Jala Neti recommendations

May 17, 2007 9:55 AM

Neti pots - good idea before nose surgery, and how do you heat the water to the correct temperature?

I'm soon due for a course of rhinoplasty and septoplasty, as well as a general reaming out of the old airway.

Should I begin jala neti prior to surgery? I know I'll have to do nasal irrigation as part of the recovery, anyway, but it seems like a good idea, is it? I know there's a Lancet study indicating that jala neti is definitely beneficial - should I pass this on to my surgeon, or would I seem like a quack?

Also, I've got the neti pot on order. I've got a little filtration jug so I'm not snorting our hard, chlorinated water. I've got the little packets of salt on the way. But how does one heat the water to the optimum temperature in a practical and efficient manner? I do not have access to a stove. What's the voice of experience on this? Electric kettle? Hotpot? Is there a specialty item that goes "ding!" when the water reaches 98.6 F, then shuts off, and I simply haven't found it in Google?

posted by adipocere to Health & Fitness (16 answers total)

My ENT recommend starting the irrigation after the surgery, but didn't recommend against starting before. You might want to do it a time or two just so you get the hang of it before the nasty mess that will be your sinuses starts coming out through your other nostril.

Your ENT didn't recommend to do irrigation? Frankly, that makes him sound a little quacky to me! You MUST, absolutely and without question, keep your nasal passages and sinuses moisturized after your surgery, and irrigation is an excellent way to do that. My doc recommended twice a day for a month, and I still do it on occasion. There's no better way to get the "gold" out. :)

I used this container for my irrigations. Do you have a microwave? The manufacturer recommends heating the water in 5 second increments until you get to a comfortable temperature. After using that method several times, I found that I could just nuke my room temperature mixture for 25 seconds in my microwave and it will be perfectly heated. I'd recommend, for convenience's sake, that you keep a pre-mixed solution in a water jug so you can quickly get it all done. Pour, heat, pour, ... pour (squirt, for me).

If you do not have a microwave, you can take the long way of putting a bottle or other container into a sink of warm tap water. It takes a while, but accomplishes the same thing.

Good luck on your surgery! I hope your recovery is without complication and pain!
posted by odi.et.amo at 10:07 AM on May 17, 2007

Best answer: Honestly, I just use our hard, chlorinated water from the tap, in a temperature just a bit cooler than I'd use to take a bath. It doesn't need to be that precise. :)

If you're really set on using filtered water, though, I'd highly recommend picking up a baby bottle warmer, which is specifically designed to heat small amounts of fluids to that warm-but-not-too-hot point. Maybe something like this one? (Though I don't know if any of them ding when they're done.)

Giving it a go ahead of time is a good idea, since it can be tricky to get the hang of what position to hold your head in, and once you've had surgery, you're going to want to be comfortable with what you're doing. And go ahead and consult with yoru doctor, but call it "nasal irrigation" and not "jala neti." The simple change in terminology will make him take you a lot more seriously. Sad, but true.

Good luck!
posted by Andrhia at 10:08 AM on May 17, 2007

Some allergists/sinus specialists recommend nasal douches, which sound very similar to what jala neti is, so it might be OK. You definitely want to ask your surgeon about it, though, because he will have his own views on the practice. Various forms of nasal irrigation are common enough that he has probably been asked about it before and therefore won't think you are strange for asking. Even if he does think it is an odd request, it is better to ask than to go ahead and do it only to find your surgery has been cancelled because the surgeon doesn't like the practice.
posted by TedW at 10:11 AM on May 17, 2007

I use a neti pot from time to time. Although I started out heating distilled H2O in the microwave, I got lazy and decided to try good old tap water (formerly known as "water") a try. I thought the chlorine might burn, but it doesn't, and this is much easier than heating the water. We have a water softener, which might help, I'm not sure. YMMV.

Would an electronic thermometer (the kind you take you temperature with) work? You'd have to hold it so the tip isn't touching the container you're heating water in, but I would think it would be accurate.

I can't comment on the pre-op benefits of using the neti pot, but I can't see any reason why it would hurt. I'd definitely let your doc know you intend to use it post-op, and get his or her take.
posted by altcountryman at 10:11 AM on May 17, 2007

I doubt it makes any significant difference whether the water is ten degrees colder or warmer. I imagine the main benefit of that temperature is comfort (cold water up the nose is not so much fun). Just heat the water up to comfortable temperature in a kettle or whatever you have on hand. You could also just use hot water from the tap, but that won't be filtered.

Also, using special little packets of salt is unnecessary. Just go buy a package of sea salt. If you want to get started before your neti pot arrives, just use a small measuring cup or something similar. All you want to do is get that water up your nose.

My doctors have always encouraged me to do the nasal irrigation: they always say it can't hurt. I imagine that the situation is the same here. If the surgeon is going to be removing blockages, etc. it probably won't make too much difference, but I can't see how it will hurt.
posted by ssg at 10:12 AM on May 17, 2007

I just used the sinusrinse product as well and followed its instructions. Worked great.
posted by striker at 10:13 AM on May 17, 2007

I use a Neti pot every night (it helps keep the snoring down) but I can't comment on the surgical aspects of your question.

