Nasal spray for congestion?

My doctor recommends using saline nasal spray to help with congestion. I
have very bad allergies and before I was pregnant, took Zyrtec daily along
with Rhinocort Aqua prescription nasal spray. I find that saline nasal spray
does not help (and tastes very bad)...I am trying not to take anything
during my first trimester, but I was wondering if anyone knows if it's ok to
use a prescription (in the U.S)nasal spray along the lines of
Flonase/Rhinocort/Nasonex?

My doctor's office allows sudafed up to 3 times a day, but I don't like the
way it makes me feel and don't want to use it while pregnant unless I
absolutely have to.

I forgot to ask my doctor's office, and this is something that can wait
until Monday for me to call them, but I just wanted to check around and see
if anyone here is using one while pregnant. Doctors are different- an
acquaintence who's also pregnant says her doctor will NOT allow sudafed in
the first trimester. Some doctors seem to think some things are more ok in
later trimesters so I am wondering if Rhinocort may be ok or is a no-no.

On Sun, 19 Oct 2003, Jill wrote:

My doctor recommends using saline nasal spray to help with congestion.

You might want to consider some non-"treatment" options. If you like hot
foods, you might want to use some really hot salsa with chips as your
snack, or maybe california rolls with extra wasabi. Or sweet and sour
soup. Or you could go with a more traditional sinus clearer: Chicken
noodle soup. I also like hot oatmeal -- something about the heat and steam
and stick-to-your-ribs density really keeps the sinuses feeling open. And
then there are some beverage options, but you may want to check with your
doc before trying anything -- I've read warnings about lots of standard
tea herbs including chamomile and licorice, so ask ahead. It kind of feeds
into the "small meals to avoid indigestion" mindset. Good luck!

"Jill" wrote in message
...
My doctor recommends using saline nasal spray to help with congestion. I
have very bad allergies and before I was pregnant, took Zyrtec daily along
with Rhinocort Aqua prescription nasal spray. I find that saline nasal
spray
does not help (and tastes very bad)...I am trying not to take anything
during my first trimester, but I was wondering if anyone knows if it's ok
to
use a prescription (in the U.S)nasal spray along the lines of
Flonase/Rhinocort/Nasonex?

My doctor's office allows sudafed up to 3 times a day, but I don't like
the
way it makes me feel and don't want to use it while pregnant unless I
absolutely have to.

I forgot to ask my doctor's office, and this is something that can wait
until Monday for me to call them, but I just wanted to check around and
see
if anyone here is using one while pregnant. Doctors are different- an
acquaintence who's also pregnant says her doctor will NOT allow sudafed in
the first trimester. Some doctors seem to think some things are more ok in
later trimesters so I am wondering if Rhinocort may be ok or is a no-no.



I am currently taking Flonase, Clarinex, and Flovent (for asthma) for bad
allergies. They seemed to think ti would be worse for me to be off of them.
I was on allergy medicine with my first and she is completely alright.
Kat
Mama to Maggie 11/03/01
and #2 EDD 02/01/04 (It's a Boy!)

On Sun, 19 Oct 2003 00:21:05 GMT, "Jill" wrote:

My doctor recommends using saline nasal spray to help with congestion. I
have very bad allergies and before I was pregnant, took Zyrtec daily along
with Rhinocort Aqua prescription nasal spray. I find that saline nasal spray
does not help (and tastes very bad)...I am trying not to take anything
during my first trimester, but I was wondering if anyone knows if it's ok to
use a prescription (in the U.S)nasal spray along the lines of
Flonase/Rhinocort/Nasonex?

I was allowed to use it in the third trimester because I couldn't
breathe and wasn't sleeping. It's definitely something to ask about
but since I gather the sprays act directly on the nasal membranes and
don't really pass into the blood stream it shouldn't be too had. The
only thing to remember is that it does have a rebound effect if you
use it for more than about 48 hours and can actually make your
congestion worse. I restricted myself to just using it before I
wanted to sleep and having hot showers to help clear my nose out in
the mornings.


--
Cheryl
Mum to DS#1 (11 Mar 99), DS#2 (4 Oct 00)
and DD (30 Jul 02)

Jill wrote:
My doctor recommends using saline nasal spray to help with
congestion. I have very bad allergies and before I was pregnant, took
Zyrtec daily along with Rhinocort Aqua prescription nasal spray. I
find that saline nasal spray does not help (and tastes very bad)...I
am trying not to take anything during my first trimester, but I was
wondering if anyone knows if it's ok to use a prescription (in the
U.S)nasal spray along the lines of Flonase/Rhinocort/Nasonex?

