I started using Pulmicort in my nasal rinses in late november. I had been looking for something to add to my saline to help with inflammation and I can honestly say that I think it helps keep things open. I had sinus surgery in Oct and have seen my ENT 3 times since then and its been very clear every time. I do the pulmicort only at night (I do two rinses a day) but I don't use the neilmed because I don't feel like it had enough pressure for me. If you haven't before, I would try making the saline solution yourself (you can search the forums for the recipe) and use a bulb syringe. Gets the stuff out! Also, pulmicort is a pain in the butt with insurance. I had to pay 20 dollars out of pocket even though I have private insurance and medicaid. For some reason they only tell me they'll cover it for people under 9 years of age. ????? It's crazy but I think it does help my sinuses so its worth it.