Asthma and Wind Instruments

Ed Dumas

It seems as more time passes band teachers are receiving an ever-increasing number of students with significant asthma. Whether it is due to growing air quality problems or other factors in our world, band teachers still have to face the reality that this challenge is one that many people are unprepared for. As an asthma sufferer and trumpet player myself, I would like to offer some insights and suggestions for possible answers to students wanting to make music on a wind instrument.

As a toddler, I very nearly died from my asthma, though I do not remember that event myself. My asthma has been significant enough that it has coloured almost every activity that I have entered into during my life. Many of the sports that I wanted to be a part of simply were just a non-starter. Yet, playing trumpet was still a possibility for me, and I have kept at it faithfully. As a result, I have some suggestions for band teachers who face the question of how to help a band student who is also an asthma sufferer.

First, please understand that as a band teacher, you must never go against orders from a doctor or a parent. If a child or parent asks for their student to rest out at times, please allow them to do so. Some students are far more asthmatic than others. If one asthma sufferer does not need a rest, it does not mean that all asthma sufferers are capable of the same thing. The parents and doctor will know the child best, and this should be respected.

Now, having said that, there are some things that you can do to help the situation. First, you need to understand exactly what asthma is. I have heard many times from people statements such as “Gosh, you must feel panicky when you have an asthma attack and you cannot get air in.” That statement just tells me that they don’t understand the troubles.
Asthma is not a problem of getting air in, it is a problem of getting air OUT. The airways are constricted primarily for the exhale, and noticeably less for the inhale. The telltale sign for asthma sufferers is a “wheezing” sound on the exhale breath caused by the constricted airways. Doctors and other care providers will use a stethoscope to listen for that sound to diagnose asthma. So, instead of panicking from a lack of air, asthma sufferers feel like they are “drowning in their air.” It can still cause panic, but the root cause is different. 

The second thing that band teachers new to asthma should know about is that different asthma sufferers have different triggers for their asthma. These could be things such as dust, mould, various animal furs, foods, perfumes, and plenty of other common allergens. Physical activity is also a very common asthma trigger. Let’s deal with the allergens first.
Students that are asthma sufferers in your band room will need to have those allergens considered. The ventilation in the band room will need to be functioning well to keep the dust bunnies at bay. The room should be vacuumed out frequently to remove dust as it builds up. If there are carpets on your band room floor, insist that it is cleaned often as mouldy smelly carpet will surely trigger bad responses, since mould is one of the worst allergens for asthma.

Having asthmatics in your band is also a valid justification for having the carpet removed and replaced with something much better for air quality (and sound!), such as linoleum. It is easier to keep linoleum clean and it will not grow mould when brass players drain their water on it! If you are using carpet for sound control, there are much better products to install on the band room walls which will not be an allergen to asthma sufferers or anyone else.

Now, speaking of allergens, I remember some days conducting in my band classes when I had to stop for a “breather” as I could feel my asthma kicking in. The amount of activity that I was doing as a conductor was not enough to bring on an asthma response, so I often wondered what could be causing it. Finally, I started to clue in that one student in the front row of the band just in front of me had several rather “strong” cats at home. The presence of these cats on her clothing was enough to trigger that asthma response. Once I figured that out, asking her in private to kindly change seats due to my asthma solved the problem. You may need to consider this issue with asthmatics in your band, and their reactions to others around them, but be as tactful as possible.

Now, let’s consider the issue of activity-related asthma response. Many people have asthma triggered by heavy physical activity. Remember as I mentioned before that asthma is a problem of exhaling, not inhaling. As a result, some instruments may trigger that asthma reaction more than others. The common misunderstanding would be that an instrument that requires you to blow “hard” would be a bad choice. This is sometimes where parents are at when talking about instrument choice for asthmatic children.

The idea of “blowing hard” to a non-musician usually means something of great pressure, such as trumpet or oboe. But, again, remember that asthma is trouble with exhaling, which means delivering VOLUME of air is the issue. Because of that fact, asthmatics should be steered away from low-pressure high-volume instruments such as flute or tuba. Playing a low-pressure high-volume instrument may mean that the asthmatic student now has to blow even harder to overcome their air delivery issues before the airstream even gets to the mouthpiece! This alone can bring on another asthma attack. 

Mid-pressure mid-volume instruments such as trombone, euphonium, and sax can be iffy, depending on the student. Trial and error for those students are recommended. From my experience, high-pressure low-volume instruments such as trumpet, clarinet, or oboe are the best choice for asthmatics who cannot deliver a large volume of air. 
Of course, there is always the option of avoiding the problem altogether by putting asthmatics in percussion. Not everyone, though, is suited or ready for percussion, and some students just have their heart set on playing a wind instrument. If asthma is an issue, try the high-pressure instruments first to avoid having to deliver great volumes of air to an unforgiving instrument.

Now, there is one more concept regarding asthma that might be valuable for you to know. Playing a wind instrument can have a long-term positive effect on the asthmatic student. I have often credited the good condition of my lungs despite my asthma on the fact that I am regularly breathing deeply in and out, which keeps my lungs healthier.
Years back when our children were little, I purchased a life insurance policy because it was the responsible thing to do at the time. A nurse came to our house to evaluate our health to protect the interests of the insurance company. The opening questionnaire asked if I had any long-term health conditions, and so I answered yes to asthma. At discovering that, the nurse then used a fabric tape measure around my chest to check the amount of chest expansion from minimum to the maximum while taking a deep breath. I happily watched her eyes pop during my breath, to which she exclaimed that I have a superior lung expansion even compared to a non-asthmatic person. She understood when I told her I was also a trumpet player. 

I have used this story many times to students and parents to help them understand that if you can play a wind instrument, such as a clarinet or trumpet, without getting consistent asthma attacks, it will be a good, positive activity for the future of the student and the health of her lungs. “Use it or lose it” has never been so obvious to me.
I once explained my thinking on asthma and wind instruments to a new family doctor, as she had discovered to her surprise that I was a significant asthmatic as well as a trumpet player. After explaining why I felt that asthmatics can deliver pressure, but not volume, she responded by saying, “I might have to re-think my understanding of asthma.”
“Yes,” I said, “You might.”

Ed Dumas, B.Ed., M.A.Ed.