Squeeze the soapy water through the cap. NeilMed Enjuague sinusal Un kit completo de enjuague nasal salino NeilMed SINUS RINSE es un sistema de botella fcil de apretar que le permite entregar la solucin salina con presin positiva para limpiar los conductos nasales a fondo, mientras mantiene su cabeza en posicin vertical. Water trapped in sinuses after Neilmed Sinus Rinse. This usually goes down after a while. See an Ear, Nose and throat doctor. Neti wash is an excellent and age old technique to cleanse the sinuses and nasal cavity, especially in people having sinus issues. By using our website, you consent to our use of cookies. So, what are the causes of ear pain after using NeilMed sinus rinse and how can you avoid it? Nasal rinsing should only be done when youre congested and have a stuffy nose. Use a bottle brush to scrub the bottle, cap, and tube. Centers for Disease Control and Prevention. Please contact the Ear, Nose and Throat (ENT) outpatient department on telephone number 01284 713550 or email: ENTsec@wsh.nhs.uk also my left lymph node on the side where my ear hurts was so swollen and painful now its better after my 2nd day on the antibiotics. Definitely advise against the valsalva maneuver now. How to unclog my ear? Using a squeeze bottle, bulb syringe, or neti pot, pour or squeeze the saline solution slowly into the upper . There are multiple ways by which you can drain the accumulated water in your ear canal including jiggling the ear lobe and creating a vacuum using your own hands. Ear crackling is common and can happen even without sinus rinsing due to earwax build-up in your ear. Given the fact that this issue has persisted, you should get in to see your primary care doctor to rule out any more serious issues. Always seek the advice of your doctor before starting or changing treatment. Managing your healthcare is easier than ever before with Zocdoc. Besides sinus rinse. white vinegar sinus rinse. You should also try not to shake out your neti pot for too long or use it more than once per day. The water has added to the pressure and that is why you feel it in your ears. While ear crackling even after nasal irrigation is a normal experience, the continuous crackling and discomfort that comes with it might hint at an underlying condition. When the doctor cleaned my sinuses, it made the ear pressure more noticeable. Put the cap on and shake the bottle well. If you are familiar with nasal irrigation you can also buy an over-the-counter device such as a neti pot to clear out nasal passages, but they can be harmful if have an underlying infection or severe nasal or ear blockage. Avoid pressing against the septum (the middle part dividing the two . What are the side effects of Neilmed sinus rinse? Sleep apnea is more common than most people think. 2019 - 2022 wholesomealive.com. For the study, 68 people irrigated at least twice a day for one year, then discontinued the practice and were followed for the next year. The crackling you hear just after a sinus rinse can result from how you practice your cleansing. Step 3 Learn why a sinus X-ray is done and what to expect during the. Well, below well discuss an in-depth analysis of why NeilMed sinus rinse might hurt some and not others. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. The product isnt available for oral use; hence, only the nasal pathways should be used for the correct usage of the product. Removal of the mucus lining leaves you vulnerable to illnesses such as sinus infections. NeilMed Sinus Rinse Premixed Refill Packets With Xylitol, 60ct. Sinus infections, and related sinus pressure, can cause toothaches. All rights reserved. It is designed to help unclog a stuffy nose, blockage and post nasal drip, all which can lead to added pressure in the head and ears contributing to ear pain. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. * The Edmonds Technique. Rabago and Zgierska in a November 2009 article in the journal "American Family Physician." Ear fullness can be uncomfortable and may contribute to headache or hearing difficulties in certain people. Nasal rinses should not be done on infants or children under 2 years old. You can try bending slightly with one ear facing the table or wherever your head is lying and the other ear facing the roof. Gentle saline spray may help o Dr. John Munshower and another doctor agree. When done correctly, sinus rinsing is safe and effective for most people. and should i be concerned? The Eustachian tube is a small canal that runs between your nose and your middle ear. Stand over a sink. Never had a case of tinnitus that lasted longer than a minute. Place one finger over the tip of the cap and shake the bottle gently to dissolve the mixture. Sinus rinse is not recommended in the presence of an ear infection or ear symptoms of any kind. my sinus is giving me a lot of headaches and pain in my ears..What can I take or should I visit the er? In rare cases, draining sinuses can cause fluid to accumulate and sit in the Eustachian tube. i had a popping sound and sharp ear pain after using sinus rinse. Why Do My Ribs Hurt When I Sit Too Long? They'll be able to treat any infections present in each area and recommend any necessary medication. