Empty Nose Syndrome Survival Tips

 

 

The following list was found to be the most popular tips suggested by more then 300 forum members:

 

ü      Daily nasal irrigations of regular saline are always recommended. Many patients prefer to use Ringer Lactate solution instead, as they find it's easier on the mucosa than regular saline, and there are some empirical studies that back up that claim.

 

ü      Saline, Ringer Lactate, or hyaluronic acid based - nasal mist sprays, or gels, are always helpful when proper irrigation is not possible.

 

ü      Sesame oil can help in cases of extreme dryness and crusts.

 

ü      Sleeping with a cool mist humidifier.

 

ü      Sleeping with a CPAP machine that has a built-in humidifier.

 

ü      Some patients respond well to orally taken vitamin A and D.

 

ü      Acupuncture and shiatsu meant to improve nasal blood supply and nerve function.

 

ü      Dressing warm, drinking plenty of water and sleeping in a warm environment.

 

ü      Regular physical activity and a healthy life style are most important too.

 

 

 

 

A collection of tips posted on the patients forum:

 

 

Tips suggested by “Anthony”:

 

-Taking vitamin A/D helps the mucosa produce mucus and sustain itself. It makes my nose less dry.(atrophic rhinitis has been associated with vitamin A deficiency)  -The proteins in Milk and eggs also help the mucosa.  They will make your mucus thicker, and this may help your nose feel less open.

 

 -I've used Glucosamine chondrin and it had a strange effect on my nose.  It helped me a lot for about a week but then the effects kind of diminished.

 

 -The best diet for me consists of fruits, vegetables, foods high in protein, and water.  Things that should be avoided are junk food, over eating, and not getting the proper nutrition and vitamins.  I have talked to a lot of ENS sufferers and they mentioned that ever since they've had ENS, they started to eat more and more.  This is true for me too. Recently I've limited the amount of food I eat and noticed such a difference in my entire body.  all the fat and cholesterol from junk food will damage your cardiovascular health, and this will cause your tissues to get less oxygen and nutrients, and more toxins.  If you want your body to heal than keep it in good health by exercising, and eating right, so that your body can regenerate.

 

 -Applying Nouricel-MD topically to my turbinates has benefited me a lot.  I use a Que tip and I message the gel onto my turbinates/septum/lateral wall, and it stimulates the tissue to repair and grow.  TNS Recovery Complex is the only product containing a professional concentration of patented NouriCel-MD. NouriCel-MD contains an array of natural human growth factors, proteins, amino acids, antioxidants, and soluble collagens,  -I've started doing a technique where I use gravity and muscles to force blood into my turbinates.  Basically I lay on my stomach on my bed with the upper half of my body hanging off the bed and my nose facing down toward the ground and the bed, and my turbinates fill up with a decent amount of blood. but then while in this position I try to push all the blood to the front of my nose, by doing what you do to make your face red and filled up with blood. I apply pressure on my eyes and my upper cheeks with my hands so that they don't fill up with too much blood. And when I do this my turbinates fill up with more blood than they ever have(since I've had ENS). If I do this a one or 2 times a day, it makes a huge difference in how my nose feels.  If you try this make sure to never force to much pressure on your eyes, ears or brain, because you don't want to over do it and make a blood vessel burst.  Also if you do this technique too many times a day it may give you a headache.  This exercise is really just meant to get some blood in your turbinates, and prevent further atrophy.  This is the position you need to be in for this technique to be effective.

 

-Sleeping is necessary for your body to regenerate, so if you're using growth factors or healing from a surgery, its very important that your letting your body get enough sleep to function.

 

 

 

David Posted: Thu Jan 12, 2006 3:39 am: My Survival Tips:

 

Here is a list of things that I do that have worked for me. But as always, "your mileage may vary"...

 

1. Saline Rinse 2-3 times daily. Inverted in the tub works best. I haven't noticed any difference with different recipes so I just use plain salt and tap water. Lying flat on my back for about 5-10 minutes afterwards helps the excess water drain out.

 

2. Sesame Oil 2-3 times daily. I use a formula I got from Mayo during my visit there. It also contains rose/geranium for a pleasant scent. I've found I need to apply it about 10 minutes after the rinse so it doesn't get washed out with the water.

 

3. Swimming Nose Plugs. I buy them at sporting goods stores. I wear them when the pain is bad and on planes or anywhere else with harsh air.

 

4. Cogenten/Benzatropine. The doctors at Mayo suggested that a trycyclic anti-depressant might help relieve the pain I had from ENS. I tried one and it did. However, the tricyclics are "old school" meds with lots of nasty side-effects. I had my psychiatrist help me find a medicine that causes dry mouth, but is otherwise benign. He found Cogenten and it has given me about a 50% reduction in the daily pain I live with. It seems that whatever causes dry mouth reduces my pain.

 

These items have been the most helpful to me in the past 7 years I've been dealing with ENS. I hope some of them help you too.

