The Sinus Flush

The Flip-Turn Sinus Flush, excerpted from the not-for-sale book "Clear Your Sinuses Forever", by friggy

Great ideas often look identical to stupid ones, right up until the moment they work.
                                                                                    Scott Adams (creator of "Dilbert")

UPDATE:  Kudos to Dr.Ketan Mehta and his wife Nina, who invented and patented the Neilmed Sinus Rinse.  It is a simple and convenient way of doing sinus irrigation, it's available in most drugstores now, it has been proven effective and is now being recommended by doctors for infections of the maxillary and lower ethmoid sinuses.  I wish I'd thought of that.

However, if your sinus problems are in your frontal, sphenoid, or upper ethmoid sinuses, gravity will take over and the Neilmed saline solution won't be able to reach the infection.  That is where The Sinus Flush takes over. It's not convenient and it has its risks, but The Sinus Flush is highly effective in removing any infection from your head.

WARNING!    DISCLAIMER!

The technique in this manual involves bending over in a hot shower.  Obviously, if you bend over in a shower, there is a slight possibility that you can get dizzy and fall down.  You could possibly hit your head, get knocked out, or break something.  It’s a tiny risk, greater if you are older, overweight, obese, or have reduced blood flow in your neck arteries, but it’s a risk you must assume if you want get rid of an otherwise untreatable sinus infection.

There is a possibility that the infection could go into your ear, which happened to me once, but I found a way to avoid it.  You could also accidentally rub infected snot into your eye and get an eye infection, if you are careless.

The physiology of your head may be different from my head and you could experience a problem that I would not have, so it’s another risk you must assume.

Over the last five years I have used the Flip-Turn Sinus Flush to cure a 5-year-long incurable chronic sinus infection, which included an alien-looking gel–covered fungus ball the size of a marble, and the complete loss of taste and smell for a month.  I have cured 5 subsequent bouts of acute sinusitis, 7 out of 11 colds, a mold intrusion, and an infection that smelled like dog-poop-and-Parmesan, and one that smelled like burning ammonia.   I have never had a complete day of nasal congestion since this invention.

This technique will work for almost any infection of the nose, if you‘re willing to take the risk.  If an unfortunate side effect should happen to you, well, I am sorry.  I am not charging you for this, you are not paying me for it, so don’t sue me.  It’s a responsibility that you have to assume.  If you are one of those entitled Americans who expect a risk-free life, with massive compensation should things don’t work out, then don't try this.

So, why is this book manuscript free?  The physician who reviewed it said, “The materials cost less than $5.00, so there’s no income, and if, on the outside chance, a patient falls in the shower, they can sue me.  What doctor’s gonna recommend this?”  He’s right, doctors aren’t stupid—that’s why they’re doctors.  So the Flip-Turn Sinus Flush is now “alternative medicine”.

If you don't wish to take the risk involved, then at least you may wish to try the Dr.Grossan Hydropulse Nasal Irrigation System.  It gently pumps the saline solution into your sinuses, and I don’t know if it pumps saline all the way up into the far reaches of your sinuses, because of gravity, but it follows the same line of treatment expressed here.

There is also a neti pot, which was recently demonstrated by Dr. Oz on the Oprah Winfrey Show.  Many people swear by a neti pot, so it is apparently effective for some colds and some sinus infections. However, a neti pot flush may or may not reach the upper part of the sinuses. At any rate, thanks to the Oprah Show, they are now widely available on the internet.

BUT, before you try anything here, you should go to a doctor and have your problem checked out.  You may have a problem that looks like a sinus infection, but is something else.  The medical model works for most people, and if you have a severe sinus infection, it could spread to other parts of your head or body, and it would be a good idea to be on antibiotics.

The Flip-Turn Sinus Flush is intended for anyone who has not been cured by antibiotics or other means, and who may be facing sinus surgery to remove a bacterial or fungal infection of the sinuses, and are young or fit enough to dare to do the procedure.

Part I explains why the technique works, Part II tells you how to do it, Part III tells you how to prevent sinus problems.

Good luck, and breathe free!


INTRODUCTION

     Oftentimes antibiotics do not work for chronic sinusitis.  The reason is simple: antibiotics are delivered to the site of infection by the bloodstream.  There is some blood flow in the sinuses, but for many people it’s not sufficient to deliver enough of the drug to kill the large number of bacteria in the infected sinuses.
     You may also have learned that saline irrigation works a little bit to relieve your sinusitis, but not enough.  The reason for this is even simpler: gravity.   Gravity will pull the salt water out of your nose before it can wash out the infected mucus in the upper part of your sinuses.
     A study released a few years ago by the Mayo Clinic revealed the surprising discovery that if the cause of sinusitis is the toxins from the infected mucus in your sinuses, and that if you remove the infected snot, the problem will go away.  More on that, later.
     There’s two ways to remove infected snot from your sinuses, if long-term antibiotics do not work. The medical way is with surgery—stick an endoscope up your nostril and suck enough of it out to end the infection.  This usually works, but it sometimes causes complications, or scarring, and the infection often returns.
     The other way to get rid of sinus problem is to make your head an inhospitable place for a virus, bacteria, mold, or fungus to exist.  The superior way to make germs leave the warmth and comfort of your nose and sinuses is with saline solution, also known as salt water.  Saline is easy to make, but hard to administer.  As I mentioned, without the proper procedure, saline irrigation doesn’t always work well.
     This guide will show you a simple and extremely effective way to get the saline solution where it needs to go, and get rid of your sinus problem.  You will also learn some ways to prevent these problems before they get settled in your head and make you miserable.
     I am not a doctor, but my father was an honored and highly respected family physician.  He was the one that told me that all the antibiotics, anti-histamines, corticosteroids, and nasal sprays that my top-notch local HMO doctor was treating me with might not work, because he’d seen them fail in many patients.   The medical model of treating most diseases doesn’t always succeed with sinusitis, and he recommended saline solution for some relief.
     It worked a little, but not enough saline would reach the upper part of my sinuses.  Then I remembered, from being on a swim team, that when you botch a flip-turn, massive amounts of water would get in your sinuses, which was uncomfortable, but caused no damage. It also drained every bit of snot out of your nose.   The Flip-Turn Sinus Flush mimics this process.  Plenty of saline drains into every nook and cranny of your sinuses, and when you stand straight up, it drains out with most of the infected snot and pus.  During the first treatment, you will see.  After several treatments, your sinuses will resume their normal function, and you will be able to breathe freely through your nose.

