I'm very interested in medicated saline rinses, as I'm dealing with nasal congestion caused by dust mite allergy. I've seen great progress with standard nasal rinse. Question: Is there any way you can just crush any standard oral antihistamine, and add it to your nasal rinse? I think these special azelastine capsules featured in the video would be hard for me to obtain. Also: what is your experience with long term use of steriods (mometasone) dissolved into nasal rinse. I would imagine a big problem over time would be breakdown of the septum / nose bleeds, as the medication comes more into contact with the septum using the nasal rinse, compared to when using the standard nasal spray (flonase).?
@@rasmusvindinghansen The dose is going to be different when obtaining an antihistamine or steroid or any drug intended for a high volume nasal rinse (240mL is a standard rinse bottle). The capsules, which I currently obtain for patients via prescription to AdvancedRX in Pennsylvania, are formulated to dissolve to an appropriate dose in these 240mL saline bottles and the usual rinse packets (NeilMed or Xlear) are also added to prevent irritation and maintain salt balance. When dilute, the medications are safe for twice daily use and I haven’t seen anyone with localized irritation, bleeds, or mucosal atrophy/breakdown. This can happen with sprays because a more concentrated dose of medicine reaches the mucosa near the front of the nose (I.e. anterior septum where this crusting and bleeding is most often seen). Mometasone in particular is the safest topical steroid option, least likely to cause mucosal reactions (which I did see occasionally when prescribing Budesonide for rinses), and absorbs more locally into the mucosa and less into the bloodstream compared to other steroid options.
@@snotdoctx8742 thanks, that's a great answer! Could you inform me with the typical dosages you typically prescibe for nasal rinses with medicine, because I'm not sure my own ENT doctor has a lot of experience with these medicated nasal rinses? It's not something I've ever heard her talk about.
@@rasmusvindinghansen the usual rinse I prescribe includes 1mg Mometasone and 0.5mg Azelastine added to 240 mL distilled water and a NeilMed sinus rinse packet. When inflammation or polyp disease are more significant, I occasionally use 2mg Mometasone and 1mg Azelastine on tough cases. These rinses are safe up to twice daily for long term use per the pharmacy and the studies they reference when determining dosing.
@@Gladioli10 the xylitol works great when treating a dry or irritated nose. I recommend Xlear nasal rinse packets in place of the usual NeilMed packets whenever someone has those complaints. The baby shampoo is more complicated. Its regular use is associated with progressive loss of smell function, but there are occasional cases where sticky and infected drainage is challenging to clear and short courses of baby shampoo rinses are worth that trade off.
@@snotdoctx8742 Thank you! I've had chronic sinusitis since August, antibiotics didn't help (cefixime). Been rinsing with xylitol/salt with great relief but last week out of desperation I rinsed with one drop of baby shampoo as well. To my surprise I haven't had green/yellow mucus since, and I'd get it daily especially in the morning before. I'm not gonna do it again since it seems risky, I'll stick to xylitol/salt, but what an interesting experiment it was lol. It may have "cured" me.
@@watchyourplate9150 I would get an ENT evaluation - usually we would scope your nose or check a CT Sinus scan to determine the cause in addition to a careful history in case it’s allergic or a recent viral illness, etc. Structural issues like a deviated septum might require surgery, especially if it’s felt clogged for a long time and is bothersome
Hello sir,how can take treatment from you.sir my problem is that my nose is blocked all time and i have mild headache and there is a loud noise from my throat during sleep.No one wants to sleep next to me.i think if i get your treatment,i will get rid of this problem.
@@rashidserker5426 I’m located in Houston and The Woodlands, Texas. If you live elsewhere, I do virtual consults, but generally in person is much better to allow for better care including imaging and nasal endoscopy when needed. You can set up an appointment by calling 713-791-0700 (My Houston Surgeons) or submit online at premiersinus.com
Every time I tried to nasal rinse I felt some discomfort in my ears afterwards (changes in ear pressure and feel like I need to pop my ears) even though I made sure I’m being gentle, my technique is correct (leaning forward) and my nose isn’t blocked at the time. I don’t know if it’s safe for me to continue using it, what should I do?
