by: Stephanie Kertesz, Playtester at Flute Center

Content Warning: hospitalization, illness

I did several competitions and auditions while dealing with cancer. Here are the practice habits I picked up during that time and how they can help other musicians.

On March 10, 2021, I received life-changing news; I had stage 2 breast cancer at the age of 27. For the past year and a half, I did chemotherapy, two surgeries, radiation, and more chemotherapy until July of this year. When I was initially diagnosed, I vowed to not let cancer get in the way of my career. And I upheld that promise, sort of. While I did a few gigs, competitions, and auditions during cancer treatment, the side effects from treatment absolutely got in the way of playing. There were many days when I was too sick and/or tired to play flute or even do much period. I did competitions and auditions to motivate myself to play flute regularly. However, there were a few practice habits I learned that helped me play flute even with my limitations. Now that I’m in remission, I would like to share some insights from that year and a half. In this blog post, I’m going to share what I picked up during cancer treatment and how these practices can help other musicians (healthy or not). I will include some stories during my treatment and how they are relevant to my list. The list below may seem obvious, but there are little things that one can implement into their playing that will make a big difference in the long run.

1. Don’t work hard, work smart.

This was the most critical lesson I learned during my cancer treatment. After I got sick, I soon realized that the way I was playing flute before was not efficient and that I was overcompensating in my playing.

Before I started my first rounds of chemotherapy, I had my eggs extracted. A lot of young adult cancer patients choose to have fertility treatments done before starting chemo since chemotherapy can cause a lot of harm to their reproductive system. However, after I had the treatments done, my body had a horrible reaction to the procedure and I was hospitalized for a week. When I was first admitted, my belly was very distended, my heart rate wouldn’t go below 150bpm, I couldn’t hold down food or drinks, my electrolyte/sodium levels were off, I had a hard time walking, I had a hard time breathing (I was even on oxygen for the first 24 hours), and my kidneys were injured. When I was in the hospital, I also developed a blood clot in my left arm going from my shoulder to the tips of my fingers. Fortunately, I recovered from those symptoms after a few weeks. However, when I picked up my flute after I got out of the hospital, I had a rough time playing. I was very out of breath for a while and had to approach how I played the flute differently.

Shortly after I started playing flute after my hospitalization, I quickly realized that I was overblowing on my instrument before. With the right support, not a lot of air is needed to produce a beautiful sound on the flute. When I started to be more conscious about engaging my abdomen when playing and using less air, my normally “edgy” sound became a lot smoother. If you are ever playing your instrument and something seems off, ask yourself if you think you’re overblowing/overplaying.

In addition to having the right support, one also needs to be in the right playing position and use good posture to help make a good sound on the flute. For myself, I realized that I needed to roll in my flute while playing but the headjoint needed to be rolled out far enough. I also noticed that I was slouching a lot when I was playing and didn’t have a great grip on my instrument, due to being fatigued and feeling weak. This was also pointed out to me a few times I played for people during that time. For me, I needed to BRING the flute to ME, not the other way around. While this may present itself differently in musicians, ask yourself while you’re playing if your posture is how you want it and if the position of your instrument needs to be adjusted. Even the smallest adjustment can make the biggest difference.

One of the disadvantages I had during treatment was that I was easily out of breath when playing the flute (and I still do). At first, I thought this would prevent me from playing the repertoire I wanted but I realized that if you plan your breaths smartly, you can get away with a lot. If you realize that you need to breathe during a passage but there is no logical place to breathe, think about where and how you can implement that breath musically. This also has started forcing me into the habit of quieter breathing with my mouth as opposed to nose breathing which is a lot more audible.

If you want to have an easier time with technique, consider using harmonics for some of those nasty passages in the piece you’re working on. One of the pieces I had to prepare for one of the competitions I did had a lot of difficult and different-sounding runs. Due to the speed of these passages, I realized that I could use harmonics for some of those tricky fingerings. For instance, it is a lot easier to facilitate from a high E to F# when you’re using the fingerings for an A and B and overblowing. When looking over a difficult technical passage, try to see if there are alternate harmonic fingerings you can use to make the passage easier. If the sound isn’t too compromised and the passage is easier to play, then you will have just saved a lot of time and energy learning a difficult passage.

