Saturday, January 29, 2011

Snake Oil Revisited

Just over a year ago I posted about my unfortunate experience with various allergy medicines. At the time I had been suffering from a globus sensation (the feeling of a having a lump in your throat) due to post-nasal drip. The Zyrtec I was given made me drowsy, but did little else, and the Flonase gave me frequent and profuse nosebleeds.

This past fall (i.e., weed season when my allergies are at their worst) I started having sinus problems again. The pressure and inflamation got so bad that it started to affect my ears, which gave me vertigo. I couldn't look from one computer screen to the next without a wave of dizziness. After several weeks of this, I finally conceded to go to the doctor. Apparently the view up my nose and in my ears was worse than usual, so he prescribed me antibiotics and Flonase (yes, the nosebleed stuff).

The antibiotics didn't really do anything, suggesting that bacteria doesn't have much to do with my sinusitis. It's probably being caused by allergies and is being worsened by a cold that's going around in our family. As for the Flonase, it turns out that I had probably been using it wrong before. I may not have been putting the tip of the spray bottle far enough in and I was allowing the medicine to spray towards the septum. Apparently directly spraying Flonase at that area can thin the skin and result in nosebleeds; you're supposed to spray away from the septum and towards your eye. Also, my congestion may have been so bad that the spray wasn't getting very far up the nasal passages.

This is where the Neti pot comes in. The Neti pot originated in ancient Hindu practices and has become popular with the alternative medicine crowd. Normally I have little faith in such things, but I'm willing to try anything if it works. The device looks like a small tea pot and is used to flush out the sinuses. I had never heard of it until a friend of ours posted about his positive experience. A little while later we received a free NeilMed Neti pot thanks to my wife's ongoing crusade to take advantage of every product promotion possible.

To use the Neti pot, you mix warm water with a mixture of salt and baking soda, tilt your head over a sink, and then pour the solution into one nostril and allow it to run out the other. Yes, this is as weird as it sounds. And it actually works.

Effective, but undignified

WebMD (in which we put nearly as much credence as in a real doctor), says this:
The basic explanation of how the Neti pot works is that it thins mucus to help flush it out of the nasal passages.

A more biological explanation for how the Neti pot works has to do with tiny, hair-like structures called cilia that line the inside of the nasal and sinus cavities. These cilia wave back and forth to push mucus either to the back of the throat where it can be swallowed, or to the nose to be blown out. Saline solution can help increase the speed and improve coordination of the cilia so that they may more effectively remove the bacteria, allergens, and other irritants that cause sinus problems.


In studies, people with very severe sinus symptoms found relief from using the Neti pot or other nasal irrigation system daily. Three times a week was often enough once symptoms subsided.
Recently, I've had pretty good results by irrigating my sinuses with the Neti pot followed with a dose of Flonase. Although not exactly a cure, this has reduced the pressure and prevents most of the vertigo. At this point I'm happy to have any relief at all.

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