NoseEXPERTWasher,

Nope, I don't know Grossman.  But, it is always interesting to hear how people get their ideas and life paths.  The ASAA main site has an interview with Colin Sullivan.

I would never consider myself an expert in this area, I am just wired to be data driven and I probably comes off as being too pragmatic at times.

It was unclear to me if hypertonic solutions did or did not inhibit ciliary function.  Just for my own peace of mind (and because I have few cilia left after two rounds of roto-routing) that would be great if you could point me towards a few of the articles.  Because of osmosis, I would think that hypertonic solutions would also help decrease swelling since the higher salt concentration would pull water out of the tissues (for anyone who doesn't know, hypotonic=below physiological salt concentrations, isotonic=the same as physiological, hypertonic=above physiological salt concentrations).

I try to keep an open mind as far as potential treatments for folks but remain objective and science based.  I am even working on a collaboration with Didgeridoo playing as a supplement to CPAP therapy based on a preliminary "proof of principle" clinical trial that was done.

We hear on this forum so much about how this simple in home technique helps people.  This thread has more hits on it than any other.  I am not an expert, but I seem to have become the queen of mucous.  Please, please let me know if any studies that show home solutions are dangerous.  Above all, our motto here is "Do no harm".

I look forward to your continued input!!  Thanks!!

Vicki


_________________
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

HE HE, thanks for the catch, I meant "irrigate" not "irritate"  

Thanks pseudonym  LOL

Vicki,

I have the references and studies in hard copy, it will take some time to put them on the computer, but I will have it on in a day or so.  You might also want to study the differences in your head/neck position when washing and the way the solution enters/exits the sinus cavities.  Some systems introduce the mixture into the sinuses and others pull or plunge the contents out of the sinuses.  

There is an ENT in KC that has had patients cancel their surgery because they had so much success with nasal irrigation and no longer had a need to have the nasty roto-routing surgery.

To my knowledge those are the two of the key components to effective nasal irrigation.  The position your head and neck (and sinuses)(it seems many people have never considered this an important factor?) and the solution you are washing with.  What are your thoughts?

-George (you may call me by my first name instead of that stupid forum name I created , if you wish )  By the way, can I change that?

Hi George!,

That ENT in KC is amazing.  Most ENTs jump straight to surgery.  I didn’t know that some do irrigation in their office until someone posted about it.  Does he have patients do it at home?  Where is he at?  Both my brother and SIL are RNs in KC.

I have the same thoughts.  My surgeries were in 1994 and since then I have to do this at least once daily because of the surgeries.  I snort, I blow, I do this thing where I inhale and exhale fast to “scrub” my sinuses (OK, maybe that is a little TMI).  Anyway, I intimately know my sinuses and all the crevasses within.

After my second surgery, my ENT jokingly told me “those cavities are so big now it is all air up there” (I’m blond).  It isn’t as easy to breathe now 13 years later, there is some resistance and I think my turbinates have grown back.  Unfortunately, I don’t think my ENT used a turbinate reduction protocol that saves the cilia (lifting the tissue and shaving the cartilage rather than shaving the tissue).  I haven’t had a CT in years and maybe there are also polyps up there again despite my daily irrigation and use of Zyrtec and Nasonex.  I do know that if I am not vigilante about irrigating at least once daily and using my meds., I rapidly start acquiring a sinus infection.

By the same token, if I feel the start of an infection, I can usually avoid it by increasing the irrigation and keeping all that gunk and bacteria flushed, giving my immune system more of a fighting chance.  Once I get an infection though, I give it 4 days to elicit an immune response but I always have to take antibiotics to clear it.

But with my irrigation, I haven’t had a sinus infection in over 2 ½ years.  I don’t mind doing it since it feels good and makes me feel better.  It is part of my routine along with brushing my teeth.

I’m up for trying different premade solutions, run my own empirical little experiment.  Pseudonym uses Alkalol (posted above).  The components sound like they would burn like heck, but she swears by it.  My sinuses have been acting up and I definitely have a sinus headache tonight so I’m hitting the drug store tomorrow.  Off to hose my nose!

Oh, as far as forum issues go, PM our forum administrator Mike (just use his name) and he’ll help you do what you want to do.

