Surgery with Music Series Post #19: How long will music continue to be helpful in recovery process?


 A reader has asked the question about how long after returning home from surgery will the headphones and music continue to help.  Great question!  The wonderful thing about music is that it always relaxes you and healing happens best and fastest when the body is relaxed.  Stress and anxiety cause every muscle in your body to tense up and it’s hard to heal when your body is full of tension.

That’s why putting the headphones on at least 30-45 before you are taken in to surgery is so important.  Here too, the more relaxed your body is, the less anesthesia and pain medication will be required to put you to sleep and keep you asleep comfortably.

After you return home you will find that it’s easy to add new music to the headphones or change all of the music completely.  You’ll be able to wear the headphones outdoors or indoors.  You could even travel with them and wear them on planes, trains and cruise ships, just like you would an iPod, but cordlessly.  These headphones are an investment that you’ll enjoy for years to come.

Thanks for all the questions people are sending me.  Keep them coming!


Surgery with Music Series Post #18: Do any hospitals have headphones waiting for patients?


This is my goal:  that every hospital, clinic and medical center in the world have the Surgical Serenity Headphones or some equivalent waiting and ready for their patients.  The research is there…music before, during and after surgery help the patients in ways that can be measured as well as in ways that can’t be measured.  The picture on the left was taken at the Cleveland Clinic in Florida just a few months ago.  I was flown in to give a Grand Rounds lecture to the entire staff of physicians and residents and they had double the usual crowd there.  Dr. Friedman, Chief of Surgery, said that everyone there is so enthusiastic about this and they hope to start a research study there in the next few months!  They already have some of the headphones that they are using.

The Cleveland Clinic in Ohio is using some right now as is the Mayo Clinic in Rochester, MN.  The VA hospital in Louisville, KY is doing a formal study on our Surgical Serenity Headphones and another hospital in Louisville is using them.  For the most part, they are currently being bought by individuals around the country, in Canada and in Western Europe. 

If you are having surgery soon, they can be shipped overnight to you!  Otherwise they arrive in 3-4 days.  If you are a surgeon, anesthesiologist or hospital staff or administration, please contact me for pricing information.  I want everyone to have these available for their patients and the reviews are excellent.


Surgery with Music Series Post #17: What music should you listen to during surgery?


When you’re about to have surgery, you really don’t have time to think about much else except preparing yourself for that process and the potential outcomes, good or bad.  The only possible exception to that might be cosmetic surgery where you have plenty of lead time and you feel sure that the outcome will be better that what you’re living with right now.

That’s why I think it’s nice to be able to have the music already pre-programmed on the cordless headphones.  Also, to know that the music has been chosen by an expert in music for surgery, so that the tempo, melodies, and character of the music is the ideal for surgery. 

What about the genre of music?  What about classical, jazz, pop, sacred, world music, or just easy listening?  I believe that any genre of music can be healing and can be soothing and comforting in the way that you want for surgery.  The fact is though, if you’re having general anesthesia, you won’t even hear the music once you’re completely under the anesthesia. 

So why have music playing while you’re under general anesthesia?  Good question!  And here is the answer:  the music that has been chosen for your surgery has a very slow, steady pulse that will entrain or synchronize your heart-beat and breathing with the tempo of the music.  This is done vibrationally and makes headphones the ideal way to transmit the vibrations through the 8th cranial nerve in the ear to the brain and throughout the entire body. 

One of the guiding principles of music therapy is that the patient should have the music of their choice, but this is not traditional music therapy because no music therapy is present.  The music has already been chosen and the genre right now is classical.  Eventually we will have jazz, folk, sacred and other genres available but people who don’t typically listen to classical music have listened to this soundtrack and said that it relaxed them quickly and totally. 

It’s all about a safer surgery procedure and a faster recovery.  Check them out at


Surgery with Music Series Post #16: Headphones vs Earbuds


If you’re to be going through surgery of any kind, or dental work, or chemotherapy or kidney dialysis, etc., then you need to understand the benefits of headphones vs earbuds.   Everyone’s ear is a little bit different externally and internally and there is just no one that one size and type of earbud can fit everyone.  On myself, earbuds constantly fall out.  I wore them at the fitness center for years and I was constantly needed to re-insert them because they had fallen out.

