Avoiding Pneumonia

Pneumonia is often thought about as a winter disease, but it can occur at any time in anyone. Individuals who have compromised breathing due to paralysis are at higher risk due to the reduced ability to clear the lungs of fluids and bacteria, especially in the lower lobes, as pushing the fluid out can be more challenging.

Pneumonia is a respiratory infection usually caused by bacteria that is treatable with antibiotics or a virus that can be treated with antiviral medications. A laboratory test will indicate which treatment is right for you. Pneumonia can occur in a small area of one lung, a lobe, several lobes, or both lungs. It can be confused with or occur with other lung infections such as bronchiolitis, RSV, COVID, flu, a cold, or asthma.

Symptoms of pneumonia can vary in intensity. The National Institutes for Health lists these common symptoms of pneumonia. You may have some or all of them:

Chest pain when you breathe or cough
Chills
Cough with or without mucus
Fever
Low oxygen levels in your blood, measured with a pulse oximeter, bluish tint to lips, fingernail, or toenail beds.
Shortness of breath
Headache
Muscle pain
Extreme tiredness
Nausea, vomiting, diarrhea

Individuals with neurological injury and older adults may also have symptoms that vary due to issues with the autonomic nervous system, difficulty coughing, poor control of the breathing nerves and muscles such as the phrenic nerve controlling the diaphragm, the intercostal muscles (those between the ribs), and the abdominal muscles, among others. This may lead to these symptoms:

Lower than normal temperature rather than fever
Weakness
Sudden confusion

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The best way to protect yourself from pneumonia is to prevent it. This takes ongoing effort but is well worth successful results.

Pneumonia vaccines will help prevent the disease. If you do get pneumonia, your course will be less and shorter. Other vaccines include those for COVID, flu, pertussis, HiB vaccine for pneumonia and meningitis.
Wash your hands and towels. Ensure those providing your care do as well.
Social distance.
Stop smoking, vaping, or inhalations of any kind except those treatments medically necessary for your lung health. Avoid areas that emit toxins into the air, such as fireplaces, and campfires. Use a HEPA filter in your home if needed.
Sit upright to your tolerance. This position uses gravity to help your lungs pull down during inspiration, allowing more air to flow in more efficiently.
Strengthen your body and immune system by exercising and eating a healthy diet. For example, performing wheelchair push-ups or leaning from side to side for skin pressure relief, using the tilt on your power chair will benefit your skin and your lungs. Rolling in bed or having someone roll you will move the fluid in your lungs and bladder, as well as helping your bowel move, gives you a three-for-one benefit.
Strengthen your lungs by deep breathing in and out three times and then coughing as strongly as you can three to four times a day. Build up to this goal. Strengthen your breathing using an incentive spirometer or breathing through straws of varying diameters starting with a smoothy straw, slowly working to a regular straw, and then moving down to a coffee-stirring straw.
Use suctioning or cough assist machines if needed. If using mechanical ventilation, use the cough and sigh buttons to give your lungs a boost.
Drink fluids as able if you have fluid restrictions, to keep secretions thin.

Pediatric Consideration:

Children may have symptoms that are different from adults. Babies or small children may have these symptoms:

Vomiting
Fever
Cough
Restlessness
Lack of energy or tired
Bluish tone to the skin and lips
Grunting
Pulling inward of the muscles between the ribs when breathing
Rapid breathing
Widening of the nostrils with each breath

Playing games can assist in breathing more deeply. This might include blowing bubbles, using arms to bat a small beach ball, expanding the chest, dancing with the arms and or legs as able, or using play equipment for exercise.