      If you want to know what causes sinusitis, and why the saline solution works, read on.  If you are sick, and you don’t feel like reading much, and just want to start getting rid of the slimy clog in your head, you’ll be tempted to go directly to Part II of this book, which shows how to do it.  PLEASE READ THE WARNINGS IN SECTION #11 (BEFORE YOU BEGIN). If you don’t, you can possibly cause a more extensive infection.


PART I

1.  WHERE THE PROBLEM BEGINS

     You’ve got holes in your head.  The sinuses are hollow spaces in the bones of your face.  They help you breathe, by making the air warm and moist.  They help you smell, by letting odors and fragrances waft up to your olfactory nerves, which transmit the smells to your brain.  If you are using your voice correctly, you can feel your sinuses vibrate with sound.
     The sinuses make your head lighter, because solid bone would weigh too much, and your neck would be sore all the time. The sinuses make mucus, which moisturizes your nasal passages, and cleans them, too, leaving a neat package of rubbish in your nose—boogers.
     Inside the sinuses are tiny little moving hairs, called cilia, which move the mucus out of the sinuses into the nose, to make boogers, or into your throat, where it is swallowed, usually without you noticing it.  There are millions of cilia in your nose, and they each beat 16 times per second, acting like miniature oars to push the waste out of your nose.
     Each sinus has an opening, called an ostium, into the nose, which lets air and mucus in and out, and each sinus is connected to the nasal passages with a continuous mucus membrane lining.  Sinusitis is the inflammation of these linings, which cause them to swell up and block the ostia.  The ostia are only about 3 millimeters in diameter, which is about as big as this letter “O”, so it doesn’t take much to block each hole.
     When the ostia become blocked, mucus can get backed up in your sinuses, and air can be trapped inside.  This causes pressure in the sinuses, which leads to face pain or headache.  Sometimes, the oxygen in the blocked sinuses is absorbed by the blood vessels of the mucus membrane.  This creates a vacuum inside the sinus, which causes pressure from the outside, and of course, pain.
Doctors use three ways to classify sinus problems:
• Acute: a severe attack which lasts less than 3 weeks
• Chronic: sinusitis which lasts for 3 to 8 weeks, or longer, sometimes for months and even years.
• Recurrent: several attacks of acute sinusitis in one year.



2. WHAT CAUSES SINUSITIS?

     Here are some of the other afflictions that can cause the sinuses and connecting holes and passageways to get clogged:
• An infection by a bacteria or virus of your respiratory system, which includes your lungs, throat, nose, and nasal passages.  It’s usually caused by a cold, which inflames your membranes, makes them thicker, and makes the mucus thicker, which blocks your sinuses and creates an ideal condition for bacteria to grow. Then white blood cells come to attack the bacteria, and the battle further swells and congests the nasal passages.  The discharge that comes out of your nose is usually yellowish or greenish.  Doctors refer to it as purulent nasal discharge.  It’s this nasty mess that is the problem we are going to deal with in this book.
• Your sinuses may react to an allergen, such as pet dander, dust, dust mites, pollen, or any other tiny particle you are allergic to, and your immune system will attack it and cause your nasal membranes to swell up and block your sinuses.  In the case of pollen, it could be seasonable.  A food allergy can also cause this condition.  The discharge that results from this is usually clear or whitish.
• A fungus, including mold, can settle in the nose and cause chronic sinusitis.  The name of this specific reaction is called “allergic fungal sinusitis”.  Researchers at the Mayo clinic found that 96% of chronic sinusitis sufferers had a fungus in the nose.
• Nasal polyps can grow inside your nose from years of allergic reactions or infections.  These growths can get as big as your fingertip, and block your nasal passages and sinus openings. Polyps may possibly be related to chronic allergic fungal sinusitis, but doctors aren’t exactly sure what causes them.  Polyps can be removed by surgery, and the air passages will be opened considerably.  A recent study suggests that the prescription drug Nasonex may shrink the polyps.
• A defect or injury in the cartilage of the nose, called a deviated septum, can cause chronic blockage in the nasal area.  This may be corrected by surgery.
• Other irritants can inflame the nasal passages, such as air pollution, cigarette smoke, cigar smoke, and perfumes made from synthetic ingredients.  Once again, see your doctor, or avoid the irritants.
• Asthma is an immune disease, and asthma sufferers are highly susceptible to sinusitis.  About 3 out of 4 people with asthma also have chronic sinusitis.  There is evidence that some asthma and the chronic sinusitis associated with it is caused by Chlamydia or mycoplasma bacteria.  The mycoplasma is difficult to detect with the standard tests.  Your doctor would have to request a special test to find it.  There is also a strong possibility that asthma is a chronic reaction to a fungus that has taken up residence in the lungs, in the same manner that a fungus can cause sinusitis.
  
     This book is going to concentrate on acute and chronic sinusitis caused by cold viruses and other viruses which lead to bacterial infections in the sinuses and nasal passages.  With the methods I will show you, the yellow and green purulence, which we better know as snot, will be removed from your nasal passages.  When the infected snot is removed from your head, the cold viruses, bacteria, and perhaps the fungi will not have a comfortable environment to thrive, multiply, and release the poisons which inflame and destroy the otherwise healthy red mucus membranes in your nose and sinuses.
     Doctors have difficulty treating sinusitis caused by fungi.  They can give you an antifungal medicine, but there is no definite proof that it can cure the sinusitis. Some researchers are looking for an anti-fungal nasal spray at this time.
     This book will show you how to flush out the fungus or mold when it first appears, which will prevent chronic sinusitis. The technique has not been tested on chronic fungus infections, although I had great success against one.  It certainly does work in the early stage of exposure to a mold or fungus, for the same reason that it works against bacterial infection—if you flush out the toxin, you may flush out the problem in your sinuses.
     If you have one of the other forms of sinusitis, your doctor can take an x-ray of your head, and the infection may show up as an opaque area on the x-ray.  Of course, you don’t really want to get an x-ray of your head unless you really have to, so it’s better to get a CAT scan of your sinuses, which is the more accurate way to diagnose the specific form of sinusitis that you are suffering from.  
     Sometimes, however, you can have a sinus infection that won’t show up on a CAT scan of your sinuses.  In this case, you will have drainage into your throat, called post-nasal drip, and your throat often have too much mucus in it, which can cause a mild sore throat or cough on a chronic basis.



