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Medical Forum / Diseases and Disorders / Sinusitis / December 2004

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My first time again with Hydro-Pulse - Questions.

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Killer Cabs Sales Team - 16 Dec 2004 15:15 GMT
I just got my Hydro-Pulse and a few things immediately spring to mind ...

I'm guessing it should sting a little as you're putting salt into a very
sensitive area - the effect an hour later can still be felt.

One question - should the tip completely cover the nostril, i.e. blocking
it? If I do this, the water runs out of the other nostril. That's not a
problem, I'm just wondering if that's the way it should be done, or if it
should not block the nostril completely and run out of the same nostril?

Also - can it be the case that different levels of the salt solution can
work for different people - my nose has started to sting again!

Thanks

--

Tony

www.killercabs.com
Arcade Game Cabinets
ENTconsult - 16 Dec 2004 17:26 GMT
Dear Tony,
Yes, the solution is supposed to run out the other nostril. Yes, the tip should
be FIRMLY in the nostril so the nostril is sealed, so the soluton goes entirely
into the nose.
The position of the head should be so you can clearly see the sink drain.
It is important that you keep your head "centered", not turned from side to
side.
If you are using Breathe.ease XL there should be no stinging.  If you are
getting stinging, it means your nose is extremely sensitive or raw.
Suggest you use some of the Breathe.ease XL sample that comes wiht the Hydro
Pulse as a spray 3-4 x a day to ease the inflammation. Use the packet to make
the solution by adding one packet to the 500 cc, then pour some of that into
the spray bottle.  Use any of your old nasal spray bottles or if none available
pick up one from the 99 cents store. If not available use the breathe.ease as
nose drops.
Murray Grossan, M.D.
http://www.ent-consult.com
Killer Cabs Sales Team - 16 Dec 2004 21:12 GMT
Thanks very much. I actually started using blocking the entire nostril, but
the feeling of it coming out of the other nostril was quite strange and I
assumed I must let it drain from the same one, so pulled the tip away
slightly. I probably hence didn't get an effective use anyway.

I used the supplied sachet that came with the Hydro-Pulse and it really did
sting my nose for a couple of hours. Should I still persist with using it to
make spray?

Would I simply not get the required benefit if I say diluted half a pack of
the Breathe XL into the 500ml container until I felt my nose could tolerate
the full packet?

My nose never runs - in fact the only time it ever runs is when I eat
anything hot which happens always. So maybe I have a particularly dry (and
sensitive) nose. Should I be taking steps to lubricate it somehow to keep it
more moist?

Tony

> Dear Tony,
> Yes, the solution is supposed to run out the other nostril. Yes, the tip should
[quoted text clipped - 13 lines]
> Murray Grossan, M.D.
> http://www.ent-consult.com
ENTconsult - 17 Dec 2004 01:40 GMT
No, do not dilute the Breathe.ease XL . One packet ot 500 cc is Isotonic - just
right for the nose. If you dilute it then its hypotonic and not right for the
nose.
If the breathe.ease stings it suggests that your nose is ectremely "raw" and
using the breathe.ease solution from the Hydro Pulse as a spry 3-4 x a day
would help reduce that "rawness".
Murray Grossan, M.D.
http://www.ent-consult.com
MS - 19 Dec 2004 04:01 GMT
> The position of the head should be so you can clearly see the sink drain.
> It is important that you keep your head "centered", not turned from side to
> side.

Again, many people have better results with the head turned to the side.
Messier, but gets out more junk than only head facing down. I actually turn
my head all different directions while irrigating.

Find what works best for you.

> If you are using Breathe.ease XL

Plug for a product sold by writer. No evidence that it works better than
plain salt, or salt and baking soda.
ENTconsult - 19 Dec 2004 05:07 GMT
Plug for a product sold by writer. No evidence that it works better than
plain salt, or salt and baking soda.

Wrong again. The reference to Breathe.ease XL is becuase this comes with the
Hydro Pulse machine and the writer can benefit by using it as a spray if the
nose is "raw".  

Wrong too re your advice to hold the head to the side.  You don't want to hold
your head to the side, that puts solution pooling at the eustachian tube and if
the tube is widely patent the solution can enter the ear.
Murray Grossan, M.D.
http://www.ent-consult.com
MS - 21 Dec 2004 09:37 GMT
>> Wrong too re your advice to hold the head to the side.  You don't want to
hold
> your head to the side, that puts solution pooling at the eustachian tube and if
> the tube is widely patent the solution can enter the ear.
> Murray Grossan, M.D.
> http://www.ent-consult.com

Just saying that it works for me, don;t know that it works for everyone. I
certainly get out more stuff with my head turned to the side than facing
down, although more messy. I've never had problems with ears and eustachian
tubes as a result of doing that, for many years.

