DailyDispatchOnline

Bringing You the Daily Dispatch

After contracting Covid, I have experienced a loss of my sense of smell. Here are some insights I have gained about living without it.
Science

After contracting Covid, I have experienced a loss of my sense of smell. Here are some insights I have gained about living without it.

T

To celebrate our anniversary, my partner and I went to a fashionable restaurant in Hackney, London that has been awarded a Michelin star. It was my first time dining in such an establishment. We were served a crispy little treat labeled as “Pine, kvass lees and vin brûlé.” I observed my partner’s excitement as the waiter placed it in front of us, her eyes illuminated by the flickering candle. The aroma had already made an impact on her face. With her first bite, she was transported back to her childhood in Massachusetts. She exclaimed, “Wow,” and closed her eyes as memories of a New England virgin pine forest flooded her mind. When she opened her eyes again, she looked at me with a guilty expression. I took a bite and winced. Unfortunately, I did not experience the same coniferous wonderland. Instead, I was met with unpleasant bitterness that lingered on my tongue.

I am genuinely happy for her. I am a generous person. However, after that moment, the rest of the evening feels like watching a show and by the end of it, I get the sense that she is downplaying her enjoyment, toning down her reactions as if to say, “You’re not missing anything.” She discovers that some dishes are more successful than others – the sweetness of cherry, the savory taste of mushrooms – but I am missing out on the subtleties, the feelings, the memories, and the aroma.

It has been three years since I experienced total loss of smell in November 2020. At the time, I was living with three roommates in a flat in Glasgow and we all contracted Covid before the vaccine was available. Both myself and one other roommate lost our sense of smell and have not fully recovered it. This is a common experience, as it is estimated that around 700,000 people in the UK have experienced complete loss of smell due to the virus, and six million still have some degree of olfactory dysfunction. My sense of smell has returned to about 30% of its original capacity, but it is inconsistent and often distorted. In summary, my symptoms of anosmia (total or partial loss of smell) include some things having a faint odor, some things not smelling as they should, and others having no smell at all. For example, basil has a mild but pleasant scent, ground coffee and a specific brand of toothpaste smell like fish, and thankfully, feces do not have a noticeable odor. Overall, this has been a challenging experience.

Occasionally, I experience a brief moment of accurately smelling something before it vanishes. It’s like my sense of smell suddenly wakes up to the newness of a scent, but quickly loses interest and falls back asleep. For example, when I slice open an orange, I’ll catch a hint of floral and citrus on the first breath – oh wow, my nose is back! But on the next inhale, there is no response.

During a conversation with Carl Philpott, a professor specializing in rhinology and olfactology at the University of East Anglia, I begin by asking a basic question: what exactly is smell? According to Philpott, smell is a chemical sensation that enables us to identify scents in our environment, bringing both enjoyment and pleasure, but also serving as a warning of potential hazards.

My sense of smell, which used to be quick to detect danger, is now failing. I once left a moka coffee pot on the stove for so long that the plastic handle and rubber gasket melted off. I was in another room when a neighbor came to check on the strong fumes coming from my home. In the past, I would have noticed the smell of coffee brewing as soon as it started to boil. Now, I am not even able to detect potentially toxic fumes. Detecting spoiled milk is also no longer possible.

Noses off: Rudi Zygadlo contemplates another flavourless meal.

According to Professor Philpott, accidents like the molten coffee pot are quite common. He also mentions that without the sense of smell, we have to rely on visual cues to detect potential danger. He further explains that there are two ways in which we use smell – through orthonasal olfaction, where we smell things from the outside as air enters through the front of our nose, and retronasal olfaction, where we exhale the smell of the food we are eating as air travels backwards through our nose. In both cases, the odour particles reach the olfactory epithelium, which is located at the top of our nose and contains specialized receptor cells.

The nerves travel upward through the cribriform plate and into the olfactory bulb, located at the base of the brain, from the receptors. According to Philpott, this area acts as a “relay station” and relays information to the amygdala, orbitofrontal cortex, and hippocampus. A study conducted in 2023 revealed that individuals with anosmia experience reduced brain activity and impaired communication between these regions. In a healthy olfactory system, a 2014 study showed that we can detect over a trillion scents, surpassing other senses in its ability to distinguish physically different stimuli.

