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I have adapted the following instructions from the work of Dr. David Parsons, a nationally recognized authority on sinus disease in children. While virtually all doctors caring for sinus disease agree that irrigation is helpful, there are different opinions about the best irrigating solution and the best way to irrigate.

I'm now irrigating my nose on a regular basis, and I find that it makes my nose feel better. Here's how I do it.

Irrigating your nose with saline (salt water) can be beneficial in many conditions. The saline that you can make is better than the saline you buy at the store for several reasons:

It's preservative-free. To date, all of the commercial saline solutions contain benzalkonium chloride, a preservative which is toxic to the cells lining your nose. Does this mean it causes any problems in everyday use? I don't think anybody knows, but why ask for trouble?

It's more concentrated.

It's much less expensive.

Why irrigate your nose?

1. When you irrigate, the salt water dissolves mucus, crusts, and other debris and washes them out of your nose.

2. The concentrated salt solution pulls fluid out of the swollen membranes and shrinks them. This decongests your nose, improves air flow, and helps to open sinus passages.

3. Studies have shown that hypertonic saline improves ciliary function. (Cilia are hairlike processes on the surface of cells; they move mucus over the surface.)

The Recipe:

Choose a one-quart glass jar and clean it thoroughly.

Fill it with tap water or bottled water. You do not need to boil the water.

Add two to three heaping teaspoons of pickling/canning salt (available at Meijer's) or kosher salt. Do not use table salt, which contains many additives.

Add 1 teaspoon Arm & Hammer baking soda.

Mix the ingredients and store at room temperature. The solution will keep for about a week, then you will have to discard it and make fresh solution. Most people experience a little burning sensation the first few times they use hypertonic saline solution; usually this goes away after a few days. If you find the solution too strong, you may decrease the amount of salt to 1 or 1 and a half teaspoons. For children it is often best to start with a milder solution and gradually increase the strength.

The instructions:

Check with your doctor to be sure it is safe for you to increase your salt intake.

Irrigate your nose with hypertonic saline 3 or 4 times daily. You may use a bulb syringe or ear syringe, a 30cc medical syringe, or commercially available devices. Irrigation tips for your Water-Pik are available from Hydromed, call (800) 560-9007 or from Kenwood Therapeutics, call 800-929-9300. Kenwood Therapeutics has other devices as well, including a refillable bottle at about $31 that I find very helpful. The Sinus Rinse system from NeilMed may be even better.

Always pour the amount of fluid you plan to use into a clean bowl (or go to the how I do it section for an easier method). DO NOT put your used syringe back into the quart bottle because it will contaminate the solution. Many people find warm solution more comfortable; you can warm it in the microwave, but be sure it is NOT HOT. Stand over the sink (some people do this in the shower) and squirt the solution into each side of your nose, aiming the stream toward the back of your head, NOT the top of your head. The saline solution will flow into your mouth, and you can spit it out. It will not harm you if you swallow a little.

For younger children, you may want to place the solution into a pump spray container such as "Ocean" or a nasal steroid container and squirt several times into each side of the nose. Do this with the child sitting or standing, NOT lying down.

If you have been told to use a nasal steroid (prescription nose spray) you should always use the hypertonic saline solution first and then the nasal steroid. The medication will be much more effective if sprayed into a clean, open nose.

Please note: several companies, including Hydromed and Kenwood Therapeutics make their own irrigating solutions, which are said to work even better than plain saline. They're not cheap--they'd probably cost you a few dollars a week, and as far as I know I can't get them covered under a prescription plan--but if I had chronic nose problems I'd at least try them.