My doctor's office allows sudafed up to 3 times a day, but I don't
like the way it makes me feel and don't want to use it while pregnant
unless I absolutely have to.

I forgot to ask my doctor's office, and this is something that can
wait until Monday for me to call them, but I just wanted to check
around and see if anyone here is using one while pregnant. Doctors
are different- an acquaintence who's also pregnant says her doctor
will NOT allow sudafed in the first trimester. Some doctors seem to
think some things are more ok in later trimesters so I am wondering
if Rhinocort may be ok or is a no-no.

I was prescribed Flonase during my 2nd trimester for allergies, but I found
that Claritin (also recommended) worked well enough. I took Afrin for a
NASTY head to chest infection (zero to needing antibiotics in 3 days) during
my late first trimester. My OB said it was okay but that you should never
use Afrin (or similar) for more than 3-4 days to avoid making things worse.

As for Sudafed, I was advised by a pharmacist during that horrible infection
that it is only Category C because of its effect on blood pressure during
the 3rd trimester. Other than that, its basically a Category B (same as
Tylenol).

Every doctor has differing opinions on safe medicines, but Sudafed and
Tylenol are the ones I see listed the most as okay. If you want to be
safest, wait and call your doctor on Monday.

- Joanne
#1 - 36w4d

"Kat" wrote

I am currently taking Flonase, Clarinex, and Flovent (for asthma) for bad
allergies. They seemed to think ti would be worse for me to be off of
them.
I was on allergy medicine with my first and she is completely alright.
Kat
Mama to Maggie 11/03/01
and #2 EDD 02/01/04 (It's a Boy!)


I am going to try to wait until I am as far along as possible but I am going
to go ahead and talk to my doctor about at least the nasal spray...I can't
sleep and I feel so panicky that my heart starts beating really fast when I
can't breathe through my nose. I have tried eating hot foods to clear my
sinuses but my nose is very stopped up- I think what makes it worse is that
I have a problem with small nasal passages anyway; I have had a few doctors
comment that it looks like I have a hard time breathing through my nose
because "there's no room in there", whatever that means. One doctor though I
had polyps stopping it up.

I have been doing great as far as not having panic attacks and I ended up
not even taking Paxil for that, but my nose has been a lot worse over the
past few weeks. I feel SO very short of breath. I keep mentioning that to my
doctors.
I really don't *want* to have to take anything, but .....if it's ok I do
want to take a nsoe spray- that works better than pills anyway.

"jjmoreta" wrote
Every doctor has differing opinions on safe medicines, but Sudafed and
Tylenol are the ones I see listed the most as okay. If you want to be
safest, wait and call your doctor on Monday.

- Joanne
#1 - 36w4d

I'll let you know what my doctor says tomorrow. Even if she gives an ok I am
still going to try to hold out, but I will be honest, I am hoping she says
it's no risk. Why does my nose stop up at bedtime anyway, and is fine during
the day?? If it were the reverse it wouldn't be as much of a problem.
Hot/spicy foods do tend to drain my sinuses but after that effect wears off
my nose stops up more than ever. I have tried wasabi (I love california
rolls normally but have lost a bit of my appetite for them pregnant)....I
have tried hot salsa and I forget what all else- I can't eat too hot because
it gives me heartburn.

On Sun, 19 Oct 2003 16:36:42 GMT, "Jill" misc.kids.pregnancy :


"Kat" wrote

I am currently taking Flonase, Clarinex, and Flovent (for asthma) for bad
allergies. They seemed to think ti would be worse for me to be off of
them.
I was on allergy medicine with my first and she is completely alright.
Kat
Mama to Maggie 11/03/01
and #2 EDD 02/01/04 (It's a Boy!)


I am going to try to wait until I am as far along as possible but I am going
to go ahead and talk to my doctor about at least the nasal spray...I can't
sleep and I feel so panicky that my heart starts beating really fast when I
can't breathe through my nose. I have tried eating hot foods to clear my
sinuses but my nose is very stopped up- I think what makes it worse is that
I have a problem with small nasal passages anyway; I have had a few doctors
comment that it looks like I have a hard time breathing through my nose
because "there's no room in there", whatever that means. One doctor though I
had polyps stopping it up.