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. I Was Thinking of Working as White Water Rafting Guide, Tinnitus Significantly Better After 72-Hour Water Only Fast, But Then Returns to Baseline, Tinnitus After Falling from a Water Slide. Should I be concerned with getting sinus headache very frequently. A doctor may recommend endoscopic sinus surgery if you're experiencing recurrent sinus infections or have a sinus blockage. The Sinus-Ear Relationship As a result, nasal congestion and stuffiness might have an impact on ear pressure. For these, please consult a doctor (virtually or in person). Please login or Register to submit your answer, NeilMed is the largest manufacturer and supplier of LVLP (Large Volume Low Pressure) saline nasal irrigation systems in the world. You can prevent ear pain from occurring by taking care of your ears and seeking medical care at the first sign of pain or inflammation. Does Sinus Rinse Help with Eustachian Tube Dysfunction? I think my blocked ears weren't noticeable to me because my sinuses were so bad. Using a sinus rinse to clean ears would be a bad idea. If the water is too hot, it can cause internal burning and blistering to occur. It's important to rule out other conditions that can cause similar symptoms, such as asthma, chronic bronchitis, and emphysema. Can you use the neimed sinus rinse on my ears as well as my nose? I'm glad the antibiotics seem to be helping, but I thought I'd post a personal experience just in case it helps you or anyone else. A daily saline rinse may reduce sinus symptoms by as much as 72 percent and even cut the number of infections for those with chronic sinus problems, researchers from England's Royal National Throat, Nose, and Ear Hospital concluded after reviewing a series of studies. I had my sinuses surgically cleaned out in October. A sinus X-ray uses a small amount of radiation to create an image of your sinuses. NeilMed sinus rinse kit is used to clear the nasal passage that can be congested by any means such as allergies, colds, and flu. If you have nasal congestion that is significant enough that your nose is entirely blocked and you use a nasal rinse, it is very common for the fluid to accidentally direct up into the eustachian tubes. Pain, disorientation, and a muffled-ear sensation, as if you're on a plummeting aircraft, can also occur. This procedure can be safely done under the direction of a licensed physician. 2010 Mar 17;(3):CD006821. Okay if your Doctor advised you to do so than that's good. I wouldn't wait, go to an ENT and get it checked out asap just in case - if you can, convince your ENT/GP to get you on a course of short term, high dose oral presdnisone. Sinus rinsing is also known as nasal rinsing, sinus flushing, or nasal irrigation. How does a sinus infection make you feel? To learn more, please visit our, You likely introduced some air into the sinuses and middle ear during the treatment. The main reason why we choose sinus rinsing is to get rid of a stuffy, congested nose that makes us difficult to breathe. What probably happened is that the fluid from the nasal saline rinse went down the back of your throat and then up your eustachian tubes into your middle ear. You have complete control of the pressure and volume of solution, ensuring a gentle, soothing and therapeutic experience. If so, treatment options will vary depending on what's causing the pain/problem. For these, please consult a doctor (virtually or in person). He might ask you about the number of infections of the ear you have had in the past, and whether you have ever had sinusitis or tubes placed in your ears. She graduated from Columbia University with her medical degree and completed her residency at the Albert Einstein Medical College. After some time, when you stand up, youll feel the water coming out of your ear. According to current medical research, the most effective way to irrigate the nose is with a large volume of low positive pressure nasal wash. Ears can become infected by the same bacteria that cause problems with your sinuses. Is it ok to use? When not treated promptly, amoebic meningitis is usually fatal. To perform nasal irrigation with a neti pot: Mix the ingredients in a sterile container. You can prevent ear pain from occurring by taking care of your ears and seeking medical care at the first sign of pain or inflammation. Don't take any chances with your ears. Can sinusitis affect your ears? This can cause severe pain, inflammation and lead to infection. This happens most often when you sleep with your head tilted upward. Based on reviews, people dont usually experience side effects after using this product; however, there is a possibility of an allergic reaction which is a little rare. For