Q: In my ongoing quest to live more simply, I recently performed an audit of my medicine cabinet. While there were some items that I absolutely refuse to part with (you’ll have to pry that fancy anti-wrinkle serum from my cold, dead hands), I’m thinking that my stockpile of over-the-counter sinus and congestion meds can go. My mother-in-law has been pushing a certain sinus-related home remedy, neti pots, on me for some time now, but I’ve always been a touch skeptical of their effectiveness. Now, I’m more than a bit apprehensive, after catching wind of a couple of neti pot-related deaths. I’d love to give neti pots a trial run but want to make sure that they’re safe to use. Please advise!
A: A friend of mine who recently relocated to a crystal-happy, new age-minded section of northern California — the same cynical city girl who experimented with smudging — recently decided to go the way of the neti (Sanskrit for “nasal cleansing”) and equated it, via Facebook, to “waterboarding for hippies.” Ouch. Well, no ouch at all — using a neti pot should not be unpleasant, torturous or painful (although some people do experience mild side effects) and should certainly not be lethal when used correctly. And these genie lamp-meets-a-gravy boat-esque nasal irrigation vessels based in ancient ayurvedic medicine aren’t exclusively for hippies. Heck, even Oprah loves 'em. Whatever you do, just don’t reach for a neti pot and a “drip bucket” while sitting at your desk in the office. That is unless you’ve already broken the “totally inappropriate” seal and traumatized your co-workers by partaking in cubicle ear candling. You’ve got to up the ante somehow, right?
The neti pot-related deaths that you read about, two in Louisiana in the span of only a year, were the results of folks contracting a rare, brain-eating amoeba (scary, I know) known as Naegleria fowleri when they irrigated their sinuses with contaminated tap water. These unfortunate souls broke the cardinal rule of neti pot usage: Only flush out your sinuses with a saline solution diluted in lukewarm water that’s been distilled, sterilized, filtered or previously boiled.
The two deaths, the only known fatalities associated with neti pots, prompted the Louisiana Department of Health and Hospitals to issue an official warning with Louisiana State Epidemiologist, Dr. Raoult Ratard noting: "Tap water is safe for drinking, but not for irrigating your nose." Additionally, he adds that neti pot users should rinse the vessel out thoroughly after each use to eliminate any lingering bacteria — no autoclave is necessary since hand-washing or running through the dishwasher should do the trick — and to let it air dry between uses.
And when I mentioned that Naegleria fowleri infections are rare, I meant it. According to the Centers for Disease Control and Prevention, between 2001 and 2010 only 32 infections were reported in the U.S. Thirty of these infections occurred when the freshwater-dwelling parasite entered the nasal passages of folks, many of them children, swimming in and diving into natural swimming holes like ponds, rivers and lakes (in the future, you may want to rethink that cannonball or at the very least hold your breath and your nose). The other two cases resulted from contaminated geothermal drinking water supplies. In very rare instances, Naegleria fowleri can thrive in improperly chlorinated swimming pools and in heated tap water with a temperature less than 47 degrees C (117°F), which is what appears to have caused the two deaths in Louisiana last year.
So to reiterate, neti pots are safe by design while the practice of nasal irrigation to flush out gunk from what my grandmother endearingly called “the snotbox” in order to provide relief from sinusitis, allergies and a variety of other maladies has proven to be nothing but beneficial. It’s the water that you fill that neti pot with that you need to be careful about. If you’re willing to give up all those OTC decongestants in your medicine cabinet and give neti-ing a spin, I say go for it. And, of course, if you’re experiencing some truly gnarly symptoms, pay a visit to an ear, nose and throat specialist before proceeding with any sort of home remedy.