Ep.6 - Sinus Saline Rinses and the Dreaded Neti Pot
Stacy Wellborn compares using her neti pot to getting waterboarded and Dr. Ron Swain, Jr. explains why in this sixth installment of the Swain Sinus Show. Dr. Swain sets Stacy straight on how she should be using her dreaded neti pot. We all get some tips on baby-stepping the routine use of saline rinse bottles and other sinus irrigation products. Plus, Dr. Swain discusses the importance of saline rinse solutions and clears up why they are so important for the before and after a sinus operation.
What You WIll Hear:
1. Dr. Swain likes the NeilMed Sinus Rinse kits. 2. What is a saline rinse? 2. The difference between the “smooth” isotonic saline and hypertonic saline. 3. How to properly use a saline rinse and a nets pot. 4. First steps and some secrets to being able to use a saline rinse. 5. How to customize the salinity and temperature of the water to fit your personal needs. 5. The importance of saline rinses before and after sinus surgery.
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Call Dr. Swain’s nursing staff at 251-470-8823 or schedule and appointment at drronswain.com
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Full Transcript of Ep.6 - Sinus Saline Rinses and the Dreaded Neti Pot
Stacy: Hi, Dr. Swain.
Ron: Hello, Stacy.
Stacy: What is a sinus rinse? Are there different types, and is there one you recommend the most?
Ron: Not to put a corporate plug out there, but I'm a real fan of the NeilMed Sinus Rinse kits, which they sell at most of the big drug stores and even some of the grocery stores. So there's isotonic saline, which is kind of the...you can think of it as the same way as the same salt as your body has, or there's hypertonic saline, which is much more salty than your body, than the salt in your body. And so isotonic saline is usually very soothing. You don't want to use the hypertonic saline, which can be kind of irritating. And occasionally I'll have people come in and say, "You know, I've been using some of that salt, but I figure if, you know, more is better, so we've got two or three packets in there."
Stacy: Not always better.
Ron: Not always better, but physicians have been using salt since the beginning of time really, in terms of managing wounds and keeping things clean. So salt has an anti-inflammatory property, but in higher concentrations, it can be irritating. So if I'm getting someone and they're using over-the-counter stuff, when you walk in what medicine do I pick, the real question is, is what's going on with me? And so many times you don't know. And sometimes people come in and see me, and it takes me a little while to kinda figure it out because you gotta ask the right question, you gotta look in the nose, and then you gotta maybe take some pictures to say, "Hey, you know, this is what it is," and then, you know, it's a trial and say what works and what doesn't work. And what people are willing to tolerate, you know? You were telling me earlier that, you know, using saline rinses in your nose is like waterboarding.
Stacy: Yes, I couldn't do it. I tried that neti pot thing, and that did not work for me.
Ron: Right, and there are people like that. But when I have someone who's really gun-shy about using something like that in the nose, even if you get 'em using some baby saline nose drops, and most people can tolerate something that, you know, you can use in a baby's nose, it's very gentle, but the idea that the salt drops can actually get in the nose and maybe help wash or rinse some of the mucus that they're complaining about is helpful.
It's kind of a first step, you know? You may not be the one to use the saline rinse now, but if I can get you to start using just a few little saline nose drops in your nose, and then maybe we can graduate to a nasal steroid spray, then maybe, maybe you'll be the one person that we can get to use that.
I would probably say on average, once I start people...telling people about the saline rinses and explain to them how to use the rinses, I probably have about 85% of my patients come in and say, "That's the best thing I've ever done."
Stacy: Well, you know, I see people on Facebook all the time say they love their neti pot, they love their sinus rinse, and I'm thinking, "I can't do that." And so I see where you have to start small and graduate up and eventually get there, because I know people get value out of the rinses, obviously. I'm just a big wimp.
Ron: No, you're not. I think there are a few little secrets, things you don't think of. One of the biggest things is the temperature of the water. I have actually done this on myself. I've used water that I've gotten outta the freezer, I've gotten water that's room temperature, I've used warm water because I don't wanna tell somebody to do something that I haven't done...
Stacy: I appreciate that.
Ron: ...or at least, you know, just so I can understand what they're telling me, you know? So warm water usually always is a winner. I will...most people will tell me, "Look, if I use cold water, I get a headache." And it can; I'm just telling you.
Stacy: Like an ice cream freeze, you know, freezes your head.
Ron: Right. I've done that. I'm admitting that on the podcast, but I have done that, and it...I mean it will give you a headache. And there are some people who, if they come in to see me, especially after they have sinus surgery, because if you've had a sinus operation using those rinses, it's so important. It is the most important thing. The aftercare of a sinus operation is just as important, if not more important than the actual operation. You gotta have the operation done properly in the right way, but you've gotta have the appropriate aftercare. And so getting someone to use the rinses or trying to figure out why they're not able to tolerate it, I mean that's a...that's so important. If we were talking about you in particular and what we were gonna do, you know, I'd say, "Look, start with baby steps."
Stacy: I might practice before my surgery.
