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Sinusitis Tips - Relief for the Sinus Sufferer

Sinus Sufferers: Most Often Asked Questions about Chronic Sinusitis, Sinus Relief.
By Dr. Murray Grossan
Dr. Murray Grossan is a noted ENT specialist . Dr Grossan is one of the USA's leading medical experts on Sinusitis. Dr Grossan is the creator of the pulsatile nasal irrigator attachment to Waterpik, an award winning medical device and subject of numerous research studies over the past 20 years. Visit Dr. Grossan's web site.

Check out Dr Grossan's new book "The Sinus Cure" published by Ballantine for $12.95 goes on sale at bookstores, or at www.sinus-relief.com on February 27th. This Book is about simple solutions to chronic sinus problems.
Index    
Why is a nasal irrigator more effective than saline nose drops...?
The recent Mayo Clinic research findings talked about finding fungi in the nostrils of sinus sufferers. Could one add an anti fungal such as grape seed extract to the saline solution for better results...?
After using your nasal irrigator I have the urge to blow my nose-is this a good thing to do? Does it clean out the nostrils of bacteria, allergens etc or does blowing my nose dry it out again...?   I noticed you don't recommend steam inhalation for sinus relief why...?
Would it be helpful to take saline spray to the workplace to keep one's sinuses moist in the dry air-conditioning at work...?   So, would using a saline spray several times daily be a good preventative measure for sinus sufferers to keep their sinuses moist...?
What do you consider to be the optimal humidity for a sinus sufferer in their bedroom at night...?   What is the best compromise between fresh air/open windows [more moisture] and avoiding allergens entering the bedroom...?
Some sinus sufferers seem to have the worst time at night, waking up with pain over the eyes and nose...?   For the early morning sinus sufferer I see you recommend lemon tea on wakening...?
It is the middle of the night and I wake up with my sinuses killing me- the best quick fix...?   I read that heart burn [digestive problems ]trigger sinus problems-is this why you recommend papaya enzyme tablets to reduce sinus swelling...?
You talk about using slow acting niacin as a supplement how does that help...?   I have read that Urtica /Stinging Nettle is recommended in Germany...?
There are a number of new over the counter saline plus herbs/oils sprays such as Alkalol, Ayr, Ocean available. Can you comment on what you see to be the best of the bunch...?   What do you think of Vancenese and Flonase as prescription nasal sprays...?
What are the ingredients to avoid in over the counter nasal sprays-the ones that have the rebound effect and make you worse long term...?   Does Sudafed have a rebound effect...?
When is the time for any sinus sufferer to say "Ok I have had it" and ask for antibiotics...?   When should you go for surgery...?
How important is it to get the proportion of non iodized salt to the Water Pik well water exactly right...?   In summary: What would be a good regimen of care for a problematic sinus...?
What is the difference between using the Netti pot and the Grossan Sinus Irrigator ?
Q.

What are the main causes of sinus disease ?

A.

The main causes of sinus disease are blowing nose too hard, not clearing up the first infection, getting chilled , not resting, and drinking iced drinks. This may start out a mild infection but with heavy "macho" blowing, the pus is spread all around the nose and ear.

With the allergy sufferer, after sneezing and exhaustion, without rest, the sinus infection may become chronic. Weather can make a sinus condition worse, but it is not be a cause.

In menstruation and pregnancy there may be swelling of the membranes, but this is not the cause of the sinusitis.

Most sinus problems show slow nasal cilia. These are the microscopic hairs that beat to move the bacteria out of the nose into the throat where they are swallowed and the stomach takes them out. By using saline with a special attachment that fits on the standard pulsating dental irrigator device such as a Water Pik " the cilia are pulsed at a rate of 20 pulses per second at a special pressure that is just right. Thick mucus is removed so that the cilia return to normal rate of beating. If the pressure is too high you can put pus into the ear or other parts of the sinuses. There is a chemical called ICAM - 1 that is the entry way for the common cold virus. Pulsatile irrigation is ideal for removal of this so that the cold virus can't enter. IgE is the chemical that the allergy products - dust, pollen - combine with to make the allergy symptoms. This is also removed by pulsatile irrigation. The flow of the saline past the sinus openings displaces out the pus in the sinus. There are at least 30 medical journal articles that recommend this treatment for both sinusitis and allergen control.