I have been doing great as far as not having panic attacks and I ended up
not even taking Paxil for that, but my nose has been a lot worse over the
past few weeks. I feel SO very short of breath. I keep mentioning that to my
doctors.
I really don't *want* to have to take anything, but .....if it's ok I do
want to take a nsoe spray- that works better than pills anyway.



I'm having a terrible time with nasal congestion too. I take a medicine at night that stuffs up my
nose EVERY night exactly one hour after I take it. I can not sleep without the medicine but I also
can not sleep when my nose is stopped up. I've had to give up and use OTC nasal spray every night..
that is really a bad thing to do.. but what I do it just use one squirt in one nostril each night..
every other night I switch nostrils so one side sort of gets a 48 hour break before I use the spray
in it again. I also use Beconase and I irrigate with saline soulution.

I have a water pic and a grossen tip that I use for nasal irrigation. .. often I have to get up in
the night and use it so I can sleep because the stuff running down the back of my throat gets too
think to swallow.

On Sun, 19 Oct 2003 16:40:24 GMT, "Jill" misc.kids.pregnancy :


"jjmoreta" wrote
Every doctor has differing opinions on safe medicines, but Sudafed and
Tylenol are the ones I see listed the most as okay. If you want to be
safest, wait and call your doctor on Monday.

- Joanne
#1 - 36w4d

I'll let you know what my doctor says tomorrow. Even if she gives an ok I am
still going to try to hold out, but I will be honest, I am hoping she says
it's no risk. Why does my nose stop up at bedtime anyway, and is fine during
the day?? If it were the reverse it wouldn't be as much of a problem.
Hot/spicy foods do tend to drain my sinuses but after that effect wears off
my nose stops up more than ever. I have tried wasabi (I love california
rolls normally but have lost a bit of my appetite for them pregnant)....I
have tried hot salsa and I forget what all else- I can't eat too hot because
it gives me heartburn.


http://www.ent-consult.com/irr_bibliog.html

Partial Irrigator Bibliography with Abstracts

--------------------------------------------------------------------------------

General Articles on Pulsatile Nasal Irrigation & Sinusitis
Pulsatile Nasal Irrigation in Children
Rhinitis
Allergy
Asthma
Post-Operative Care
Fungus Infection
Cystic Fibrosis


More Laboratory-Oriented Topics:

Ciliary Function & Mucociliary Clearance (Documentation of Improved Function of the Cilia)
Irrigation Fluid & Salinity
Pulsatile Action



Pulsatile Irrigation of the Throat
Pulsatile Irrigation For the Ears


--------------------------------------------------------------------------------




General Articles on Pulsatile Nasal Irrigation & Sinusitis
Clinical Study and Literature Review of Nasal Irrigation, Davidson, T., Laryngoscope 110: July 00

Patients at the Nasal Dysfunction Clinic an Univ. of Cal. San Diego had excellent relief by daily
irrigation with pulsatile irrigation for sinusitis, perennial allergy, seasonal allergy, postnasal
drip, and associated fatigue. Very well accepted by patients.

The Complete Self-Care Guide to Holistic Medicine, Robert Ivker 1999

"[Pulsatile] Nasal Irrigation with salt water using a . . . nasal attachment to a pulsatile
irrigator is extremely helpful for flushing infected sinuses or cleansing the membranes of the nose
and sinuses."

Management of Sinusitis: Current Clinical Strategies, Michael Kaliner MD and David W Kenned, MD, in
Sinusits Disease Management Guide. PDR 2000

"If the patient has recurrent disease he may buy a Pulsatile irrigator with the ... nasal adapter.
....particularly effective after surgery." page 121, "Treatment of Chronic Sinusitis - Nasal washing
....applied through the Pulsatile irrigator and [nasal] adapter twice a day is recommended. Page 122

Therapeutic Agents In The Medical Management Of Sinusitis, Mabry, R.L. In: Inflammatory diseases of
the sinuses. Otolaryngologic Clinics Of North America, Volume 26, Number 4, pp 561, 1993.

Not only is the [pulsatile] Sinus Irrigator beneficial for patients with bothersome thick postnasal
secretions, but is especially helpful for postoperative cleansing following nasal surgery.

Sinusitis: Acute, Chronic and Mangegeable, Rachelevsky G S, Slavin R G et all. Patient Care. Feb 28,
1997 Vol 131:4.