3. WHAT ARE THE SYMPTOMS?

     The main symptom of sinusitis is pain.  Pain in your face, pain in your head.  The pain is caused by the pressure of mucus and pus and air trapped in your clogged sinuses, or pain caused air pressing on the outside of your sinuses, a result of a vacuum inside a clogged sinus or sinuses.  On the following pages are illustrations of each of your sinuses, and the pain that is caused by their affliction.

(Insert illustration of side cross-cut view sinuses)

NOTE:  Go to Google Images and type in "sinus" if you want to see a picture of all the sinuse

These are your frontal sinuses.  You may have pain in your forehead when you touch it, if they are infected.

(Insert illustration of frontal sinuses here)

These are your maxillary sinuses.  They can hold about two tablespoons of mucus.  If these are infected, you may have pain in your upper jaw, your teeth may ache, and your cheeks may have pain when you touch them.
     Note:  One of the causes of maxillary sinusitis is a tooth abscess that has leaked the infection into the maxillary sinus.  The teeth may be X-rayed to find this.

(Insert illustration of maxillary sinuses here.)

These are the ethmoid sinuses.  If infection occurs, you may get puffy eyes and pain between them.  The sides of your nose may get tender to the touch, your nose may get stuffy, and you won’t be able to smell so well.  You may also get a splitting headache, felt most intensely in the forehead.

(Insert illustration of ethmoid sinuses here.)

Lastly, here are your sphenoid sinuses.  If they get inflamed, you may feel an earache, a pain in the neck, and an ache in the top of your head.

(Insert illustration of sphenoid sinuses here.)

     Most of the time, though, you are just going to feel a general pain everywhere in your head, especially when you awaken in the morning.

Other symptoms may include:
• A runny nose.  This is called rhinitis.
• Nasal congestion
• Fever
• General weakness
• Fatigue
• Malaise
• A cough caused by infected mucus draining into your throat and irritating your throat.  It gets more severe at night, because it can’t drain while you are lying down.
• The mucus draining from the back of your nasal passages into your throat, or post-nasal drip, can also cause a sore throat.
• An odd smell that won’t go away—an odor like a mix of dog-poop and old Parmesan cheese.

You may have some or all of these symptoms, and if you have some of these symptoms, it doesn’t necessarily mean you have sinusitis.  
     You may also have fever with chills, which usually indicates that the infection has gone outside of the sinuses to somewhere else in your head or body.



4.  THE USUAL TREATMENTS FOR ACUTE SINUSITIS

If you get an attack of acute sinusitis, a doctor may recommend the following:
• A decongestant to help reduce stuffiness and congestion
• Antibiotics, if a bacterial infection is indicated
• A painkiller to relieve any pain or tenderness in your face or head.

     Antibiotics are usually prescribed if you have yellow or green nasal discharge from one side of the nose, or both sides of the face, localized pain on one side of the face, or evidence of pus inside the nose.  Doctors rarely take a sample of pus from your nose and actually test it, in order to determine if it is a bacterial or viral infection.
     However, it’s a safe bet that a bacterial infection is present, because most of us already have bacterial in our upper respiratory tract.  These bacteria, such as haemophilus influenzae and streptococcus pneumonae, don’t cause a problem when you are healthy, but after a cold virus infection clogs your nasal passages and weakens your body’s immune system, these germs are able to multiply and thrive.
     Doctors usually prescribe antibiotics for 10 to 12 days in cases of acute sinusitis. Whether or not the short-term use of antibiotics actually works against sinus infection is still open to debate.  The sinuses are holes in the bones of the face, and bones don’t have much blood going through them, and the blood circulation through the mucus membranes in the sinuses is not great, so it’s extremely difficult for antibiotics, which travel though the bloodstream, to reach the sinuses to fight the bacteria.
     A study published in the Journal of Family Practice in February of 2005 showed that there was no difference between the patients who received an antibiotic and the patients who received a placebo.  That’s just one study, but it does cast doubt on the effectiveness of short-term antibiotic treatment for mild acute sinusitis.   Taking antibiotics also increases the chance that you can develop a drug-resistance strain of bacteria living in your upper respiratory tract.  Lately, many ear-nose-and-throat doctors have spoken out against the use of antibiotics for mild acute sinusitis, claiming they are useless and contribute to the development of antibiotic-resistant strains of bacteria.
     On the other hand, antibiotics may prevent the infection from spreading to other, more dangerous parts of the head or body, in certain cases.
     At any rate, this can be said for taking antibiotics, or any other treatment  that people use for a cold or acute sinusitis—many times the body fights off the infection anyway, and whatever medicine or treatment that people are taking or doing when the infection clears up is going to get the credit.
     Your doctor may prescribe a corticosteroid nasal spray to help reduce your sinus congestion and the swelling and inflammation in your mucus membranes.



5.   THE USUAL TREATMENTS FOR CHRONIC SINUSITIS

     The treatment for chronic sinusitis is similar to that for acute sinusitis, at first.  Doctors may prescribe antibiotics for 10 to 12 days, and if that doesn’t work, as it rarely does, they may prescribe a different antibiotic for anywhere to 4 to 6 weeks, which is often effective.  Sometimes it takes months and even a year of antibiotics to effect a cure.
     Steroid nasal sprays can also be prescribed, but the medical community is unsure of the possible side-effects of long-term use of steroid nasal sprays.
     Antihistamines and decongestants may help relieve some of the symptoms, but just a little bit.  These drugs can also make your problem worse, by making the mucus even thicker in your head.
     If the antibiotics and other treatments aren’t effective, then surgery is sometimes recommended.  Surgeons use an endoscope, which is an instrument that they stick up your nose, to open up the drainage holes in your sinuses and clear out some of the infected pus and tissue.  Surgery provides immediate relief—significant relief—but it often does not provide a permanent cure.  
     What you will learn in this book is how to clear out the infected schmoo in your sinuses, even more effectively than surgery does, without somebody sticking a machine up your nose.



