Breath Cycle: A Singer's Perspective

In 2012, composer Gareth Williams and I conceived Breath Cycle, a new opera project for singers with cystic fibrosis. Cystic fibrosis is genetic, and though it affects many of the body’s systems, it most notably affects the lungs. As part of our work exploring the connection between voice and breath, Gareth and I have been very fortunate to write words and music for some incredibly inspiring singers.

A sketch by composer Gareth Williams.

Together with Scottish Opera and Gartnavel General Hospital's respiratory unit, the pilot project also explored the effect of learning classical singing techniques and breath control on the respiratory health of Breath Cycle participants.

Due to a high risk of infection, people with cystic fibrosis can't physically spend time together. With this in mind, most of the pilot project was developed and presented online. Voices were recorded individually and put together through video and sound editing.

In 2013, we worked with three cohorts of participants at Gartnavel Hospital in Glasgow, Scotland. Yvonne Hughes, one of the singers in the first cohort of Breath Cycle, recently gave a talk to music educationalists who attended Music Education Matters, an annual event held in Glasgow. She has graciously allowed me to share that speech in its entirety here. It beautifully discusses Breath Cycle from a participant’s perspective.

Her willingness to share her thoughts on the project, the challenges, and the benefits are something Gareth and I carry with us as we prepare to expand Breath Cycle’s scope from the original pilot project of 20 singers to around 300. Creating a community and improving quality of life remains at heart of this project and its artistic goals.

Yvonne Hughes' Breath Cycle Talk – Music Education Matters, the Arches, Glasgow City Centre on Friday, May 30, 2014

Thanks for inviting me along, and I am here to speak about my experience of the project to you. I have cystic fibrosis and was in the first of three groups of Breath Cycle participants last year. I am speaking from my own experiences and perspective.

My Cystic Fibrosis

As you have heard, cystic fibrosis affects lungs and digestive system, clogging them up with thick, sticky mucus, which over time causes infections that can lead to scarring and eventual decline in lung capacity...

I am SUPPOSED to do physiotherapy twice a day in order prevent mucus from causing problems. I am not so good at this...

As with any long-term condition, each day I take around 40 tablets that help prevent infections and digest all my food intake. I also now take what seems like a ton of inhalers, nebulised treatments, and physiotherapy devices all to keep my chest clear.

I keep reasonably healthy and try my best to look after myself, alcohol intake permitting. My current lung function sits around 30%. Capacity 1.13 litres. To compare, a healthy person would have around 80% and above.

Introduction to Breath Cycle

My introduction to Breath Cycle started at a fairly routine or dare I say boring CF clinic appointment when I was asked by my CF Consultant if I could sing. Well, it certainly wasn't a question I expected to be asked in amongst what colour my spit was that day, but a few things went through my head...oh aye, I am brilliant, oh my goodness no! And, why is he asking me that...?

When it was explained what Scottish Opera and the Breath Cycle team were trying to do—to see if singing can positively impact on a CFers lungs I had to give it more thought....

But could I learn to sing? And what did I know about opera? A thought went through my mind to leave it to the younger patients attending the service and say no, but something inside me was sparked so I agreed, by the end of clinic, to take part. And I can honestly say it was the highlight of my year last year, even topping my 40th birthday celebrations!

Reservations

Of course I had reservations about starting. Feeling self-conscious about myself, my age—was I making a fool of myself? Fears about letting go. I was also experiencing voice hoarseness so whether that would hinder my practice. What if I would sound too nasally, Scottish, even worse…Glaswegian during singing!! And finally, what would those luvvies from Scottish Opera think of us?

I can say that straight away most of those reservations went out of the window. Rachel, Marie Claire, Laura, Gareth and Rim were extremely kind and encouraging to us from the off and I cannot thank them enough for making us all feel comfortable.

My Breath Cycle Group and Cross Infection

As you have heard, the programme took place over 12 weeks with fortnightly lessons held not in the lovely Scottish Opera building but in my second home, Gartnavel Hospital. My group started on February 7 and seven or eight of us were carefully appointed a time slot, so we didn't come into contact with each other for cross infection purposes.

Cross infection is the reason people with CF can't meet and was the nucleus of Gareth and David’s idea. I carry bugs in my lungs, which another person with CF may not have, or vice versa. If I were to come into close contact with another CFer there is potential for us to infect each other with these harmful bugs. May I stress these bugs are not harmful to non-CF population.

So we begin. On day one, I made some notes to share with you here:
"In session for an hour. We have been given iPads! And after a quick demo on how to upload and email our practice videos, it was on to musicality testing with Rachel looking at beats, timing and note recognition. This was then followed by my first vocal coach session with Marie Claire. She gave me exercises for posture and opening up my chest. I have to focus on the core and practice the scales already on the iPad, once happy, record and email to her for feedback. Tips: relax shoulders, keep head steady and mouth open. Drink plenty of water. Practice, practice, practice!

