January 2009

Why I Will Use Inderal

January 23, 2009 19:57

I know, I know: its use is viewed with jaundiced eye by many professional musicians. Some consider that no musician worth his violin strings would even think of using it. After all, a professional musician should learn to deal with performance anxiety, right? Drugs like Inderal dull the edge of a performance and just show the weakness of the individual, don't they?

But I'm not talking about using Inderal to control performance anxiety. During the last year, tremors in my hands and fingers, especially my right hand, caused by multiple sclerosis, have gotten progressively worse, making playing all but impossible. At first it was just my right thumb. That posed a challenge for me in maintaining control of my bow, but it wasn't anything I couldn't handle. But over the course of the spring and summer, the tremors spread to the rest of my fingers. I asked my neurologist what I could do about it; she prescribed Gabapentin, a drug typically prescribed to control seizures. And she said if that didn't help I could try Lorazepam, a drug related to Valium. Neither of the drugs worked. The tremors continued to worsen; by the beginning of this year I couldn't play without my bow skipping horribly. In mid January I was asked to audition to play a wedding this coming summer. I almost cancelled. Feeling despondent as I faced the probability that I would no longer be able to play for weddings or for church, or at the nursing home, I prayed I would be able to perform well for the young couple who wanted me for their wedding.

The audition was, I thought, disastrous. My bow skipped horribly, and because I was concentrating so hard on just controlling my bow-arm, intonation and interpretation suffered terribly.

Inexplicably, the couple hired me.

On Monday of this week I saw my neurologist  and told her the drugs she'd presecribed four months ago were not helping. I had heard about a surgical procedure in which an electrode is placed deep into the hypothalamus in the brain to control tremors, and I was thinking of asking her about the procedure, even though it carries risks. But she told me that the Gabapentin was a newer drug, and that I should try the older "tried and true" drug, Inderal. She said to give it about three weeks to reach therapeutic levels in my blood, but tonight I had the best practice session I've had in months; my hand and fingers behaved, and Bach's Air and Handel's Sonata No. 4 in D Major rolled sweetly and smoothly from my fingers and my bow. For the first time in months I am encouraged rather than exhausted by a practice session and I don't feel that playing is a hopeless pipe-dream, and I am excited to be able to play well.

Now, after the setbacks of the past year I am a little leery of the possiblility that the tremors will worsen again, and I worry that I may develop a tolerance for Inderal that will require an increasing dosage. But the fact that I could play this evening and control my bow was a very encouraging sign.

Inderal: who'd a thunk it?

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