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Archive for the ‘anosmia’ Category

girl smelling flowers 2I’ve been waiting for this. No sense of smell! Technical term: anosmia. There’s the temporary, short term variety, or the long term variety – like permanent. Though I’m not a medical man, I do know quite a bit about it, having had the condition, studied it and written about it during a long period of recovery. I also know that after much messing about in the ENT departments, long term anosmia is generally written off, and people are advised to just live with it, hopefully before the surgery. Sometimes the sense of smell comes back, as in my case, but it can take years.

Why we lose our sense of smell permanently isn’t understood, but in its temporary manifestations, it’s most commonly related to an infection of the upper respiratory tract. This causes inflammation of the mucous membrane. A cold will do it. But allergies such as seasonal hay-fever will also do it. And since we’re heading into peak hay-fever season just now, I expect a lot of people will be losing their sense of smell. Alcohol will do it too, or even spicy food. Regarding the latter two, many people don’t even think to notice, and anyway, in most of these cases, it comes back after a day or so, so no problem. But anosmia can also settle in. No smell, no taste. Ever.

What complicates matters, and the reason I’m writing this, is anosmia has just been listed in the UK as one of the key symptoms of Covid-19. As of this afternoon, if you go anywhere near the NHS online Covid symptom checker and put in anosmia related symptoms, even if you’ve had them for ages, and even if you list no other symptoms, like fever or cough – you’ll be told to self-isolate. Don’t go to work. Stay at home. You and anyone you live with.

I understand a lot of clever people have decided, on balance, this is a sensible precaution. But, judging by the hits I get on anosmia related posts, it’s a more common condition than is generally appreciated, and long before Covid-19 came along. So there’s going to be a lot of people phoning in sick and self-isolating suddenly, a rush on demands for testing too.

I’ve pretty much recovered a normal sense of smell now. But a normal sense of smell varies. Some days its almost supernatural, some days middling, some days it might be gone for any of the benign reasons listed above, or none of them. I notice these things because, having lost my sense of smell once, and for a long time, I really value it now that it’s back.

I checked myself with common scents today just to make sure I’d not relapsed. Ground coffee? Check. Cherry scented candle? Check. Mr Sheen polish? Check. Vanilla car freshener? Check. I’m okay then, no time off work for me. But plenty of long and short term anosmics are going to get caught up in this. And right now, they’re confused and anxious.

Could it be hay-fever? Was it the curry you had? That extra glass of red wine? Common or garden, mysterious anosmia you’ve had for years? Or is it Covid? I don’t know. I’ve been hoping they wouldn’t do this. But now they have. Self-isolating is no trivial matter, especially if you’re only entitled to statutory sick pay, or none at all, and you’ve a family to feed. So what do you do?

Well, to the letter of the guidelines, if you have anosmia, even if you’ve had anosmia for as long as you can remember, or even if you think it’s only hay-fever, go to the  NHS symptom checker online and follow the instructions.

Take it from there.

My guess is you won’t be in work tomorrow.

 

 

 

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scent-of-a-womanFirst of all I apologise for my last post. If any of you were feeling down when you read it, it will have done little to cheer you up. I can only say it was the result of a workaday Monday morning at the year’s back end. I read the poem to my son and he said it was impressively bleak. He also said he didn’t like the poet at all – far too depressing on an empty stomach – and was appalled when he learned it was me.

So, I’m glad to say I don’t feel like that all the time, that just as there need be no firm reason for a decline in spirits, it can take equally little to restore a sense of buoyancy.

Take Sunday for example. There is a donut seller on Southport pier. A few years ago, I could not smell the donuts. Indeed, I could not smell anything. I could push my nose into a bag of the freshly fried little things and smell nothing. On Sunday though, I caught the scent of them even from the road as I drove along the promenade, and they cheered me. Ah,… donuts!

Perhaps it was the wind that carried the scent – it was a fresh day, cold – but the scent of those donuts rendered at once last Monday morning’s poem of measured misery a distant memory. I bought six. It’s one of life’s little paradoxes that even the most heavenly scent emanates from sources that in excess are bad for us, but on occasion we simply don’t care. I carried my bag of donuts to the pier’s end, their scent mingling with a brininess of the wind and an incoming tide. Heaven!

Less wholesome,  was the scent of blocked toilets in the cafe in town. I had called for coffee after my blow on the pier. The cafe was empty. I didn’t linger, yet years ago I would not have noticed the maleficent odour and would have sat down quite happily, in all ignorance. Instead, I followed my nose along Lord Street, enticed by the scent of restaurants, pizzerias, more coffee shops, then an impressive waft of perfume from through the doors of Beals.