6.  THE COLD

     The common cold is caused by several different viruses, in fact over a hundred of them. They have names like maxilovirus and rhinovirus.  The rhinoviruses are the cause of more than half of the colds that people get.
     Colds mostly start in the nose, but they can also thrive in the lungs, the ears, and the sinuses, leading to sinusitis.
     A cold usually lasts for a week, sometimes two weeks, or more for some nasty strains, or if your immune system handles it well, only 2 or 3 days.  A cold makes you sneeze, makes your nose run, stuffs up your nose, makes your throat rough or sore or hoarse, and you can get mild chills or fever, and you might get a headache, and you might just feel funky and tired and sick.
    Sometimes, a cold won’t cause any symptoms at all, and it will clear up in the same amount of time.
     A cold starts when a virus gets into your nose.  Your nose actually helps the virus get to the back of nose, to where it can infect a nasal cell. The virus latches onto a receptor, called an ICAM-1, on the nasal cell, which plugs into the virus and draws it into the healthy cell.  Once inside, the cold virus infects the cell and makes multiple copies of itself.  Then the infected cell dies and explodes, releasing all the new cold viruses into the tissue and mucus inside the nose, and spreads to other cells in the nose.  This takes about 8 to 12 hours for this cycle to happen.  About 10 to 12 hours after this, cold symptoms begin to appear.  About 12 hours after that, the cold symptoms may seem their worst, although it may take longer for the symptoms to reach their peak.
     Cold viruses don’t attack very many cells in the mucus membrane, so damage to the membrane is minimal.  The symptoms are due to the body reacting against the infection.
The immune system releases many substances, such as prostaglandins and histamines, which makes the blood vessels get bigger and begin to leak, and makes the mucus glands begin working overtime, in order to flush out the viruses.  These substances also make you cough and sneeze in order to expel the viruses, which helps you get rid of them, and also helps the virus to spread to other humans.
    This manual shows you how to use saline solution to help get rid of the cold viruses, the toxins from the infected and ruptured nasal cells, the bacteria that take advantage of the viral infection to cause their own infection, and most of the substances that the body releases to inflame and swell up your sinus and nasal tissues, which often leads to sinusitis.  Once you get rid of this toxic schmoo, your nose and sinuses and throat will quickly recover.



7.  THINKING OUTSIDE THE TISSUE BOX

     About a year after I developed the technique put forth in this book, the Mayo Clinic of Rochester, Minnesota released a study, led by Dr. Jens Ponikau and Dr. David Sheriss, which explains why it works.
     Until the study, it was believed in the medical community that chronic sinus infection was caused by the bacterial infection that set into the nasal tissues after they had been inflamed by viral infections.  It was believed that toxic proteins were released by the infected cells into the surrounding tissues of the nose and sinuses.  Doctors have therefore targeted their treatment to curing the surrounding tissues, with various prescription drugs and antibiotics.  This is common sense, because that is what works with most infections.
     What the Mayo Clinic study discovered is that in a chronic sinus infection, the white blood cells, called eosinophils, respond to an infection by getting together in the nasal mucus and the sinus mucus, and they release a toxic protein, called major basic protein, into the mucus.  It’s the poison inside the mucus, which we see as greenish or yellowish snot, which damages the nasal and sinus membranes.
    The study suggests that surgeons focus on removing the infected mucus during nasal surgery to prevent the disease from coming back.
     So there you have it—get rid of the infected mucus, with the toxic major basic protein, and it will stop damaging the mucus membranes in the nasal passages and sinuses, and the bacteria will stop infecting the damaged tissue.  
    What’s the best and safest way to flush out this infected mucus?  It is saline solution—salt water—which you will make yourself, and administer to yourself in the most effective manner, and soon you will be breathing free, with sinuses as clear as you can remember.  Perhaps, you may be smelling things that you haven’t smelled for quite some time. They may be fragrances that you miss, and some of them may be dreadful funks you wish you’d never experienced.  If this technique does not work, then at least you can narrow down the real cause of your sinus problem.



PART II

8.  MAKING YOUR OWN SALINE SOLUTION

     Saline solution is just another term for salt water.  You can buy a bottle of saline solution in a drugstore, and that would work just fine.  However, the store-bought saline solution will contain a preservative, to keep things from growing in the water, and some people will find the preservative to be irritating to their mucus membranes.  Store-bought saline is also expensive, and the quantities required will make you hesitant.
     It’s cheap and easy to make your own saline, a gallon at a time.  Buy a one-gallon plastic bottle of distilled or osmosis-purified water.  I always buy distilled, because the water has been boiled.  The water usually has an expiration date.
     Don’t buy a regular bottle of regular drinking water or spring water.  This water contains more contaminants than you think—not enough to make you sick if you drink it, but you don’t want to add them to the other germs you are working to get out of your sinuses.
     Buy some table salt without iodine.  Iodine is an irritant to some people.  Sea salt is okay, as long as it has the same size grains as table salt.  Pickling and canning salt is the very best, because it doesn’t have any additives (calcium silicate) to keep the salt grains from sticking together.  Avoid kosher salt, because the anti-caking agent may cause a strong burning sensation in your nose.
     The best saline solution has the ratio 2 grams salt for 98 milliliters of water.  This is about 78 grams of salt to the gallon.  Do the math, and make it practical, it works out to be 10 teaspoons of salt poured into one gallon of distilled water.  Shake it up.
    
     Now you have plenty of saline solution, enough to get rid of the toxic schmoo in your nasals and sinuses.  If you are concerned about germs growing in your gallon of salt water, then make a new batch every month, or every time you feel a cold coming on.



9.  THE POWER OF SALT

     Why does salt water work?  Simply put, germs need water, and salt takes the water away from the germs.  
     There are two kinds of saline solution.   Isotonic solution has the same concentration of salt as the human body.  Hypertonic solution is saltier than the water in the human body.
     Infected and inflamed secretions, like the ones in your sinuses when you have sinus infections and colds, are excessively sticky.   Allergies make your secretions sticky, and people over forty have stickier secretions.  That’s why Old Men have a stereotype of being phlegmy.   Hypertonic solutions thin the sticky secretions and make them easier to wash out of your sinuses.
     Hypertonic solutions shrink swollen tissues by drawing out the excess moisture.   When the swollen tissues shrink, the openings of the sinuses (the ostia) get bigger, and all the infected pus and snot can drain better.
     Hypertonic solutions wash out particles of pollution, fungus, and mold, so that your body won’t have an allergic reaction to them.
     Finally, hypertonic solution soothes infected or irritated tissue, helps it heal, and helps the cilia in your nasal membranes function better.  It’s safe for people of all ages, even children.



10.  THE SQUIRT BOTTLE

          You aren’t going to squirt the saline up your nose, but rather pour it in slowly; it helps to have the right applicator.  The best is a 4-ounce plastic travel bottle with a spout that folds open and shut.  You may or may not find them in a local outdoors store, or a luggage store, and you can definitely find them at R.E.I., online if you have to, or at a Container Store, if you have one where you live.  You may possibly find a 3 oz. bottle, which is fine, in the travel-size section of a drugstore or department store. They are becoming easier to find, because these bottles are what you have to put liquids in when you fly on an airplane.
     If you can’t find one anywhere, then you can just use any plastic bottle with a spout that squirts, like a Rubbermaid picnic bottle or a kitchen squeeze bottle.
     The best, once again, is a small travel squeeze bottle, which is listed as a 4 oz. bottle, but actually holds about 5 oz. or about 140 milliliters.  Fill it up from the gallon of saline solution.  Keep the small bottle in your shower, but store the gallon bottle somewhere else.

