Q: What is the estimated number of people suffering from allergic rhinitis and sinusitis?
A: The number ranges from 30 to 50 million. It may be difficult to get the exact number. It is a known fact that nasal allergies and sinus symptoms are extremely common. Our goal as a medical product company is to join the health care forces already in play to help people suffering from these symptoms. We do not claim that our product, SINUS RINSE™, will cure the problem, but we can certainly say that either alone or with other medical therapies it will reduce symptoms.

Q: What is rhinitis?
A: Rhinitis is an inflammation of the mucosa (delicate lining of the inner body surfaces) of nasal passages.

Q: What is sinusitis?
A: Sinusitis is an inflammation of the mucosa of various sinuses, which are located around the nasal passages. Usual symptoms include increased nasal secretions and pain or headache around the sinuses.

Q: Do sinuses usually drain?
A: Yes. Sinuses make mucus and usually drain into the nasal passage through openings called the ostia.

Q: What are the symptoms related to sinusitis and blockage of the ostia or opening of the sinuses?
A: The following are symptoms of acute and chronic sinusitis which occur when the sinuses are inflamed and ostia are blocked:

• Nasal congestion
• Headache
• Runny or stuffy nose
• Night time cough
• Persistent fatigue
• Fever
• White, yellow, or green discharge
• Pain in the upper jaw or teeth
• Loss of sense of smell or taste
• Rarely and unfortunately serious infections like meningitis, brain abscess, ear infections, etc.

Q: What are the causes of rhinitis and sinusitis?
A:

• cold viruses
• allergies
• bacterial or fungal infections
• smoking
• various dusts
• grass and smog
• nasal polyps and deviated nasal septum
• at times, severe acid reflux

Q: How do I differentiate between rhinitis and sinusitis?
A: Due to overlapping symptoms, it may be difficult to differentiate between the two. Usually, symptoms of rhinitis include: stuffy, runny or drippy nose, scratchy throat, and dry cough. However, symptoms of sinusitis are more severe than the symptoms of rhinitis. We have also described these symptoms above.

Q: What is FESS & ESS?
A: FESS is the abbreviation for functional endoscopic sinus surgery and ESS is the abbreviation for endoscopic sinus surgery and are essentially interchangeable terms. Current technology of fiberoptics, video camera, and television monitors, allows excellent examination of all openings of the sinuses, nasal turbinates, and nasal septum. Surgery restores the anatomy to as normal as possible or as functional as possible in order to help improve or cure the symptoms of chronic sinusitis.

Q: How do I know if I need surgery for my sinuses?
A: There are various forms of endoscopic sinus surgeries that can often be curative. We strongly advise that you contact your physician. You can ask your doctor to refer you to an ENT (ear, nose & throat) specialist or same as Otorhinolaryngologist.

Q: Would I need to change my nasal irrigation technique after sinus surgery?
A: You may need to rinse more carefully and may find that a larger amount of rinse solution maybe necessary. After you finish rinsing, you will probably need to take a little more time to change head positions to allow more complete drainage from the sinuses. While bending over the sink, consider tilting head sideways to help improve drainage of any leftover rinse solution.

Q: What is a corticosteroid nasal spray?
A: Corticosteroids are anti-inflammatory drugs. They are not anabolic steroids. Physicians prescribe corticosteroid nasal sprays to reduce chronic inflammation of the mucosa (lining membrane) of nasal passage and sinuses.

Q: What are nasal decongestants and when do I use them?
A: Nasal decongestants constrict the dilated blood vessels and reduces nasal and sinus congestion. You can get further advice from your doctor or pharmacist.

Q: Can nasal rinses prevent or reduce a head cold and/or flu symptoms?
A: Saline rinses, in the very earliest stages of a head cold and/or flu, may reduce the incidence and duration of symptoms of the sinus and nasal infection.

Q: What are antihistamines?
A: Antihistamines are the most common medications used to treat allergies. They work by blocking the effects of histamine which is released during an allergic reaction and help relieve the symptoms of sneezing, itchy nose and eyes and runny nose. They are not as helpful with nasal congestion.

Q: What is an allergen?
A: Allergens are organic particles, which attach to the nasal mucosa or respiratory mucosa and lead to the development of an antibody, which creates a series of chemical reactions leading to allergic symptoms. Everybody's reaction to an allergen exposure is different. The same amount of exposure to allergy particles can cause mild, moderate, or severe reactions in different people. Some may not have any reactions at all. Those with moderate to severe reactions will have symptoms.

Q: Can you name a few “allergens”?
A: There are indoor allergens as well as outdoor allergens. Examples of indoor allergens include dust mites, molds, pet dander (from animals and birds) and cockroach related particles. Examples of outdoor allergens are pollens, grass and mold. Other substances such as cigarette smoke, perfumes and aerosol sprays can be irritants and worsen allergy and sinus symptoms or act as allergens.

Q: Are allergens always visible?
A: Most individual allergens are not visible. Dust mites are a typical example. They are not visible to the naked eye, yet they are present in every house. Dust mites are microscopic creatures that feed on human skin flakes and are present in mattresses, pillows, carpets and upholstery.