Vicki


_________________
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

Hey Vicki,

His name is Dr. Kelvin Walls, he is one of several ENT's for the ENT Associates of Greater KC and he is amazing.  He obviously makes money by surgery, but he recommends most all of his patients wash their nose before and after surgery with the hopes to prevent surgery. He sells Nasopure out of his clinic as does the ENT group at Olathe Med.  Dr. Vargas, Dr. Metz, Dr. Hill, and Dr. Zimmerman.  There are some clinics that sell it in Columbia, MO as well.  

Dr. Walls does have his patients do it in their homes.  All of the docs have dvd's made by the blue bottle company that they show their patients in the clinic.  

My brother also lives in STL!

References below: enjoy

                                                                                                  SCIENTIFIC REFERENCES: Hypertonic buffered Saline Nasal Irrigation
1) Rabago D, Zgierska A, Mundt M, Barrett B, Bobula J, Maberry R: Efficacy of daily hypertonic saline irrigation among patients with sinusitis: a randomized controlled trial. Journal Family Practice 51(12): 1049-55, 2002 Dec. "Conclusions: Daily hypertonic saline irrigation improves sinus-related quality of life, decreases symptoms, and decreases medication use in patients with frequent sinusitis. Primary care physicians can feel comfortable recommending this therapy".
2) Bothwell MR, Parsons DS: Pediatric Chronic Rhinosinusitis: A Step-Wise Approach to Medical and Surgical Management. Operative Techniques in Otolaryngology - Head and Neck Surgery 12,1:34-39, 2001. "Three key elements summarize the normal physiology of the paranasal sinuses: the patency of the ostia, the function of the ciliary apparatus and, integral to the latter, the quality of secretions. General treatment measures are directed at establishing a more normal nasal environment through moisturization, humidification, and the reduction of swelling. Nasal irrigation with buffered hypertonic saline."  
3) Georgitis JW: Nasal Hyperthermia and Simple Irrigation for Perennial Rhinitis. Chest 106,5:1487-1491, 1994. "Conclusions: This study demonstrated the usefulness of large particle vapor treatment and saline solution irrigation in reducing inflammatory mediators in nasal secretions and indirectly supports the clinical efficacy of these treatments for chronic rhinitis."