There was more perfume from the girls in the crowds on the street.Ah, the scent of a woman!  Indeed on days like these I am in an ecstasy of perfume and can happily follow one trail after another. I realise this is not a good defence against accusations of stalking, but I am also fickle – the lightness of a daytime perfume, or the sultry heaviness of evening,.. girls, you can still warm the cockles, but it is your perfume that sets them on fire. I politely decline all other charms.

Scent opens up the unseen dimensions of the world. It’s impossible to say how extraordinary this is unless you have lost your scent, say for decades, then had it make a recovery. The health professionals I consulted offered little hope. But there’s good information out there – people who tried things and said: this worked for me. You can usually tell them apart from the charlatans by the fact they don’t want any money in exchange for this information. Alpha Lipoic Acid has worked for me. It’s just a food supplement, and it took a while, but it’s gradually opened up a door to a greater experience of the world once more.

I return to the car, return to it’s familiar scent. Yes, the familiar scent, the multilayered scent of place – impossible to label as one thing or another. I can’t define the scent of my car at all. It may be the carpets, or the vinyl top, or something leaking through from the battery in the boot. It smells, dare I say, manly, spicy, a little oily but with an acidic, almost citrus tang. And this is odd because for the first twelve years of its life this little car was owned by a woman. There were lipsticks and little perfume bottles lost down the backs of the seats, and Duran Duran CDs. Yet for all of this purely physical detritus, she seems not to have left behind much of an olfactory impression at all.

I massage my nose with fingertips while I think about this, bring back some feeling after the cold of the air, and as I do so I smell the shaving cream I used that morning, also the hint of an aftershave transferred from the fingers of my gloves – Kuros – an aftershave I wore so long ago I no longer recall the occasion. Yet there it lingers in the pockets of time, waiting to trigger the unexpected – memories of a girl I used to know, and who had a particular liking for that scent – so much so, she would borrow it from me. It would render her weak, she said.

Ah, when the scent is sharp it is a revelation.

When it’s missing from your life altogether, it’s not funny.

Sunday scent and the day feels warmer.
Pity’s Mondays round the corner.

We’ll end it there.

 

Graeme out.

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roamerInhibition. Self consciousness. It makes our dancing stiff, our singing flat, faltering, subdued. We know we can do better, but the crowd or at least the suspicion of its scrutiny puts us off. It’s better then to close our eyes, to believe we’re the only person in the room. But what about writing? Do we write best when we believe no one will ever read what we’ve written? For most writers this is a distinct possibility, but what’s the point in writing anything at all if you’re the only person who’s ever going to read it?

This is an existential question. The point of writing is opaque, defiant of reason, cycling between the black dog of depression and an over-inflated self worth. Both are damaging in their way, but in particular we fear that black dog getting the drop on us, for then surely we’ll never write another word.

For whom do we write, then?

I asked this question of Google and turned up one of my own blog pieces entitled, appropriately enough: For whom do we write? I concluded we write for ourselves, that the person we imagine reading our work, the imaginary “other” is a projected version of ourselves, and who am I to argue with my own analysis? But this is not to detract from the mystery of the process. Yes, we write for ourselves, but are inspired by the belief that any revelations we uncover in the process are potentially of value to others following in our wake.

1960AviaAs I write this evening, I’m wearing an AVIA wrist watch from the sixties. It’s nearly as old as I am. Although we’ve only recently become acquainted, it means as much to me as my father’s Roamer which dates to the late forties, and as much as the Rolex I bought myself with my first month’s salary, at the outset of my dayjob, in 1982. By contrast, I bought the AVIA off Ebay, last month for £20. Why should it mean anything? It’s worthless. What puzzle does it pose? And  why should you be interested in my telling you about it?

I mean, who are you anyway?

My father’s watch tells the story of his life, a story that ended when I was fourteen. I rarely wear it, but his life and its premature ending is what I think about when I handle it. It needs a minor repair, but one I’m not yet confident enough to tackle for fear of damaging it. The metaphor in this is complex and strange and deeply personal and may only yield further revelations when I have the courage to finally take the back off the watch.rolex

The Rolex was to some extent a marker of stability, telling of a time when I had stilled the stormy seas somewhat and established a way forward in life for myself. I wear it on special occasions, but am sometimes embarrassed to be the owner of an aspirational timepiece, all be it by now a vintage one – that a part of me once thought such things were important or impressive to anyone. I would never spend that sort of money on a watch today, no matter what my disposable income, yet I could never sell it, so appear to be clinging to those old perverted values, no matter what my opinion of them.

