I have a perforated septum. Any special directions or precautions?

This is a tricky situation. You will need to push the saline solution beyond the level of the perforation. One suggestion is to buy a baby bottle nipple and insert it over the round cap of the Sinus Rinse bottle or neti pot spout. The Sinus Rinse low pressure squeeze bottle will be better because it allows you to control the flow of the solution. Then cut the nipple to fit past the perforation.