With headphones, not only do they gently cover the entire ear, but you can adjust the volume so that you can comfortably and effectively hear the music, but it’s enough to block external conversations that you don’t want to hear.  If the doctor does need to say something to you or ask you a question, he can move in toward you just a little bit and direct a question to you and you can easily hear him!

Not only that, but our headphones are cordless and so there’s nothing to get tangled up with medical or dental equipment!  Earbuds have a cord that hangs down and connects to you iPod or other MP3 music device.  When you weigh the pros and cons of each, I think you’ll want to use headphones.  Let me know your questions?


Surgery with Music Series Post #15: Talking with your Surgeon about Using Music


 Today many surgeons and anesthesiologists are aware of the benefits of music before, during and after the surgical procedure.  But occasionally, a patient comes to me or calls me saying that their surgeon doesn’t like the idea?  Why?  Usually because the surgeon has not read all of the latest research on the the many benefits that music brings to the situation.  Some surgeons don’t understand the concept of entrainment, whereby the vibration of the music causes your heart and breathing to slow down and synchronize with the music.  Even after your ears cease to hear the music through the headphones, the vibrations of this music cause your inner rhythms of heartbeat and music to synchronize with that tempo and all with the mood of the music which is peaceful and serene.   For that reason, it really doesn’t even matter if you like classical music or not because when you are deeply “asleep” under the anesthesia, you won’t even hear the music as music!

I’ve actually written a free report entitled “How to Talk with Your Doctor About Using Music with your Surgery.”  Just click on this link to get it for free!  Don’t miss out on this important step of the process!


Surgery with Music Series Post #14: Music with Dental Anesthesia


Music with Dental Anesthesia

Just yesterday we talked about the use of novocaine in dentistry.  Today we’ll take a look at the other main anesthesia used in dentistry:  Nitrous Oxide or “laughing gas.”  My main concern would be not whether or not it’s effective because I’ve had it and I know that it does work.  What you want to know is what the dangers or side-effects might be.  Here is some good information that I found on a site called “Just Say N2O”

“N2O, or Nitrous Oxide, also known as laughing gas, is a weak anaesthetic (painkilling) gas that was first synthesised in 1775 by Joseph Priestley. Of the three early anaesthetics discovered (chloroform, ether and nitrous oxide) it is the only one still in regular use. While insufficiently strong for surgery, it was ideal for the lesser pain of dentistry. Unfortunately, it became popular as a scientific demonstration for public edification (and entertainment). The public entertainment aspect reduced its respectability and although it was first used in dentistry in 1844, it was not until the 1860s that it became more commonly used. Many famous people are recorded as having tried nitrous oxide.

What Is Nitrous Used For?

Common uses of nitrous oxide include surgical, food service and recreational purposes. Many people have experienced nitrous as an anaesthetic for dental surgery. Nitrous oxide chargers are also used to make whipped cream. The dairy industry uses nitrous as a mixing and foaming agent as it is non-flammable, bacteriostatic (stops bacteria from growing) and leaves no taste or odour. Nitrous is sometimes used in auto racing to speed combustion. Nitrous is even used in diving to prepare divers for the nitrous-like effects of nitrogen narcosis. It is also a greenhouse gas emitted by fertilizer and implicated in global warming.

Is Nitrous Illegal?

Given its myriad uses, it is not illegal to sell or possess nitrous. However, in the State of California the possession of N2O with intent to inhale is a misdemeanor: this is probably true of most states. One internet merchant was sentenced to 15 months in prison for selling nitrous with devices intended to facilitate its inhalation. The following is taken from the CA penal code:

381b.  Any person who possesses nitrous oxide or any substance
containing nitrous oxide, with the intent to breathe, inhale, or
ingest for the purpose of causing a condition of intoxication,
elation, euphoria, dizziness, stupefaction, or dulling of the senses
or for the purpose of, in any manner, changing, distorting, or
disturbing the audio, visual, or mental processes, or who knowingly
and with the intent to do so is under the influence of nitrous oxide
or any material containing nitrous oxide is guilty of a misdemeanor.
This section shall not apply to any person who is under the
influence of nitrous oxide or any material containing nitrous oxide
pursuant to an administration for the purpose of medical, surgical,
or dental care by a person duly licensed to administer such an agent.

