Adventures in Ethics and Science

One of the sprogs gave me a cold. There is nothing like being knocked on your butt by a cold to take all of the fun out of a weekend spent not-grading research projects.

Also, it seems to have filled my head with phlegm that then got … phlegmatic. Not quite congealed, but on its way in that direction. Desperate for relief, this led me to try something new.

OK, a neti pot is actually a very old treatment, but its use is new to me. Also, it’s apparently mainstream enough that you can find it in Walgreen’s, and that the package insert claims that “it has been clinically proven to provide effective relief for uncomfortable sinus and nasal conditions and promote better breathing”.

So, the idea is that you a warm saline solution plus gravity to wash your sinus passages. The neti pot is like a little watering can that lets you introduce that warm saline into one nostril. It flows from the nostril into a sinus passage and out the other nostril, at least provided that your head is titled to offer that other nostril as the gravitationally preferred exit route. (Keeping your mouth open and breathing through it as you do it helps prevent the saline from draining into your mouth.)

Then, you repeat the process introducing saline into the other nostril. (“What, you can’t do both sides at once?” asked my better half. I chose to interpret that as a question asked from ignorance rather than a desire to make sport of a sick person.)

Watching this video demonstration made the process somewhat more intuitive to perform myself:

Let the record reflect that I skipped the calisthenics demonstrated near the end.

Some observations from a neti n00b:

First off, cramming the spout into my nostril was kind of uncomfortable. I have never thought of my nose as petite, and I’m guessing that there are plenty of folks out there with smaller nostrils than mine (especially as the packaging indicates that this product can be used by adults and children 4 years and over). I’m wondering if maybe there’s an adapter for smaller nostrils? I’m guessing, though, that it’s supposed to be a snug fit to help force the saline into the nasal passage rather than letting it dribble out around the entry nostril.

I suppose it’s also possible that my nostrils are kind of swollen on account of the cold. If I were a regular neti user while healthy, maybe there would be less difficulty with insertion.

OK, next, enjoying the sensation of the water flowing through? I’m not sure “enjoying” would make the top ten list of best words to describe the sensation. It did give me a little bit of a flashback to wave-jumping in my youth (or more precisely, to the sensation I’d get in my head when I’d been knocked underwater by a hard wave and was doing my level best not to end up with a lung full of saltwater). It wasn’t painful, but it wasn’t really relaxing, either. Maybe with practice it will be more compatible with being relaxed.

In the immediate aftermath of the nasal irrigation, it was easier to breathe freely. My nose was less stuffed up, albeit more runny. However, this didn’t last very long. I suspect part of it has to do with the miscibility of mucus (of varying thickness) and saline — some snot flowed out with the salt water, but not all of it. As well, my head is currently configured as a factory to make more mucus, so even if irrigation shipped all of what was in my nasal passages out, those nasal passages would be restocked in no time.

The neti pot may deliver temporary relief, but it is not magic. (That the package indicates you can use it as frequently as every 2 hours suggests as much.)

However, I’m hopeful that, as I’m in the stage of this cold where the mucus gets thick and sluggish, the neti pot will help me move things through effectively enough that the yummy thick mucus in my sinuses will not become the site of a secondary infection. Sinus infections can make grading (indeed, even drawing breath) a lot less fun.

Finally, here is the video demonstration I almost watched before my first use of the neti pot:

Please don’t try this at home.

Comments

#1 peter
December 15, 2009

I’ve been using one since just before some sinus surgery last april. it can feel very nice… I have found a sort of squirt-bottle variation of it that I find much easier to use. though the idea of a squirt-bottle up the nose might sound even worse, it isn’t. it’s not so much a squirt as a gentle pressure. and it means that you don’t have to cock your head off in some odd direction to pour the saline in.

one thing to look out for with these things is that depending on how full your sinus cavities are, a fair amount of water can stay behind. the first few times I used one of these, there would be a sudden rush of water coming out a couple of minutes after I thought it was all out. generally a good idea to roll your head around a couple of times just to help it all out.
#2 hibob
December 15, 2009

@ #1: Surfers call that phenomenon faucet nose. Several hours after getting tumbled by a few good waves, you lean over and (inevitably someone else is there to witness) one more sinus cavity drains out.
And I’ll second using the squirt bottle.
#3 Clayton
December 15, 2009

