Sunny summer weather requires skin shading


Hello again, dear readers, and welcome back to the monthly letters column. It’s almost summer, which means it’s time to break out the hats, sunscreen and beach umbrellas, because a sunburn is a sign of skin damage. Unfortunately, that damage adds up with each additional sunburn, so please take the time to protect yourself. And now, onward to your letters.

-- A column about nasal irrigation, which uses sterile or distilled water to flush mucus and debris from the sinuses, is getting a lot of mail. We want to respond to one reader who wrote that she “snuffles tap water up my nose while in the shower, or over the sink, then gently blows it out.” We understand the point you made in your letter, that this is easier than using sterile water. However, as we said in our column, tap water is not safe to use in this way. It is not adequately filtered or treated, and it can contain microorganisms. The high pH of stomach acid makes it safe to swallow these microorganisms because it kills them. However, the environment of the nose and sinuses is a different story. The organisms can stay alive in the nasal passages and can cause potentially serious infections. In rare cases, they can even be fatal. For your safety, we hope you will consider switching to sterile or distilled water.

Elizabeth Ko, MD and Eve Glazier, MD

-- We recently wrote about a technique known as inspiratory muscle strength training, or IMST. It’s a type of resistance training that uses a handheld device to strengthen the muscles we use to breathe. In addition to helping people living with COPD and sleep apnea to breathe more easily, research suggests the technique can have a beneficial effect on blood pressure. This prompted a reader from Dallas to ask where he can buy the device. It’s often referred to as an RMT device. This is shorthand for inspiratory/expiratory respiratory muscle training. There are several different models, and all are widely available online. Some are also sold at large retail stores. These devices are drug-free and do not require a prescription. However, we recommend that you check in first with your health care provider about your plans to buy and use one.

-- We continue to hear from many of our readers who are interested in becoming part of a variety of clinical trials. We hope that a recap of the process will be helpful. Begin by visiting This is a searchable database of clinical studies being conducted around the world. There’s a search box at the top of the page where you enter the name of your disease or condition. For studies that are seeking participants, you will also click the button labeled “recruiting and not yet recruiting.” Each study has its own webpage with detailed information about the study, its goals, criteria for participants and directions for how to apply.

Thank you, as always, for taking the time to write to us. We love hearing from you. We read all of your letters and will continue to respond to as many as we can.

(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)