Hematoma!

[gregsundt]

Rats!! After 50 years of playing, now I get a hematoma in the middle of my lip? I was playing high, ff, accented. Anyone else ever get this? What's the recovery period/plan? And what in the world did I do wrong, in the first place?

[Doug Elliott]

That kind of playing is stressful to the lip, plus the air pressure required for loud and accented at that range causes a rise in blood pressure, plus you are probably using quite a bit of additional mouthpiece pressure on the attacks to seal against the sudden high air pressure.

The air pressure can cause other injuries too, like a hernia in the neck or neck puff. The rise in blood pressure is normal during exertion but can still be dangerous.

There are ways to play more efficiently.

Right now I would give it a couple of days to go through the natural healing process, and then play relatively normally but with much less volume and stress.

[gregsundt]

I don't suppose the daily Prednisone helps, either? Everything else bruises easier, but this is a first...

[Doug Elliott]

I'm not familiar with the side effects, but bruising easier is absolutely related...

[Doldom]

Do you regulary have medications like aspirin or anti-coagulant like clopidogrel?
If not, and having symptoms of easy bruising, it is not normal and you might have to check blood labs for abnormal hematologic condition.
For lip hematoma, I think most doctors would say conservative management will do and would recommend resting until complete resolution of hematoma.

[robcat2075]

Four weeks later... how did this turn out?
Are you back to playing as before?

[gregsundt]

The swelling abated within two days, and the blood resorbed within four. From an abundance of caution, I waited a week, then resumed gently. Still not 100%, and some things feel different (not as "automatic" as before). But there is no pain, and I expect the feel will come back. Meanwhile, my accompanist is adjusting her sense of dynamic levels.

[gregsundt]

Do you regulary have medications like aspirin or anti-coagulant like clopidogrel?

Just prednisone, 7 mg daily. I do bruise easily as a result. But this is a first.