 

 

Mark Posted: Thu Jan 12, 2006 4:36 pm:

 

Ayr saline nasal gel - applied inside the nostril - last several hours or more and helps with the dryness feeling.

 

Saline Bottle - I have one in the car and at work - use it several times throughout the day as needed to help with dryness

 

Beer/Alcohol - in moderation it helps or makes my nose feel fuller for several days.

 

vaporizer or humidifier used at night helps me sleep and helps with dryness.

 

Swimming - great exercise for ens vicitims who otherwise can't run due to suffocation

 

Steam room - great break during the day if you have access

 

Information about Saline Irrigations:

 

 

 

 

Matt Posted: Wed Nov 15, 2006 11:46 pm: My Ratings of Nasal Washes etc:   

 

Hello Friends and ENS sufferers. I am posting my ratings of various nasal lubricants and what has been effective for ME.

 

Of course keep in mind that we are all different, and what has or hasn't worked for me, may not be the case for you. Alas, hopefully this will be of interest to those on the quest for your own best. Good luck.

 

Regards,

Matt

 

Like many of you, I have tried a myriad of products. Here are my power rankings: 10=panacea, as close as I remember breathing great

0=crapper, did little, or in fact irritated.

 

Ocean spray: One of the first salines I had ever tried (circa,1993). It seemed ok at the time until nose became more dry over the years. Negatives: Contains preservatives (benzalkonium chloride), and inflated cost for saline due to the "ocean" label.

Overall rank: 2

 

ARY Gel, but as a metered spray: Not good. They added aloe, and for whatever reasons, this product would cause my nose to stick shut almost instantly as if it were glued--for me this means a crapper. I would give this a 0=crapper product, but it does make me sneeze, so it gets a few points. There are many ingredients, including Benzalkonium chloride. Perhaps I am allergic to their formula, hence the sneezes. I will say however, with this reaction, I almost always PRODUCE mucus like crazy, so it feels kind of good in that way for a short while. Rank 3 (only due to allergic reaction)

 

Simply Saline GEL: I was very disappointed from this. I had really liked Simply Salines aerosol saline, and thought that their version of ARY gel would be great. It did relive dryness longer than saline spray, but they added aloe, and it had a bad smell, and flavor when it would PND down my throat. Overall rank: 4

 

AYR Gel (tube-based, not metered pump)

Good ol' reliable for traveling or going to a smoky bar, etc. Unlike their gel spray, AYR in the tube form doesn't cause my nose to glue shut like their pumped product. There is aloe in it, but it doesn't seem as pungent as simply saline's or AYR's spray gel. Also, when compared to AYR's spray-gel, the tube doesn't add Benzalkonium Chloride. Of course, gels=bit messy since you have to use a q-tip or your finger. Rank=6

 

Rhinaris Sesame oil

I was so excited when I first tried this out. It DID seem to keep moisture levels constant for the longest time. However, I began to get annoyed by this product. It will run right back out your nose down your chin. Watch out...that sesame oil is GREASY and will look like you just spilled some nasty McDonalds down your shirt. I also began to get annoyed by the oil's smell and taste. BUT-it does last long. Rank= 6.5

 

Simply Saline sterilized saline (aerosol) I have really liked this product for a few years. I feels so gentle and nourishing to have the aerosol sprayed into nasal cavities. NO PRESERVATIVES (e.g benzalkonium chloride) very nice. Negatives: cost $4-6 bucks/can. Also, as others report, I started to notice that saline often dried my nose out in seconds after it was used. Rank=8

 

Grossans Breathe·EaseXl: NO preservatives at all. Really good if you don't mind mixing yourself. Negative: cost and availability. They say this is more cost effective than purchasing a product like simply saline aerosol.

True, but this will add up over time, I found myself wasting the extra from a mixture, and I couldn't find it locally. In sum, the best "saline only" product. Rank=9

 

Xclear: Well folks, this is it for me, my panacea. Xclear is purified saline, with Xylitol and grapeseed extract. For me this has been the best.

It lasts longer than normal saline (not as long as sesame oil) almost as long as gels--and much easier to spray. It has no smell, and is very soothing. With the Xylitol, it will actually taste mildly sweet if it drips. I use it 2x AM and PM. More if harsh day/conditions. This is available at local health food shop and runs me $12 for a 1.5 oz bottle.

I don't know if I overlooked it, but I don't recall anyone posting on Xclear or Xylitol. Google just Xylitol for yourself. It has some very good qualities to it, and putting this in a nasal wash is just dandy. RANK=10

 

 

 

Posted by TE, co-founder of the forum and ENS Association:

 

Never give in to ENS. Force your self to do all the activities your heart wishes. Try and live the fullest life you can. ENS is just one more piece of luggage you have to carry with you as you age.