NOTE:  The Neilmed Sinus Rinse bottle can be used for this.


(Insert illustration of 4 ounce plastic bottle here.)



11.  WARNINGS: DON'T DO ANYTHING UNTIL YOU READ THESE

     The same pustulence that causes your sinuses to be infected can also get into other
places in your head.  Heed these warnings and it won’t.

     WHENEVER YOU BLOW SNOT AND PHLEGM AND PUS OUT OF YOUR NOSE, ALWAYS BLOW IT OUT ONE NOSTRIL ONLY.  Press the other nostril closed with your finger.  IF YOU DO OTHERWISE, YOU CAN BLOW THE INFECTION INTO YOUR EARS OR THE PART OF YOUR NOSE WHERE YOUR SENSE OF SMELL IS.

     NEVER BLOW YOUR NOSE AS HARD AS YOU CAN.  THIS CAN BLOW THE INFECTION INTO YOUR EARS OR THE PART OF YOUR NOSE WHERE YOUR SENSE OF SMELL IS.  Blow very very very gently.  Let the gravity do the work of removing the saline and infected mucus.

     DO NOT TURN YOUR HEAD TO THE SIDE WHEN YOU HAVE SALINE SOLUTION IN YOUR NASAL PASSAGES.  Gravity can cause the infection to get into your Eustachian tube and ears..

     DO NOT RUB YOUR EYES IN THE SHOWER AFTER YOU HAVE BLOWN INFECTED MUCUS OUT OF YOUR NOSE.  THIS CAN CAUSE THE INFECTION TO GET IN YOUR EYE.  Use the top of your wrist to wipe the water out of your eyes.

     You are also going to be bending over forward in the shower.  The shower is not a good place to find out that bending over makes you dizzy.  Practice it first before you get in a shower, no matter how young and fit and healthy you assume that you are.  Stand in front of a bed or couch or a carpeted floor.  Slowly bend forward as far as you can comfortably bend, and look between your legs at the crotch.  Slowly stand up erect.  Bend over and stand up again several more times to make sure, before you get in the shower.  If you do get dizzy, see a doctor.  You may have some blockage in your carotid arteries—the ones in your neck that provide blood to your brain.

     Figure out which direction you will be bending over in the shower.  Preferably, it’s the side away from the shower head.  Take everything out of this side of the shower, so that you don’t mistakenly grab it and fall down.

     If the thought of falling in the shower bothers you, you can also perform this technique standing on a towel next to the running hot shower or other source of running water, and wash the towel after you create a mess.  In fact, hot running water is not essential to this technique—but the steam provided by the hot water helps loosen the phlegm and pustulence in your sinuses.




12.  THE FLIP-TURN SINUS FLUSH

     Saline solution works best when it is warm.  Place the filled squeeze bottle in a cup or glass of hot tap water before you get in the shower.  It is not necessary, just slightly more comfortable.  Don’t submerge the top of the squeeze bottle in the hot tap water, because water from your hot water heater has things you don’t want to know about.  When the bottle is warm, put it in your shower.
     Turn on your shower as hot as is comfortable and jump in.  The heat and the steam will loosen the mucus in your nose and nasal cavity.  After a minute or so in the shower, press your right nostril closed with your right index finger, and very, very, very gently and slowly blow out the open left nostril, into your hands.  Rinse the hands off, then close the left nostril with your left finger and blow out the open right nostril.  Wash off your hands with soap.

(Insert illustration of nostril clearing here.)

     Years ago when I worked at a TV station, I had a friend named Lynette, a pretty young girl with a punky haircut.   She was also the first person I met who was a practitioner of yoga.  For her yoga class, Lynette was required to be filmed doing her yoga positions, and I was, of course, the videographer.  She mentioned something that stuck with me, about breathing.  According to the principles of yoga, one nostril of your nose is always open, and the other one is constricted.  The nose then switches, so the other nostril opens up, and the open side closes.
     Medical science tells us the same thing, that the blood vessels on one side of the nose swell up with blood, on purpose, to close off that side of the nose to air.  This gives the cilia in the closed nostril a chance to clean out all the pollution and mucus.  When it’s clean, it opens up and the other side is closed to repeat the process.  The things that swell up to close your nostrils are called turbinates.
     Keep this in mind when you are blowing your nose.  One side will always seem more congested than the other, even if it’s clean.

     Step One: Spread your feet so they are about 2 feet apart, for better stability in the shower.  Stand so that the water stream is hitting you on the butt, so that when you bend over, water doesn’t flow down to your face.  Take the squeeze bottle, tilt your head back slowly, and squeeze as much saline solution as you can into each nostril.  TILT YOUR HEAD BACK VERY SLOWLY AND CAREFULLY, BECAUSE SOME PEOPLE CAN EXPERIENCE NECK PROBLEMS IF THEY TILT THEIR HEAD BACK QUICKLY.
      Note:  If the water goes immediately down your throat, say the word “Go”.  Notice how your throat closes off at the beginning of the letter G.  That is how you close off your throat when you are filling your nostrils.    
      After you have filled both of your nostrils, pinch them shut.  Set down the squeeze bottle.  Then, very slowly bend forward, at the waist, until you can look between your legs at the crotch.  If you have balance problems, use the fingertips of the hand that is not pinching the nose to make a three-point stance, just like a football player makes before the ball is hiked, to be extra safe.
     When you are still bent over, release the hand from your nostrils.  Some water will come out of the nostrils, and some will percolate into your nasal cavity and sinuses.
Stay in this position for 5 to 10 seconds.
    
      DO NOT TURN YOUR HEAD TO EITHER SIDE, OR THE INFECTION COULD GO INTO YOUR EAR CANAL.  There is a low chance of this happening, but it is possible.  An ear infection can be treated with antibiotics.
    
The first few times you do this, it may feel uncomfortable to have saline and water up your nose.  You will probably feel a burning sensation. This is due to the fact that the pH of the hypertonic saline solution is different from the pH of the water in your body.  This will not affect the power or safety of the saline solution, just the comfort level.  The comfort you are looking for is to get rid of sinus problems.  You will get used to the burning sensation, to the point where it doesn’t bother you anymore.  

