More than a few times in the months following a spinal cord injury in which the ability to breathe normally is affected there are problems relating to the reduced lung capacity and significantly reduced ability to inhale and exhale. Our breathing depends on our trunk muscles, diaphragm, and to a small degree our shoulders. With a spinal cord injury in the neck one of the two diaphragm innervation locations is cut off as well as the muscles in the trunk. That is a lot of lost function in a critical area. The worst time after and injury is immediately following, when breathing function instantly goes from using your diaphragm and trunk muscles to just part of the diaphragm. I clearly remember the distress I was in and the offer of nearby friends to perform some mouth-to-mouth assistance which I refused, being a foolish teenager not wanting his friend placing his mouth on my own.
This reduced capacity resulted in multiple initial pneumonias, the regular need for a suction hose to extract phlegm, and a general inability to expel air with adequate force. Thankfully, I never needed deep suction, as in when the hose needs to be inserted much deeper into the throat by a trained individual, but simply the same as they give you at the dentist's office. Though I still may be considered more susceptible to pneumonia it has never been a problem for me, personally.
I still cannot cough properly while sitting up or laying on my back without a learned technique, and the satisfaction of a good sneeze only graces me about one out of 20 times that the tickle and urge causes me to inhale in preparation. If I time it just right I can apply pressure to my abdomen to execute a proper sneeze. The critical act of coughing will be addressed next week.
Thankfully, there are tools to assist in building lung capacity and strength. Pictured above is an incentive spirometer, which is designed to do just that. The hose can be attached to either side of the body of the device. One side allows you to suck air in and the other side allows you to blow air out. The idea is to increase the resistance as your strength increases so that keeping the ball at the top while the air moves through it is just difficult enough. It's no different than any other strength training.
An incentive spirometer can also be helpful to encourage very deep breathing and complete exhaling which is a very good practice in clearing congestion and preventing sickness. For we who find it very difficult to get our heart rate and respiration high enough to naturally perform this deep breathing this can be a lifesaver when dealing with any kind of respiratory illness. Regardless of illness, I try to do some deep breathing a few times each day in the interest of prevention.
Source: Respiratory therapists, occupational therapists and many medical professionals. They are very affordable and can be ordered online.