After your visit

Our goal is to ensure you have the best visit possible.

At the bottom of this page we have included directions on how to take most of our commonly prescribed medications.

We also know that as life gets busy, we can feel more disconnected from each other. Our providers want to connect with you and your family. Taking care of you and getting to know your family is what makes our job fulfilling. You can learn more about us below.

 

Dr. Michael Menachof

Outside of medicine, Mike enjoys cooking, the Denver Nuggets, and we think he’s an excellent photographer. He is a San Francisco native who has been in Denver for longer than he’d like to admit.

 

If you have any questions for your provider, please feel free to call our office, or email us at info@advancedentdenver.com

 

Understanding your medications:

Using Nasal Sprays:

• Insert the spray bottle slightly into your nose at parallel angle to the bridge of your nose.  
• After you put the tip into your nostril, point it slightly out toward your ear to keep the spray from hitting your septum. 
• Spray and breath in deeply

 

Sinus Rinses:  Available Over the Counter

Purpose: Washes irritants and germs out of the nose to prevent nasal swelling, or runny nose, or congestion. 

Directions: Pick up a Neti Pot or Neil Med Sinus Rinse Kit over the counter. Lean your head over the sink and squeeze/pour the contents of the applicator up one nostril and into the nasal passages. The liquid may come back out the nostril or mouth. Switch nostrils as you continue to rinse until the mixture is gone. Wash the inside of the nose as well as possible.

Use: Rinse with this mixture one to two times a day.

Bactroban (Rx) ointment mixed with a Saline Rinse (see above): Bactroban is a prescription antibiotic ointment. You may ask the pharmacist for a generic version.  Saline rinse is available over the counter. 

Purpose: This nasal spray is meant to moisturize the inside of the nose as well as provide antibiotic protection so that infection does not occur.

Directions: Remove the top from a 45mL bottle of saline spray (Ocean Spray brand has an easily removable top). Squeeze approximately one-fifth of the tube of Bactroban into the saline spray bottle. Replace the top to the saline spray and shake vigorously to dissolve the ointment. The tube of Bactroban ointment should last for five bottles of this mixture.

Use: Spray two sprays in each nostril twice daily.

 

Vaseline/Ayr Gel: Available Over the Counter

Purpose: Hydrating cream/gel used to moisturize and heal dry, damaged mucosa.

Directions: Apply a small amount of Vaseline/gel to the knuckle and rub gently into nostrils, then lightly pinch nostrils together. The hair inside your nose will help carry the cream/gel deeper.

Use: Apply as needed throughout the day.

 Alkalol Rinses:  Available over the counter, but may need to ask the pharmacist

Purpose: Rinses and calms the membranes inside the nose. This rinse is an over-the-counter solution available at most pharmacies.

Directions: Mix two ounces of Alkalol with four ounces of warm distilled or sterilized water. If this mixture is too strong, you may use a one to three or one to four ratio of Alkalol to water. Fill either a Neti Pot, saline nasal rinse applicator bottle from a sinus rinse kit or a bulb syringe with this mixture. This rubber syringe is often used to clean out noses or mouths of infants (aka. aspirator) and can be found at most drug stores. Lean your head over the sink and squeeze/pour the contents of the applicator up one nostril and into the nasal passages. The liquid may come back out the nostril or mouth. Switch nostrils as you continue to rinse until the mixture is gone. Wash the inside of the nose as well as possible.

Use: Rinse with this mixture one to two times per day. 

Nasal Steroid Spray (e.g. Nasonex, Flonase, etc): Prescription & Over the Counter, generics encouraged.

Purpose: Nasal steroid sprays decrease any type of swelling in the nasal mucosa including post-surgical and allergic swelling, thus increasing airflow through the nose. These sprays are safe to use long-term because they are NOT absorbed into the body the way systemic (injected or oral) steroids are and, therefore do not result in adverse reactions commonly seen with long-term steroid use.

Use: Spray two sprays in each nostril once daily. Aim the nozzle of the spray AWAY from the septum to protect the septum from getting irritated. Nasal steroid spray must be used daily in order to be effective in reducing swelling in the mucous membranes.

 

Afrin (Oxymetazoline HCl): Available Over the Counter

Purpose: Nasal Decongestant; Constricts blood vessels in the nose, which temporarily decreases swelling in the nose, allowing better airflow through the nose.

Use: Two to three sprays in each nostril every 12 hours for up to five days. 

 **Continued use of Afrin beyond three to four days results in increased swelling in the nasal mucous membranes.**

 

Astepro/Azelastine:  Requires Prescription

Purpose: This is a liquid antihistamine spray which is similar to Claritin. This relieves symptoms of seasonal allergies.  

Use: One to two sprays in each nostril once or twice a day as needed for allergy symptoms. Aim the nozzle away from the septum to protect the septum from getting irritated.

  

Atrovent (Ipratropium Bromide) Prescription: Requires Prescription

Purpose: This medication decreases mucus secretion and is great for an overly runny nose. 

Use: Spray two times into each nostril, pointing towards the back of the head and not up towards the eyes, up to three times a day as needed for excess mucus secretion. If using for excess mucus production during exercise or while eating, use 2 sprays in each nostril 30 minutes beforehand.

 

Dymista: Requires Prescription

Purpose: Antihistamine and Nasal Steroid. Antihistamine; relieves symptoms of seasonal allergies. Nasal steroid sprays decrease any type of swelling in the nasal mucosa including post-surgical and allergic swelling, thus increasing airflow through the nose. These sprays are safe to use long-term because they are NOT absorbed into the body the way systemic (injected or oral) steroids are and, therefore do not result in adverse reactions commonly seen with long-term steroid use.

Use: One spray in each nostril twice daily. Aim the nozzle away from the septum to protect the septum from getting irritated.

 

Oral Antibiotics: Requires Prescription

Purpose: Antibiotics will assist your body in fighting off bacteria. If our team thinks you have a bacterial infection that your body needs help beating, we will prescribe an antibiotic that will help kill the suspected germ.

Use: Take as directed on the prescription. Because antibiotics can often hurt the good bacteria in your gut in addition to the bad bacteria in your nose, we always recommend patients use a probiotic, or yoghurt with live cultures to help re-populate your gut with natural bacteria.

 

Oral Steroids: Requires Prescription

Purpose: Your body naturally makes steroids, but sometimes we will augment your body’s natural steroids with prescription steroids. Steroids help fight inflammation, and often reduce swelling. Often our team can use this to help you feel better faster.

Ue: Take as directed. Additionally, with steroids it is very important that you do not simply stop without talking to our team. Usually we will taper you off them.