The burning will not damage your sense of smell.  In fact, it will improve it.  I keep a small bottle of Dr.Bronner’s Peppermint Pure-Castile Soap in the shower.  It’s the soap with the "interesting" blue label that you can find in most health-food stores like Whole Foods.  When I’m sick I can barely smell it, but after a saline flush the smell will be strong enough to give me a jolt.

(Insert illustration of bent-over position on this page.)

     Next, bend halfway up, so that you’re looking straight down, and your face is facing the floor of the shower.  Close the right nostril with your right finger, gently blow out the left nostril.  Open both nostrils, then close the left nostril with the left finger, and blow gently out the open right nostril.

(Insert illustration of halfway bent-over position here)

     Very slowly stand up straight, and wash the snot off of your hands.  DO NOT RUB THE WATER OUT OF YOUR EYES WITH YOUR HANDS, OR YOUR EYES MAY GET INFECTED!  Use the top of one of your wrists to wipe the water out of your eyes.

DO NOT TURN AROUND TO FACE THE SHOWERHEAD, UNTIL YOU HAVE STOOD UP STRAIGHT.  IF YOU TWIST WHILE YOU ARE STANDING UP, IT WILL INCREASE THE POSSIBILITY OF GETTING DIZZY.

     Step Two: Tilt your head back and fill both nostrils with saline solution for the second time.  Pinch your nose, slowly bend all the way down again, release your nostrils, and wait 5-10 seconds.  Slowly stand all the way back up this time.  Close the left nostril and blow out the open right nostril.  Open the left nostril, close the right nostril, and blow gently out the open left nostril.
     Rinse the schmoo off of your hands.  Wash your hands with soap, just to make sure they are clean.

     Step Three: Tilt your head back slowly, and fill both nostrils with saline solution for the third time. Pinch your nose again, bend over all the way so you can look through your legs at the crotch, and release the nostrils.  Wait about 10 seconds, and slowly stand all the way back up straight.  Don’t blow your nose this time.  Let whatever is in your nose and sinuses drain slowly out of your nostrils, while the hot water of the shower falls on your chest.  Put a finger across your top lip if you don’t like the salty water getting in your mouth.
     After about 20 seconds, snort inward, so the mucus goes into your throat, then do some hawking, and spit it out of your mouth.  Repeat once or twice.  Then, close one nostril, and blow out the open nostril as slowly and gently as you can.  Open both nostrils, then close the opposite nostril, and blow out the open nostril as slowly and gently as you can.
     If you still feel congested, you may repeat Step One and Step Two, or you can repeat Step Two twice.  Remember, one of your nostrils will always be closed or partly closed anyway, so don’t expect that you can breathe clearly through both nostrils.

     Be sure to wash your hands thoroughly with soap before you get out of the shower.  Also use soap to wash the outside of the squeeze bottle.

     An examination of the nasty material coming out of your nose may give you an indication of your sinus problem.  If it is thick and yellowish or yellowish-brown, you most likely have a bacterial or viral infection.  If the snot is the usual greenish or clear stuff, your problem may likely be the result of an allergy, or from mold or fungus.  If you have had a chronic infection, a strange alien-looking ball of gel may come out, after which you will experience a dramatic improvement in your breathing.  
     Some blood may come out.  This comes from the damaged tissues in the nose and sinuses.  The best treatment for minor bleeding in the nasal region is saline irrigation, which is what you are already doing.

     Do this procedure at least twice a day, once in the morning when you wake up, and once in the evening before you go to bed.  You may also do it for a third time in the afternoon, or when you come home from work.

     If your sinus infection is in your upper sinuses (sphenoid, frontal, or upper ethmoid) your results may not be as obvious on your first attempt.  Don't give up.

     When you feel that your sinuses have been cleared, continue the procedure twice a day for at least 2 days afterward, to prevent any residual infection from growing back and causing sinus problems again.

     After you have flushed out your sinuses, some saline solution may remain inside your head.  While this is harmless to you, if you bend your head down during the day, a few drops of saline may leak out into the nose, and cause you some unpleasant business.  Keep a facial tissue on your person or nearby at all times.

NOTE:  This procedure looks difficult at first, but it's basically: tilt head back, squirt saline in nose, hold nose, bend over, release nose, stand up, blow nose.
  
   Once your sinuses get cleared out, the cilia start functioning properly, and your sinuses, your sense of smell, your nose, and your breathing just start working better and better as the days go by.

PART III

13.  PREVENT DEFENSE

     The best way to kill your sinus problems is to attack a cold virus with everything you’ve got, before it leads to acute sinusitis.
     The first thing you can do is not get a cold.  Cold viruses are acquired from other people who have a cold.  If somebody with a cold blows their nose, or touches their nose or mouth, or sneezes into their hand, and then shakes hands with you, you will have cold viruses on your hand.  If you then touch your nose, the viruses will go in, and your nose will escort the germs further into your nose.
     If a cold sufferer with viruses on his hand touches a pen, a keyboard, a doorknob, a dime, or anything, the viruses collect on the object.  When you touch the object, and then touch your own nose or mouth, you will get the germs.
     What’s the best defense?  Don’t touch your face, and especially your nose, with the parts of your hand that you touch things.  If you feel the urge to rub your nose or eyes, use the back of your hand.  And of course, if you have to pick your nose, make sure that you have thoroughly scrubbed your hands, or use an alcohol-based hand sanitizer that contains at least 62% ethanol, which hospital studies have shown to be about as effective as washing with soap and water.

     If you find yourself with a little too much phlegm in your throat, or some congestion that is clearly not allergy-related, or your throat is beginning to get soar, hit the shower as soon as you can and use the saline solution to flush out the cold viruses and infected nasal cells and toxins, before they have a chance to establish themselves in your sinuses.  You will never be able to beat all the colds that attack you, but you can beat most of them.

     Drink as much water as you can tolerate.  Filling your body with water dilutes the mucus in your head, throat, and lungs, and helps the body get rid of the microbes and their toxic waste.