The Navage electric nasal rinse device might be a good alternative in your case, as it pulls the saline across with a vacuum rather than pushing with the squeeze bottle. This is better at avoiding getting liquids into the ears with rinsing. The only downside is that it limits head position such that you’re more upright. Fine for rhinitis from allergies, less ideal if you’ve had sinus surgery and you’re trying to get rinses into all of your sinuses.
@@simonstones1918 could be allergies, chronic sinusitis, frequent exposure to airborne irritants such as dust, fumes, cigarette smoke, etc. if it’s persistent and you have other symptoms such as facial pressure, nasal congestion, smell loss, etc you should be evaluated by an ENT with nasal endoscopy and possibly CT Sinus to determine the underlying nature of the symptoms and guide treatment
@@snotdoctx8742 I’ve had a long standing issue with nasal polyps. I’ve had around 5 polypectomys. Just this last week my nose is morning inflamed than it has been and there’s a bit of white and very sticky mucus coming out. I lost my taste and smell completely about a week ago, too. Airways seem mostly clear though 🤔 I’m seeing an ent consultant tomorrow as it goes. Last consultant I saw said only small polyps up there so thought no need to operate. However, now I’ve lost my taste and smell….! 😖
@@ET4eva9487 the problem with Navage - it can only be used in a suboptimal head position. As I mention in this video, you can only rinse into your sinuses by tilting your head forward or back significantly. The squeeze bottles like NielMed can be used in any head position. Navage is designed to use with your head upright, which is essentially cleaning the lower nasal cavity and can help with allergy symptoms, but doesn’t clean or deliver meds into the sinuses. It’s also unclear if the suction of the machine might risk causing bleeds while healing from surgery. It’s not a bad product, but you should pick delivery system based on what you need to treat
Thanks, Doc! I’ve been rinsing as directed and I’m happy to see that I’m doing everything correctly. So glad I found your video. Time to rinse now!
Thank you for sharing this. I recently had surgery and was having difficulty figuring out how to do this correctly. Very informative.
Good job
I'm very interested in medicated saline rinses, as I'm dealing with nasal congestion caused by dust mite allergy. I've seen great progress with standard nasal rinse. Question: Is there any way you can just crush any standard oral antihistamine, and add it to your nasal rinse? I think these special azelastine capsules featured in the video would be hard for me to obtain. Also: what is your experience with long term use of steriods (mometasone) dissolved into nasal rinse. I would imagine a big problem over time would be breakdown of the septum / nose bleeds, as the medication comes more into contact with the septum using the nasal rinse, compared to when using the standard nasal spray (flonase).?
@@rasmusvindinghansen The dose is going to be different when obtaining an antihistamine or steroid or any drug intended for a high volume nasal rinse (240mL is a standard rinse bottle). The capsules, which I currently obtain for patients via prescription to AdvancedRX in Pennsylvania, are formulated to dissolve to an appropriate dose in these 240mL saline bottles and the usual rinse packets (NeilMed or Xlear) are also added to prevent irritation and maintain salt balance. When dilute, the medications are safe for twice daily use and I haven’t seen anyone with localized irritation, bleeds, or mucosal atrophy/breakdown. This can happen with sprays because a more concentrated dose of medicine reaches the mucosa near the front of the nose (I.e. anterior septum where this crusting and bleeding is most often seen). Mometasone in particular is the safest topical steroid option, least likely to cause mucosal reactions (which I did see occasionally when prescribing Budesonide for rinses), and absorbs more locally into the mucosa and less into the bloodstream compared to other steroid options.
@@snotdoctx8742 thanks, that's a great answer! Could you inform me with the typical dosages you typically prescibe for nasal rinses with medicine, because I'm not sure my own ENT doctor has a lot of experience with these medicated nasal rinses? It's not something I've ever heard her talk about.
@@rasmusvindinghansen the usual rinse I prescribe includes 1mg Mometasone and 0.5mg Azelastine added to 240 mL distilled water and a NeilMed sinus rinse packet. When inflammation or polyp disease are more significant, I occasionally use 2mg Mometasone and 1mg Azelastine on tough cases.
