Medical Forum / Diseases and Disorders / Sinusitis / December 2004
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
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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?
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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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