"A particularly helpful strategy is saline washing using a Pulsatile irrigator. Sinus irrigator is
so effective in clearing the blocked passages that , if it is done regularly, some patients with
persisitent or chronic sinusitis need no drug treatment at all.

A Device for Nasal Irrigation,Grossan M Transactions of the American Academy of Ophthalmology and
Otolaryngology. 78: July 1974 279-280

An easy method of sinus treatment at home or office. With this device the patient can leave the
office with the bacterial load reduced, hence requires less antibiotic and much greater patient
satisfaction.

Sinusitis: Bench to Bedside, Kaliner MA et al. Otolaryngology June 97 116:6 Part 2 Study of
Sinusits.

Pulsatile sinus irrigation is recommended as a treatment for sinusitis, and as a supplement to other
treatment modalities.

A New Nasal Irrigator Device. Grossan M. The Eye, Ear Nose And Throat Monthly. March 1974

Application of pulsatile irrigation for post nasal drip and phlegm

A Device To Aid Nasal Mucociliary Flow, Grossan A.N.L. March 1976 pp 65-70.

In Japan there is a very high incidence of sinusitis requiring surgery. Pulsatile irrigation is
helpful to avoid surgery.

Office Measurement of Nasal Mucociliary Clearance, Grossan, M. English: Otolaryngology 1994 Vol 2 ch
7

The saccharin test is an objective measure of one very important aspect of the respiratory defense
system. Many diagnostic dilemmas are solved using this test. The nasal test reflects the chest
condition. Using pulsatile irrigation, one can improve both.

Treatment of Sinusitis in the Next Millennium, Kaliner, M. Allergy and Asthma Proceedings, 19:181-4,
1998

Saline irrigation using a pulsating stream and sinus adaptor is an effective non-drug treatment for
sinusitis

Nasal Hyperthermia and Simple Saline Irrigation for Perennial Rhinitis, Changes in Inflammatory
Mediators, Georgitis JW. Chest 106:1487 - 82, 1994

Saline irrigation with Pulsatile irrigator and . . .[nasal] adaptor reduces significantly the
presence of mediatiores of inflammation in the nasal exudate six hours after treatment.

Sinus Survival, Ivker R., Putman Publication 1995.

Pulsating irrigation is shown to remove pus and allow for natural, holistic healing.

A Device for Nasal Irrigation, Grossan, M. Transactions of the American Academy of Ophthalmology and
Otolaryngology. 78: July 1974 279-280.

Nasal irrigation is found to be an easy method of sinus treatment at home or office. With this
device the patient can leave the office with the bacterial load reduced, hence requiring less
antibiotic and producing greater patient satisfaction.

Pulsation Irrigation: a Simple, Safe Effective Treatment of Many Nasal Complaints, Pope, A., O.R.L.
Digest August 1974 15:8 pp 3638.

Pulsatile nasal irrigation is recommended as a simple safe treatment for many sinus, ear and allergy
complaints. High patient acceptance and enthusiasm is reported.

A New Nasal Irrigator Device, Grossan, M., The Eye, Ear Nose and Throat Monthly, March 1974.

Application of pulsatile irrigation for post nasal drip and phlegm is described.




Pulsatile Nasal Irrigation in Children
Pediatric sinusitis, Manning, Scott, C., In: Inflammatory Diseases of the Sinuses. Otolaryngologic
Clinics of North America. Volume 26, Number 4, pp 623-638 (1993).

Pulsatile irrigation works for children, even without antibiotics.

Irrigation of the Child's Nose, Grossan, M., Clinical Pediatrics, March 1974 13:3 229-231.

Children with sinusitis, post nasal drip or nasal blockage use pulsatile nasal irrigation at age 5
or older. By removing discharge, adenoid and tonsil hypertrophy were reduced. Irrigation was also
found to be an aid to clearing the ear.




Rhinitis
Geriatric Rhinitis: What it is, how to treat it. By Jennifer A Jordan, Geriatrics: June 98.

Pulsed irrigation of nasal passages may be performed using a [pulsating] device equipped with the .
.. . nasal tip applicator.

RhinitisAnd Nasal Obstruction, Lucente, F.E. In: Nasal Obstruction. Otolaryngologic Clinics Of North
America, Volume 22, Number 2, pp 307, 1989.

