Sliding hiatal hernias and the piob mor

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By David V. Kennedy

piper blowing
Blowing strong reeds? You may be at risk of developing herniation.

Shortly after some recent surgery and during the course of post-surgical examinations, the physicians discovered that I had a sliding hiatal hernia. This could have been possibly the result of the surgical techniques now commonly used by neuro-surgeons for cervical vertebrae fusions; but there is really no hard evidence that it was, because many people have slight sliding hernias and don’t know about them until old age starts to creep up on them.

The relevant question in this essay is: Will such hernias interfere with or prevent a piper from continuing to blow up his pipe? I can answer this question only by personal experience of two persons who have suffered from the infirmity: me and a young lady ex-student of mine. In her case, she needed a very responsive chanter with an easy reed in it; a tight bag; and drone reeds which were not ‘open’. Fortunately, I was able to set up her pipe so that she could continue as a piper; but occasionally she did complain that after a while of blowing, the hernia did bother her. (There is now a medicine that is specific for relaxation of the incompetent hernial ring i.e. metoclopramide, but she was unaware of it).

In my own case, the hernia does not act up unless I blow a strong reed or unless I have a very elastic bag. However, this is not the way I set up my own pipe, so I have no trouble in playing for over an hour with a medium strength chanter reed and appropriately bridled drone reeds.

It should be obvious that playing a pipe with a hiatal hernia is not to be done immediately after eating a meal or when one is tired, irrespective of the fact that metoclopramide has been taken before eating a meal.

A second question inevitably may arise: Was the hiatal hernia the result of blowing fairly strong reeds over a long period prior to surgery? I shall have to leave the answer to this to practicing gastro-intestinal specialists, who no doubt will raise the issue of genetic weaknesses in the individual; but from my viewpoint of looking in from the outside, as it were, I should say that there is an excellent possibility of developing such a herniation from blowing strong chanter reeds. In my own case again, the only other possibility is that when the oesophagus and trachea were retracted during surgery, the posterior end of the oesophagus was pulled through the diaphragmatic incompetent ring, which in turn had been weakened by 20 years of blowing reeds too strong for it.

But I really am tempted to reject this idea without having a physician to back up the idea.

In conclusion, pipers who think that they have sliding hiatal hernias should check with their physicians to determine how serious is the weakness; and if the diagnosis is not that serious the pipers should adjust their blowing and their pipes to their physical abilities to perform without incurring discomfort.

• From the May 1986 Piping Times.