Just wanted to second Peter’s comment. I cannot imagine using the pot, but I’ve become a huge fan of the squeeze bottle. I’ve not used it for colds, but I have really bad allergies now in my new city and it’s done wonders for me on that front.
#4 Tracey
December 15, 2009

I tried this on the recommendation of a friend a few weeks ago when I was having horrible sinus pressure. It did indeed clear all the gunk out of my sinuses…and pushed it right into my Eustachian tubes! My ears were clogged for days and I was more miserable than before. Lesson: be careful with these and don’t blow too hard!
#5 k8
December 15, 2009

My neti pot has a tiny little hole on a bulbous end. Cheapo one from ShopKo. But I do swear by it on the worst nights of a sinus infection. It doesn’t “cure” my ills like it says it will, but it certainly helps me get to sleep at night.
#6 Peter Lund
December 15, 2009

“It wasn’t painful, but it wasn’t really relaxing, either.”

You are not supposed to be able to feel the water inside your nose (and sinuses). You probably added a little bit too much or a little bit too little salt. Or you have chlorine in the water supply?

You are also not supposed to stuff anything into your nostril — it seems like the Walgreen’s one and the one in the lower video are simply not built right. A proper one should be built like k8′s.

This is what mine looks like:
http://www.bricksite.com/neti

And the “callisthenics” at the end actually matters if you want to avoid this:
“one thing to look out for with these things is that depending on how full your sinus cavities are, a fair amount of water can stay behind”

You might also want to tilt your head more than she does in the video. She tilts very little for the first nostril and a bit more for the second — try tilting your head a bit more than that.

And finally, you might want to do it a couple of times in a row to get everything cleared it
#7 Paula
December 15, 2009

Now that the your nephew is reporting to his petrie dish every day (oh wait, I meant school), I have been getting a lot more colds, and beating them faster and had less severity. I started “experimenting” and here is my new remedy: as soon as I feel a cold coming on, I take an extra multivitamin, 1 800mcg tablet of Folic Acid and 1 Metagenics Ultra Flora Plus capsule (probiotics). A little extra fruit and veggies, and rinse with listerine once a day. After following this for 2-3 days my cold is completely gone.
#8 Texas Reader
December 15, 2009

Guafanesin, which thins the secretions so things will drain (thus decreasing the risk of getting a secondary bacterial infection) is now over-the counter. It’s sold as Mucinex. Anytime I get congestion I take that AND do the neti pot. The guafanesin makes the sinus rinse much more effective. I also take naproxen (Aleve) as it has much more of an anti-inflammatory effect than ibuprofen.
#9 RM
December 15, 2009

Texas – Guafanesin has been OTC for the longest time – think “Robitussin”. What makes Mucinex different (and therefore advertiseable) is that it’s a timed release formula, reducing dosing to once every 12 hours, as opposed to the once every four hours with prior formulations (and most house-brand Mucinex-alikes).

Also, I’m no doctor/pharmacist, but I was under the impression that guafanesin is really only for chest congestion. Nasal congestion needs a decongestant, rather than an expectorant – something like Pseudoephedrine/Phenylephrine (Sudafed). The topical/nasal spray decongestants like Oxymetazoline (Afrin) work wonders, but relief is unfortunately short lived, as you tend to suffer from rebound congestion when you come off of them.
#10 padraig
December 15, 2009

Speaking as one who has sinuses designed in hell — I went through the clean-out surgery TWICE, and I would suffer through a thousand dental visits before doing another one — I am a devoted user of sinus flushes. My incidence of severe sinus infections has dropped from 2-3 per year to about one every 18 months at most.

I think the pot, though, is a leftover from the hippie holistic days. I use the squirt bottle (also available from Walgreens). Take the top off, nuke for 10-30 seconds depending on fluid level, lean over sink* and squirt. Squeeze gently until you get the touch to avoid the tsunami effect. It’s a lot easier to squirt way up there than to try to pour it uphill.