The Pulsatile irrigation device with the ... nasal irrigator tip is an efficient system for
irrigation . The irrigant is instilled as a pulsating stream into one nasal cavity and drains out
through the other side. [Pulsatile irrigation] effectively loosens crusts.

Atrophic Rhinitis, Goodman, Wilfred S. English: Otolaryngology Vol 2 Ch. 14 1984

Atrophic rhinitis varies in severity and is difficult to cure. Dr Goodman recommends Pulsatile
irrigation for symptomatic relief and treatment.

Medical Management of Rhinitis, Fadal R. English: Otolaryngology Vol 2:Ch 13

The principal benefits from pulsatile irrigation include: 1. Augments mucociliary flow 2 Liquefies
tenacious mucus 3. Soothes irritated tissues 4. Removes crusts and microforeign bodies 5. Augments
tissue repair 6. Reduces forceful noseblowing 7. Improves olfaction.

Chronic Rhinitis, a Practical Approach to Diagnosis And Treatment, Zeigler, R. Shatz , M Part 2
Treatment. Immunology, Allergy Practice 1982. 4:3 pp 26-36

Good allergy management includes use of irrigation for removal of offending particles and restoring
normal ciliary flow.

Allergic or Non Allergic Rhinitis, Meltzer EO, In Allergy: Principles and Practice, editors:
Middleton and Reed. Vol 2 pp 1181, 1992

It has been shown in many patients with chronic rhinitis that mucociliary transport is markedly
increased after two weeks of one or two times a day irrigation using the Pulsatile irrigator with
the [nasal] attachment.

Rhinitis, Allergy: Principles and Practice, 3rd edition. Middleton E. CV Mosby Company Ch 17, 1988

All forms of allergy rhinitis are benefitted by saline irrigation with the Pulsatile irrigator and
nasal attachment.

Medical Management of Rhinitis, Fadal R. English: Otolaryngology 1996, Vol 2:Ch 13.

The principal benefits from saline irrigation are shown to include: 1. Augments mucociliary flow 2
Liquefies tenacious mucus 3. Soothes irritated tissues 4. Removes crusts and microforeign bodies 5.
Augments tissue repair 6. Reduces forceful noseblowing 7. Improves olfaction.

Atrophic Rhinitis, deSouza, F.M.: Chapter 14N English: Otolaryngology 1996.

The Pulsatile irrigator dental irrigation device with the... nasal irrigator tip is shown to
increase the efficiency of saline nasal douches.

Atrophic Rhinitis, Goodman, Wilfred S., Otolaryngology Vol 2 Ch. 14 1984.

Atrophic rhinitis varies in severity and is difficult to cure. Pulsatile irrigation is recommended
for symptomatic relief and treatment.

Chronic Rhinitis, a Practical Approach to Diagnosis and Treatment, Zeigler, R. Shatz , M Part 2
Treatment. Immunology, Allergy Practice 1982. 4:3 pp 26-36.

Good allergy management is shown to include irrigation for removal of offending particles in order
to restore normal ciliary flow.

Atrophic Rhinitis, deSouza F.M.: Chapter 14N, English: Otolaryngology 1996.

"The Pulsatile irrigator dental irrigation device with the . . .nasal irrigator tip has increased
the efficiency of saline nasal douches."





Asthma
Sinusitis and Bronchial Asthma, Slavin RG: J Allergy and Clinical Immunol 66:250-257, 1980

Slavin presents three mechanisms re sinusitis causing asthma. Clearing sinusitis is important in
asthma.

Allergies and Asthma for Dummies by William E Berger, MD

"use a Pulsatile irrigator with nasal attachment to irrigate with warm saline solution to relieve
pressure and congestion in your nasal passages "







Allergy
Inhibition Of The Seasonal Ige Encrease To Dactylis Glomerata By Daily Saline Nasal - Sinus
Irrigation During The Grass Pollen Season, Journal of Allergy and Clinical Immunology. In press

Pulsatile irrigation works for allergy by removing the IgE so that the pollen doesn't cause
symptoms.



Allergies and Asthma for Dummies by William E Berger, MD - see above in Asthma

Current Review of Allergic Diseases 2001 edited by Michael A Kaliner

[Pulsatile] Irrigation is recommended for nasal problems.

Prospects for ancillary treatment of rhinosinusitis in the 1990's, Zeiger RS. , J Allergy Clin
Immunol 1992;90:478-495

Recommends pulsatile irrigation to reduce or eliminate allergy symptoms.





