serious.

I like the name. I know ladies can get some vicious fungi goin' under a bikini bottom. That A and D diaper rash goop probably smells a lot worse.

No doubt from kissing the wrong toilet seats.
"I toast all the kisses I've snatched and vice versa"
Thanks, pal. You're a lotta help.

"If they are small blisters full of clear liquid then they are probably fever blisters (cold sores) and not zits."
These have white heads like your basic teen-age pimple-poppin'up on me in my 60's.