Playing a Harmonica: A Breathing Exercise for COPD

Benefits of Playing a Harmonica 

Dear Dr. Mahler:

I recently read about a pulmonary rehab program that includes playing music on a harmonica in addition to usual exercises. What are your thoughts? I haven’t tried it, but it sounds like fun.

Claudia from Jackson, MS

Dear Claudia,

I found several stories on the internet about the benefits of playing a harmonica for those with COPD.

Woman with COPD playing a harmonica

Woman with COPD playing a harmonica while breathing oxygen

There were several stories about how patients with COPD enjoyed the harmonica and found it made their breathing easier.  These anecdotes came from pulmonary rehabilitation programs at hospitals in Mountain View, CA, Austin, TX, Jacksonville, FL, and Chicago, IL. A group of patients with COPD in Colorado found their own musical group which they call the Harmonicats.

The COPD Foundation lists the following benefits of Harmonicas for Health program.

♦ Learn better control of breathing

♦ Exercise the muscles that help to breathe in and breath out

♦ Strengthen abdominal muscles for a more effective cough

♦ Relieve stress

♦ Socialize with others and have fun

One individual with COPD commented, “While I am playing the harmonica, I am enjoying it and not thinking about my breathing. I have found that playing different tunes has gradually improved my breathing capacity.

I also searched for studies evaluating the use of harmonicas in patients with COPD on PubMed. There is one study published in the July-August 2012 issue of the journal Rehabilitation Nursing (volume 37; pages 207-212) that compared usual pulmonary rehabilitation (16 subjects) with the same program plus harmonica playing (9 subjects practiced 5 – 20 minutes, twice a day, for 5 days per week). The authors found no differences in functional or psychosocial outcomes between the two groups enrolled in pulmonary rehabilitation.

Claudia – despite the findings of this one study, you might consider trying a harmonica. Remember, it is one of the few musical instruments that is played breathing both in and out.  It is likely to help with better control of your breathing. Let me know how it goes if you decide to give it a try.

Sincerely,

Donald A. Mahler, M.D.

Can Depression Affect my Breathing and COPD?

Depression Occurs in 25% of those with COPD

Dear Dr. Mahler:

I wanted to know your thoughts on whether depression can affect my breathing. I am 57 years old and have had COPD for about 3 years. I seem to be tired all of the time and get short of breath with little activity. I was treated for depression when I was in my 20s, but have been fine until about 3 months ago. I work as a teacher’s aide in a grade school in my town, and am now off for the summer. I quit smoking soon after I was told that I had COPD. I have an appointment with a nurse practioner in a few weeks. What do you think?

Karen from Tupper Lake, NY 

Dear Karen:

I encourage you to discuss your concerns with your health care provider. Being tired and feeling short of breath may be due to various causes including a low red blood cell level (anemia), low thyroid function (hypothyroidism), another medical problem, and a psychological condition. I suspect that the nurse practioner will order tests to check for these possibilities.

Man with depression

Man with depression

Depression is considered a mood disorder caused by changes in chemicals within the brain. According to the World Health Organization, it is estimated that 21% of women and 12% of men in the U.S will experience an episode of depression at some point in their lifetime. Recent reports from the United Kingdom and from the U.S. found that about one in four (25%) of those diagnosed with COPD suffer from depression over a three year period.

The risk of an episode of depression is related more to how may episodes you have had in the past rather than life stresses. Your previous treatment in your 20s simply means an increase in risk for another episode. That is why is important that your health care provider do a complete evaluation of all possible causes of your symptoms.

Effects of depression

Effects of depression

This condition can affect your thoughts, emotions, behaviors, and overall physical health. Typical feelings are sadness, hopelessness, guilt, moodiness, and loss of interest in friends and family. You may find that it is hard to concentrate or make decisions. It is common to withdraw from others, use drugs or alcohol to “numb yourself” in order to temporarily feel better, and miss work or other commitments. Other symptoms are lack of energy and changes in appetite resulting in weight gain or weight loss.

Depression is usually diagnosed by excluding other medical conditions and by your answers to a questionnaire. Once again, tell you health care provider how you are feeling and that you were treated for depression in the past.

Best wishes,

Donald A. Mahler, M.D.

 

My Breathing is Worse… What Should I Do?

Breathing is Worse Requires Medical Assessment

Dear Dr. Mahler:

I am 72 years old and take Advair twice a day for my COPD. About 5 weeks ago my arm swelled up, and my primary care doctor thought it was due to an insect bite. She prescribed an antibiotic. When it did not get better, I saw my oncologist who diagnosed that the swelling was due to a blockage in my armpit because my previous breast cancer had spread to the lymph glands. I just completed 4 weeks of radiation treatments.

I am writing to you because my breathing has been worse for the past month or so. I went to the Emergency Room two weeks ago to be checked out. A CT scan was normal except for emphysema. There was no blood clot to my lungs. What should I do? I am using albuterol 2 -3 times per day, but it really doesn’t help much. I do take Ativan every couple of days because I have been feeling anxious.

Linda from Montpelier, VT

Dear Linda:

Sorry to hear about the cancer recurrence.

Regarding your shortness of breath, it is important to have breathing tests done and your oxygen saturation checked to see if these results show any changes. Without this information, it is impossible to know if your breathing is worse because of your COPD or another reason, such as anemia, anxiety, being out of shape (reduced physical activity while you were receiving your radiation treatments, and possible heart disease. All of these conditions are common causes for chronic breathing difficulty.

Oximeter which measures the percentage of oxygen being carried by hemoglobin in the blood

Oximeter which measures the percentage of oxygen being carried by hemoglobin in the blood

Spirometry performed to assess why Breathing is Worse

Woman performing breathing test.

 

 

 

 

 

 

Sincerely,
Donald A. Mahler, M.D.