Nandani Sinha the kind of lung capacity she needs to sing major roles on the opera stage. But it also gave her something she never could have predicted: a special kind of knowledge that can help patients who are suffering from poor lung function after their battle with COVID-19.Years of breath-control training gave mezzo-soprano
That is exactly was Sinha has been doing, with a special program that pairs post-COVID patients at the UCLA Health with teaching artists from LA Opera Connects.
"During the pandemic, I wasn't singing, and I wanted to be useful," Sinha told me in an interview in late September. "What could I do to help people who are suffering?"
Sinha and fellow LA Opera teaching artist Michelle Patzakis were tapped by Stacy Brightman, Vice President of LA Opera Connects, and music educator Rondi Charleston to help provide weekly opera classes via video conference for patients who had suffered severe COVID and needed to learn how to breathe all over again.
Both Sinha and Patzakis are also experienced voice teachers - "We have a very sympathetic pedagogical approach," Sinha said.
Working in concert with UCLA medical doctor Nida Qadir, Sinha and Patzakis developed a functional and therapeutic treatment, based on patients' medical needs, teaching breathing exercises in conjunction with relaxation therapy and some singing. They teach about 10 patients for six weeks, then take a week off and start another six-week pod. A UCLA staff person is present for each session.
"Sometimes we get patients who continue for multiple sessions," Sinha said. "One person has been participating since the beginning. When he started, he had a ventilator and an oxygen mask. Then, by the second session, he was no longer using the oxygen mask during day. Now he is completely off of it."
Sinha knows what it is like to be a patient who has to learn to breath again - in 2008, at the height of her singing career, she broke her back, injuring vertebrae L4 and L5 in her lower back.
"I really had to learn how to breath all over again, how to use my core, and how to support my breath," Sinha said. "I also have asthma, as well as horrendous allergies. Going through an asthmatic episode, or allergic episode - it is incredibly frightening. So I sort of understand where these patients are coming from. When you can't catch a breath, when you are so exhausted just walking across the room, it's that level of disregulation in their system. It's terrible how badly this disease decimates the system."
Opera singers train for breathing at what might be considered an Olympic level, and so they develop a hefty toolbox of exercises that go straight to the issue of lung capacity and breath control.
"An opera singer has to efficiently use their breath for very long, florid, very loud singing," Sinha said. "This is all dependent on our own breath capacity and stamina - we have no microphones when we perform."
The curriculum that the artist teachers developed for post-COVID patients takes a three-level approach, Sinha said.
First they begin with mindfulness and meditation, including emotional freedom tapping. "I use these techniques for auditions or competitions," Sinha said. These methods help people feel more comfortable in their own bodies. "When you are in a panic and can't breathe, all you want to do is get out of your own body," Sinha said. These techniques calm the nervous system, allowing patients to proceed to the next step: the actual breathing exercises.
For the breathing exercises, patients generally start by sitting, but as they gain strength they can start doing them while standing. "It is important to build that strength," Sinha said. The breathing exercises involve visualization, as well as deep-breathing that helps strengthen the diaphragm.
Then, "we actually work on how to sing a song, using these tools," Sinha said. And after that, they sing for fun - songs like "Amazing Grace" and "You Are My Sunshine."
"It's really special to be part of their healing journey," Sinha said. "Are they going to be singing 'Carmen' by the end? No. But being able to give them even a fraction of that kind of lung capacity and internal muscular support is really what it's about."
In the time Sinha and Patzakis have been helping COVID patients, they have seen patients make considerable progress. Sinha remembers a particular moment, when teaching patients a lower back breathing exercise: putting a hand on the lower back, then trying to take a deep breath. "One person said it was the first deep breath she had been able to take in the last two years," Sinha said. "She was so accustomed to breathing with her clavicles, and that kind of breathing produces a shallow breath." The exercise opened her to a different type of breathing. "I'm proud of that moment."
She is also proud of a patient who made great progress not just learning to breathe again, but learning to speak after being intubated.
"During her first session, her voice sounded like a gravelly whisper - you could barely get a sound out of her," Sinha said. "When people are intubated, they lose their voice - not just because COVID is so rough on the lungs, but also because of the irritation caused by the intubation. Now it's her second session, and her voice is coming back. She now has some range. As of last week, it was a strong sound - she has full tone now when she is speaking."
The LA Opera/UCLA Health program actually not the only program of its kind in the world, but one of the few. The very first such program was developed by the English National Opera at the beginning of the pandemic. While the concept is the same, the two programs developed separately, with their own methods. They hope their work will inspire people to create similar programs around the world.
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