Clinical Observations about Aging
In my medical work, it has become clear to me that aging of the body has its major impact on "function". Functional age is not always synonymous with chronological age. I frequently tell my patients "Your body has no way of knowing how many candles were on your last birthday cake; your body, however, on a daily, almost on a minute to minute basis, knows and feels what age you are operating at." I have frequently observed patients of exactly the same age, where one would be functioning at a very high physical level, running marathons, playing competitive sports, etc. while the other was virtually crippled, sitting on the couch, barely able to move around. The cause of this stark difference seems to have one common denominator: physical activity, and the resultant fitness achieved by being physically active. From the cardiac point of view, it is now accepted and proven that aerobic endurance exercise significantly improves cardiac function (25 - 27% in our data), reduces cardiac disease, and increases longevity. From the pulmonary point of view, it is generally accepted that those who use their lungs in a more extraordinary way (breath hold divers, horn players, opera singers, etc.) have "better lungs" and live longer. However, there has not been any established scientific data to confirm this and there has not previously been a method available to directly address the lungs. It became clear to me however, that aerobic endurance exercise, which is without question the main exercise required for cardiac benefit, does benefit the lungs, but doesn't totally address the needs of the lungs.
Therapeutic Parameters
In my quest to find a method that might benefit the lungs, I determined three "needs" I felt would be important to address:
• Work the lungs above and below the "comfort zone". I define the comfort zone as the comfortable range of inspiration and expiration, where most of us function most of the time (approximately the middle 25 to 30% of the range).
• Strengthen the muscles of breathing (the intercostal muscles, the accessory muscles of respiration, and the diaphragm).
• Re-recruit dormant areas, if these exist in a given individual (it is known that as individuals age and become less active, they may develop areas of the lung that no longer adequately fill up with air). Evidence suggests that with appropriate "breathing exercises" these dormant areas can be re-recruited to hopefully function normally again.
I explored many mechanisms and devices to see how these objectives might be met and eventually came up with the harmonica as a respiratory tool. It had a number of advantages, including compact size, affordability, and the possibility of making pleasant sound and music. The most important advantage related to the fact that this tiny instrument made sound with both inhaling and exhaling. It is the only instrument in the world that makes sound with inhaling.
Early Observations
After a year of using the standard harmonica, playing single note melodies, the primary use of such a harmonica, I was disappointed in the lack of pulmonary "challenge" that I was observing and measuring. Switching to multiple note chordal playing, the pulmonary challenge was improved, however, some of the musicality was lost. The standard key of Charmonicas we were using provided only two chords and the somewhat high pitch and shrill sound, although adequate for melodies, was less than pleasing when playing chordal accompaniment. This led to the development and invention of the Diatonic Chord MedicalHarmonica, an instrument that is significantly lower pitched, providing deeper pleasant tone, while at the same time, providing the versatility of 8 chords.
The Challenge of Research Results
We have been making measurements on our patients relating to the strength of the muscles of breathing, both inspiratory and expiratory. I am getting quite a variation in results and this is undoubtedly due to the fact that there is such tremendous variability in what the patients are actually doing on a day-to-day basis with their harmonica. Some hardly touch it and others play as much as 30 to 60 minutes per day. So, unlike the pharmaceutical industry where patients are given a precise dose of a drug, with patients playing the harmonica, it is almost impossible to quantitate the “dose". I recently studied a patient who has been in the program for two years. I singled out his data as he seemed extremely diligent and consistent throughout the two years, performing the harmonicaexercises for 20-30 minutes, 6 to 7 days per week. At the end of the first year his expiratory muscle strength increased by 11.7% and the inspiratory muscle strength by 91.7%. In the second year the improvement continued and the expiratory muscle strength increased a further 6.7%, and inspiratory muscle strength increased a further 58.8%. Looking at his data, comparing his starting measurements to the present (a two year span) a surprisingly staggering improvement in respiratory muscle strength was noted, with the expiratory muscle strength increasing by 19.2% and the inspiratory muscle strength increasing by 204.5%. I find this to be a rather shocking result and I'm not sure how one translates this into prognostic implications. It is certainly accepted that the inspiratory muscle strength is more important then the expiratory muscle strength (inhaling definitely requires significant muscular activity, while exhaling largely can occur without muscle activity as the expanded chest naturally rebounds back to its resting position). The unexpected increase in the inspiratory muscle strength compared to the expiratory muscle strength is a mystery. Possibly day-to-day activities utilize expiratory muscles disproportionately then inspiratory muscles. For example expiratory muscles are used in talking, singing, laughing, blowing out candles, blowing up balloons, playing wind instruments, etc. Possibly the inspiratory muscles do not have similar daily strengthening activities, giving them a greater potential for improvement.
