A program at Allegheny Health Network is working to help patients breathe easier through music: patients spend 10-12 weeks learning to play the harmonica because playing it can help increase lung capacity.
In its early stages, the Harmonicas for Health program is proving to be beneficial, said Kevin Nauer, manager of pulmonary rehabilitation for Allegheny Health Network.
Harmonicas for Health was created by a respiratory therapist working with chronic obstructive pulmonary disease (COPD) patients. The COPD Foundation owns the program and sells and trains other health care institutions on it. Allegheny Health Network secured grant money to purchase the program and use it for COPD patients enrolled in pulmonary rehabilitation.
“When you can’t breathe, it can be stressful,” said Becky Jordan, a respiratory therapist with Allegheny Health Network who was recently working with patients at West Penn Hospital in Bloomfield. “The more you try to catch your breath, the more stressful it can become.”
Shortness of breath is one of the most common reasons people go to a hospital. In the U.S., up to 4 million emergency room visits each year involve not being able to breathe properly, according to WebMD, an online medical information source.
Trying to eliminate or lessen the stress of not being able to breathe is the goal of the therapy, which teaches patients to use harmonicas to mimic pursed lip breathing. Pursed lip breathing is a technique where patients are taught controlled breathing through inhalation through their nose and slow exhalation through pursed lips.
Patients relax their neck and shoulders, and then breathe in through their nose, slowly counting to three. They pucker their lips as if they were going to whistle. Keeping that shape, they breathe out gently through their mouth, counting to five. It’s important to breathe out for longer than they breathe in and never hold their breath in between.
It is essentially exercise for the lungs.
The program began in March. Two members of the second group of patients, Sheila Muller and Itellia Dean, were in an afternoon session on April 4.
The sessions are twice a week. It was their fifth week practicing on a harmonica, which has been incorporated into their rehabilitation schedule that includes walking on a treadmill and other exercises.
“This therapy is working,” Jordan said. “When they first started, they would cough a lot. Now they can play a song and not cough at all. The more they practice, they better they get.”
Muller and Dean have been learning tunes such as “Jingle Bells,” “Happy Birthday,” “Row, Row, Row Your Boat,” “When the Saints Go Marching In,” “Camptown Races” and “Taps.”
Each week, the songs become more challenging as a way to extend their ability to take deeper breaths over time.
The plan is for the program to expand across Allegheny Health Network’s pulmonary rehabilitation sites and create a virtual program for patients, Nauer said.
There are various reasons for people to experience shortness of breath: when they exercise hard, have a cold, or are feeling stressed out. Medical conditions such as asthma, allergies, heart disease, long-term covid-19 and COPD can also affect a person’s ability to breathe.
Breathing exercises can help strengthen the diaphragm and other muscles patients need to force air in and out. Exercises may help them relax and slow their breathing rate.
The harmonicas also provide a social activity.
Playing music is fun, said Muller, who added it’s getting easier each week.
“And it’s more enjoyable than walking on a treadmill,” said Muller, who performed “Taps.” “I play songs for my grandchildren. I can walk up some steps now.”
Dean and Muller didn’t know each other before meeting at West Penn Hospital.
“Now, we are friends,” said Dean after playing “When the Saints Go Marching In.” “We support each other.”
They definitely do, said Jordan, who has kept in touch with the first group of patients she worked trained on the harmonicas. Learning a musical instrument is something they can do for life, Jordan said.
“There is so much value in this program,” Jordan said. “It’s been wonderful watching and listening to them. They become a family. They understand what the other COPD patients are going through. If you could see the progress they’ve made from the first week, it’s great.”
Participation in a pulmonary rehab program helps increase strength, manage shortness of breath and decrease anxiety and depression, Nauer said. Adding the harmonica aspect complements what the team at Allegheny Health Network is doing to help these patients improve their overall health.
Typically, a physician will refer a patient to pulmonary rehabilitation for a program followed by maintenance. Patients typically find it hard to continue with exercises on their own, Nauer and Jordan said.
The hope is that Harmonicas For Health will be a way to keep them engaged in breathing exercises such that they are able to maintain good breathing, stay out of the hospital due to shortness of breath and maintain a good quality of life.
It also isn’t a physical medication, but still can help a patient feel better.
“This is an important program,” Nauer said. “Even if they practice at home 10-15 minutes a day it can help. And there is no formal prior musical training required. If we can help keep people from having to go to the emergency room with this program, then that’s a huge benefit.”
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