Post-Operative Care
Perioperative Care in Functional Endoscopic Sinus Surgery, Sonkens JW, Miller R.J. Highlilghts of
the Instructional Course. Ed Lucente, editor Chapter 24. pp267-277

Pulsatile irrigation should be done 1 to 3 times a day postoperatively until no further benefit is
achieved.

Endoscopic Paranasal Sinus Surgery, Rice, D., Ravens Press 1993.

Pulsatile irrigation before sinus surgery is recommended to reduce infection and after surgery to
restore ciliary function and reduce patient's symptoms.

Rhinoplasty Edited by Rolin K Daniel, M.D. 1993 Chapter 2 by Geroge Meredith.

Four days after nasal surgery start to use the Pulsatile Irrigator . Almost all patients find the
cleaning provided by pulsatile irrigation a great source of comfort. It significantly improves
mucociliary transport in the first few weeks postoperatively

Evaluation of methods of Sinus Nasal Irrigation Irrigation Post Sinus

Surgery, Cenjor, C. Gutierrez, R. Congress of Spanish Society of Otolaryngology and Cervical Facial
Pathology. Las Palmas de Gran canaria, 12- 16 Octubre de 1998

"Pulsatile Irrigation is the preferred method of treatment after endoscopic surgery. Highly accepted
by patients.



Fungus Infection
Effect of anti-fungal nasal lavage with amphotericin B on nasal polyposis.

Ricchetti A, Landis BN, Maffioli A, Giger R, Zeng C, Lacroix JS.

J Laryngol Otol 2002 Apr;116(4):261-3

Rhinology Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Geneva University
Hospital, Switzerland.

Recent studies have suggested that allergic fungal rhino-sinusitis could be involved in the
development of nasal polyposis. The aim of this study was to evaluate the response of anti-fungal
nasal lavages. Patients performed nasal lavage with 20 ml of a one per one thousand amphotericin B
suspension in each nostril, twice a day, for four weeks. In addition, all patients continued their
saline nasal lavage and their conventional topical corticosteroid spray. This study included 74
patients, with a mean age of 46 years (range from 19 to 73). Before anti-fungal treatment, the
distribution of nasal polyposis, according to Malm, was: 13 patients in stage I (17.5 per cent), 48
patients in stage II (65 per cent) and 13 patients in stage III (17.5 per cent). After anti-fungal
nasal lavages, the total disappearance of nasal polyposis was observed in 29 patients (39 per cent).
Eight patients were stage I, 21 stage II, and none stage III. In patients who have had previous
endoscopic polypectomy and functional endoscopic sinus surgery,

total disappearance of nasal polyposis was seen in 24 patients (47 per

cent). Hyper-reactivity to fungal organisms could be one of the mechanisms underlying the
development of nasal polyposis. A direct effect of amphotericin B suspension on the integrity of the
cell membrane of the polyps' epithelium could not be excluded.

Effects of Aspergilis fumigatus and Alternaria on human ciliated epithelium in vitro

Cody,DT 2nd,Mcaffrey, TV. Kern,E Laryngoscope.1997. Nov:107 1511-4

Nasal cilia are inhibited by toxins from Fungi. Inhibition of the cilia can reduce the effectiveness
of natural healing.




Cystic Fibrosis
Management Of Sinusitis In Cystic Fibrosis, Moss RB, King W. . Arch Otolaryngol Head Neck Surg.
1995;1 21:566-572.

Stresses the use of pulsatile irrigator with nasal adaptor for home use. Recommends antibiotic
irrigation of sinuses.

Pulsatile irrigator Irrigation with [Nasal] Adaptor is used for CF, Cystic Fibrosis Currents Volume
11, No 4

Method For Rapid Evaluation Of Topical Of Topically Applied Agents To Cystic Fibrosis, Wine JJ, King
W, Lewiston NJ Am J Physiol. 1991261 (Lung Cell Mol Physiol. 5):L21 8-L221

Pulsatile isinus irrigation makes an ideal vehicle for local administration of antibiotics and other
products.

Management of Chronic Sinusitis in Cystic Fibrosis, Davidson, T., Laryngoscope 105:354 April 1995.

Cystic fibrosis is commonly associated with sinusitis due to mucociliary system failure. Patients
may benefit by lung transplant. Pre-op pulsatile saline irrigation is found to be a successful means
of clearing the sinus of disease.





