Sore on lip, can't play

[timothy42b]

For some time now I've had a sore spot on the bottom edge of the lower lip where the rim hits. (I'm high placement.)

It looks/feels something like a pimple or blister. I'm not sure when it started but it seemed to get better when I played more alto and jhorn and worse with more time on my regular horn. If I spent a week on those two it mostly healed; after a week solely on the 42B it's now so bad I can't play at all. Any pressure is very painful.

I don't get cold sores, not since a kid. Chemical sensitivity to the mouthpiece, maybe? The one I play is ancient, and I'm not a mouthpiece collector so don't have many other choices. It's a 1971 Bach 4G. The alto is a DE 102 and that seems to not irritate as much. The jHorn has a plastic mouthpiece that sounds bad but with the rubber cup is fairly comfortable. Or all that could be pure coincidence.

I've been practicing about 2 hours a day and feel like I'm starting to make progress on some issues, so I hate to lay off, but no choice this morning.

Help! Any suggestions are welcome. I can place the mouthpiece low enough to miss the spot but that seems like a really bad idea. Couldn't find a Kelly locally, Amazon is sold out of 5G - I was thinking lexan might rule out the silver/brass sensitivity thought. Fingernail polish over the rim?

[hyperbolica]

Vitamin E on your lip, maybe some Aleve to dull the pain, DE lexan rim, Lance the sore - it might be an in grown rogue whisker, see if hydrogen peroxide cleans it out, visit a dermatologist, take up accordion temporarily... I don't necessarily recommend it, but you can just play through the pain - ignore it and just play, as a last resort in time of gigs.

[OneTon]

Any sore that has lingered as long as this should be seen by a general physician or dermatologist asap.

WWBW has Faxx 5G large shank mouthpieces for $34.99. Mouthpiece Express has Bach 4G and 5G mouthpieces in gold or silver plate, in stock.

I wash my mouthpiece in Dawn dish soap and water after every practice and rehearsal if possible and once a day if not. I keep each mouthpiece in the rubber/vinyl tuba mouthpiece cover with a paper towel on the rim location that I replace after I clean the mouthpiece. I go years without getting mouth sores.

I have found that I cannot eat uncooked green peppers without getting sores. I pick them out of salads at restaurants and don’t have them in my house. I can eat cooked stuffed green peppers without getting sores. No sore that I have had ever lasted more than three days.

See an MD asap. Check for food sensitivities. Keep the mouthpiece clean. Plating allergies are somewhat rare but you can try an alternate or fresh plating.

[timothy42b]

Good advice, and actually I have an MD appointment Friday.

My wife pointed out this morning my whole lower lip is swollen. That's not good, time to lay off a bit until I sort this out. Could be mouthpiece sensitivity, mechanical abrasion (I don't think the mouthpiece slides, but that doesn't mean it doesn't), totally unrelated, who knows. Meanwhile I have a broken toe on the left foot and a swollen right ankle from a tick bite. Means I'm balanced!

[BGuttman]

Swollen lip could be from the tick bite as well.

[OneTon]

Good luck with healing.

[Wilktone]

Good advice, and actually I have an MD appointment Friday.

Yes, do discuss this with your doctor. None of us (to my knowledge) are medical professionals and we are unqualified to offer you medical advice. No ethical medical professional would diagnose and prescribe treatment for something they didn't get a chance to examine anyway. Get it checked out.

If a serious medical issue is ruled out, then some time off to recover might be necessary. Also, catch a lesson from someone who can diagnose how you're playing and help you avoid a future injury. Doug Elliott is a good source, he's a moderator here, teaches lessons online, and is quite expert in this topic. If you want to go "slumming," I've started teaching online lessons too. There's some other folks I can recommend if you get stuck.

Dave

[BGuttman]

Actually, Dave, Tim is not far from Doug and could get the lesson in person.

[timothy42b]

While a lesson is always a good idea, the suggestion implies that I caused the injury by doing something wrong.

I probably do a lot of things wrong! But I've never had this kind of pain or swelling, and not sure what I could do that would have this effect. I maybe practice a lot for an amateur, but I pace myself, don't play to exhaustion, keep the pressure as steady as possible on a firm lower lip.

Could be age related too, coming up on 70.

I skipped playing yesterday, first time in years unless traveling, and won't play today. In fact, I'm drinking my coffee with a straw this morning, as it hurts too much to touch a cup to the lip.

I've been practicing a lot because I got totally frustrated with my playing around Christmas, enough trouble starting notes cleanly in the staff that I seriously thought about quitting. I took 3 lessons and increased my practice to see what could be done.

[Doug Elliott]

To me it sounds like an allergic reaction and/or related to the tick bite. I would try benadryl if you can afford to be sleepy for a while.