The sense of taste, however, is rather basic. When individuals lose their sense of smell, they often believe they have also lost their sense of taste because the enjoyment of eating is diminished. However, the ability to taste is typically unaffected. According to Philpott, who has a medical background, taste refers to the perception of salt, sweet, sour, bitter, and umami on the tongue. In most cases of anosmia, this function remains intact. The majority of causes for loss of smell do not impact the taste receptors. While a pinch of salt still has the same effect, the intricacy and enjoyment of eating primarily comes from our advanced smell system.

In order to truly understand taste, you must lose your sense of smell and rely solely on your tongue. Anosmia often leads to a discussion about the impact it has on food and how people find ways to cope. For example, my friend Megan, who also suffers from anosmia, developed a strong preference for crunchy foods due to the importance of texture. Similarly, I found myself gravitating towards spicy chips as a way to compensate for my lack of smell. Food critic Tejal Rao shared her own struggles with anosmia, describing how cheese became unappetizing and popcorn lost its appeal. However, she found comfort in a Sichuan seasoning called mala, which creates a tingling sensation in the mouth and lips.

Some items, like wine, can be quite aromatic. My partner and I used to have a lot of laughs over it. It was a highlight during our first lockdown together. We would joke about the scents, like “hose-pipe rubber,” “armpit sweat,” and “my gran’s closet.” My partner would even go as far as describing the wine as “elastic.” I thought it was a bit silly, but she was adamant. The pleasant smells and fun times disappeared when I lost my sense of smell. It’s like trying to hug the memory of an old friend – you know it’s there, but it’s intangible. You reach out for something to hold onto, but it slips away.

The ghost has become slightly more visible as conditions have improved. I have found a workaround by taking a sniff of fresh coffee grounds between sips of wine, which tricks my sense of smell into perceiving the wine differently each time. This is not the most sophisticated solution.

According to Philpott, loss of smell can occur due to different factors. This includes a physical obstruction in the receptors (like in rhinosinusitis), dysfunction of receptor cells caused by viruses like Covid, damage to the olfactory system from a head injury, or failure of the equipment due to neurodegenerative diseases like Parkinson’s.

I belong to the second group. Duncan Boak, the creator of Fifth Sense, an organization focused on aiding individuals with smell and taste impairments, falls into the third group. In 2005, he sustained a head injury that resulted in complete loss of smell. Initially, he was grateful for surviving the accident and tried to move forward, disregarding his lost sense of smell. However, over the next five years, he noticed that his emotional experiences were becoming more limited. He explains, “I began to feel disconnected from my surroundings. The scents that were once associated with certain places and memories were no longer accessible. I even felt distant from my girlfriend. I lost something that I never knew I had.”

There is a significant correlation between scent and memory. In 2023, a research study discovered that individuals may encounter a weakened sense of smell prior to the manifestation of Alzheimer’s disease symptoms. During the initial stages of my loss of smell, my partner provided me with a collection of essential oils to engage in “smell training” – a popular treatment for anosmia that involves intentionally and repeatedly smelling familiar scents to restore damaged connections between the nose and brain. While I sniffed, most of the scents were faint and distorted, but there were a few that I could identify.

One bottle had a strong unpleasant scent, similar to chemical waste. When I found out it was lavender, I couldn’t help but cry. Lavender was my mother’s favorite scent. She cultivated it in our garden and used it to make oil and sachets for our clothes and pillows. During a trip to Provence many years ago, I walked through a vast field of purple flowers. I discovered that the word lavender comes from the Latin word “lava” meaning “to wash”. The Provencales used the flower to wash their linens, and the washerwomen were called “lavandières”. In the past, the mere fragrance of lavender would bring up these emotional and nostalgic memories. It makes sense, then, that without the ability to evoke memories through smell, those memories may fade away.

In 2011, Boak discovered Molly Birnbaum’s Season to Taste, a book about her loss of smell. This was a revelation for him, almost like turning on the lights in a dark hangar and illuminating everything. He had avoided thinking about his disorder for five years, but now he realized that his inability to smell was the root of his despair. He also came to understand that he was not alone in experiencing this. Through Birnbaum’s book, Boak connected with others who also suffered and experts like Professor Philpott. He saw the urgent need for an organization to offer support and raise awareness for this disorder. Driven by a determination to turn the most negative experience of his life into a positive one, he founded Fifth Sense.