Has this happened to you or many of your patients, that when they irrigated
with head to the side, they had problems with ears and eustachian tubes?
Anyone reading this who has had such problems? Or is it a supposition, that
it "could happen"? (In which case, since you sell an irrigation product, you
wish to remain on the safe side in your usage recommendations, to avoid
possible lawsuits. Completely understandable, if that's the case. All
product manufacturers have to be careful about that these days.)

I in fact put my head in all different positions while irrigating. I start
head facing down, later head moving towards upright (of course not fully
so). Then head to the side--first so the solution comes out of lower nostril
(irrigating into upper nostril). Then further to side, towards head facing
up (I don;t know if this is what the guy wrote about here as "upside-down
irrigation", where the solution goes into the throat, and you spit it out.
After doing that, put the head back in the other "side position" (more or
less straight to the side, where the fluid comes out of the lower nostril.
Much more will come out now, after doing the one with the head facing more
upwards, than when one earlier was in that position. Of course, repeat on
other side. After the irrigation I have to shake my head in all directions
over the bathtub, and a lot more junk comes out.

I am not recommending this to everyone. (In fact, as I just wrote in another
post, an ENT today told me to irrigate much less, and another prominent one
years ago, the head of the sinus dept at a major medical school, suggested
that I stop irrigating entirely.) It is certainly more of a hassle than
irrigating with just the head down, more unpleasant, more messy, takes more
time and solution (in fact, I usually have to use two full 1000 ml Waterpik
tanks), etc. But I can say for sure--that I get a lot more junk out that
way, than comes out when my head is facing down.

Not a recommendation to everyone. Just a statement of what works for me.
Anyone else here do that?
augustwestern - 21 Dec 2004 19:42 GMT
> >> Wrong too re your advice to hold the head to the side.  You don't want to
> hold
[quoted text clipped - 12 lines]
> with head to the side, they had problems with ears and eustachian tubes?
> Anyone reading this who has had such problems?

Yes,  it's happened to me. I find I have to be careful to keep head down
looking straight ahead while irrigating or solution gets into my Eustachian
tubes and ears and won't dry out for several days. very uncomfortable.

Sometimes, approx. a  half hour after finishing irrigating I will turn my
head side to side to release excess water from sinuses but turning my head
side to side while irrigating is a sure recipe for creating immediate
problems.
Killer Cabs Sales Team - 21 Dec 2004 21:40 GMT
Sadly I don't think any method is going to work for me - the irrigator (even
with just water in) hurts the inside of my nostrils.

I'm wondering if there's a right way to hold the handle - or should it reach
where it needs to regardless of which 'angle' the stem of the shaft faces?
(i.e. out at right angles like a tooth-brush, or held with the fist under
the chin, so as to be pointing upwards towards the nose?

--

Tony

> >> Wrong too re your advice to hold the head to the side.  You don't want to
> hold
[quoted text clipped - 41 lines]
> Not a recommendation to everyone. Just a statement of what works for me.
> Anyone else here do that?
augustwestern - 21 Dec 2004 22:22 GMT
> Sadly I don't think any method is going to work for me - the irrigator (even
> with just water in) hurts the inside of my nostrils.

Have you tried adding a bit more plain water to the irrigation solution
until the irritation heals up? Also - The Breathease preparation does work
better than plain salt/soda mix if you have severe nose irritation. Much
easier on the nose and sinuses. Unfortunately it's too expensive to keep
using all the time, so when my nasal irritation and tenderness cleared, I
switched to mixing the solution myself and now have no problems with nostril
irritation.

> I'm wondering if there's a right way to hold the handle - or should it reach
> where it needs to regardless of which 'angle' the stem of the shaft faces?
[quoted text clipped - 4 lines]
>
> Tony

The only given for me is holding the irrigation tip flush against my
nostril. Doesn't matter how I hold the handle. I do move the position around
slightly every couple seconds to redirect the irrigation solution in order
to best dislodge the mucus.  YMMV

Another important tip for irrigating is to RELAX while irrigating. If I'm
too tense I have a tendency to turn my head or blow my nose or other actions
that really don't help with the irrigation process.

Don't expect too much too soon. It took me a week of 2-3 times a day
irrigation to see any improvement at all and at least a month of daily
irrigations before I felt like I was significantly improving.    Have
patience.       AW
Larry Fletcher - 23 Dec 2004 00:30 GMT
> Sadly I don't think any method is going to work for me - the
> irrigator (even with just water in) hurts the inside of my nostrils.