At the start of the project after a grueling pre-study exercise tests, I was asked by Rachel if I would describe myself as a singer. My answer to that was a definite NO. But to my surprise I did practice most every day and, over time I could hear a difference in my voice as I played back my multitude of recordings.

I was really enjoying it.

Initially, in our closed Google+ group there was a distinct lack of participation as we were all reluctant to put ourselves practicing online, but later on a couple of us posted videos, myself included. It was great to see these other curiosities, with the same disease as me, practicing scales and singing their favourite songs. People I could never meet but could share this new experience with and enquire about their own CF.

Later on, my notes say…
"I submitted my first videos to vocal coach. The exercises are not too difficult and don't take up too much time. Feedback given: need to remember to keep my head straight as I have been lifting my head and neck, which puts a strain on my voice. With my partner away, I find it easy to sing loud and proud but it won't be the same when he gets home!"

Can I just mention to you that I spent a LOT of time driving around Glasgow in my car practicing my scales during this time!

Physio and Singing

The idea around learning to sing was to see if lung capacity could be improved and used as an aid to physio. I had to challenge myself to learn to get enough breath to help me sustain and hit high notes, so I made sure I practiced as much as I could. The Breath Cycle team had worked with our physiotherapist to carefully select breathing exercises and these were a big part of us strengthening both our core muscles as well as our voices.

The vocal coach had given us an exercise where we took a breath in and let it out on an S or a Z sound. I think, over time, I managed to get up to around 10 seconds with the breath I had which, for me, was a fantastic achievement

With physiotherapy, we breathe in via the nose to help expand our lungs. Then I use a controlled breathing technique, involving taking little breaths to larger breaths to let air into my lungs, circulate around and clear them out on a short huff breath, avoiding coughing.

With singing, every movement was done using the mouth. So I breathe in from the mouth, which was different, and make the sounds from there also. I learned to engage the core and use my diaphragm to control the air or sounds coming out. By doing this, I could reach high notes but also sustain them.

If I was to use my mouth for physio, it could negatively impact me as my throat may close up or catch which could make me cough, defeating the purpose.

My Songs

I learned to sing Charlie Chaplin's 'Smile' in the key of F. For the piece that was to be recorded—a duet—my partner was Veronica who has CF and we have never met. Our song was called Miles Apart, with the concept being that we were sisters who lived in different countries and would meet online each Sunday to sing together. The internet was being turned off, so the session would be our last conversation together.

Gareth used both our capabilities to compose the music. This was mine and Veronica's piece of music written just for us. I hope I did the song justice and thanks to Gareth and librettist David Brock for making it beautiful. Good melody with a tempo change further on, a few extremely high notes but overall a lovely, emotional and joyful song.

Benefits

I found the combination of physio and singing to work hand in hand. My chest needed to be clear to sing, so this meant me doing my physio before practice. And a benefit from the new techniques in engaging my core and diaphragm helped me control the breath and prevent coughing fits.

There were other benefits to participating... my self confidence improved, I kept well and felt more fulfilled through this time and I was really happy! I listened and read more about music, but more importantly this was a way to see other people with cystic fibrosis in a safe and supportive environment.

....but there was a surprising bonus also...my family were really interested in the study. Myself, my mum, aunt, sister and cousin would visit my grandma over this time and after a catch up would take great joy in hearing of the project. I played back videos to my grandma and to see tears of joy and laughter in her eyes was priceless. I'd never heard her really laugh before this, she was probably laughing at me, but I feel it brought us all closer as a family and she was absolutely delighted.

Legacy

When Breath Cycle ended, it was like a little light going in my life out, but opportunity still remained. When you have CF, your days are taken up with treatments, medication and therapies you cannot escape from. When Breath Cycle came along because of CF, it became, for a while, about us as people and not as patients.

For me this was about taking on this unique, exciting opportunity head (mouth?) on. This project has legs in the CF community and the ripple effect continues. Since ending, I have been invited to speak at events, been on radio and been contacted by an American opera singer with CF.

It has opened me up to more music, I am more interested in opera, having seen Don Pasquale and this summer looking forward to Madame Butterfly. I have a new CF support network and a better way of regarding myself. I haven't sang formally since Breath Cycle ended, but I now can call up my vocal coach for a lesson, if I choose to do so! Other participants have also joined choirs and regard themselves and their cystic fibrosis differently as a result of taking part. I continue to keep in contact with the Breath Cycle team.

So, to conclude and answer Rachel again, the question remains: Would you describe yourself as a singer?

To which I now can reply yes, I have learned how to sing and so much more.

To see me sing, please go to www.breathcycle.com/skype-opera.html