[Wilktone]

While a lesson is always a good idea, the suggestion implies that I caused the injury by doing something wrong.

I haven't watched you play or gotten enough information to know one way or the other, but it's certainly a possibility that I feel should be considered. Especially considering...

've been practicing a lot because I got totally frustrated with my playing around Christmas, enough trouble starting notes cleanly in the staff that I seriously thought about quitting. I took 3 lessons and increased my practice to see what could be done.

So back in December you were having some troubles. You took some lessons and increased your practice. Did you ever get your issues with clean attacks solved? What was the cause? Are you sure you didn't cover up the results in some way but ended up getting better at playing wrong?

Honestly, I dunno. But again, you're asking for medical advice in a trombone forum. I'm not qualified to offer medical advice, just trombone advice, so that's all I can offer. Do get your doctor to check it out, it's obviously affecting your quality of life.

Dave

[timothy42b]

Update.

Tick bite first. Doctor said it's a judgement call, I don't have the classic Lyme rash but I had a little more than is usual; in the end we decided on a course of Doxy. There is a Lyme test but it wouldn't show this early and it's not super accurate.

The lip lesion (that's what he calls it). That one was a little harder to sort out. He says it doesn't look like a typical allergy or sensitivity, nor an ingrown hair or pimple; he says it looks more like mechanical trauma from the mouthpiece than anything else. Probably. Prescription is rest it for two weeks and use hydrocortizone cream, call him if it doesn't get better.

[CharlieB]

I am living with lifelong after-effects of Lyme disease because my doctors failed to recognize the seriousness of Lyme and act promptly and aggressively. The Lyme bacterium very quickly invades the entire nervous system and can cause otherwise unexplainable and sometimes permanent symptoms anywhere. If you suspect Lyme disease, prompt and aggressive treatment is essential. There is a very early point of no return after which treatment is ineffective. The tick bite that caused my Lyme disease did not exhibit the classic red circle symptom. It looked like like a standard tick bite, just as you describe yours. Not all doctors are Lyme doctors, so it's a good idea to find one who is............quickly.

[robcat2075]

mechanical trauma from the mouthpiece

After decades of playing, suddenly it's injuring you?

[Doug Elliott]

Tissue gets thinner as you age. It only takes a little more playing than usual, or something louder or more strenuous than usual.

But I know Tim and his playing, and I'm doubtful about that diagnosis. I totally agree with aggressively treating it as Lyme, with a doctor who knows how. Better to be safe than wait and see

[timothy42b]

mechanical trauma from the mouthpiece

After decades of playing, suddenly it's injuring you?

Yes, that's the weird part. Either something is different inside me or outside - or both of course. But if Lyme related it can't be this tick, because the lip lesion has been there a while, it just didn't interfere with playing as much. I agree take Lyme serious and I'll follow the whole 21 days he gave me.

I wish I'd been more disciplined about recording my playing. I found a short one from May 2 that shows every fault I had at Christmas only worse - tone that is exactly like a mute, bunched chin, and upper face fully tensed. And one from Aug 29 that doesn't show those but also sounds like I didn't shift enough to get cleanly down.

I have two guesses on what I might be doing different. One is that the mouthpiece has a rough edge, and the other is that in trying to shift into the trigger range I'm letting the mouthpiece move on the lip and rub. The evidence for that is by spending a week on alto and jHorn the lip improved. Different mouthpieces plus no attempt to play low. I think the progress I made, if real, came from attention to detail on Doug's basic stabilizer and track routines, combined with the mouth resonance he worked on in the last lesson.

The doctor says two weeks off. Well, we'll see, one for sure. <smiley> And that daily buzzing routine talked about in the other thread.

[cmcslide]

You haven't said anything about the condition of your normal mouthpiece. I imagine something like this might happen if the silver plating is wearing/worn off the rim? Some people might choose gold plated mouthpieces or lexan rims because they have an allergic reaction to the silver plate, I think... Just putting that out there as one other possible cause.

[timothy42b]

I don't think I have an allergic reaction. It's quite possible the old mouthpiece is rough enough to be abrasive and it's worth trying another when I play again. I don't have another 4 but I have Bach and King 5G's in the drawer. And I have a shiny new DE alto mouthpiece.

However I'm having second thoughts about the diagnosis. After 5 days of laying off and doing his recommended hydrocortizone topical treatment, the surface damage has cleared but a lump remains underneath. It now seems possible the lump was unrelated to playing, but caused point pressure on the mouthpiece contact point and subsequent surface damage. So somewhat grudgingly I'll follow doctor's advice for the full two weeks off and then return if that lump is still there. So far a little bit of buzzing each morning doesn't seem to be a problem.

[robcat2075]

Has an infection been ruled out? Like a pocket of puss that needs to be drained?