More Laboratory-Oriented Topics

Ciliary Function & Mucociliary Clearance
Mucociliary Clearance and Buffered Hypertonic Saline Solution, Talbot A, et al Laryngoscope
107:April 1997

Stresses the importance of saline irrigation for Mucociliary Clearance for patients with acute and
chronic sinusitis, and post operative functional endoscopic sinus surgery. Finds close correlation
with the saccharin test to other methods of measurement.

Enhancing The Mucociliary System, Grossan, M. Advances for respiratory care practitioners.. April
17, 1995 8 pp12-13

Coughing, wheezing, respiratory complaints may be significantly benefited by use of the pulsatile
saline irrigator. Removing pus from the sinus via simple irrigation can significantly speed healing
and prevent spread of infection from the sinus to the lungs. Daily removal of pus by the patient at
home is beneficial.

Sinusitis: Complications And Sequelae: An Otolaryngologist's Perspective, Fairbanks, D.N.F.: Pediatr
Infect Dis J 4 (Suppl 6) 875-878 1995

Shows that radiographic material placed in the nose before bedtime is found in the tracheobronchial
tree in the morning. Thus sinus secretions can contaminate the tracheobronchial tree causing
infection and bronchospasm. Hence the value of irrigation to remove offending material.

Evaluation of methods of Sinus Nasal Irrigation Irrigation Post Sinus Surgery, Cenjor, C. Gutierrez,
R. Congress of Spanish Society of Otolaryngology and Cervical Facial Pathology. Las Palmas de Gran
canaria, 12- 16 Octubre de 1998

Pulsatile irrigator irrigation with ... sinus adaptor is the preferred method of treatement after
endoscopic surgery. Highly accepted by patients.

Office Measurement of Nasal Mucociliary Clearance, Grossan, M., English: Otolaryngology 1994 Vol 2
ch 7.

The saccharin test is shown to be an objective measure of one very important aspect of the
respiratory defense system. Many diagnostic dilemmas are solved using this test. The nasal test
reflects the chest condition. Using pulsatile irrigation, one can therefore improve both chest and
sinus problems.

Ciliary Beating Frequency in Chronic Sinusitis, Nuutinen J, Arch Otolaryngol Head Neck Surg 119:645,
1993.

After diseased mucosa is cleared of thick mucus and bacteria, ciliary function is shown to return.

Mucociliary Flow in Otolaryngology Practice, Grossan M., Insights in Otolaryngology. August 1993 8
:2-8.

Many noxious exposures can inactivate mucociliary clearance, including smog, exhaust fumes,
chlorine, chromium, etc. The sooner normal ciliary activity is restored, the sooner the natural
physiology of the defense system can ward off illness. Hot tea, chicken soup, iodides, and pulsatile
irrigation are shown to be important aids to the natural defense system.

The Saccharin Test of Nasal Mucociliary Function, Grossan, M., Eye, Ear, Nose and Throat Monthly
1975 5411), pp 415-417.

An objective test of mucociliary clearance is described. This test is useful for measuring cilia
function before and after pulsatile nasal irrigation to objectify degree of improvement.

Nasal Mucociliary Flow - A Clinical View, Grossan, M., Amer Acad of Otol and Ophth Scientific
Presentation Dallas 1975 (certificate of merit award).

How to effect improvement of mucociliary clearance.






Irrigation Fluid & Salinity
Classification of Cilio-Inhibiting Effects of Nasal Drugs. Paul Merkus. Laryngoscpe: 111 April 2001
pp595 - 601

Use of Locke-Ringer's formula is best for enhancing cilia. On a 1-100 scale, Locke-Ringer's is 100.

Physiologic and Hypertonic Saline Solutions Impair Ciliary Activity in Vitro, Boeck,Wilbert. Keles,
Nesil. Graamans, Kees, Laryngoscope March 99 No 3, p.396.

Certain hypertonic saline solutions cause ciliostasis (the cilia stop functioning) from which the
cilia may not recover. If cilia are permanently damaged, the ability to fight infection is lost.

Ringer-Lactate solution versus isotonic saline solution on mucociliary

function after nasal septal surgery.

Unal M, Gorur K, Ozcan C.

