Not being able to contract his stomach muscles means that Nick’s coughing is enfeebled and very frustrating. A standard bit of kit for physios treating spinal injury cases is a kind of compress/suction machine but the process reminded Nick of breath holding competitions he used to hold with his brother John, in which they found they could super inflate their lungs using breath stacking and then super stacking by ‘gulping’ additional air using their cheek muscles.

This innovative techniques – new to medical science – might not be quite as good as the expensive machine made by Philips, but it is available whenever you need a cough rather than once a day when the physio pops in!

And when Sam the physio did pop in, and Nick had managed a good cough, Sam was persuaded to measure the cheek assisted lung capacity. Much to his surprise the technique added 1,000 ml of air. Expect a paper in the BMJ.