These rinses are safe up to twice daily for long term use per the pharmacy and the studies they reference when determining dosing.
I'd be curious to know your opinion on rinsing with one drop of baby shampoo and xylitol.
@@Gladioli10 the xylitol works great when treating a dry or irritated nose. I recommend Xlear nasal rinse packets in place of the usual NeilMed packets whenever someone has those complaints. The baby shampoo is more complicated. Its regular use is associated with progressive loss of smell function, but there are occasional cases where sticky and infected drainage is challenging to clear and short courses of baby shampoo rinses are worth that trade off.
@@snotdoctx8742 Thank you! I've had chronic sinusitis since August, antibiotics didn't help (cefixime). Been rinsing with xylitol/salt with great relief but last week out of desperation I rinsed with one drop of baby shampoo as well. To my surprise I haven't had green/yellow mucus since, and I'd get it daily especially in the morning before. I'm not gonna do it again since it seems risky, I'll stick to xylitol/salt, but what an interesting experiment it was lol. It may have "cured" me.
My right nasal is dry no mucus yet always clogged i feel there something inside that is swelling. What should i do?? 😢😢
@@watchyourplate9150 I would get an ENT evaluation - usually we would scope your nose or check a CT Sinus scan to determine the cause in addition to a careful history in case it’s allergic or a recent viral illness, etc.
Structural issues like a deviated septum might require surgery, especially if it’s felt clogged for a long time and is bothersome
Hello sir,how can take treatment from you.sir my problem is that my nose is blocked all time and i have mild headache and there is a loud noise from my throat during sleep.No one wants to sleep next to me.i think if i get your treatment,i will get rid of this problem.
@@rashidserker5426 I’m located in Houston and The Woodlands, Texas. If you live elsewhere, I do virtual consults, but generally in person is much better to allow for better care including imaging and nasal endoscopy when needed. You can set up an appointment by calling 713-791-0700 (My Houston Surgeons) or submit online at premiersinus.com
Every time I tried to nasal rinse I felt some discomfort in my ears afterwards (changes in ear pressure and feel like I need to pop my ears) even though I made sure I’m being gentle, my technique is correct (leaning forward) and my nose isn’t blocked at the time.
I don’t know if it’s safe for me to continue using it, what should I do?
The Navage electric nasal rinse device might be a good alternative in your case, as it pulls the saline across with a vacuum rather than pushing with the squeeze bottle. This is better at avoiding getting liquids into the ears with rinsing. The only downside is that it limits head position such that you’re more upright. Fine for rhinitis from allergies, less ideal if you’ve had sinus surgery and you’re trying to get rinses into all of your sinuses.
What’s causing my white very sticky mucus?
@@simonstones1918 could be allergies, chronic sinusitis, frequent exposure to airborne irritants such as dust, fumes, cigarette smoke, etc. if it’s persistent and you have other symptoms such as facial pressure, nasal congestion, smell loss, etc you should be evaluated by an ENT with nasal endoscopy and possibly CT Sinus to determine the underlying nature of the symptoms and guide treatment
@@snotdoctx8742 I’ve had a long standing issue with nasal polyps. I’ve had around 5 polypectomys. Just this last week my nose is morning inflamed than it has been and there’s a bit of white and very sticky mucus coming out. I lost my taste and smell completely about a week ago, too. Airways seem mostly clear though 🤔 I’m seeing an ent consultant tomorrow as it goes. Last consultant I saw said only small polyps up there so thought no need to operate. However, now I’ve lost my taste and smell….! 😖
Just get navage it's automatic and way better
@@ET4eva9487 the problem with Navage - it can only be used in a suboptimal head position. As I mention in this video, you can only rinse into your sinuses by tilting your head forward or back significantly. The squeeze bottles like NielMed can be used in any head position. Navage is designed to use with your head upright, which is essentially cleaning the lower nasal cavity and can help with allergy symptoms, but doesn’t clean or deliver meds into the sinuses. It’s also unclear if the suction of the machine might risk causing bleeds while healing from surgery. It’s not a bad product, but you should pick delivery system based on what you need to treat