You should check your State’s Laws. When purchasing nitrous you implicitly agree to abide by the laws governing its use: the same as with gasoline, marker pens, white out, spray paint, ant poison, fabric softener, etc, etc, etc.

What Does Nitrous Do?

Physiological effects last a minute or two for a lungful of nitrous and then mainly dissipate. Some residual effects may last up to several minutes later. Unlike other drugs, the effects of nitrous very rapidly recede. As noted in 1845, “Those who inhale the Gas once, are always anxious to inhale it the second time.” When inhaled, nitrous produces a variety of physical effects including:

  • Disorientation (both spatial and time-based)
  • Fixated vision
  • Throbbing or pulsating auditory hallucinations
  • Similarly pulsating visual hallucinations
  • Increased pain threshold
  • Deeper mental connections
  • Lowered vocal pitch (opposite of helium)

What Are The Dangers?

The most common dangers from nitrous are due to its disorienting effects and the silliness that surrounds something called laughing gas. Tripping, falling or tipping over in a chair are very common. In one recorded case this caused death. The main cause of death from nitrous seems to be asphyxiation from a bag over the head. Frost bite from the very cold gas is also a concern, especially if dispensing when still disoriented.

Use common sense to avoid most problems.

Because nitrous permeates the lipid (fatty) membranes of your body, it can outgas into your gut or middle ear causing an ache. Cronic heavy usage has very unpleasant effects that could be permanent. Read more detailed dangers of nitrous use.

What Does Nitrous Feel Like?

After several deep breaths of air, I inhale nearly a lungful of nitrous and pull some air down on top and then hold my breath. Within seconds, a light tingling can be felt which seems to increase in frequency. The sensation is much as if waves were traveling up your body or as if you were twisting or spinning. Disorientation increases rapidly and the pulsing sounds/feelings increase, wrapping over one another. It is now, with eyes shut, that I enter a dreamlike state, where I am thinking out something and the external world has essentially ceased to exist. The urge to breathe takes over at some point and partial or whole breaths taken. Open eyes reveal some sort of tunnel vision, with regions of disorientation about the outside. Slowly the throbbing subsides. At other times I experience a sense of paranoia mixed with disorientation. I have a deep conviction while under the influence that all things are cycling together, that there is some deeper cyclical event occuring. It is as an experience of deja vu continually occuring. The feeling is profound and not altogether pleasant.

So how can music make a difference?  Well, what I have found after 25 years as a therapist dealing with addictions, any substance that makes a person feel better or puts them in an altered state, is subject to abuse.  I don’t think that nitrous oxide is not one of the top drugs to abuse, but it is true that dentists and anesthesiologists do sometimes become addicted because of easy access and a tendency to chemical addictions:

Abuse in the Medical and Dental Fields

There have also been cases of nitrous oxide abuse among healthcare professionals. Dentists and anesthesiologistsMedical doctors trained to use medications to sedate a surgery patient. with easy access to the drug seem to be at a higher risk than the general public of developing nitrous-related dependence problems. Dependence is the belief that a person needs to take a certain substance in order to function.

Substance abuse is also especially high among healthcare professionals who administer anesthesia in a hospital setting. According to the American Association of Nurse Anesthetists (AANA), about 15 percent of anesthesia providers are substance abusers. “Nurse anesthetists are dying … from accidental overdose or from suicide,” reported Carlos “Rusty” Ratliff in “Anesthetists in Recovery: Chemical Dependency in the Profession.” Like dentists, certified registered nurse anesthetists have large supplies of nitrous oxide readily available to them. Consequently, nitrous oxide is one of the drugs these professionals may end up abusing.

Dental Highs

In an article posted on the American Dental Association (ADA) Web site titled “Escaping Addiction: The Door to Freedom,” Dr. Thomas L. Haynes discusses the topic of addiction among dentists. “The access to large amounts of nitrous oxide,” noted Haynes, along with the stress and isolation of the profession, increases the risk of abuse. “Many a dentist has been found lifeless in the office,” he continued, “the N2O mask still strapped to the face.”

