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many paralysed patients experience difficulties when coughing? Our colleague Wolfgang Illek is quadriplegic and knows why.

After catching a cold, most people don’t worry too much about when and how they cough. They just do it. I was exactly like them, until I had a serious and life-altering bicycle accident in 2004. I sustained injuries to my spinal cord in the cervical area, which resulted in high spinal cord injury. As a result, my entire immune system shut down, which ultimately led to severe pneumonia. I tried so hard to cough up the mucus, but I did not succeed. I found that I could not produce more than a rattling breath. I panicked and thought I was about to suffocate. In the end, the mucus had to be suctioned, which is a painful process. The doctors told me that the paralysis had also affected my breathing. The higher the paralysis is, the fewer muscles you have as support for breathing and coughing. Coughing is a hugely important protective reflex of the lungs; it ensures that the respiratory tract remains clear. Coughing removes anything that blocks the human airway.
In my case, the most important muscle for breathing, the diaphragm, is fortunately still fully operational. The same does not, however, apply to my intercostal muscles. This means that I need to rely solely on my diaphragm and neck muscles for both breathing and coughing.
Today – 11 years after my accident – I use a technique that helps me to cough: I try to compress my abdomen and diaphragm through a rapid forward movement of my upper body. This allows me to squeeze out the air faster. Nevertheless, I am very careful not to get ill, especially during the colder months. I am always very concerned that a common cold could escalate quickly into life threatening pneumonia.

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