In my medical work, it has become clear to me that aging of the body has its major impact on "function". Functional age is not always synonymous with chronological age. I frequently tell my patients "Your body has no way of knowing how many candles were on your last birthday cake; your body, however, on a daily, almost on a minute to minute basis, knows and feels what age you are operating at." I have frequently observed patients of exactly the same age, where one would be functioning at a very high physical level, running marathons, playing competitive sports, etc. while the other was virtually crippled, sitting on the couch, barely able to move around. The cause of this stark difference seems to have one common denominator: physical activity, and the resultant fitness achieved by being physically active. From the cardiac point of view, it is now accepted and proven that aerobic endurance exercise significantly improves cardiac function (25 - 27% in our data), reduces cardiac disease, and increases longevity. From the pulmonary point of view, it is generally accepted that those who use their lungs in a more extraordinary way (breath hold divers, horn players, opera singers, etc.) have "better lungs" and live longer. However, there has not been any established scientific data to confirm this and there has not previously been a method available to directly address the lungs. It became clear to me however, that aerobic endurance exercise, which is without question the main exercise required for cardiac benefit, does benefit the lungs, but doesn't totally address the needs of the lungs.
Therapeutic Parameters
In my quest to find a method that might benefit the lungs, I determined three "needs" I felt would be important to address:
• Work the lungs above and below the "comfort zone". I define the comfort zone as the comfortable range of inspiration and expiration, where most of us function most of the time (approximately the middle 25 to 30% of the range).
• Strengthen the muscles of breathing (the intercostal muscles, the accessory muscles of respiration, and the diaphragm).
• Re-recruit dormant areas, if these exist in a given individual (it is known that as individuals age and become less active, they may develop areas of the lung that no longer adequately fill up with air). Evidence suggests that with appropriate "breathing exercises" these dormant areas can be re-recruited to hopefully function normally again.
I explored many mechanisms and devices to see how these objectives might be met and eventually came up with the harmonica as a respiratory tool. It had a number of advantages, including compact size, affordability, and the possibility of making pleasant sound and music. The most important advantage related to the fact that this tiny instrument made sound with both inhaling and exhaling. It is the only instrument in the world that makes sound with inhaling.
Early Observations
After a year of using the standard harmonica, playing single note melodies, the primary use of such a harmonica, I was disappointed in the lack of pulmonary "challenge" that I was observing and measuring. Switching to multiple note chordal playing, the pulmonary challenge was improved, however, some of the musicality was lost. The standard key of Charmonicas we were using provided only two chords and the somewhat high pitch and shrill sound, although adequate for melodies, was less than pleasing when playing chordal accompaniment. This led to the development and invention of the Diatonic Chord MedicalHarmonica, an instrument that is significantly lower pitched, providing deeper pleasant tone, while at the same time, providing the versatility of 8 chords.
The Challenge of Research Results
We have been making measurements on our patients relating to the strength of the muscles of breathing, both inspiratory and expiratory. I am getting quite a variation in results and this is undoubtedly due to the fact that there is such tremendous variability in what the patients are actually doing on a day-to-day basis with their harmonica. Some hardly touch it and others play as much as 30 to 60 minutes per day. So, unlike the pharmaceutical industry where patients are given a precise dose of a drug, with patients playing the harmonica, it is almost impossible to quantitate the “dose". I recently studied a patient who has been in the program for two years. I singled out his data as he seemed extremely diligent and consistent throughout the two years, performing the harmonicaexercises for 20-30 minutes, 6 to 7 days per week. At the end of the first year his expiratory muscle strength increased by 11.7% and the inspiratory muscle strength by 91.7%. In the second year the improvement continued and the expiratory muscle strength increased a further 6.7%, and inspiratory muscle strength increased a further 58.8%. Looking at his data, comparing his starting measurements to the present (a two year span) a surprisingly staggering improvement in respiratory muscle strength was noted, with the expiratory muscle strength increasing by 19.2% and the inspiratory muscle strength increasing by 204.5%. I find this to be a rather shocking result and I'm not sure how one translates this into prognostic implications. It is certainly accepted that the inspiratory muscle strength is more important then the expiratory muscle strength (inhaling definitely requires significant muscular activity, while exhaling largely can occur without muscle activity as the expanded chest naturally rebounds back to its resting position). The unexpected increase in the inspiratory muscle strength compared to the expiratory muscle strength is a mystery. Possibly day-to-day activities utilize expiratory muscles disproportionately then inspiratory muscles. For example expiratory muscles are used in talking, singing, laughing, blowing out candles, blowing up balloons, playing wind instruments, etc. Possibly the inspiratory muscles do not have similar daily strengthening activities, giving them a greater potential for improvement.