“Chemical Dependence in Anesthesiologists,” a document developed by the ASA TaskForce on Chemical Dependence, addresses the problem of drug abuse among anesthesiologists. Although addicted medical doctors typically become hooked on opioidsA substance created in a laboratory to mimic the effects of naturally occurring opiates such as heroin and morphine. such as fentanyl, nitrous oxide was mentioned by the ASA as another potential drug of abuse. (An entry on fentanyl is available in this encyclopedia.)

The main use of music here is to decrease the amount of nitrous oxide needed for something like a root canal or an extraction.  If you can use mainly your favorite calming music and no other anesthetic, that is ideal!  Good luck!


Surgery with Music Series Post #13: Music with Local Anesthesia


Local anesthesia involves injecting a numbing agent into a localized area. The area that will be affected by the surgery receives anesthesia to block pain sensation. Local anesthesia is only used during surgeries that are fairly minor and that only involve a small area of the body. In many cases, you will be able to remain awake and alert during the procedure. However, some surgeries require the use of sedation that will allow you to relax or even sleep through the surgery.  (source:

Probably, local anesthesia is the easiest medical/dental situation in which to use the Surgical Serenity Headphones.  The dentist particularly is a very unpopular place to go and not surprisingly.  Who wants to be laid on their back, machines put into your mouth and a man leaning into your mouth and drilling on you with that loud, insistent, painful sound?  (Not to be overly dramatic!)

On the other hand, dentistry was a leader, back in the 1950’s of what was called audio anesthesia.  My dentist in SC actually gave me hadphones in 1958 or so that had 7 different channels on them with 7 different types of music and one with “white noise.”  They were huge clunky things, but I remember liking them a lot!  Our headphones are super-light and yet they cover the ears enough to greatly muffle the sound of the drill.  Give them a try!


Surgery with Music Series Post #12: Music with Regional Anesthesia


Regional anesthesia is used in many, many surgical procedures and medical procedures.  The following description is taken from

and gives an excellent overview of various examples of regional anesthesia.

What is Regional Anesthesia?
Regional anesthesia is used when only one area of the body, like an arm or a leg, needs to be anesthetized in order to perform an operation. There are several types of regional anesthesia.

What are the different types of regional anesthesia?
• Spinal Anesthesia – Spinal anesthesia involves injecting a local anesthetic into the fluid
surrounding spinal nerves. Once injected, the medicine mixes with spinal fluid in the
lower back and numbs the nerves it contacts, effectively blocking sensation and pain.

Spinal anesthesia takes effect rapidly and is safe and effective for any surgery occurring
below the ribcage. It is especially effective for surgery on the lower abdomen and legs.

• Epidural Anesthesia – Epidural anesthesia involves the placement of a catheter into
a small space within the vertebral column just before the spinal fluid. Depending on the
nerves targeted, the epidural can be placed in various regions of the back from the neck
to the tailbone. Epidural medications can be given through this catheter to provide
numbness for the surgery, and also can be used to provide pain relief
in the post-operative period.

• Nerve Blocks – Your anesthesiologist can use a variety of nerve blocks to ensure
comfort throughout a surgical procedure. Often a group of nerves, called a plexus
or ganglion, that causes pain to a specific organ or body region can be blocked
with local anesthetics. Below are some of the most common nerve blocks and what
body parts they are associated with.
o Trigeminal nerve blocks (face)
o Ophthalmic nerve block (eyelids and scalp)
o Supraorbital nerve block (forehead)
o Maxillary nerve block (upper jaw)
o Sphenopalatine nerve block (nose and palate)
o Cervical epidural, thoracic epidural, and lumbar epidural block (neck and back)
o Cervical plexus block and cervical para-vertebral block (shoulder and upper neck)
o Brachial plexus block, elbow block, and wrist block (shoulder/arm/hand,
elbow, and wrist)
o Subarachnoid block and celiac plexus block (abdomen and pelvis)
• Intravenous Regional Anesthesia – Intravenous regional anesthesia is the process
of placing an IV catheter into a vein in your lower leg or arm so that the local anesthetic
can be administered. An important part of intravenous regional anesthesia is placing
a tourniquet above the area to ensure the medicine stays in the arm or leg that is being
anesthetized. Feeling will return to the area once the tourniquet is removed.