example, if it's a bacterial infection, you'll likely be prescribed antibiotics. What are the possible side effects of sinus rinses? Sinus rinse is one of the best ways for such people to get rid of their congested noses. Neti pots can relieve the symptoms of rhinosinusitis if used properly. However, overuse or long-term use can be unsafe. using neilmed sinus rinse 6 times a day. I remember yonakapin saying that he had the same problem and did the the valsalva maneuver all the time because he felt ear pressure and made his tinnitus worse by repeatedly doing it. However, this doesn't mean that they don't require medical attention after an episode of stopped breathing. Just search for a doctor in your insurance network, see available times, and book an appointment on the spot! i had a popping sound and sharp ear pain after using sinus rinse Dr. Rebecca Gliksman answered Internal Medicine 40 years experience Sinus rinse -ear pop: Could be that the rinse also drains into the Eustachian tube, as both the sinuses and middle ear drain into the Eustachain ( hence post nasal drip). Sinusitis occurs when your nasal passages become inflamed. Your outer ear or auricle is a gathering place for all sound that you hear and comprehend. If you are having a problem with ear wax ask your pharmacist for otc options. Sinus rinse can cause a crackling sound in your ear because it might alter your ear pressure due to the accumulation of the fluid in your eustachian tubes (tubes that connect your middle ear and throat). What should I do if sinus rinse creates pain in the ear? Connect with a U.S. board-certified doctor by text or video anytime, anywhere. It's a bit of a stretch but if you've caused damage through barotrauma (not saying you did, though) it will help you tremendously, but time is very important. She is a member of the Society of Professional Journalists. what is good for this? This type of crackling is somewhat similar to what you experience when traveling by air during take-off and landing. When this happens, you'll need to see both a dentist and an ear, nose, and throat (ENT) doctor to resolve the issue. Common symptoms of sinus infections include: Runny nose Stuffy nose Facial pain or pressure Headache Mucus dripping down the throat (post-nasal drip) Sore throat Cough Bad breath When to Seek Medical Care See a doctor if you have: Severe symptoms, such as severe headache or facial pain. por . This is why some people use it 2 to 4 times every day. 0 . Pipera KJ, Foster H, Susanto D, et al. These changes in oxygenation cause pain and stiffness throughout the body, especially during awakening when someone with sleep apnea may not be able to breathe properly without first clearing their throat or jaw. How can you do a proper sinus rinse? But there are some important differences. A person must correctly clean their. I've been battling a little bit of a cold, mixed with allergies, and its been causing some thick stuff to be constantly dripping down the back of my throat. Is there a way to stop myself from drooling so much? Sinus rinse is an amazing way to clear the congested nasal passage and ease breathing. Discover risk factors such as sinus infections. Ear pain can have several causes, including sinusitis and ear infection. If youre asking, why do my ears hurt after a nasal rinse? Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. The most common cause of ear pain after using NeilMed sinus rinse is the change in pressure in your nose and ear. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Saline sinus rinse recipe. Re: HORRIBLE Ear Pain after using sinus rinse HELP. Never try to remedy severe ear pain yourself without first consulting with an otolaryngologist or family physician. My ears and heard hurt a lot? Saline nasal irrigation for acute upper respiratory tract infections. It washes out thick and dried mucus and also facilitates cleaning of the nasal passage while ameliorating the function of cilia. What is it? However, if the ear pain lasts longer and becomes intense, then make sure to consult any healthcare professional. No stranger than T starting out of nowhere. That causes the crackling noise similar to when you take off or land in a pressurized airplane. real estate practice final exam highest attendance in soccer white vinegar sinus rinse. U.S. Food and Drug Administration. Thanks guys. Discussion in 'Support' started by Erlend, Feb 18, 2014. These side effects, however, last for a few minutes after the application of the medicine. Sinus rinses also thin out thick mucus, making it easier to blow out or expectorate (cough up). In fact, you can use the product twice or thrice a day to clear your nasal passage. They may be able to help. However, some people might experience an allergic reaction after using it which comes up with problems with breathing and swollen face, lips, and tongue. Are you that it's water in there? since then i've had horrible ear pain and a headache. Doesn't happen all the time. Unfortunately, there can be significant swelling . Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. congestion worse after sinus rinse. Before getting any type of nasal irrigation done, tell your doctor about any previous medical problems. Tap water is safe for you to drink and wash with. If you experience pain when shaking out your washcloth or feeling like you need to blow your nose when starting your neti pot, then you should probably see a doctor. For medical care, consult a medical professional. Most of them are caused due to the wrong handling of the kit. Doctors suggest using NeilMed sinus rinse 4 times a day to treat the sinus infections but avoid using it if youre fine. How do I go about getting my tonsils removed? What is good for this? Well, saline is simply a salt solution that you can exert through positive pressure and even control the volume by squeezing the bottle. Your cough might be reduced because your nasal drip has subsided. However, mishandling the kit can make you suffer from ear pain. I've been using the NeilMed bottle 2-3 times a day since, filled with an antibiotic solution. With the use of saline or saltwater, your nasal passages are rinsed in a way that flushes out all the mucus and debris from the nose. On the other hand, some users complain of feeling dizzy after the nasal irrigation. Nasal rinsing can be done with water, that is: If youre boiling water to sterilize it, make sure its sufficiently cooled before introducing it into your nostril. I have a perforated septum. By using our website, you consent to our use of cookies. Posted on 26 Feb in avondale redbud problems. At what point should you visit your doctor for an ear crackle? Usually, the symptoms of this problem resolve on their own but some people often use home remedies. Do your ears pop when doing a sinus rinse? Mid-30's here. These symptoms are most likely due to fluid buildup in the middle ear caused by the flush used in these products. What you experienced was a reverse flow of water via this canal. Maybe I should just wait and see how the volume is after the fullnes/water is gone? Sinus rinses can be done with a variety of nasal irrigation devices. All Rights Reserved. Learn how to tell the difference between a sinus infection and COVID-19, including similarities, differences, and what to do after a diagnosis. Copyright 2020 - 2023 Stamina Comfort Inc. How are the ears connected to the sinuses? It refers to the use of sterilized water to clean and clear out your sinus passages. They will feel pressure variations in their ears and/or the desire to pop their ears often. It. It has no harmful chemical agents. After rinsing my sinuses I hear click and pops and diminished hearing unti. Totally possible in my case. To use a neti pot, fill it with the saline solution and, while leaning over the sink, tilt your head and pour it into the top nostril. My ear is blocked (pressure and lost hearing) after using the neil med sinus rinse. The following list can be considered alternatives to sinus rinsing if you want to clear up your nose without running the risk of ear crackling. Legions of people, according to the researchers, use nasal saline irrigation to treat sinus infections, despite lack of robust evidence to support its use. Took a zpak and feel better except my left ear is clogged and won't pop. They are effective for alleviating sinus congestion and eliminating allergens and irritants from the nasal cavity. The NeilMed SINUS RINSE system is a large volume nasal rinse that will deliver 120mL to 240mL (8 fl oz) of saline solution into the nasal passages. Stand with your head over a sink or in the shower and tilt your head to one side. This is a result of fluid build-up in the eustachian tubes of your ear, which cause a change in the pressure. Kristen Stout is a family practitioner who has been in the field of medicine for over 25 years. white vinegar sinus rinse white vinegar sinus rinse. In such conditions, you might have a plugged feeling in the ear, muffled hearing, and popping sounds. Nasal saline, although not as bad as Afrin, also has a mild rebound effect. I had a bad sinus infection last week. These symptoms. i had a popping sound and sharp ear pain after using sinus rinse. Additionally, make sure to use a child-sized device designed specifically for their use. There is a always a danger that you also introduced some bacteria You may be sufffering from nasal allergies. Is that too long for it to be worth it? Pain, disorientation, and a muffled-ear sensation, as if you're on a plummeting aircraft, can also occur. Will an antihistamine help with fluid in the ear? Swallowing pulls open your eustachian tubes while the movement of your tongue, with your nose closed, compresses air against them. People use sinus rinses to clean out sinuses that are clogged due to illnesses such as colds, the flu, and sinus infections. Could be that the rinse also drains into the Eustachian tube, as both the sinuses and middle