You can locate your closest regional support center for Fifth Sense on the website. You can also access the most recent research and treatments, as well as read personal accounts from those affected by the condition. Boak emphasizes the importance of building a community for those who feel isolated due to their condition. Sharing experiences can provide comfort and a sense of belonging. Although I have never been a fan of club memberships, I have found solace in exchanging stories with Boak; there is even some dark humor in our shared experiences.

Along with similar emotional situations, he also experienced a close call with his oven. He accidentally left the gas on overnight and almost lit a cigarette before deciding to smoke outside. His roommate then alerted him to the gas leak. (The charity prioritizes gas safety.)

Philpott confirmed that strange-smelling coffee and toothpaste are common distortions, known as parosmia. While my case is not severe, I appreciate the sense of connection knowing that others also experience similar issues. This is especially important as Boak highlights that smell is often overlooked and understudied compared to other senses. “You can easily get a vision and hearing test at Specsavers while walking down the high street.” Why not have a simple smell test as well? Implementing a national smell screening is one of Fifth Sense’s main objectives. Smell loss has been linked to various medical conditions, including hazard perception, mental health problems, and neurodegenerative diseases, all of which can result in early mortality. Therefore, early detection is crucial.

It’s interesting how losing something can help us appreciate it more. I’m not an expert, but I probably wouldn’t even know what an olfactory bulb is if mine was functioning properly. But now, I have a newfound gratitude for it. It’s a recurring theme in my research, like a Joni Mitchell song, that we often don’t realize the value of something until it’s taken away from us. I asked Boak if he would go back in time and prevent the accident that caused him to lose his sense of smell, would he? He replied, “No,” before collecting himself. “No. Even though there are challenges that come with the condition, on the other hand, I wouldn’t have developed such a strong passion for this topic or started a charity.”

I inquire about potential treatments for smell loss with Philpott. He explains that sinus disease, the leading cause of smell loss, has several established treatment options. However, when it comes to smell loss caused by viruses like Covid, there is a greater need for the development of treatments. While there are medications available, they have not undergone a randomized controlled trial, which is considered the gold standard. Some evidence suggests that drugs like theophylline (used for asthma) and sodium citrate (a nasal spray solution) may be effective, but it is weak.

Recently, there has been a trend of administering “plasma-rich protein injections” into the nose. Philpott is doubtful about its effectiveness due to the resource-intensive process and the use of needles. He is not interested in this method. However, he finds the ongoing research in the US on stem cell treatment promising as it may reactivate smell receptors. Philpott is currently traveling to Geneva for a conference on olfactory implants. He mentions the possibility of a device being implanted under the skin of the forehead with a wire connecting to the olfactory bulb and providing electrical stimulation, similar to how a cochlear implant restores hearing. Philpott is interested in this option and notes that there is still a lot of progress to be made.

The concept of “smell training” is also worth mentioning. The professor states that there is some evidence supporting its effectiveness, but it may not work for everyone. After attempting smell training with lavender in early 2021, I abandoned the practice as it was disheartening. Similar to Boak, I did not want to focus on my disorder. However, while composing this piece in the past few weeks, I have kept essential oils on my desk to use a few times a day. Although I am unable to smell jasmine, sandalwood, or pine, lemon verbena brings tears of joy to my eyes.

On a chilly morning in December, I am in London for a photoshoot. After the session, the photographer, who had read a draft of my work, gives me a gift. She hands me a bar of chocolate wrapped in paper and tells me that she has been informed that lavender has a taste similar to its scent. It is a gesture reminiscent of a story by Charles Dickens, and despite my generous nature, I do not mention my recent research findings that suggest the taste of lavender is likely just its scent. When I return home, I try a piece of the chocolate, but the bitterness overpowers any other flavors. However, I continue to eat more pieces and suddenly, a aroma of lavender appears like a ghost. It is faint yet powerful, evoking memories and bringing to mind Provence and scented pillows. It contrasts with the sharpness of the chocolate on my tongue, like a gentle floral spirit. As I savor this experience, I am reminded of the famous quote, “I live in the past, the present and the future!”

Source: theguardian.com