I use distilled water, which is very cheap at the grocery story (65 cents per gallon, iirc) and sea salt, which is also very cheap. I have used tap water, but the impurities "smell" bad. Or is it "taste"? Just last night I was out of distilled, so I used Brita-filtered water, and didn't notice any funky smaste.

I've found that four good-sized pinches of salt in one of these Neti pots works, and if it burns a little, it probably needs more salt. (I tried the procedure once without salt and it was like snorting Drano. Unbearable.)

And as far as I know, temperature just affects your comfort. I've used it cold (stored on the cold bathroom floor), and that gave me a bit of an ice-cream headache. I've had success nuking it and storing the jug on the heating vent in the winter.
posted by booth at 10:26 AM on May 17, 2007

I use this stuff. Picked it up at Rite Aid, and it works great. I use ordinary tap water, warm out of the faucet, mixed with the included salt/baking soda packets. The plastic squeeze bottle is a whole lot more convenient than a ceramic neti pot; I'm sure of it.
posted by Faint of Butt at 10:28 AM on May 17, 2007

Response by poster: odi.et.amo, My ENT mentioned that there would be irrigation after the surgery, and I definitely plan on it (as well as keeping a room humidifier going), but we didn't discuss pre-irrigation. I suppose a short letter, with a reference to the Lancet study, is in order.

Baby bottle warmer - that's freakin' brilliant. I have no babies and wouldn't have thought of this in a million years.
posted by adipocere at 10:28 AM on May 17, 2007

No official help on the surgery aspect. Personal opinion - neti pots rock, so go ahead.

I heat water in my electric kettle and dissolve enough salt (plus 1/4 tsp baking soda) in a bit of hot water at the bottow of a jar, then fill with enough room temp water to make up two neti pots of solution (one neti pot per nostril). I test the water temp by tipping the jar as if I were going to take a sip with the tip of my nose.
posted by jaruwaan at 11:54 AM on May 17, 2007

My husband had septoplasty a few months ago, and did nasal irrigation (first using a bulb syringe, then using a neti pot) afterwards. The hospital gave him a "recipe" for the irrigation solution, basically distilled water, baking soda, and kosher salt (it doesn't have anti-caking agents like regular salt). I can't see how doing some nasal irrigation before surgery could be a bad thing (maybe don't do it the day or 2 right before), but I would use distilled water instead of tap to prevent any issues.

For the temperature, you can use the microwave, just try warming it in short 5-10 second intervals and testing it with your finger. It should feel neither warm nor cold, just ... tepid. That is the right temperature. It's not that hard to figure it out once you do it a few times.

After you've healed up after surgery, you can probably switch to regular tap water. Honestly, that's what my husband & I both do now, as we both use neti pots fairly regularly. After about 4-6 weeks, my husband switched to the Sinucleanse packets to more easily make the saline mixture and he hasn't had any problems.
posted by tastybrains at 11:58 AM on May 17, 2007

Nasal irrigation (netti or squeeze bottle or syringe) is a good thing for your nose but not exactly a precision thing. I use warm tap water and premixed salt packets. Just use a temperature you're comfortable with. You'll get a feel for it quickly. Don't bother boiling the water or using distilled water or any of that. My doctor handed me a sheet with lots of facts & research and it basically says the sterility of the water doesn't matter much and adding microbicides didn't do much either.

You're goal is to wash out the muck. Beyond that, it's all a matter of preference.
posted by chairface at 12:05 PM on May 17, 2007

What chairface said, except I just use plain old Kosher salt, and I just sort of eyeball it. All the salt does is keep the water from irritating your sinus tissues, it's not performing any miracles, so the exact chemistry of it doesn't seem to make much difference.

I'd definitely recommend doing it a few times before the surgery, just so you get the hang of it. It can be tricky the first couple times, and I imagine after surgery there'd be more swelling and might make it more difficult. Relax and remember to breathe through your mouth while doing it.
posted by jeff-o-matic at 12:41 PM on May 17, 2007

I use straight tap water (we're on a well) at whatever temperature feels warm but not too hot. I can't speak to the surgery though. Like mentioned above, I think the temperature mostly is just for comfort.
posted by MrToad at 12:54 PM on May 17, 2007

Nthing the use of warm tap water.

One convenient salt delivery method I've found is to use a salt cellar and spoon. I use a far less fancy version of
this . It sits in my medicine cabinet - one scoop of salt in my pot and I'm good.
posted by minervous at 2:53 PM on May 17, 2007

I've had a septoplasty but wasn't using a neti pot then - but I use one now any time I'm at all sniffly. I boil water in an electric kettle (I'm usually making tea anyway), pour a little the my neti pot, then eyeball in 1/4 tsp kosher salt. Then I add Panna water until it's only a little warmer than room temperature, and pour it up my nose.
posted by nicwolff at 12:12 AM on May 18, 2007