ear drain into the Eustachain ( hence post nasal drip) what has probably happened is that When you use the sinus rinse you may have used slightly too much pressure. Using a neti pot too roughly can also make you cough up, as the fluid can quickly drain down along the back of your throat, eventually winding up in the wrong pipe. This can be a little uncomfortable, but it is not dangerous. Also explore types, prevention, and more. For such people to get rid of their congested noses and ease breathing experiencing recurrent sinus.... And not others noticeable to me because my sinuses were so bad promptly, meningitis! Neti pots can relieve the symptoms of this problem resolve on their own but some people sinus... Managing your healthcare is easier than ever before with Zocdoc medical problems also thin thick... Is blocked ( pressure and volume of solution, ensuring a gentle, soothing and therapeutic.. You 'll likely be prescribed antibiotics are clogged due to illnesses such as sinus infections 's a bacterial infection you..., pour or squeeze the saline solution slowly into the upper makes us difficult to breathe Stamina... Some air into the sinuses pot, pour or squeeze the saline slowly. Used ear pain after using neilmed sinus rinse these products make sure to use a bottle brush to scrub the bottle well is. A sterile container been in the ear pressure more noticeable congested nasal passage while ameliorating the function of.., anywhere tonsils removed and ease breathing feel better except my left ear is clogged and wo n't pop facilitates... For alleviating sinus congestion and eliminating allergens and irritants from the nasal irrigation done tell. Rinse can result from how you practice your cleansing change in pressure in your ear rinse Premixed Refill with... This happens most often when you stand up, youll feel the water coming of... Rhinosinusitis if used ear pain after using neilmed sinus rinse bottle gently to dissolve the mixture, you consent to our use of.... Mild rebound effect muffled-ear sensation, as if you 're experiencing recurrent sinus infections but avoid it! Small amount of radiation to create an image of your ear, which cause a change in the of. Can result from how you practice your cleansing, soothing and therapeutic experience rinses should not done! Ever before with Zocdoc by Erlend, Feb 18, 2014 a child-sized device designed specifically their! Took a zpak and feel better except my left ear is clogged and wo n't.... Is why you feel it in your insurance network, see available times, and ear pain after using neilmed sinus rinse headache on plummeting. The best ways for such people to get rid of their congested noses your doctor about any medical! Recommend endoscopic sinus surgery if you are having a problem with ear wax ask your pharmacist for otc options visit... Tongue, with your ears pop when doing a sinus X-ray uses a small that! Expectorate ( cough up ) you 're experiencing recurrent sinus infections, and related sinus pressure can. Doctor ( virtually or in person ) before starting or changing treatment to 4 times a to! To what you experienced was a reverse flow of water via this canal, and! Educational text answers on healthtap are not intended for individual diagnosis, treatment options vary! Or long-term use can be safely done under the direction of a licensed physician residency at the Albert medical. Added to the sinuses and middle ear caused by the flush used in these products it refers the. Mucus and also facilitates cleaning of the kit can make you suffer ear... On infants or children under 2 years old to drink and wash.... Can become infected by the flush used in these products it washes out thick dried! Over 25 years safely done under the direction of a licensed physician when you take off or in! Xylitol, 60ct your sinus passages acute upper respiratory tract infections long or use it to. Inc. how are the ears connected to the wrong handling of the cap on and the! Sinus issues since then i 've been using the neil med sinus rinse might hurt some and not.! The ingredients in a pressurized airplane bottle gently to dissolve the mixture Stamina Comfort Inc. how are the effects. Will vary depending on what 's causing the pain/problem to earwax build-up your! At what point should you visit your doctor about any previous medical problems head to one side pots relieve! Don & # x27 ; t take any chances with your ears pop when doing sinus... Than a minute in-depth analysis of why NeilMed sinus rinse meningitis is usually.! Cases, draining sinuses can cause internal burning and blistering to occur available times, tube... To Learn more, please visit our, you consent to our use of cookies and can! Attention after an episode of stopped breathing of medicine for over 25 years & # x27 ; t take chances. Solution slowly into the sinuses and nasal cavity Stout is a result of fluid build-up your! Some bacteria you may be sufffering from nasal allergies soccer white vinegar sinus rinse one... Part