Q: How do I reduce the problem of dust mites?
A: Clean all the areas where dust may be collecting. Carpets and sofa upholstery should be vacuumed on a weekly basis. Wash pillow cases, sheets and blankets in hot water. Enclose mattress and pillows in special allergy proof encasements. You can also contact an allergy care product company for more details. heater fans, etc.

Q: What is a mold?
A: Mold is a fungus. It is present in several places, particularly where it is damp and warm. It can be present in basements, bathrooms, kitchens, water damaged areas such as wood or carpets, water coolers, heater fans, etc.

Q: What is pet dander?
A: Any pet with hair or feathers will shed dander. These are the particles from its skin. Dander is a very common cause of indoor allergies in the home and can also cause allergies due to hobbies or occupational exposures such as raising animals or birds.

Q: What is seasonal allergic rhinitis?
A: Allergy symptoms that bother you only at certain times of the year such as Spring or Autumn are commonly called “hayfever” or seasonal allergic rhinitis. These symptoms are commonly caused by pollens and occasionally molds.

Q: What is perennial allergic rhinitis?
A: This occurs when a person develops symptoms due to exposure to a wide range of indoor allergens that account for sensitivity throughout the year.

Q: Can I drink alcohol during acute or chronic symptoms of rhinitis and sinusitis?
A: Alcohol worsens these symptoms, and it is recommended that you do not use alcohol during these symptoms.

Q: Does smoking lead to rhinitis and sinusitis?
A: Smoking worsens the symptoms of rhinitis and sinusitis.

Q: Does rhinitis and sinusitis affect asthma?
A: It has been established that there is a good correlation between the symptoms of rhinitis, chronic sinusitis & asthma. Curing or reducing rhinitis and/or sinusitis may improve the symptoms of asthma significantly. Approximately 80% of the patients suffering from allergic asthma do have coexisting allergic rhinitis.

Q: Are nasal Spray bottles or Pressurized Spray Cans considered a nasal wash, nasal rinse or nasal lavage system?
A: There are various spray products and in our opinion, they are only moisturizers and cannot be considered as nasal wash systems by any means. It is not possible to get a sufficient volume lavage using a spray system. You can also check with your doctor. For a true nasal lavage, wash or douche, one needs volume. With a few seconds squeeze on NeilMed's SINUS RINSE™ bottle, you get at least 15 mL (1/2 oz.) to 30 mL (1 oz.) or even a higher volume of rinse. With a few seconds spray from the pressurized cans or few sequential squeezes on spray bottles, you may get a minuscule volume of 0.1 mL to 5 mL at the most. Certainly, it will have a good moisturizing effect, but will not wash out the excessive mucus or allergens. They definitely have a place for applying moisture to the sinuses, but will not do the required nasal hygiene or cleansing NeilMed's SINUS RINSE™ will provide.

Q: Do nasal rinses reduce or cure snoring?
A: In some cases, nasal rinses have reduced the symptoms of snoring.

Q: What about an electrical powered nasal irrigation system with a specially designed tip?
A: Our cap and tube assembly can easily adapt to any electrically powered commercial irrigator. However, our SINUS RINSE™ kit is packaged with everything you need to relieve your symptoms without the additional hassle or expense

Q: What is the best time of the day to do nasal rinse?
A: Nasal rinses can be done at any time of the day. However, if the procedure is done at night, we recommend that you rinse at least one to two hours before going to bed or leaving your home in order to avoid the occasional, accidental drainage of the solution from the nasal passages.

Q: How many times a day should the nasal rinse be performed?
A: Usually, no more than once or twice a day. You can rinse more than twice a day, but it may not provide any additional benefit. Please follow your physician's advice.

Q: Which type of water is recommended for nasal rinsing?
A: Boiled tap water is safe since it gets sterilized from boiling. Make sure that the boiled water is stored in a clean container. Discard any unused, previously boiled water after three days. We do not recommend it, but several customers and doctors in the US and Canada do use warm tap water. Please avoid using non-chlorinated or non-ultra filtered well water unless it is boiled.

Q: Can I use bottled water?
A: Bottled water is usually safe to use.

Q: Can I microwave the bottle filled with solution?
A: It can be warmed in the microwave. The time needed to warm the solution can only be determined by trial and error. Try in increments of five seconds to find the right temperature. Over heating will damage the plastic bottle. Cap loose during heating in the microwave oven.

Q: What is the advantage of SINUS RINSE™ packets?
A: EachSINUS RINSE™ packet contains a preservative free mixture of Sodium Chloride and Sodium Bicarbonate that is pH balanced. The packets are easy to dispense and contain enough mixture to make 8 oz. of saline solution, taking the guesswork out of preparing this solution. Our mixture will not produce any stinging or burning in the nasal passages.

Q: What is the advantage of SINUS RINSE™ bottle?
A: SINUS RINSE™ easy squeeze bottle has printed instructions on it and also has a custom designed cap that comfortably fits different size nasal openings.

