The miseries of losing the sense of smell.

Health and medicine explained.
July 8 2008 5:36 PM

The Nose That Never Knows

The miseries of losing one's sense of smell.

(Continued from Page 1)

Taste and smell are intimately linked, so when I lost my sense of smell, I also lost my appetite. While the taste buds detect sweet, salty, sour, bitter, and umami, it's the olfactory cells in the nose that allow us to appreciate the delicious complexities of flavor. My taste buds are in perfect working order, but without smell, each meal is a variation of sweet, salty, sour, bitter, or vaguely savory cardboard. During the first year of adapting to anosmia, I lost eight pounds because I had to force myself to eat. As I passed by my favorite fruits, vegetables, cheeses, or treats in the grocery store, I'd feel my usual surge of desire replaced by a jolt of frustration. I rejected food to punish it for letting me down. I heard plenty of jokes about how lucky I was not to enjoy eating from people struggling with their weight. Turns out, they were on to something. The company Compellis Pharmaceutical is developing a nasal spray for weight loss that blocks the sense of smell and taste. To me, the thought of someone deliberately giving themselves anosmia, even temporarily, seems sad and crazy.

What saved food for me, eventually, was texture, or "mouth feel." Ben Cohen of Ben & Jerry's, who has said he is anosmic, pushed his partner Jerry Greenfield to add bigger and bigger chunks to their ice cream. And voila—a distinctive brand was born. Apples, which I never liked before, have become a treat while saucy foods like daal or coconut curry, which I used to love, feel mushy and repellent. I've come to appreciate sour foods like lemon or tamarind because they don't rely on subtlety to make themselves known in my mouth. Japanese food is the perfect anosmia cuisine since it's so much designed around balance of tastes and variations of texture.

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What's the upside of my nonfunctional nose? The smell-impaired are often called on to do those things their friends or loved ones dread, like changing cat litter, picking up dog poop, cleaning vomit-stained carpets after drunken parties. Useful, true, but not being able to smell yourself makes personal hygiene incredibly stressful. I've never read an account from an anosmic that doesn't cover this embarrassing topic. Even after the usual grooming ritual—shower, deodorant, teeth brushing—I still have a nagging fear that I've missed something. What if I reek but don't know it? What if I have something gross on the bottom of my shoe, and everywhere I go I leave behind a foul trail? I'm not only dogged by the fear of stinking; I've also found that life is more dangerous. I've burned food and melted pots so many times I should be declared a walking fire hazard. Like most anosmics, I view any gas appliance as an archnemesis. I've become compulsive about making sure my gas stove is really on when I turn the dial.

After three years of living with anosmia, I got a full reprieve for one aromatic week when I went back East in the middle of winter. Whether it was staying in a place that was completely devoid of plant life, or being at sea level (my sinuses have been appreciably worse since I moved to a higher elevation), or who knows what else, my smell and taste returned. I went home to California feeling reborn. I cried when I entered my house and smelled its familiar, welcoming atmosphere for the first time in years. Everywhere I went, I was greeted by glorious scents, from the musty smell of our car to the freshness of clean laundry. I reveled in the fragrance of soap, the inside of the spice cupboard, the coffee—ahhh, the coffee—my clothes, the sheets, my husband, and even my dog. The trip we took to the dump was wonderful. Imagine being eager to take in the reek of rotting garbage!

I was stunned by how much more engaged I felt in my own life. I noticed that being able to smell made me feel focused again. I was fully in my body, lighthearted with a clear, keen mind.

Then it began to slip away. I tried not to panic. But one day, in the middle of a cup of coffee, smell vanished. I tried to convince myself it was no big deal. At least I'd had a vacation from anosmia for a week. But I quickly plunged into a despair that sapped all my energy. I wanted to smash my useless nose against the wall.

I'm still searching for a cure. I recently read about sinuplasty, a relatively new procedure that opens blocked sinuses with a thin balloon similar to the one that's used for angioplasty. I've made an appointment with a specialist to see if I'd be a candidate for the operation. And despite my town's horrible housing market, we've made the decision to move because of my allergies. When the realtor came by to see the property, the first thing she said was, "Wow, your roses smell so good! And that jasmine. …" When I explained my situation, she looked at me with a mix of pity and incredulity. "You really can't smell them? But they're so fragrant!" I knew then that moving was the right thing. Although the financial ramifications will be terrible, it's worth it if I can regain my priceless sense of smell.

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