6) Manning SC: Pediatric Sinusitis. Otolaryngologic Clinics of North America. 26,4:623-637, 1993. "A gentle squirt of saline into each nostril once or twice daily can improve nasal function by mechanically removing sensitizing agents, by enhancing mucociliary transport via increased relative humidity, and by improving sinus drainage and ventilation via a mild vasoconstrictive effect. Compliance can be enhanced by using prepared pH-neutral solutions and by emphasizing to the parents that saline lavage represents a long-term hygiene strategy aimed at prevention of sinusitis, analogous to tooth brushing to prevent cavities."
7) Rachelefsky GS, Slavin RG, Wald ER: Sinusitis: Acute, Chronic - and Manageable. Patient Care. February 28, 1997 pp 105-117. "Inflammation of the sinuses occurs when the narrow drainage ostia become blocked, the natural movement of the cilia within the mucous layer of the sinus cavities becomes impaired, and sinus secretions accumulate. Adjunctive treatments are very helpful for many patients. Saline drops can be used as often as the patient wishes; this helps to clean the nasal passages, remove crusting, and may soothe the inflammation."
8) Salvin RG, Cannon RE, Friedman WH, Palitang E, Sundaram M: Sinusitis and Bronchial Asthma. Journal of Allergy and Clinical Immunology. 66,3:250-257, 1980. "The frequent association of paranasal sinus disease and bronchial asthma has been observed for many years. Occasionally the mucosa becomes sufficiently swollen to result in obstruction of the natural ostia through which the sinuses normally drain. Failing to drain freely, the sinuses become secondarily infected."
9) Seaton T: Hypertonic Saline for Chronic Sinusitis. The Journal of Family Practice. 47,2:94-96. "Clinical question: Are hypertonic saline nasal washes beneficial in the treatment of chronic sinusitis in children? Recommendations for clinical practice: This study demonstrates some clinical benefit from the use of intranasal hypertonic saline washes. This treatment is inexpensive, safe, and generally well tolerated. It should be considered as adjunctive therapy in children with chronic sinusitis."
10) Talbot AR, Herr MH, Parsons DS: Mucociliary Clearance and Buffered Hypertonic Saline Solution. Laryngoscope. 107:500-503, 1997. "Nasal irrigations have been used for centuries without any scientific data to determine efficacy. For 10 years, the senior author has used buffered hypertonic saline nasal irrigation for patients with acute/chronic sinusitis and for those having undergone sinus surgery. A simple study was undertaken. The outcome showed buffered hypertonic saline nasal irrigation to improve mucociliary transit times of saccharin, while buffered normal saline had no such effect. Buffered hypertonic saline is a mildly alkaline solution. Buffered hypertonic saline nasal irrigation is an important addition to the care of sinus disease."
11) Tomooka LT, Murphy C, Davidson TM: Clinical Study and Literature Review of Nasal Irrigation. The Laryngoscope. 110:1189-1192, 2000. " Nasal irrigation is effective in improving symptoms and the health status of patients with sinonasal disease."
12) Virant FS: A Guide to Therapeutic Interventions for Rhinosinusitis in Children. The Journal of Respiratory Diseases for Pediatricians . 4,1:8-14, 2002. "Nasal irrigation with a buffered saline solution theoretically may improve mucus flow and provide a less satisfactory environment for bacteria."
13) Zeiger RS, Schatz M: Chronic Rhinitis: A Practical Approach to Diagnosis and Treatment. Immunology & Allergy Practice. 4, 4:26-35. "Nasal tissue appears to benefit greatly from warm irrigation with saline. Saline irrigation augments mucociliary flow, liquifies tenacious mucus, soothes irritated tissue, augments repair processes, reduces forceful nose blowing, and improves olfaction. Should be considered for all  with chronic rhinitis; benefit appears maximal for rhinitis medicamentosa, atrophic rhinitis, nasopharyngitis, sinusitis. Emphasis on avoidance of allergens and non-specific precipitants, the use of intranasal saline is the initial approach to pregnant women w/ rhinitis."
14) Allergy and Asthma Center of Rochester, Michigan: Medical Conditions: Rhinitis and Pregnancy. Web site Jan 2003. "For example, a buffered saline nasal rinse spray may be useful for the dryness, bleeding, and vascular congestion associated with rhinitis during pregnancy."
15) Pediatric Allergy Immunology 2003 Apr;14(2):140 in Pediatric Notes 2003 Jun 26;27(26):103) "'hypersaline nasal irrigation improves symptoms in children during allergy season;' 20 children with seasonal allergic rhinitis randomized to 3% saline 2.5 mL in each nostril tid for 6 weeks vs. no extra therapy, treatment group had significant decreases in total symptoms and use of antihistamines, benefits not seen until third week of therapy."
16) David Shoseyov, MD; Haim Blbl, MD; et al: Treatment with hypertonic saline versus normal saline nasal wash of pediatric chronic sinusitis.  Journal of Allergy and Clinical Immunology 1998; 101:602-5. " Hypertonic Saline three times a day for 1 month improves the clinical and radiologic status among children with Chronic Sinusitis. The treatment is tolerable, inexpensive, and effective." 
17) Diane G Heatley, MD; Kari E McConnell, RN, CORLN; Tony L Kille, BS; Glen A Leverson, PhD: Nasal Irrigation for the alleviation of sinonasal symptoms. Presented at the annual Meeting of the American Academy of Otolaryngology- Head and Neck Surgery, Washington DC. 9/25/00. "Daily nasal irrigation with hypertonic saline significantly improved symptoms of chronic sinusitis in this "study.  Many subjects were able to decrease or eliminate medication used during the study period."
18) Garavello W, Romagaoli M, Sordo L, Gaini RM, Di Berardino C, Angrisano A: Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: a randomized study. Pediatric Allergy and Immunology 14:140-143, 2003. "This study supports the use of nasal irrigation with hypertonic saline in the pediatric patient with seasonal allergic rhinitis during the pollen season. This treatment was tolerable, inexpensive and effective."

