Alice Cash, PhD, LCSW

Music with Surgery:  A Patient's Guide

     Some of the most exciting research in music medicine today centers on the concept that patients who are listening to music of a certain type, through headphones, while they are being put to sleep, and during surgery, need up to 50% less anesthesia during the surgery! This is a wonderful awareness because one of the primary things people must recover from during surgery is the anesthesia. Recently, I have been receiving more and more requests from patients to help them make tapes of appropriate music for themselves to listen to before during and after their surgery. So far I have created tapes for patients undergoing back surgery, heart bypass surgery, complete hysterectomies, and numerous small out-patient procedures.

      Lately, there has been quite a bit in the professional literature as well as the popular literature about the value of using music with surgery. As a result, I have received dozens of inquiries as well as requests from people locally and out-of-state to help them create their own tapes for upcoming surgeries. The research is clear: listening to carefully selected music, through headphones before, during and after your surgical procedure results in less anxiety medication before the procedure, less anesthesia during the procedure, and less pain medication afterwards! Who wouldn't want to try this? The only prerequisite is a little advance notice so that you can carefully choose the music that you want to listen to and also have time to clear this with your surgeon and your anesthesiologist. So far, the patients that I have worked with have had no problems when they had time to explain their reasons to their surgeons.

      What about the surgeon listening to music? No problem. It is actually very desirable for the surgeon to listen to music too. The surgeon needs to keep his energy level up and most people accept that music keeps the energy flowing and the blood pumping. Unfortunately, the music that the surgeon needs is the very opposite of what the patient needs, but there is no reason that they can't both have their own music. The surgeon can listen to her music through speakers or a boom box. The patient definitely needs to have headphones. Not only does that block out the operating room sounds that could be potentially disconcerting, but also, when listening through headphones, the music enters the brain directly through the eighth cranial nerve and can instantly entrain the heart, the breathing and calm the mind and the body.

      Many people believe that when the body is "asleep" there's no point in having music playing in your ears and yet we know that for years people have been reporting things that they heard surgeons and nurses say when they were supposedly "asleep." Things that they would just as soon not have heard! Studies have shown that the music one listens to during surgery needs to be purely instrumental so that the brain does not have to "process" lyrics. The music should ideally be the tempo of the healthy resting heartbeat. That is 60-80 beats per minute. The genre of music doesn't matter so much although the slow movements of Baroque suites seem to be particularly well-suited.

     You want to choose music that has a simple texture and is not too complex, nor too loud. Some people like to listen to classical music; some like to listen to instrumental versions of hymns. My mother, a minister's wife said "Alice, please just don't play 'Nearer My God to Thee.'" Having a feeling of control over some part of the procedure is part of the benefit.

      For the pre-surgery tape, you'd want to choose music that is comforting, favorite music of yours. It can be songs, piano music, holiday music, whatever makes you feel good and safe. Probably not too lively as you're trying to calm yourself before surgery, but it definitely can have lyrics.

      When you come out of surgery, you can have a family member or friend ready to put in your recovery room tape. This will be something that you have chosen specifically to let you know that, though in a fog of sorts, the surgery is over, and you made it through and are getting ready to recover. Something upbeat is in order though you want to get there gradually. I wouldn't launch into a brass band rendition of "Happy Days are Here Again," but perhaps "Here Comes the Sun" or "Morning Has Broken."

     The important thing for the recovery room tape is that it be music that you have carefully chosen to let you know as you emerge from the fog of anesthesia that you are indeed back to life, you survived and are now listening to the familiar, comforting sounds of the music that you have specially chosen. Recently, one of my patients chose to listen to Charlotte Church's "Voice of an Angel" both before and after surgery and she said that it was so wonderful both at comforting her, and also blocking out the sounds of the nurses talking and shuffling papers that she couldn't imagine ever having surgery again without her music and her Walkman.

      The prospect of surgery is scary. Anything at all that we can do to help ourselves and our patients we need to do. Music is so simple. Let's not forget about it!

Alice Cash, PhD, LCSW

Dr. Alice Cash is one of the world's few clinical musicologists. After earning degrees in piano performance and teaching in multiple universities and colleges, Dr. Cash decided to go deeper and begin helping people in all walks of life to use music for healing purposes. After earning her Ph.D. in musicology and then getting a Master's degree in clinical social work, Dr. Cash began Healing Music Enterprises. She was also doing research at the University School of Medicine in music healing and garnered a national reputation for her research, appearing on the "Today Show," "NBC Nightly News" "Feelin' Great" and many other national shows.

Alice has also appeared numerous times in NPR and been interviewed by radio shows around the world. In October of 2008, Dr. Cash received a U.S. Patent on her "Music for Surgery Wireless Headphones." These headphones are now in use across the U.S. and will soon be distributed to France and England. Dr. Cash's passion now is helping people to prepare their bodies and minds for surgery with the use of music, thereby reducing the amount of anesthesia, pain medication and anxiety medication required.

Dr. Cash also has an international speaking career and speaks on the healing powers of music with pregnancy and preemies, Alzheimer's patients, surgery patients, recovering addicts and music through the lifespan. She customizes each and every presentation to the audiences' needs and does keynote speeches as well as half-day and full-day seminars for healthcare professionals, caregivers and families. To learn more about Dr. Cash, purchase her headphones or have her speak at your next event, visit her website, www.HealingMusicEnterprises.com. Your audience will thank you!