     As any practitioner of Chinese medicine, most organic/natural food enthusiasts, or an experienced doctor will tell you, there are four things that can increase the thickness of your mucus, and create a lot of phlegm, so avoid them while you are fighting the onset of a cold, or clearing up your sinusitis.
• Cut way back on milk products.  Milk on your cereal, cream in your coffee, those are okay, but knock off the glasses of milk and ice cream while you are sick.  If you want to see the effects of dairy products, drink a milkshake or a glass of eggnog when you are healthy, and see what happens to your phlegm levels.
• Stay away from white flour, like you find in cakes, cookies, white bread, and pastries.  White flour is a phlegm-maker.
• Moderate your sweets.  Sugar is a phlegm producer.  Eat a piece of a chocolate bar, to get a clear demonstration.
• Lower the use of alcohol.  Alcohol thickens the mucus in your head and lungs, and lowers your immune resistance.  

     If you start getting chills, you may have the flu instead of a cold.  Flush your head with saline before bed, jump in bed with as many covers as you can find, and sweat it out.  It won’t be a great night’s sleep, but there’s a very good chance you can beat the flu virus.  If you don’t, go see a doctor or deal with the flu the way you usually do.
Does saline solution work against the flu?  It might if you get to the flu virus soon enough, but that is something I am not going to talk about in this book.  The flu, if not treated properly, can be fatal to some people.  In fact, it is fatal to 1% of its victims.  I personally wouldn’t seek alternative medicine for a possibly fatal disease, so I wouldn’t recommend it to you.
    
     It’s true, what your grandmother said, that chicken soup helps a cold.  Chicken soup actually loosens phlegm in your head and lungs, and helps your body clear it out.
It also helps activate the cilia in your nose and lungs.  

     Another folk remedy is to drink apple cider vinegar, which its proponents claim will thin out your mucus.  I’ve never tried it—sounds a little too groovy for me—but you can look it up on the internet if you want to try it.

     A food that certainly helps clear out the congestion in your head is the chile pepper.  In fact, the active ingredient in all hot peppers, capsaicin, is being used by some doctors to treat sinusitis.  But forget about active ingredients, eat some spicy hot food.
Cajun food, Mexican food, Thai food, Szechuan food, red chile, green chile, jalapeños, Tabasco, and habañeras.  If it makes your scalp sweat, and your nose to run, it’s like medicine.  

     What about the “natural” cures for a cold?  Some people take zinc lozenges to ward off a cold.  Scientific studies that have been done show that zinc lozenges do not work, but not enough testing has been done to see if they work at higher doses.  Definitely don’t use a zinc spray, because some people claim it has caused anosmia, which is the loss of the sense of smell.

     I always believed, instinctively, that echinacea was a fad cure for a cold, and a study sponsored by the government’s National Center for Complementary and Alternative Medicine lends support to that view.  It found that the subjects who took echinacea caught just as many colds, had the same amount of virus in their snot, and had cold symptoms just as severe as the people who took a placebo.  As the director of the center, Dr. Stephen E. Straus said, “It’s a product with remarkable traction.  It has that traction because of a combination of folklore, myth and word of mouth which is much more than the science has borne out.”  Medical science is full of unknowns, and maybe it works for some people at a different dose.   Scientifically, echinacea follows the Last Cure Rule:  Whatever people are taking or doing when the illness goes away gets the credit.

     The only non-prescription medicine I take when I feel a cold or flu coming on is a Chinese herb combination called Ganmaoling.  It comes in the form of little yellow sugar-coated pills, and you take 4 of them every 4 hours.  If they don’t help stop a cold in two days, I stop taking them, because the anti-viral properties of Ganmaoling only work before the cold or flu has been established in your head.  It’s entirely possible that Ganmaoling follows the Last Cure Rule, but I’m assured by the fact that it has been field tested by a large number of Chinese for several centuries.

     Drinking hot tea works very well, not just for the steam effect while you are drinking it, but the warmth helps, and tea gets the cilia in your lungs and sinuses into gear.

     During your battle against a cold or sinusitis, it helps to place a warm towel or one of those rubbery hot water bottles over your face, because the warmth will help loosen the congestion in your head and face, and warm up the cilia to a temperature where they work better.

     Don’t hold your head over a steam source or do any intense steaming of your nasal passages.  At too high of a temperature the cilia temporarily stop working. The steam from a hot shower is just warm enough to get the cilia working, but not hot enough to shut them down.

     For a sore throat, gargling with a 3% hydrogen peroxide solution will kill the germs in your throat, and provide some relief.

     Never discount anything that has worked for you in the past, such as vaporizers, humidifiers, anti-histamines, steam-baths, saunas, or anything your ancestors have handed down.  My wife comes from a culture that considers Vicks Vapo-Rub to be the cure for every problem with the respiratory system, and it seems to work, as she rarely stays sick very long. In fact, some doctors have observed in their practices that the essential oils in Vicks are effective in relieving cold symptoms.  


14.   GERMOPHOBIA

     The best way to avoid a cold or sinus problem is to avoid the viruses, bacteria, fungi, microbes, and germs that cause them.  The most effective way to avoid them is to not shake hands with a sick person, avoid their sneezes and coughs, and not put your finger in your nose without making sure your finger is clean.
     This advice, by doctors and other health professionals, can be taken too far, and creep into the realm of germophobia, where people become obsessed about microbes lurking on every surface.
    As it turns out, germs can be found on some expected places, some unexpected places, and places you’d least suspect, while other surfaces are much safer than you would expect.

     A classic fear is the public toilet seat, but there are many more surfaces that can cause a greater chance of catching an illness.  The toilet seat most likely contains bacteria that cause gastrointestinal diseases, which, ironically, are the diseases we least fear to catch.

     Many people eat at their desks at work, and they rarely clean them, so a desk can have many times as many bacteria as a toilet seat.

     Some people have a 5-second rule about dropping food on the floor.  They think that food doesn’t have time to acquire germs in less than 5 seconds, so it’s okay to pick the food up and eat it.  This rule is generally correct—most microbes require moisture to grow and thrive, and most floors are dry, so the floor is one of the cleaner places in a room.  Apparently, it’s more dangerous to drop food on your desk than on the floor.

     This rule doesn’t apply in the restroom, where the floor usually is wetter, and the floor may be more contaminated than the feared toilet seat.

     A recent study was done in an elementary school, to find the greatest source of germs.  Schools are germ factories, and most cold viruses originate in the noses of children, who average 6 to 10 colds a year, vs. 2 or 3 for the average adult.
Children may or may not wash their hands after using the restroom, there may or may not be soap in the restroom, and paper towels are often not present.
     It turns out that most of the germs don’t come from the restrooms; they come from the cafeteria and drinking fountains.  The trays in the cafeteria are swarming with bacteria, and generally have a higher concentration of bacteria than the dreaded toilet seat. The highest germ count is in the cafeteria drinking fountain.  Of course, that’s where the water is, and germs need water to grow.
    