Can anyone help.  I recently joined this blog site for sleep apnea related reasons.  HOwver, I am having another sinus infection incident and realized that there was information related to this also, so here I goe....

I bought the NeilMed and tried it for the past two days to help with sinus swelling due to a bad cold.  Friday night, I used 1 bag and made it ISO.  It seemed to help a little but I started to feel like I had water around my sinuse and ears.  Sat night I used 2 bags and made it HYPER.  I really got stuffed up and have yellow junk in my running nose now.  By the way, a sinus infection is a disaster for me as I have SEVERE SLEEP APNEA and can only use a nasal mask (TMJ issues).  WHen I have a sinus infection, my sinuses close up and I cannot even breathe through the mask enough to use it.

Also, every ENT (I have seen a number of them) has recommended I use a Salt Spray product like OCEAN.  Every time I do, my sinuses stuff up worse and I end up with a raging sinus infection in three to five days.  This always greatly surprises the ENT's and they reluctantly tell me to stop using it.

Now I take SINGULAIRE and ASTELIN and have done much better with headaches and sinus pressure.

Why is it that I always get a sinus infection when I use Salt Type products?????????  Are the ENT's missing something with me physiologically speaking, as everyone else seems to get great benefit out of the salt products?

GF Baden,

I don't know your body or your nose, but I would recommend using your neil med with hypertonic for four days straight, twice a day.  It sounds like a lot of the thick yellow mucous is draining out and that is why you see it after washing.  I have yet to see anything from the medical community stating that nasal irrigation with a salty solution can cause thicker mucous and add to already unhealthy sinuses!  

I have a theory about NeilMed though.....  The NeilMed delivery system causes you to tilt your head forward and down, so the solution shoots straight up into the sinus regions....I don't believe this is good because you are taking the dirty contents in the nose and introducing them into the sinuses.. Don't get me wrong, I still think that washing with NeilMed is doing more good than harm, but in your case you may not want to introduce ANYTHING extra into your already unhealthy sinus cavities.  The sinus regions are very tiny cavelike bony structures, which easily trap junk and the cilia are easily paralized when foreign contents are introduced.  

The most effective way to wash, I believe, is to keep your head and neck in a neutral position and wash along the nasal floor.  This action creates a drawing or plunging of the sinus contents, not allowing outside junk to enter, which seems to make sense.  There are many ENT's in the midwest that support this theory.

I am hesitant to try this as the infections become so severe.  I have been complaining for years now of the sense of dizziness and strange sensations.  My ENT's diagnose me as severe allergic rhinitus and sinusitis.  I have had sinus surgery years ago.  Partial turbinectomy, rhino/septoplasty.  I think there may be something which continues to give me trouble in the sinuses - a blockage that allows anaerobic bacteria to thrive when the sinuses get the least bit of extra aggravation or fill with fluid (as in irrigations or sprays or a cold).  I wonder if maybe the surgery was not done right...  Is there any diagnostic tool that can look beyond what the ENT's do in their offices as I am learning that there are all of these small chambers and airways - how can the ENT check all of that with just his scope???  That might be my next plan of action.

GF,

I have personal experience with which you speak.  Did your doc. do a CT?  I had a complete roto routing and I was nursing my kid at the time and didn't want to take the antibiotic course my ENT wanted me to.  About a month later I felt horrific and my ENT did another CT (that is how I have been diagnosed) and it showed a sinus was completely occluded and infected.  I did what he wanted me too the second time around and, with irrigation, zyrtec and nasonex, I have maybe 1 or 2 sinus infections every couple of years.  It doesnt sound like your surgery involved opening up the passages to your sinuses which mine did (called Functional Endoscopic Sinus Surgery).  Here is a great review which also accentuates the need for a CT.

http://www.aafp.org/afp/980901ap/slack.html

If you haven't had surgery to physically open up your sinus passages, then it is possible that, as you mentioned, you are having occluded sinuses.

After my surgeries, my ENT jokingly told me I was now all air up there.

Keep us posted!!

Vicki


_________________
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

deleted

I hope someone can help me....since I started about two months ago using my grossman sinus irrigation system I have developed a very bad case of dry eyes.