Q. Why is a nasal irrigator more effective than saline nose drops?
A.

The saline drops don't pulse the cilia back to normal, don't flow past the sinus openings to displace the pus and may contain preservatives that irritate the nose.

Q.
How often should you use the nasal irrigator?
A.

The sinus irrigator should be used daily if there are symptoms ,or if the common cold or allergy season is bad. If there are no symptoms, this means the cilia are working OK and you don't need the irrigation.

Q. The recent Mayo Clinic research findings talked about finding fungi in the nostrils of sinus sufferers. Could one add an anti fungal such as grape seed extract to the saline solution for better results?
A. I see no objection to adding grape seed extract to the irrigation. It will take me some time to evaluate the result of this addition.
Q. After using your nasal irrigator I have the urge to blow my nose-is this a good thing to do? Does it clean out the nostrils of bacteria, allergens etc or does blowing my nose dry it out again?
A.

After you irrigate, your sinuses contain the saline solution. This solution has displaced the mucus, bacteria, etc that was in the sinus. Usually the cilia start to move as a result of the pulsation and this is why 20 or more minutes later the saline comes out. This is very desirable. It shows the saline went where you want it to go.

Q. I noticed you don't recommend steam inhalation for sinus relief why? I have always found when I have a cold, a steam inhalation with eucalyptus was helpful.
A. Steam inhalation does bring circulation to the area, but hot steam can inactivate the cilia and if the nose has swollen membranes, the steam keeps the moisture in the tissue from evaporating.
Q. Would it be helpful to take saline spray to the workplace to keep one's sinuses moist in the dry air-conditioning at work?
A. Good idea. Saline spray is helpful to keep the nose moist. Be sure to avoid Benzalkonium and Thimersal preservatives as these may burn and irritate the nose. Breathe.ease doesn't contain any of these ingredients.
Q. So, would using a saline spray several times daily be a good preventative measure for sinus sufferers to keep their sinuses moist? It seems a really cheap, and easy thing to do?
A. Yes, daily saline spray can be helpful to prevent sinus problems.
Q. What do you consider to be the optimal humidity for a sinus sufferer in their bedroom at night?
A. The optimal humidity is about 20 %.
Q. What is the best compromise between fresh air/open windows [more moisture] and avoiding allergens entering the bedroom?
A. Simple answer! Close the windows in allergy season. The plants pollinate at 5 AM. If the windows are open the pollen hits the nose. For allergy sufferers the body thermostat doesn't work well and any chilling starts the cascade of sneezing, etc.
Q. Some sinus sufferers seem to have the worst time at night, waking up with pain over the eyes and nose. Why is that?
A. The reason why sinus sufferers feel worse at night, and awaken with pain is that during sleep, the cilia "sleep", so dust, pollens accumulate giving maximum swelling.
Q. For the early morning sinus sufferer I see you recommend lemon tea on wakening? Why?
A. For the allergy sufferer the thermostat is off kilter. Instead of getting up out of bed and starting the day, the allergic/ sinus patient erroneously warms up his body by sneezing and hacking. This does warm the body but it starts a cascade that is undesirable. By drinking hot tea before getting out of bed the body is warmed and there is no need to sneeze.
Q. It is the middle of the night and I wake up with my sinuses killing me- the best quick fix? I am not going to irrigate in the middle of the night.
A. Prevent this before it happens. Do pulsatile irrigation and let papaya tablets dissolve in your mouth the day before. Let chewable papaya tablets one four times a day dissolve in your mouth between the cheek and gums [available in your local health food store for about $6:50 or from http://www.mothernature.com or http://www.greentree.com If you wake up place a chewable papaya tablet in your mouth and let it dissolve. You should be able to go back to sleep.
Q. I read that heart burn [digestive problems ]trigger sinus problems-is this why you recommend papaya enzyme tablets to reduce sinus swelling?
A. No, this has nothing to do with heart burn or reflux of acid from the stomach. You can take papaya for digestion, but in that case you swallow it. This is a totally different deal. The chewable papaya for sinusitis is anti inflammatory, reduces swelling and thins the mucus, allowing the cilia to function. If it is a really painful sinus pain, the relief can be very dramatic.
Q. You talk about using slow acting niacin as a supplement how does that help?
A. Slow release niacin is recommended where painful muscles are present. At a daily dose of 125 mg niacin is especially helpful in removing lactic acid from the area. Often the person doesn't know if the sinus pain / headache is from the neck referred to the sinus area or from the sinus area itself. Or could be from both. The niacin helps the neck pain.
