Lung Care

Breathing is usually an unconscious act: we do it without knowing it. But a spinal cord injury (SCI) may result in your not being able to use some of the muscles needed for breathing. This makes it hard to breathe, cough, and bring up mucus from the lungs, which leads to a greater risk of lung infections such as pneumonia.

How your breathing muscles are affected and what it means to your ability to breathe depends on which part of your spine was injured. People with injuries lower on the spinal cord (below T12) usually do not lose control of these muscles and have no trouble breathing. People with SCIs high on the neck may need a ventilator. People with injuries between these levels have a partial loss of the breathing muscles but can usually still breathe on their own.

Things you can do to help prevent lung problems include:

• Know the signs and symptoms of pneumonia. If you have the symptoms of pneumonia, contact your doctor immediately. Talk to him or her about getting vaccinated for pneumonia and influenza. For more information, see the topic Pneumonia.
• Cough. People who have had an SCI do not always have the ability to cough forcefully. A forceful cough is important, because it will help you bring up mucus in the lungs, which can help prevent some lung complications. If your cough is weak and you have difficulty bringing up mucus, you may need an assisted cough.
• Remove excess mucus from the lungs. Coughing may not bring up all the mucus. In this case, you may need chest physiotherapy and/or postural drainage, which involves striking the chest with a cupped hand or applying a vibrating device to the chest to loosen mucus and staying in certain positions to help drain mucus.
• Practice breathing. Doing exercises, such as breathing out forcefully, can help strengthen the muscles you use for breathing.
• Do not smoke.

Things you can do that are not directly related to your lungs include:

• Have correct posture (sitting up straight in a wheelchair) and move around as much as possible. This helps prevent a buildup of mucus.
• Eat well. Eating healthy foods will help keep you from gaining or losing weight. Being either overweight or underweight can lead to lung problems.
• Drink plenty of fluids, preferably water. This helps prevent the mucus in your lungs from getting thick and makes the mucus easier to cough up. If you have concerns with bladder control, talk to your doctor about how much and when to drink fluids.

Choking

Choking is a danger if you have an SCI, because the usual cough mechanism may not be strong enough to bring up the item that is choking you. If choking occurs, your caregiver should:

1. Hit you sharply 4 times between the shoulder blades with the palm of his or her hand.
2. Use an assisted cough 4 times.
3. Repeat steps 1 and 2 above until you stop choking.