J Laryngol Otol 2001 Oct;115(10):796-7

Irrigation with isotonic saline is one of the most frequently used solutions after nasal surgery.
However, the effect of saline solutions on mucociliary clearance is not well known. In a previous
study, it was found that isotonic saline solution had a negative effect on ciliary beat frequency
but Ringer-Locke solution had no effect in vitro. In this study we compared the effects of
Ringer-Lactate solution and isotonic saline solution on mucociliary transport time before, and
after, nasal septal surgery in patients with nasal septal deviation. We found that patients who used
Ringer-Lactate solution as irrigation after surgery had a significantly better mucociliary transport
time than the patients using isotonic saline solution (p 0.05). In conclusion, it is better to use
Ringer-Lactate solution instead of 0.9 per cent saline solution for nasal irrigation. (Breathe.ease
XL is a modified Ringer —Lactate product)






Pulsatile Action
Using Pulsatile Pressure Saline/Antibiotic Irrigation, Betts N. et al. Compendium Contin Educa Dent,
17(9): 871 1996.

The efficacy of pulsatile saline irrigation has been demonstrated in orthopedics, surgery and dental
literature too.

Evaluation Of Wound Irrigation By Pulsatile Jet And Conventional Methods, Brown LL; Shelton HT. Ann
Surg. 1978 Feb, 187:2, 170-3

Comparison with pulsatile irrigation versus bulb syringe - only pulsatile irrigation about
significant reduction of bacteria. Conclusion: pulsatile irrigation removed bacteria from
experimental wounds more efficiently than conventional procedures.

The Efficacy of Various Irrigation Solutions in Removing Slime Producing Staphylococcus, Anglen, J.
J., Orthop Trauma 1994 Oct;8(5):390-6.

In an orthopedic research project, it is shown that pulsatile irrigation is 100x more effective in
removing bacteria from a site than simple irrigation, and is even more effective than some
antibiotic solutions in tests for clearing infection.


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Pulsatile Irrigation of the Throat
A Mechanical Throat Irrigator, Grossan, M., Transactions of the American Academy of Ophthalmology
and Otolaryngology. 77: January 1973.

Throat irrigation is shown to significantly reduce the need for antibiotics, and to possibly reverse
the need for tonsillectomy. It is also shown to be specifically valuable to prevent the spread of
infection within the family.

An Instrument for Throat Irrigation, Grossan, M., The O.R.L. Digest July 1972 39:7 pp10-13.

A method to replace gargling is presented that is safe and pleasant. Gargling may cause laryngitis
and has been shown to be ineffective.

Irrigation Treatment of Throat Infections, Grossan, M, The Eye, Ear, Nose and Throat Monthly. August
1972 51:8 pp302-305.

Irrigation of the throat is shown to bring blood to the area, encourage lymphatic drainage, and
remove bacteria on the surface and in the crypts.





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Pulsatile Irrigation For the Ears

A New Ear Irrigator, Grossan, M.: Arch. Otorhinolaryngology 1978 86(6):936-937.
A new design for a pulsatile ear irrigation device is described. The principles of nasal and throat
irrigation apply well to irrigation of the ear. In this design, 3 balanced, pulsating water jets are
used which do not strike the ear drum; instead they rock the wax for removal, avoiding the trauma of
pressure on the ear drum or jamming the stapes back and forth.


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Last Update 2003 October 8

You might want to sleep with your head elevated. Also, hot compresses on
your face will help as will breathing in hot steamy water. Bring some water
to boil and sit with your head under a towel to loosen up the mucous.
Drinking plenty of water will also loosen up the mucous.
--
Sue (mom to three girls)
I'm Just a Raggedy Ann in a Barbie Doll World...

Jill wrote in message
...

"jjmoreta" wrote
Every doctor has differing opinions on safe medicines, but Sudafed and
Tylenol are the ones I see listed the most as okay. If you want to be
safest, wait and call your doctor on Monday.

- Joanne
#1 - 36w4d

I'll let you know what my doctor says tomorrow. Even if she gives an ok I
am
still going to try to hold out, but I will be honest, I am hoping she says
it's no risk. Why does my nose stop up at bedtime anyway, and is fine
during
the day?? If it were the reverse it wouldn't be as much of a problem.
Hot/spicy foods do tend to drain my sinuses but after that effect wears
off
my nose stops up more than ever. I have tried wasabi (I love california
rolls normally but have lost a bit of my appetite for them pregnant)....I
have tried hot salsa and I forget what all else- I can't eat too hot
because
it gives me heartburn.