Q: What are the causes of burning sensation?
A: With our product, you should expect a soothing feeling, not a burning sensation. Causes of a burning sensation are: 1. Forgetting to put mixture in the bottle, 2. Putting more than one packet for the specified water quantity, 3. Too cold or too hot water, 4. Not thoroughly dissolving the mixture in water, 5. Having an acutely inflamed mucosa or mucosal ulcers.
Under normal circumstances, one should not feel any burning or stinging. However, if you feel any burning and if the problem still continues, please quit the rinses and call our office for advice.
CAUTION: Rinsing with plain water without the mixture will create more burning sensation than rinsing with the saline solution.

Q: What should I do if nasal rinse creates pain in the ear?
A: Nasal rinse is not recommended in the presence of an ear infection or ear symptoms of any kind. We advise that you consult your physician or wait until symptoms resolve, before starting the rinses. If symptoms recur then you must stop the rinses and consult your physician as soon as possible.

Q: What should I do if my nasal passage feels plugged or stuffy?
A: It is recommended that you postpone the nasal rinses until the passage has cleared. A completely plugged or stuffy nasal passage is likely to create symptoms of pressure, retention of the solution after the rinse, and may create symptoms in the ears. You can consider the use of over-the-counter nasal decongestants, unless they are specifically not recommended for you. You can consult with your physician regarding the use of nasal decongestants. You can restart the rinses once again after the nasal passage opens up.

Q: Can I add any other ingredients such as eucalyptus oil, alcohol, herbal medications, Vicks, vinegar or antibiotics?
A: Please check with your physician.

Q: What if I prefer a higher concentration of salt solution or hypertonic solution?
A: Some physicians do recommend hypertonic solutions in certain cases. They believe that a higher concentrated solution will draw the fluid and mucous out of congested nasal and maybe sinus openings. If you prefer higher salinity or hypertonic solution, you can use our 2-3 blue packets of the mixture in 240 mL (8 oz.) of water OR use our new green Hypertonic Refill Packet. Each Hypertonic packet will make 240 mL (8 oz.) of hypertonic solution or 480 mL (16 oz.) of Isotonic solution.

Q: What should I do if I happen to swallow the saline solution during the SINUS RINSE™ procedure?
A: It should not do any harm. If you follow our directions, the chances of solution reaching the back of the throat are very small.

Q: Is it common to get solution draining from the nose following nasal rinse?
A: Yes, this is very common and hence we do not recommend rinsing your nasal passages just before going to bed. This happens in the first 15 to 20 minutes after the rinse.

Q: Should workers exposed to occupational dust perform nasal rinses?
A: Workers who are exposed to a large amount of environmental or occupational dust from construction work, farming, mining or various indoor and outdoor occupations may benefit by regular use of the nasal rinse procedure. You should rinse the nose as soon as possible after the exposure. The sooner the irritant is removed from the delicate membranes, the less likely the membranes are to get inflamed and congested.

Q: Do nasal rinses improve the sense of smell?
A: We know that chronic rhinitis or chronic sinus disease will affect the sense of smell and taste. Nasal rinses will improve chronic nasal and sinus disease which in turn will improve the sense of smell and taste. This has been well proven in several scientific studies.

Q: Can the SINUS RINSE™ mixture packet be used for nasal irrigation, which is performed by some patients?
A: Use one blue packet of SINUS RINSE™ for 240 mL (8 oz.) of water and two blue packets or one green packet for 480 mL (16 oz.) of water. However, we do not feel that it is necessary to use any electrical system when you have our simple squeeze bottle system. Our system is inexpensive, easy to clean, and portable. Please refer to page 15, Q54 for more details.

Q: Does the nasal rinse procedure improve bad breath?
A: In some cases, bad breath may be caused by chronic nasal and sinus disease. Nasal rinse will improve nasal and sinus disease which may eliminate bad breath.

Q: When do I need to replace the bottle, tube, and cap?
A: If the system is clean and functioning then there is no need to replace it. If the system is not working or has started leaking, use our order form and we will send it to you.

Q: Can I share the bottle with another family member?
A: This is not recommended due to the possibility of transmitting infection to others.

Q: Can I sterilize the bottle, cap and tube in boiling water?
A: No. This will destroy the plastic material.

Q: Can I place the bottle in a dishwasher for cleaning purposes?
A: No. The mouth of the bottle is too narrow to clean it thoroughly in the dishwasher. It is recommended that it be cleaned by hand.

Q: How do I clean the cap and tubing?
A: You can use a brush to clean the cap. If you feel that the system is contaminated, you could also use 70% isopropyl alcohol or white, distilled vinegar. After the use of vinegar or alcohol, make sure that you rinse the entire system with distilled or previously boiled water. Do not keep the cap or tubing in water with temperature above 120⁰ F. Make sure that you do not instill alcohol or vinegar into the nasal passages. To clean the tube, disconnect and rinse it.

Q: Do I need to wipe the system after each use?
A: Air drying on a clean paper towel is recommended and is adequate.