Q. I have read that Urtica /Stinging Nettle is recommended in Germany for sinus trouble as it supposedly eases inflammation of sinus passages and boosts your body's production of bacteria killing white blood cells in as little as two days. Your comments?
A. I haven't had personal experience with this.
Q. There are a number of new over the counter saline plus herbs/oils sprays such as Alkalol, Ayr, Ocean available. Can you comment on what you see to be the best of the bunch?
A. Alkalol is an excellent mucus thinner that patients use in the WaterPik irrigator. AYR, Ocean, and the other saline sprays are OK for dry nose. After you finish the bottle you can mix your own as long as you replace it once a week.
Q. What do you think of Vancenese and Flonase as prescription nasal sprays?
A. These are good products, dozens of good studies support their use. They are cortisone derivatives. They can, on long term use, cause erosion or ulceration and bleeding. If the doctor prescribes it I would certainly use it, but don't forget other "helpers" - dust proofing the bedroom, hot tea, avoid iced drinks, and other important items.
Q. What are the ingredients to avoid in over the counter nasal sprays-the ones that have the rebound effect and make you worse long term?
A. Any of the Afrin type nose sprays can have rebound effect. This can be quite upsetting. First you use it every 12 hours, then you need it every 8 hours, eventually you need it every 2 hours. In addition, that much medication makes you nervous. If this occurs you need prescription medication to counteract the nose drops.
Q. Does Sudafed have a rebound effect?
A. No
Q. When is the time for any sinus sufferer to say "Ok I have had it" and ask for antibiotics?
A. If the discharge continues to be colored, and there is fever and general feeling sick, then is the time to consider antibiotics.
Q. When should you go for surgery? Do you see surgery as being over used as a recommendation?
A. Surgery is indicated when regular treatment fails and x -rays show significant disease plus absent drainage channels. It never hurts to get a second opinion, then you can relax that you really do need the surgery. At least in our practice we don't overuse surgery since we spend considerable effort to avoid it, but sometimes there is no other way.
Q. How important is it to get the proportion of non iodized salt to the Water Pik well water exactly right? Or is it better to use a premixed saline solution?
A. Most persons do well with one teaspoon of salt or Breathe.ease to a pint of water. This is called isotonic. Isotonic means same salt mix as in your blood. If the solution is too salty, may burn and dry the nose out. If not salty enough may burn too. With salt, you can add a pinch of baking soda to make the solution less acid. With Breathe.ease you don't need to add any product. You can try making the solution more salt by gradually decreasing the amount of water. If one teaspoon of Breathe.ease to 250 cc or 8 ounces of water, that is 2x normal isotonic.
Q. In summary: What would be a good regimen of care for a problematic sinus?
A. Be very gentle when you blow. Use bed rest and warm applications to the sinus area when there are symptoms. Continue the pulsatile irrigation until the return is clear. This usually indicates return of function of the cilia. When there is sinus infection be sure to take in enough fluids so that your urine turns light. Do the procedures that restore the normal nasal cilia.
Q. What is the difference between using the Netti pot and the Grossan Sinus Irrigator?
A. The original Yoga method was to sniff saline rapidly in and out the nose in a regular rhythmic manner. The Grossan Sinus Irrigator does this by pulsing at the rate of speed that the cilia should pulse at if they were healthy. Normal cilia pulse at 16 pulses per second so the Water Pik speed waves the cilia back and forth to encourage this movement. The regular flow is ideal for creating a vacuum that sucks pus out of the sinus cavity by Bernoulli's principle. In addition the pulsing action acts to pump liquid into the sinuses and thereby displace the pus. Another point is that the pulsation is much more effective for removing debris, bacteria and crusts. Over 37 medical journal articles recommend this method . You can control the pressure and the device is such that you don't mess up your clothes while doing this. The major advantage too is that it is so gentle that 5 year olds will do it. The Netti pot doesn't pulsate. The flow is not controlled. You have to really get your head in a scrunch position to use it and even then the solution goes all over your face and down your sleeves. The rate of flow is barely enough to create a vacuum to pull puss out of the sinus cavities. There is no pulsing action to restore cillia. This is NOT the original yoga method described 3000 years ago.

For more information on Murray Grossan see his bio.

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