*I recommend private facilities for this exercise.
#11 LP
December 15, 2009

1. That burning sensation from the saline can be countered by adding a tiny pinch of baking soda, which adjusts the pH so it doesn’t hurt. (http://en.wikipedia.org/wiki/Nasal_irrigation)

2. Mucinex definitely works for nasal congestion. I use only Mucinex plus a mind antihistamine, and NEVER a decongestant – usually this combo works so well, no one can detect that I’m even sick.
#12 Lisa
December 15, 2009

http://www.neilmed.com has the “squeeze type” bottles. I’ve had a lot of success with this brand. However, they are not kidding when they say not to use it your sinuses are completely congested.
#13 Jon
December 15, 2009

Squirt bottle here as well. I make my own solution – mix 50% iodine-free table salt with 50% baking soda. 1/2 TBS of that mix goes in my 8 oz squirt bottle that I fill with warm tap water. That concentration may be a little strong for newbies.
#14 Dario Ringach
December 15, 2009

We use the bottle here for the kids. Nothing beats a bit of pressure… and one day I have to video tape what comes out of there. They enjoy grossing out their friends. Endless family fun.
#15 Janet D. Stemwedel
December 15, 2009

I’ve also had people recommend using a bulb syringe to do a nasal wash. If I knew where the sprogs hid the one we got when they were babies, I might have tried that.

On a related note, a long long time ago (when the younger Free-Ride offspring was approximately 2 years old), the younger Free-Ride offspring managed to get a whole coffee bean lodged in a nostril. (Totally wrong delivery method for caffeine, sprog!) It took a lot of fussing to coax it out, but if we had been thinking about how sinuses are connected, we could have covered the kid’s mouth and blown in the other nostril to pop it out.
#16 Texas Reader
December 15, 2009

RM – decongestants reduce the swelling in the sinuses – they don’t change the character of the mucus. Guafinesin reduces the thickness of the mucus so it can run out more easily. Of course it also makes it easier to cough up mucus in the chest.

Some folks can’t take decongestants as they can raise blood pressure.

LP – thanks for the tip about the baking soda as the salt water can burn a bit!
#17 Mandrake
December 16, 2009

What Lisa@12 said. My ENT recommended Nasal/Sinus Rinse from Neilmed after I had surgery for a deviated septum (and what padraig@12 said–the cleanout process was *miserable*). The product comes with the pre-mixed powder, which is essentially sodium chloride and baking soda. If you’re very congested and feel a lot of pressure, don’t force it–it can cause some damage. Use once or twice a day. Man, some of the stuff that flushes out during a cold…

I don’t know if it prevents or shortens colds or allergy problems, but I can tell that after I rinse, my sinus and nasal passages are clean enough to eat off of.
#18 Jerry
December 16, 2009

I was diagnosed with chronic sinusitis several years ago. My MD voted for surgery, while my sister suggested nasal irrigation.

I have tried the squirt bottles, which I use when I travel, but at home I prefer pulsatile nasal irrigation. Dr. Grossan and his company Hydromed have modified a waterpik system with a special adaptor that fits in your nostril. I find that this system works best for me. I have been rinsing every day for many years.

Hydromed sells a saline mix that contains bicarbonate as well as xylitol. They claim that the xylitol stimulates ciliary movement in the epithelium of the upper respiratory tract.
#19 dave
December 16, 2009

warm water, much more comfortable
#20 padraig
December 16, 2009

Janet, I started out using “the blue bulb” for my flushes, trying hard not to think about where it had been in its previous existence…

I switched to the Neilmed squirter that Lisa described and will never go back. I’ve also mixed my own solution, but Neilmed’s combination package with squirter and solution packs is proportioned so I run out of their solution about the same time the squirter is wearing out, so I just replace the whole shebang. Call me lazy and extravagant.
#21 kathy
December 17, 2009

Okay, first off, what does it say that so many nasal irrigaters exist and are okay with discussing it? I too prefer the squeeze bottle. I found this video, but did not know anyone who would appreciate it, but now maybe I have…enjoy
http://www.buzzfeed.com/peggy/the-downward-spiral-of-sinus-rinse-addiction
#22 Scott Wilson
December 17, 2009

First, I want to thank you for including the video of the author of toothpaste for dinner, one of my favorite comics on the web (he’s the guy who puts a very nice whiskey up his nose). You should see some of his videos of his pug, Charles.

Second, last year I had, for the first time in my life, repeated sinus infections, and someone recommended the neti pot. I had the same problem as you at first-I would use it and still have “stuff” up there. One night, in exasperation, I just went ahead and netied again. And again. And after the fourth time of doing this, ALL of it came out. At once. It was amazing. I went from unable to breathe or think, to being free and easy. Of course, the infection was still there, and it created more gunk in an hour or so. But that one hour of freedom was worth it.

So, my advice is, if at first you do not succeed, try try again.
#23 dave
December 17, 2009

the mucolytics mentioned above actually do squat all either for lung or nasal congestion. But Robitussin shots taste good….