On the days I felt too sick or tired to play (a good portion of treatment), I would find other ways to practice without picking up and blowing into my flute. This would happen a lot during the days following a chemotherapy infusion. There were a few times I would look at my part and just practice the fingerings, flute, or no flute. On a related note, I did a lot of score study while learning the competition repertoire and found that listening while following the score was really helpful. For the score study, I used the ForeScore app to follow the music on my iPad while listening to it. I also highly recommend listening to the repertoire you’re preparing A LOT. If the music is in your head, then it will be in your fingers. These types of practices would happen a lot during the “bad days” of my chemo cycles.

2. Practice in “performance mode” as much as possible.

During treatment, I faced a lot of endurance issues. I would get fatigued very easily and I would struggle to get through single pieces and excerpts. The only way I could combat these issues would be to practice run-throughs on a consistent basis.

When I was preparing for a local competition back in April, I was originally very worried about being able to get through twenty minutes worth of music. In order to build up to that point, I practiced doing a concert run of the repertoire each practice session. No matter how many mistakes I made or how unsatisfied with how I sounded, I would at least try to make it to the end of the piece or movement. After the run-through, I would take a break and then resume touching up on parts of the repertoire I was unhappy with. Between pieces and movements, I would take all the time I needed to recover. After every run-through, my endurance slowly built up to the point where I could get through the twenty minutes of music without falling apart.

When I was preparing for the auditions I did during treatment, I would practice running through a certain number of excerpts without stopping. With excerpts, however, endurance wasn’t as much of an issue because excerpts are normally shorter in nature. There are also normally a lot of rests present in excerpts so there are more opportunities to recover. With all that being said, if you feel like you’re not able to play every day or almost every day, that’s okay! Just do what you can.

3. Put your body first.

When you’re healthy, you can sort of get away with pushing yourself beyond your limit. The best-case scenario is that you feel burnt out, the worst-case scenario is that you get sick. However, I discourage anyone from working and pushing themselves way beyond their limit, as redundant as that statement sounds. There are a couple of cautionary tales that I could share from the year and a half of cancer treatment but there is one in particular that comes to mind.

This happened in November of 2021 which was the time that I started my second round of chemotherapy. This chemo was supposed to be “less aggressive” and “lighter” than the first rounds of chemo so I naively scheduled gigs close to when I received infusions. Very big mistake.

The first time was during the week I received my first Kadcyla infusion out of 13. I had an orchestra gig that week out of town. The first few days after I received the drug I was fine but a little tired. However, on the day the orchestra had off that week, I developed a fever and had to go to the Emergency Room that night. I tested negative for COVID and the other tests they did that night. Luckily, I was able to go home that night and sleep it off. I was in really rough shape when I performed at that concert, but I was able to get through. I had an out-of-state gig the next week after that concert and I made the foolish decision of going through with the gig. The past few days I was fighting off a slight fever with acetaminophen and decided that it was too short of notice to cancel my next gig. The morning after the first rehearsal after driving to the gig, I woke up with a temperature of 103 and decided I needed to go home. Miraculously we were able to find another flutist to cover for me. If I had decided to cancel the gig before I had left, this problem would have been avoided. Sadly, this was not the only story like this and I learned my lesson the hard way.

While burnout, fatigue, and sickness are exacerbated with a health condition, it is important to listen to your body when you’re healthy too. If you find yourself feeling tired or generally unwell, it is okay to take a day or more off from playing. If you don’t listen to your body on when to rest, your body will choose when to rest for you.

4. Trust the process and BELIEVE IN YOURSELF!

The last point I would like to make regarding my cancer treatment is to trust your practice and to have faith in your playing. After I was hospitalized, my confidence in my flute playing was crushed. I felt like I couldn’t trust my fingers after the blood clot and I couldn’t trust my breath after losing a lot of my lung capacity. However, with semi-regular practice, my fingers and lungs started adjusting back to “normal”. It wasn’t until this year that I realized that I’m thinking too much about my fingers when I’m playing. When I “let go” and focused on the musical line, my fingers would line up a lot better. I had to trust the practice and the muscle memory I’d built. Right now, I am going back to more technical exercises to further cement my fingers. Even with an illness, trust your practice, trust your instrument, and trust your body.

While the past year and a half has been unimaginably difficult, especially with playing flute, I have also picked up some useful musical habits. I hope that other musicians can find this information helpful too. Now that I’m on the mend, I’m looking forward to doing more gigs, auditions, and competitions when I’m healthy again. Even with a crappy diagnosis, it is still possible to find joy in music and it’s possible to make beautiful music as well. I’m so grateful I had that throughout my treatment.