Look, Yeah, But Don't Touch

Say hello to Freelove Ann Elizabeth Blessing, my great-great-grandmother on my mom's side:

With a name like Freelove Blessing, she could have been raised in a West Coast hippie commune. But she was born in 1829, died in 1901 and lived her entire life in rural Virginia.

I became acquainted with this photograph, on display in the home of an older cousin, when I was a teenager and always on alert for pictures of attractive women. At the time it was taken, a photo such as this was considered almost pornographic. I'll be forever grateful that the photographer got Freelove to loosen up for the shot. Believe it or not, she was usually rather buttoned-down.

How to Blow Your Nose

A more precise title for this post might be "How to Pick Your Nose," but that looks even less palatable in print. Just the same, nose-picking is going to be the subject under discussion. As inconsequential as picking and blowing the nose may seem, doing it wrong can lead to significant discomfort. And you've probably been doing it wrong your whole life.

I grew up in a house afflicted with nasal distress. My father suffered from post-nasal drip and coughed incessantly. Thanks to the lung capacity he achieved in decades as a professional trombonist, he was capable of producing coughs that could be heard at surprising distances. I happened to speak to one of our longtime next-door neighbors shortly after my father went on medication to treat the congestive heart failure that would take his life two years later. On that regimen, his coughing also greatly diminished. The neighbor remarked, "By the way, we don't hear your dad coughing anymore."

I was stunned. Inside their detached, single-family home with the doors shut, windows closed and several walls between us, our neighbors had been able all along to hear my father coughing inside our home, its doors and windows closed as well.

Prior to his final couple of years, my dad's go-to remedy during bouts of post-nasal drip was a hideous decongestant called Neo-Synephrine. Available to this day in the nasal spray aisle, Neo-Synephrine initially would give my father a break from his misery, but a rebound effect always followed, with an even heavier drip of mucus from the back of his nostrils into his throat.

My own post-nasal drip began to emerge in adolescence. At first, I dipped into the Neo-Synephrine a few times and learned the hard way. Unlike my dad, I went further in search of a cure. Through my twenties and well into my thirties, I tinkered with ointments, humidifiers, steam, gargling and even chicken soup. None provided lasting relief. I consulted our family physician, other internists and several ear, nose and throat specialists. Each concluded the appointment by reaching for their prescription pad and writing me an order for the latest antihistamine tablet or steroid spray. None provided lasting relief. I got myself tested for allergies; the results showed sensitivity to corn and chocolate. I wasn't convinced that desensitization treatment would be the answer, but I went through with the months of shots. Again, no relief.

On top of everything else, I was beset on multiple occasions during those years by nosebleeds I couldn't stop myself, undoubtedly caused by picking and blowing improperly. I had to rush each time to an ENT or urgent care center and have the nostril in question cauterized.

In 1997, at age 38, I caught the flu, the only such attack I've experienced as an adult. I got over it fairly quickly, but in the aftermath (a) another nosebleed requiring cauterization occurred and (b) my post-nasal drip was worse than ever. Several wretched months passed. One day, I decided I was desperate enough to turn for help to that new, foreboding No Man's Land ... the Internet.

In fact, working in the travel agency had already afforded me a couple of years of familiarity with the World Wide Web, a byproduct of transitioning our reservation activity in 1995 from traditional leased, single-function computer terminals to our own desktop PCs running Windows. Among the many benefits of the conversion was the opportunity to browse the Internet in my spare time. But I hadn't sought assistance online with a medical problem. I typed something like "post-nasal drip cures" into AltaVista and clicked the search button.

The first page of results contained a number of references to a term I was unfamiliar with: nasal irrigation. Over the years, I'd fantasized about putting the business end of a garden hose in my mouth, somehow threading it up behind my nostrils, turning the water on and flushing out the debris. Impossible, of course. Yet as I began to read about nasal irrigation, I realized that a practical application of my fantasy was indeed possible.

Nasal irrigation involves pouring, spraying or otherwise introducing a solution of water and salt into one nostril and letting it flow out the other, thus thinning and removing mucus. A small amount of salt is necessary in order to match the body's natural fluids; too little or too much salt will result in irritation.

There are a number of ways to perform nasal irrigation, some low-tech, others more sophisticated. The first technique I read about described using a Waterpik or similar oral health device with a special attachment designed to fit the nostril. This remains my method of choice.

In 1997, the makers of Waterpik weren't yet on board with the idea that their dental-oriented device could play a part in relieving sinus suffering. However, they didn't interfere with those manufacturing attachments for that purpose. I already owned a Waterpik and further research on the Internet led me to the website of Los Angeles ear, nose and throat specialist Dr. Murray Grossan, whose company sold attachments that turned oral irrigators into nasal irrigators. I ordered an attachment.

My nostrils and sinuses were profoundly congested when the attachment arrived, an ideal circumstance in which to test its effectiveness. I filled the Waterpik reservoir with a mix of non-iodized salt and tap water, snapped on the nasal attachment, placed the tip in my right nostril, leaned over the sink, turned on the Waterpik and waited. I began to feel the solution working its way up the nostril, though at a maddeningly slow pace due to the mucus block. Then the saline reached the top of my right nostril, turned left and began a downward slog through my left nostril. A few seconds later, the largest snotball I ever produced exited the nostril and deposited itself in the sink.

I straightened up and inhaled through my nose, deeply and without obstruction. If I were the crying type, I would have shed tears of joy. I had found the cure.

That was 22 years ago. While saline irrigation brought my post-nasal drip (and nosebleeds) to an end that day, I've since added a few touches of my own to the irrigation process. These are the steps I recommend:

• Stir about a quarter of a teaspoon of non-iodized salt (it's gentler than regular salt) into the reservoir of a Waterpik or similar device filled about halfway with warm water.
  

• Connect the nasal irrigation attachment, place the tip in the nostril of your choosing -- Nostril A, in this example -- set the pressure at roughly two-thirds of full volume and turn on the Waterpik.
  

• As the saline flows and eventually departs through Nostril B, twist and turn the attachment so all parts of Nostril A get a good soaking.
  

• When the reservoir has emptied, turn the Waterpik off, place your index fingers on the sides of your nose and squeeze out any residual water, in the way one would squeeze the last of the toothpaste out of the tube.
  

• Repeat the first four steps, this time with the irrigation attachment in Nostril B.
  

• With both nasal passages having been soaked and squeezed out, clear away any stubborn mucus that may still be stuck inside your nostrils. If you're at least three years old, you already know how to pick your nose; you don't need me to tell you how to do that. The difference now is the contents of your nostrils are moist and soft, enabling considerably more thorough removal with a cotton swab or an aforementioned index finger.
  

• Once the nostrils have been cleared to your satisfaction, you are ready -- finally -- to blow your nose. Success at this last step in the sequence is defined as blowing only air, no snot, no water.

If your first crack at nasal irrigation doesn't go well, stick with it. Your physiology may call for more salt, or less, than I use. Try a lower pressure setting on the Waterpik. Don't be afraid to experiment. And if you're walking around in a state of nasal distress as I used to and my father did before me, but just reading this post makes nasal irrigation sound like more trouble than it could possibly be worth, I'll just say you don't know how much better you could feel.

With all this talk about Waterpiks, I'm thinking the subject of my next post might be how to brush your teeth. You've probably been doing that wrong too.

Seen at My Last Blood Donation