I've been reading some of your posts and it looks like you might have
the same problem I had.  My sinuses were also dry with no discharge,
but there was pressure, pain and swelling that made it hard to breath
through my nose, especially at night.  When I first started irrigating
any amount of salt would be very uncomfortable, so a doctor suggested
that I use only baking soda.  I got good results with baking soda, but
eventually switched back to salt.  (If you try baking soda, use twice
as much baking soda as you would salt.  I worked my way up to 3 or 4
tablespoons of baking soda and then gradually switched back to salt.)

In my opinion, the burn you are getting is a good thing because it
stimulates the immune system to heal the infected tissue and the
salt will also kill and flush out some of the surface bacteria.  I
have always irrigated with more salt than is normally recommended, but
I only irrigate two or three times a week so tissue will have time to
heal.  I have tried daily irrigation with less salt about three times
and each time it made things worse.  (I accidently used plain water
once and it was much worse than using 3 teaspoons of salt.)  Now I use
1 1/2 to 2 teaspoons of salt to a pint of water and there is no
discomfort.  If I go over 2 teaspoons there is little burning, but
normally I don't do this because my sinuses are not infected.

 For pulsatile irrigation, one teaspoonfull of salt and between
 a pinch and 1/2 teaspoon to 16 ounces or a pint is just right.
 You are NOT going to harm yourself if you use extra salt -  up
 to 3 teaspoons - some persons recommend this. -- ENTconsult

It takes time, maybe a year or two (depending on how bad it is) for
the sinuses to completely heal, so you just have to stick with it.
But you should see continual improvement from month to month.  If it's
working some yellowish infection should wash out when you irrigate,
but not necessarily every time.  Eventually there will be less and
less, and finally none when your sinuses are healed.

I think what I had was a low grade infection that moved deeper and
deeper into the sinus tissues over time.  In my experience doctors
have no cure for this, all they can do is mask the symptoms with
steroid sprays.  Antibiotics and steroids can eventually cause
problems like fungal infections, which are more difficult to cure.
You will always get some infections from colds and the flu, but your
immune system and regular irrigation should heal those.  If for some
reason I get a stubborn infection (maybe once a year) I add a little
peroxide once or twice and after that the infection will heal.

You could also try using a near 100% saline spray once or twice a day
on the days you don't irrigate.  You don't need much, just one spray
in each side from a metered spray container.  Breathe in deeply for
each spray and it should reach all of your sinuses.  It burns like
hell for a few seconds, but I had very good results with it.

I have tried just about every irrigation additive that is water
soluble over the last 10 years and I haven't found anything that works
better than salt.  I don't know if I have ever had a fungal infection
in my sinuses, but last couple years I've been using vinegar powder
capsules (the kind without any additives) as preventive measure.  The
powder can be added to irrigation solution, but it takes some vigorous
stirring.  (I nearly died from systemic fungal infections a few years
ago.  But after trying almost every recommended cure and not getting
better, I finally tried vinegar it worked.)

If you irrigate for a few weeks and don't see any infected mucus maybe
you just have allergies that cause irritation and sinus pressure from
the trapped air.  Infected teeth, gums and ears can also cause
pressure or pain that seems to come from the sinuses.  When my neck is
out of adjustment it will cause my sinuses to swell and pressure will
eventually build up, so there is seemingly no end to the possible
causes.  But in my experience they can all be overcome, except for
allergies.  Fortunately I don't have allergies all of the time and
when I do they are usually not too bad.

If you have an infection you should increase the amount of protein
in your diet.  With less protein you might feel better, because your
immune system is not working as hard to fight off the infection, but
in the long run things will get worse.  Also try to get enough sleep
and stay away from stress.  And moderate exercise is always helpful.

By the way, I have tried Vicks VapoRub.  I apply it directly on the
skin over the area of pressure as another poster suggested and
sometimes under my nose.  If I catch a cold I use either Vicks VapoRub
or benadryl decongestant.  I think you'll probably get diminishing
returns if you use VapoRub every night indefinitely.
ENTconsult - 23 Dec 2004 05:23 GMT
If you irrigate with plain water that is painful and not good for the nose.
a teaspoonful of salt to 16 ounces fo water and 1/2 teaspoon of salt is
Isotonic - just right. If that burns you probably have a really sore nose and
should consider one of the gels for a while.
Murray Grossan, M.D.
http://www.ent-consult.com

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