I'm using the recommended purchased solution that came with my machine. Could my sinus irrigation machine be causing my dry eyes??? Could I have blocked my tear duct by using the machine??

I went to the eye doctor and there is no other eye problems that could be contributing to the dry eyes. Please help....

Inga,

That is really interesting.  I don't know the answer to your question.  Did you see an opthamologist (medical doctor who specializes in eyes)?  An opthamologist has more training than an optometrist.  It also may be time to see a good ENT specialist.  There is a medical resident who is studying tear duct problems in people who use a CPAP and I'm going to alert him to your post.  In many people (myself included) there is an open connection between the tear duct and sinuses.  Just out of curiousity, do you use a CPAP?

Vicki


_________________
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

inga wrote:

I hope someone can help me....since I started about two months ago using my grossman sinus irrigation system I have developed a very bad case of dry eyes.

I'm using the recommended purchased solution that came with my machine. Could my sinus irrigation machine be causing my dry eyes??? Could I have blocked my tear duct by using the machine??

I went to the eye doctor and there is no other eye problems that could be contributing to the dry eyes. Please help....

Inga,
Dry eye is often developed as we age, use contacts, or have allergies.  It can also come about from the air that comes out the exhaust valve of the cpap mask or the polution in the air outdoors.  I suffer from age related dry eye and my eyes get watery every time I go for a walk outdoors on a breezy day and now my cpap mask air exhaust also causes it. Dry eye symptoms can runny/watery eyes, a grainy or gritty feeling, red irritatation in the eye.  The mask does agrivate it so I use lubricating eye drops before going to bed.  The eye doctor prescribed an over the counter lubricating eye drop.  I suspect it is a coincidence that your dry eye started with nasal irrigation.  I keep a bottle fo the eye drops in my purse, bathroom, by my bed, in the car and at work.  I use the drops frequently which helps to keep my eyes well lubricated.

clk

clk wrote:

inga wrote:

I hope someone can help me....since I started about two months ago using my grossman sinus irrigation system I have developed a very bad case of dry eyes.

I'm using the recommended purchased solution that came with my machine. Could my sinus irrigation machine be causing my dry eyes??? Could I have blocked my tear duct by using the machine??

I went to the eye doctor and there is no other eye problems that could be contributing to the dry eyes. Please help....

Inga,
Dry eye is often developed as we age, use contacts, or have allergies.  It can also come about from the air that comes out the exhaust valve of the cpap mask or the polution in the air outdoors.  I suffer from age related dry eye and my eyes get watery every time I go for a walk outdoors on a breezy day and now my cpap mask air exhaust also causes it. Dry eye symptoms can runny/watery eyes, a grainy or gritty feeling, red irritatation in the eye.  The mask does agrivate it so I use lubricating eye drops before going to bed.  The eye doctor prescribed an over the counter lubricating eye drop.  I suspect it is a coincidence that your dry eye started with nasal irrigation.  I keep a bottle fo the eye drops in my purse, bathroom, by my bed, in the car and at work.  I use the drops frequently which helps to keep my eyes well lubricated.

clk

Maybe you could try Systane eye drops.  They work well for me.  I put a few drops in before I go to sleep each night.

Vicki,

I had chronic sinus problem for 30+ years.  It worsens in the recent years due to allergy.  To improve the situation, I tried nasal irrigation and steam inhaler.  

So far I have been doing both for half a year.  Both works to some extent, but could not fully solve the problem.

When using the irrigation system, I can rarely wash out some bad stuff, most time is just water going in and water going out. I never had trouble running water through my nose even if it feels stuffed, but then my nose remains stuffed after washing.  It seems the problem is deep inside my sinus, yet the water could not reach there. I tried irrigating without bending down my head, I tried different angels of the irrigation tip, no help.

I know some of you have water running out the nose hours later. That's the result I am trying to achieve. It means the water really went inside the sinus. Can you offer some tips or techniques?  Thanks a lot!!!


The nasal irrigation system I use is: Grossan Hydro Pulse Nasal/Sinus Irrigation System.



p.s. steam inhaler worsens my allergy, but did wonders to my tonsil problem.