Ron: You might practice before your surgery, but you start with baby steps. You know, we give you a bottle. I don't want you to use the whole bottle, maybe use a third of the bottle, maybe you use two or three squirts of the bottle. Let's adjust the temperature of the water. Make sure you're using one packet and not two packets. And then, you know, there are just some people that just...they're just not gonna be able to tolerate it, and so you try and use some other things. For the person that's going to have a sinus operation or is having a...has had a sinus operation, once you get them to understand and you figure out how you can adjust it, so that's...and individualize it so that it...that it's acceptable to them, most of them time they're grateful.
Stacy: So it sounds like the rinses, in general, are a great tool that you use with patients. While the neti pot might not necessarily be my thing, if I need it, I know now to come to you to learn how to use the neti pot and not to do it on my own.
Ron: So yes, a lot of people will use a neti pot, they're using it as a general term for using saline irrigation, and we just need to be sure that we're all talking about the same thing.
Stacy: Right. I do think that the one that I used was the kind you had to turn your head. And I remember kinda having my head over the sink and trying to put this in my nose, and it just made a mess.
Ron: It's awkward, especially if you're a new user to it. The first few times you actually use it before you kinda figure it out, you get water everywhere, and people are like, "Is...how is this supposed to go down my nose?" So, you know, anatomically it's...we're on the...we're on a microphone so I can't show you, but atomically, I mean, there is an opening in the back of your nose to go down to your throat, everybody has that. And so if the water is not going down the back of your nose and out your throat, usually it's because people are tensing up their palate. I mean, you know, we've been drinking water throughout the show, well, normally the way you swallow is water goes in your mouth, your...the top of your palate, and your uvula, little punching bag thing in the back of the throat, that slams up against the post pharyngeal wall, and all the water kinda goes down the back of your throat, that's why you don't have water coming out of your nose. And so when you're rising out your nose, if you activate those muscles and you're trying to fight it, then all that water comes out the same side of your nose or the other side of your nose. Occasionally how people too, they're just really are so congested, or their septums are so crooked that they just can't get any water up their nose.
Stacy: Okay, I'm gonna ask a very novice question. So when you do those nasal rinses, is the water supposed to come back through your mouth?
Ron: We would like for it to. I mean, that's probably the easiest...it's the most comfortable way for that rinse to work, because what you're doing is there...you're rinsing out your nose. And a lot of people don't understand that, especially when you start talking about this. You want the water to go through your nose and wash all that mucus with all the inflammation stuff out of your mouth and into the sink. There's an added benefit as well, when once you do that, once that mucus is gone, usually if your sinuses are backed up, usually people will notice that things start to loosen up. And so if you're really sick, you may notice that once you do that two or three hours later, your nose starts to open up, the drainage is much more efficient. I mean, we're talking about this, but basically, it's plumbing.
Stacy: Right, and I think I totally misunderstood the plumbing. I always assumed that the rinse was intended to go in one hole and out the other, so like up the nose and then back down and around, out through the other nose hole.
Ron: And that's very... When that happens, as someone who has had that happened to them, that is very uncomfortable.
Stacy: Right, that's probably why I didn't like the idea of this whole thing. I had it wrong; I totally got it wrong.
Ron: Right, that's part of the discussion you have when someone, they're like, "Hey, I can't use that." Well, let's talk about it. Let's talk about why you use it. Because of the instructions on the box...
Stacy: Are not helpful.
Ron: Right, I mean, you look at that, and you go, "Okay. Well, I'm supposed to do that." When you don't feel good, and you're tired, and you're... it's late at night, and you're in the drug store...
Ron: ...and you're cranky, and you're like, you know, "What medicine do I want? How do I... I wanna feel good. What do I have to do to feel good?" So that's why I think, you know, information shows like this are helpful because you can start talking to people like, "Hey, look, there is something that can help you." We just gotta be sure we're all on the same page.
Stacy: Well this has completely changed my perspective on nasal rinses. And again, I have learned is that the plumbing of the nose, ear...ear, nose, and throat is so different from what I thought it was, and I realize how much I don't know about my own anatomy that I'm certainly gonna come see you next time that I need to do this, because obviously, I need a lesson in nasal rinses and an anatomy of my ear, nose, and throat.
Ron: Well we're always here to help, and I look forward to trying to help you.
Stacy: How do I get an appointment?
Ron: It's really easy to get an appointment to see me. If you would call and speak to my nurses, the direct line is 251-470-8823. Again, that number is 251-470-8823, and you can find the number on the internet at swainsinusshow.com. My nurses are Mandy Webster, and Chasity Wooten, and Emily Demet. If you'd call that number directly, my nurses can help you get set up to have an appointment to say me.
Stacy: Thanks for listening to this Swain Sinus Show. Please subscribe to our show on iTunes, Overcast, Stitcher, and anywhere you download your favorite podcasts. Want to know more about Dr. Swain or to schedule a consultation or appointment, visit swainsinusshow.com or call his amazing nursing staff at 251-470-8823.
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