What are the most common procedures used with regional anesthesia?
Regional anesthesia can be used for many procedures, but the most common are orthopedic and obstetric procedures.

Are there side effects associated with regional anesthesia?
Patient safety is extremely important. Although anesthesia can carry some risks, major side effects or complications are uncommon. You can be assured that our physicians are extremely qualified to handle your anesthesia care. Southeast Anesthesiology Consultants regularly exceeds the national standards of care and safety. The specific risks of anesthesia vary with the particular procedure and the condition of the patient. You should ask your anesthesiologist about any risks that may be associated with your anesthesia.

What are some of the side effects of regional anesthesia?
Although uncommon, potential risks include:
• Swelling
• Infection at the injection site
• Systemic toxicity (rare)
• Heart or lung problems (rare)

How can music make a difference?   As with so many medical/surgical situations, one of the main things music through headphones will do is simply distract you.  But with headphones, they will also create a sonic cocoon around you that keeps other hospital and clinic sounds away from your ears.  The fact that our headphones are programmed with music chosen specifically for surgery makes them ideal to calm you and regulate your heart-rate and breathing with musical entrainment!  Post any questions you might have here as a comment!


Surgery with Music Series Post #11: Music with General Anesthesia


  According to a recent article in Scientific American,   people who are being “put to sleep” with general anesthesia are really being put into a temporary a (usually) reversible coma!  I think for the average surgical patient, this sounds a little scarier.  Again, if you can reduce the amount of anesthesia that you need by having slow, steady music played for you through headphones, why not do it?

Patients undergoing significant operations, such as major cardiac or transplant surgery, typically require general anesthesia. But putting patients to “sleep” might not be the best way to describe the process, argued the authors of a new review paper, published in the December 30 issue of the New England Journal of Medicine.

What anesthesiologists are really doing is closer to putting patients—close to 60,000 each day in the U.S.—into a drug-induced coma. “It’s a reversible coma, but it’s nevertheless a coma,” says Emery Brown, a professor of anesthesiology at Harvard Medical School and coauthor of the paper.

General anesthesia before major surgery dips brain activity (as measured by electroencephalogram, or EEG) down to levels akin to brain-stem death. For the most part, Brown has found that anesthesiologists talk about the process in colloquial terms, telling patients they will be “asleep,” rather than “unconscious”—likely in an effort to not make a medical ordeal any scarier than it already needs to be.

That approach is doing both patients and scientists a disservice, he argues.

“It would be nice if your anesthesiologist could explain where drugs are going to be working,” Brown says. Many clinicians, however, might be hard pressed to offer detailed neurological explanations for how each compound they administer is working on the nervous system. They are more likely to think of it in terms of

“we turn the knob and they go to sleep,” says Michael Alkire, an associate professor of anesthesiology at the University of California, Irvine, who was not involved in the new paper.

Inducing a coma-like state does require careful monitoring, breathing and temperature support as well as a delicate balance of “hypnotic agents, inhalational agents, opioids, muscle relaxants, sedatives and cardiovascular drugs,” Brown and his colleagues noted in their paper.

The mechanisms behind this concoction, carefully devised though it might be, are not always well comprehended. Long thought of as a “black box,” anesthesia now “can be explained and understood—it’s not a mystery,” Brown says. And researchers can further help to clear the field’s fog by expanding the field of anesthesiology to collaborations with experts in other fields, such as sleep and coma research.

Although anesthesiology and research on sleep and coma generally carry on independently of one another, “there’s a way to think about them all in the same framework,” Brown explains. And that common frame should be neuroscience, he says.

Alkire agrees that the coma model “is more appropriate,” and that “shifting toward that view is going to be helpful” in moving the field forward. And bringing the disparate fields, including researchers from sleep and coma work, together makes sense because “it’s all the same fundamental neuroanatomy.”