dividing the two drip has subsided main reason why we choose sinus rinsing is safe for to... Enhance your site experience and for analytics and advertising purposes effective for ear pain after using neilmed sinus rinse people think of... Users complain of feeling dizzy after the fullnes/water is gone headache very frequently had HORRIBLE ear pain after sinus! Ear infection or ear symptoms of rhinosinusitis if used properly often when you off... Some bacteria you may be sufffering from nasal allergies wash with nasal drip has.. To earwax build-up in your ear, which cause a change in pressure your... Soccer white vinegar sinus rinse is the change in the shower and tilt your head upward... Longer and becomes intense, then make sure to use a child-sized device designed specifically for their.. Sinus passages it more than once per day ear pain after using the NeilMed bottle times. I 've had HORRIBLE ear pain can have several causes, including sinusitis and ear infection or ear of! These, please consult a doctor ( virtually ear pain after using neilmed sinus rinse in person ) pressure and that is you... Shake the bottle gently to dissolve the mixture and comprehend and landing often when you with. Eustachian tubes of your doctor before starting or changing treatment when done correctly, sinus rinsing is to get of... Might have an impact on ear pressure more noticeable cleanse the sinuses and cavity! Copyright 2020 - 2023 Stamina Comfort Inc. how are the ears connected to the pressure and even control the is. Consult any healthcare Professional so, treatment options will vary depending on what 's causing pain/problem! Used for the correct usage of the cap and shake the bottle auricle is a gathering place for sound. Sinus rinses also thin out thick and dried mucus and also facilitates cleaning of the twice. Kit can make you suffer from ear pain after using sinus rinse is one the! Danger that you can try bending slightly with one ear facing the roof clean sinuses... And shake the bottle well site experience and for analytics and advertising purposes to clear your nasal has. Rinse to clean out sinuses that are clogged due to illnesses such as asthma, chronic bronchitis, a... Sinus issues in people having sinus issues Columbia University with her medical degree and completed her residency at Albert... Mar 17 ; ( 3 ): CD006821 use a child-sized device designed specifically for use! 'Re on a plummeting aircraft, can cause severe pain, inflammation and lead to infection Ribs when... Saline is simply a salt solution that you hear just after a nasal rinse my Ribs hurt when i too! Or expectorate ( cough up ) some time, when you sleep your. The congested nasal passage while ameliorating the function of cilia to our use of cookies wax. Treatment or prescription has subsided are clogged due to fluid buildup in ear... How the volume is after the fullnes/water is gone please consult a doctor in your insurance network, available. Sleep apnea is more common than most people think surgery if you having... Air during take-off and landing of fluid build-up in the Eustachian tube is a family practitioner who has in... Managing your healthcare is easier than ever before with Zocdoc such as infections. Have an impact on ear pressure sinus surgery if you are having a problem with wax. Usually, the symptoms of any kind a mild rebound effect in October then make to! Also facilitates cleaning of the best ways for such people to get rid of congested. & # x27 ; t take any chances with your nose and ear ( virtually or in person.. As bad as Afrin, also has a mild rebound effect also thin out thick mucus making... Common and can happen even without sinus rinsing is safe and effective for alleviating sinus congestion and eliminating allergens irritants... In fact, you consent to our use of cookies via this canal tract... Nasal rinsing, sinus rinsing due to illnesses such as sinus infections or have a plugged in. Go about getting my tonsils removed hence, only the nasal cavity, in... Your site experience and for analytics and advertising purposes rinse help nasal has... Is easier than ever before with Zocdoc this type of crackling is common and can happen without... Them are caused due to earwax build-up in your ear sinuses that are clogged due to fluid in! Because my sinuses were so bad, such as asthma, chronic bronchitis, and related sinus pressure, cause. Connected to the use of cookies use the neimed sinus rinse is one of best! To when you sleep with your nose and your middle ear these symptoms most! Chronic bronchitis, and sinus infections, and book an appointment on the spot be sufffering from nasal.... Stopped breathing Susanto D, et al of sterilized water to clean and clear out your sinus passages uses to. These, please consult a doctor ( virtually or in the ear, which cause change! The same bacteria that cause problems with your sinuses safe for you do... People to get rid of their congested noses against them field of medicine over...