BREATHING EXERCISES

Deep breathing stretches the lungs and helps to get air behind the mucus so that you can cough more effectively. It is best done while lying on your back, but it can also be done sitting. First, breathe in as deeply as you can, hold it for one or two seconds, then breathe out. Repeat 6 - 10 times, doing normal relaxed breathing in between each one. There are other breathing exercises that your therapist may teach you to do.

WEIGHTED BREATHING

Your therapist may also have you do weighted breathing. While you lie on your back he/she may place a weight on your stomach just below your breast bone. When you breathe in you will push your stomach against this weight and try to raise it up.

Abdominal binders or corsets may be used to provide support to your weak or absent stomach muscles, especially when you are sitting. It is easier to breathe when your trunk muscles are held close to your body.

BREATHING TREATMENT

You may have special breathing treatments using an Intermittent Positive Pressure Breathing machine (IPPB) which will expand your lungs and help loosen secretions. You may also be given a small "breathing exercise machine" called an INCENTIVE SPIROMETER which will help you strengthen your breathing muscles. Your breathing exercises will become part of your daily routine and will help prevent lung infections.

Another type of spirometer regulates the resistance to breathing in by changing the size of the opening that you are breathing in through. This device is called a P-flex.

QUAD COUGH

Assisted coughing, or "quad cough," simply means having another person help you breathe out forcefully in order to clear your air passages better. It is performed very much like the "Heimlich Maneuver," used to save people who are choking. The person helping you stands in front of or behind you if you are sitting, or over you if you are lying down, and pushes up on your diaphragm while you cough or breathe out as hard as you can. This is done until you can bring up any extra mucus or secretions into your throat where you can spit them out or swallow them.

When doing "quad cough" be sure to tell your helper:

• Avoid quad cough right after eating - you might throw up!
• Avoid pushing on the ribs or the chest bone - this can injure you.
• Push only when you are breathing OUT.

If possible, you can help yourself when coughing by pushing on your stomach with your hands.

PERCUSSION AND POSTURAL DRAINAGE

If the quad cough does not work to loosen and bring up secretions, PERCUSSION AND DRAINAGE is very helpful and effective. You are placed in a series of positions which allow gravity to help drain the secretions. Your caregiver taps firmly on your chest with cupped hands. This loosens the secretions from the lining of the air passages. The secretions work their way up to your throat, where they can be spit out or suctioned out if you cannot cough them up yourself.

If you need this type of treatment, a respiratory therapist or nurse will teach you and your helpers how to do it. This can then be done at home whenever it is needed to keep your breathing clear.

HOW TO KEEP YOUR LUNGS HEALTHY

Like most diseases, respiratory infections are easier to prevent than to cure. By getting into good habits, you can avoid serious illnesses such as pneumonia and improve your overall health and well-being.

1. DO NOT SMOKE, AND DO NOT ALLOW OTHERS TO SMOKE AROUND YOU.

2. DRINK PLENTY OF FLUIDS (WITHIN YOUR FLUID LIMITS).

3. AVOID PEOPLE WITH COLDS OR COUGHS.

4. USE YOUR SPIROMETER OR TAKE SEVERAL DEEP BREATHS SEVERAL TIMES A DAY TO FULLY EXPAND YOUR LUNGS AND STRENGTHEN YOUR BREATHING MUSCLES.]

5. IF YOU DO GET A COLD:

• a. Get up in your chair, do not stay in bed.
• b. Do frequent quad coughs or percussion and drainage as needed to keep secretions cleared.