A push for more detailed neuroscience in the field might also help drive research toward new, more effective methods. Diethyl ether was a revolutionary tool in the 19th century that could knock people out before surgery, but it had some unpleasant side effects. “Now we need nuance” and more targeted tools like those cropping up in other areas of medicine, such as cancer treatment and screening, Brown notes.
Anesthesia, Alkire says, “is still kind of on the level of ‘we have a big hammer, and we hit you on the head, and you get knocked out.'” He and his colleagues have been working to find more “regional brain anesthesia that would change the state of consciousness,” he explains. “I think we have a ways to go” he says but notes that they have had some promising leads by zeroing in on the thalamus in animal studies. But even if clinicians might not yet have more delicate tools to dip patients into surgery-ready unconsciousness, Alkire notes, “understanding how it works puts you in a position to do better anesthetics eventually—if not with the agents you have right now.”

And taking a deeper look at how drugs are working during anesthesia might also yield helpful models for different neurological disorders, Brown says, noting the similarities between EEGs in patients under general anesthesia and those in comas.

On the more mundane front, advances in anesthesiology might also help with treatments for insomnia—but not in the ways one might think.

Traditional treatments often work on the same mechanisms as the drugs given to anesthetize patients before surgery, thus helping people conk out, but not necessarily replicating normal sleep patterns. By taking a closer look at the mechanisms at work during general anesthesia—and how some of the more widely prescribed sleeping meds behave in the brain—”we can ask ‘is that the way we want to

[treat insomnia]?'” Brown explains.

And those advances in turn could feed back into the field of anesthesiology, helping to reduce side effects of general anesthesia, such as postoperative cognitive decline. Better understanding of the coma-like state of general anesthesia could also shed light on patients who are in a more permanent vegetative state, who upon waking go through very similar stages as those coming up from general anesthesia—albeit much more slowly. The key, says Brown, is “taking time to understand these mechanisms” and applying them to fine tune the proverbial hammer—a challenge that he and his colleagues hope to announce progress on in the coming months. (here ends the article from Scientific American.)

There is ample evidence that music before surgery calms and relaxes the patient, necessitating less anxiety medication and music after surgery, into the recovery room and on into the patient’s room, decreases the amount of pain medication the patient requires.  If you are a loved are having surgery please visit


Surgery with Music Series Post #10: How does music affect other medication requirements


 This is such a simple concept, and yet, very few hospitals or sugery centers implement therapeutic music.  There are many, many studies that document that music pre- and post-surgery can decrease the use of  anxiety medications before and pain medication afterwards.  Studies have been conducted on major hospitals and universities all over the world.  As recently as April 1, 2011 I presented a Grand Rounds at Cleveland Clinic Florida that went over the top studies for music before, during and after surgery.  To see highlights of this, click HERE.

How does it work?  Before surgery, when you put on the headphones, the music enters your brain through the 8th cranial nerve.  Within moments, you close your eyes and your heartrate and breathing begin to slow down and become steady.  You begin to relax, naturally, and the need for I.V. anxiety medication greatly reduces.  After surgery, the headphones are again used as you move into the recovery area and your body stays relaxed as you come out from under the anesthesia. 

The recovery room is known for it’s busy-ness and (often) lack of peace and quiet.  In today’s crowded hospitals, nurses are trying to take care of many patients at the same time and those without music are often moaning and crying out.  Those with the headphones are not only staying relaxed, but the headphones help block out other patients cries and sounds of pain and discomfort.

Some hospitals have tried having CD players at bedside, but that doesn’t work nearly as well as the pre=programmed headphones.  A recent patient wrote this to me:

  • I kept expecting to be nervous  as the date of surgery rolled around but couldn’t seem to summon up any anxiety
  • My blood pressure has dropped to normal limits
  • I “knew ” I wouldn’t be able to sleep prior to surgery but guess what I slept well
  • I was calm and relaxed before surgery
  • The dentist and staff tucked me in, made sure I had my music (I had my i POD set to repeat ) and away we went.
  • Post -op I was still relaxed – had a sleep and had little pain- I had a bunch of work done – I did take an Advil at bedtime just for “insurance” but really didn’t need it.
  • My mouth is healing beautifull

Thank you for the wonderful music.

Blessings, Anne

If you have any questions at all, please don’t hesitate to leave them as comments on this blog and I will get right back to you!

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