     The worst surface in public is no surprise.  It’s the handle of a grocery cart. All the bacteria from food residue picked up from shoppers’ hands is left to fester at room temperature; with many different hands per day, it adds up to about 1,000 colonies of bacteria per square inch.

     What’s the most dangerous surface in the hospital?  Once again, it’s not the toilet seat.  It’s not the doctor, or the nurse, or the surgical instruments.  It’s the TV remote control, according to a University of Arizona study by Professor Chuck Gerba, known popularly as “The Germ Doctor”.  The TV remote, on average, had the highest numbers of drug-resistant staph bacteria, which is the leading cause of death and illness in the hospital.

     It doesn’t take a genius to figure out that other electronic items with tiny buttons and keys may also be teeming with bacteria and viruses.   You can’t wash your hands every time you touch one of these objects, so just follow the general rule—don’t touch your face with your fingers, until you have thoroughly washed your hands.

     Professor Gerba also tested around the office, a hundred of them, where the phone, personal digital assistants, desk drawers, and computer keyboards harbored loads of germs.  The most contaminated places are the bottom of women’s purses and men’s wallets.  Lastly, he noted that the average desk has 400 times more germs than the average toilet seat.

I spent most of my life thinking that soap kills germs.  I was wrong.  Soap makes your hands and other parts of your body too slippery for bacteria, so they slide off the body when you rinse them with water.  Apparently, a lot of the bacteria remain.

     What’s up with the anti-bacterial soap that seems to be everywhere?  Is this a good idea?  The answer is yes and no.  Anti-bacterial soap actually kills the germs and allows them to be washed away.   Unfortunately, it doesn’t kill all the bacteria, and some of the ones that are left are resistant to the chemicals in anti-bacterial soap, and these bacteria multiply.  It’s the power and glory of evolution in real time.  The Nonprescription Drugs Advisory Committee, which advises the U.S. Food and Drug Administration, were told by experts that anti-bacterial soaps are no more effective than regular soap in reducing illness, and in fact, they may possibly help accelerate the development of antibiotic-resistant bacteria.
     The most effective way to remove bacteria and viruses from your hands is to wash them with regular soap for 15 to 30 seconds, and rinse them with cold water.

     However, look no farther than the rest of your skin for a rich source of germs.  From the New York University School of Medicine, this:  human skin has 182 species of bacteria.  Microbiologist Dr. Martin Blaser notes that the bacteria are part of our body, providing some protection to the skin.  “There are as many different species in our skin as there are in a good zoo,” he said. Knowing this, should we be washing so often?  
    
     The odd truth is that we need some bacteria, and we need to get sick every once in a while.  The polio epidemic in the United States started in the 1930’s after the nation’s water supply was cleaned up, and children under 3 years old stopped getting the polio microbe, at an age when they safely develop immunity.  The rate of asthma has skyrocketed in Japan, possibly as a result of many Japanese becoming super-clean sterile-freaks.  So forget about ridding yourself of all germs.  Your body’s immune system is set up to kill unwanted intruders, and if there’s nothing to kill, your immune system may attack you.
     The germs you do want to destroy are the ones in your head.  Keep a bottle of saline solution at hand, and breathe free.  If you smell something wonderful, or if you smell something horrendous, just be glad you can smell it all.



15. ALLERGIES

     Saline flushes can only temporarily relieve the symptoms of allergies in the nose and sinuses.  It can help clear the sinuses so that a bacterial or viral infection won’t set into the accumulated mucus.
     The best ************** for allergic rhinitis (a runny nose) is 10 milligrams of montelukast sodium (Singulair), which is available by prescription, or 240 milligram of pseudoephedrine hydrochloride (Sudafed).  According to a study by the University of Chicago, the two drugs are equally effective, even though the prescription drug costs 4 times as much.  The study was funded by the makers of the prescription drug. However, both drugs work in different ways, so one of them may work better for you than the other.
     The best natural treatment for allergies is capsules of stinging nettle leaf, also known simply as nettle leaf.  There are studies that suggest that magnesium lessens the body’s reaction to allergens, and nettle leaf is a rich source of magnesium.
    If your sinus problems are not going away after doing a saline flush, I’d recommend taking pseudoephedrine or Singulair, just to determine that your sinus problems are or are not caused by an allergy.

     In the end, when you have cleared your sinuses, you should be able to walk a block with your mouth shut.  If not, go see a doctor, again.

ADDENDUMS BY DR. ENOCH CHOI, M.D.

- pseudoephedrine hydrochloride (Sudafed) is now OTC behind-the-counter since too many drug manufacturers bought it to boil down to methamphetamines.  People can still get it, they just have to ask for it to be given to them.

- for allergic rhinitis, in addition to singulair and sudafed, there are other treatments: nasal steroids, nasal antihistamines, and nasal anticholinergics can help, and to get to the root cause, get allergy shots for desensitization

- even before you can walk a block with your mouth shut, a doctor can help you get there faster...



SOURCES

http://www.mayoclinic.com

Sinusitis, NIAID Fact Sheet  http://niaid.nih.gov/factsheets/sinusitis.htm

http://www.drmirkin.com

http://www.merck.com

Dr. Murray Grossan, Cedars Sinai Medical Center, http://www.sinus-allergies.com

Report on over-prescription of antibiotics for acute sinusitis published in Archives of Otolaryngology – Head and Neck Surgery, March 2007 issue.

Report on decongestants from University of Chicago, published in Archives of Otolaryngology – Head and Neck Surgery, February 2006 issue.

“What the Experts Say About Washing Your Nose with a Salty Solution”, Dr. Hana R. Solomon, MD, September 9, 2004

“Study Ties Sinusitis to Fungi in the Nose”, by Gabrielle Glaser, New York Times, September 26, 2000

“Sinusitis”, National Institute of Allergy and Infectious Diseases, April 2002

“When Trouble Hits Those Holes in Your Head”, by Jane Brody, New York Times, March 15, 2005

Microbiology Professor Chuck Gerba, University of Arizona

Dr. Woodson Merrell, Professor of Medicine, Columbia University College of Physicians and Surgeons

“There is a Zoo of Microbes on Your Skin”, by Will Dunham, Reuters, published on www.iol.co.za on February 5, 2007

“Experts Refute Anti-Bacterial Soap Claims”, by John J. Lumpkin, Associated Press, October 20,
2005

“Study Says Echinacea Has No Effect on Colds”, by Gina Kolata, New York Times, July 28, 2005