Dr. Kern saw my CT in 1999, and told me that I couldn’t benefit from surgery. Baffled and disappointed - I asked him - am I doomed? He answered that not at all, providing I stick to the golden rule:

The golden rule for nasal mucosa's health:

Keeping good blood supply, keeping the nose moist as possible, and exercising the residual neural activity:

 

Blood supply - maintaining low bad cholesterol, and sugars, exercising a lot, and being kind to my heart. Never smoke. Have plenty of sex (the nose is a secondary sex organ - and the highly vascular tissue responds very well to sex. In fact it responses very well to any kind of enjoyable relaxing activity because the nose is full of para-sympathetic nerve system nerve endings and receptors. I also hang my self upside down at least five minutes a day - to increase the blood flow to the head. This gives me almost a half hour of close to a normal nasal sensation.

I Think that acupuncture to the nasal regions can do a lot of good, though haven't tried it yet, but I have seen quite a few encouraging Chinese studies about improving atrophic rhinitis with deep tissue - acupuncture. I have also found that lying down and practicing relaxation with hot wet compresses over my eyes and sinuses, helps a lot. Keeping your sinuses warm at all times is paramount, especially if you live in cold dry areas.

When ever you’re doing something passive -like watching TV - massage the sides of your nose, press down on your turbinate stumps, and massage your sinuses at the sides of your nose and forehead. Do a lot of physical activity which you enjoy, to keep your blood supply network at top shape. If you don’t – the first blood vessels to get clogged are the smaller ones, like the one’s supplying the respiratory epithelium’s surface – the cilia, that will start to degenerate.

 

 

Keeping your nose moist - although it's a drag - it's a must:

 

saline gels, humidifiers at night, drinking lots of water, and hot beverages (not coffee or tea, but hot water, or healthy soups. Fresh real chicken soup for example - is anti-inflammatory, and is very good for increasing nasal humidity), salt+bi carbonated soda irrigations - morning and night.

 

I give lectures sometimes to support myself and: If I'm very dry - this will effect my speech, therefore - five minutes before a lecture begins I'll do some fifty push-ups - this will keep my nose humid enough not to gag - for the next hour.  This again demonstrates the direct connection between blood supply and humidity.

Nasal Neural Activity - I keep an aroma-therapeutic smelling oil bottle in my pocket at all times. I sniff from it constantly.

 

Preserving your residual smelling capabilities is a must: when you smell - more blood rushes to your nasal mucosa, you are focusing your brain on your nose, and your mucosa secretes more moisture - need I say more. I believe that with time - forcing yourself to smell (healthy scents... there are scents that you should avoid - like ammonia, and alcohol - ask your doctor…) you increase the amount of receptors in your nasal mucosa - and where ever nerve endings grow into - along follow the blood vessels, and regrowth of some functioning healthy nasal mucosa.

Another trick I use - is role a nice thin piece of cotton wool, and give it a nice hair thin tip, which I then use to stimulate my nasal mucosa, in any nostril I chose, to evoke a sneezing response. Try and make yourself sneeze a good few times a day. Works wonders.

 

All this above advice is a lifetime mission, and has to be maintained constantly. The old rule applies here too - If you don’t use it - you lose it!

 

 

 

Dr. Houser's suggestions for nasal irrigation:

 

I often advise patients to obtain a Grossan nasal irrigator - a tip to place into the nose; it can be purchased with a special irrigation device from Hydromed (the Hydropulse; 1-800-560-9007).  Saline is usually used in the device.  Packets of specially formulated salt can be purchased directly from Hydromed, or you can mix it yourself (may take some attempts to find the right mix): To make saline: boil 1 quart water, add 1 tablespoon of salt: pickling, canning, or regular, and add 1 teaspoon of bicarbonate to reduce any chance of stinging.  Let the solution cool before use!

 

Additives can also be placed into the irrigation solution.  You would need your physician's approval and prescription for this:

 

Directions for Hydro Pulse Irrigation with Additives.

   Add one teaspoon of salt to Hydro Pulse Basin.

   Add warm water to 500 cc and mix.

   Set the pressure at the nasal tip so that the stream is about one inch high

   Irrigate the nose 300 cc (about 150 cc each side)  to clear the mucus.

   Stop and gently clear the nose.

   Add medication to the remaining 200 cc.

   Irrigate about 100 cc each side till empty.

   Sit quietly for 10 minutes at the sink. No blowing.

   Do not blow the nose for 2 hours

 

Some physicians will add 40 mg of Gentamycin to the 200 cc. Others use Tobramycin esp for patients with cystic fibrosis. Some physicians will add 1/2 of a tube of Bactroban to the 200cc (this is hard to dissolve, but it will - keep mixing!).  Some physicians are using antifungals, as some research has shown a possible link for chronic rhinosinusitis and fungi.

 

If the discharge is purulent, then the patient may be asked to perform irrigation twice per day.

 

Children have used this regimen successfully.

 

Sitting quietly for 10 minutes keeps the solution in longer.

No nose blowing for two hours means less chance of blowing the medicine into the ears via the eustachian tubes.