Then there’s the AVIA, a curious old thing that adds it own unique twist to the story. It tells of a thing as old as I am, one that’s survived the years in good condition, and is still of use, still reliable. The previous owner is unknown to me, as are the times the watch has known, a mystery only to be guessed at, times that have ticked away oblivious to my own, yet in parallel with them, yet also now suggesting a kind of collective completeness that might be revealed in the contemplation of its feeling tones.

I may of course be stretching my metaphors to destruction here, but these things provide sufficient energy to draw my fingers to the keyboard. But  I cannot allow myself to imagine your presence, your derision, your boredom, at least not until the thing is worked out and revealed at least to me as a valid commentary on the human condition. Then, my friend, you can take it or leave it.

A telling of any kind is an exploration of the mystery of being, and the conclusion is the opening of a door, one whose threshold we arrive at by entirely abstract means. And the revelation that awaits us might similarly be expressed in abstract ways, but the writer knows when the puzzle is solved, because that’s when the story ends, whether we’re writing literature, or a murder mystery. The tale of the three watches is still seeking its conclusion, and I use it here as an illustration of the underlying psychology and both the challenge and the necessity of  writing as if no one were listening.

A story is not real life. In a story the boundaries are set as a specimen mounted under a microscope. In a romance, often the telling is of the obstacles to love, commencing with the first meeting and concluding with the marriage, or the first kiss, or the long awaited making love. The story of a life however does not end in the same way. It goes on, rich in revelatory material, at least for the writer with sufficient sensibilities. But the love story is a familiar pathway, one most of us are familiar with, and it’s pleasing to be led along it, so the writer need not feel shy or self conscious in directing his pen to such an enterprise, even under the full glare of an imaginary readership. But what of those other stories, those other questions, questions one might even be afraid to ask?

For myself I have no interest in controversy, finding, as you’ve seen here, sufficient mystery in the tale of three wrist watches, and it’s perhaps for that reason I’m content to proceed without an audience, if only because I cannot imagine anyone being held rapt by the telling of such a tale. What provides the energy to keep writing in this vein is not the arrogance  my musings are as valid as anyone else’s. To be sure they may be nonsense, but in writing the only arrogance is the belief we are in any way responsible for the creation of our own work in the first place.

The question of the three wrist watches rises from a part of me to which I have no direct access. Yet it burns, and must be given voice to or the writer in me is not complete. In this sense then the audience does not matter. So yes, although it’s a hard thing to imagine, we must write like no one’s ever going to read our words. This isn’t so difficult as the non-writer might suppose, for the words themselves, even if they lead the writer on a merry dance to nowhere, are sufficient reward, and especially if, through their telling, the writer gets to glimpse beyond the doorway of one’s liminal consciousness to an abstraction of the universal revelation of what it means to be a living, thinking, feeling human being.

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rydal mount

My lawn had grown overlong since the last mow, virtue of a week of rain and heat. It felt soft and springy underfoot, and the grass released its scent as I walked, a delicious scent that mingled with that of haymaking coming from the meadows beyond the fence. It was an overcast evening, warm, with pale white clouds rising into an oppressive background of blue-grey. I sensed the approach of a thundery rain. They say you can smell the rain, or if not the rain exactly then something of the atmosphere that precedes it. And yes, that evening I fancied I could smell the approach of rain. All of this intermingled was the scent of a rural late summer evening, rich in memory, releasing images of childhood, faces and events from a past I had forgotten, long locked in the treasure chest of experience.

The remarkable thing me in all of this was that I could smell anything at all. To lose ones sense of smell for so long as I had, and have it return as strong and keen as it sometimes is now is more than a joy. It is an intimate and profoundly meaningful re-connection with the deeper world, a connection many normal scented people take for granted. Indeed I’ve seen them pull a face, overwhelmed by scents of the wrong sort. But to the recovering anosmic, even the rancid odour of organic decay is a sensual experience of incalculable value, if not exactly to be enjoyed, then at least, like all scent, appreciated for the enhanced degree of self awareness its grants for, as any anosmic will tell you, to be without scent is to be not fully in the world at all.

I can’t remember how long I was without a sense of smell – decades probably. It faded gradually, for no known reason, and doctors could not help me. My road to recovery then was one of personal experiment, and the search for useful information in a sea of online nonsense, and hear-say, and old-wives-tales. But had I cleaved solely to accepted medical opinion I might have subjected myself to painful and invasive surgery only to find, as many had before me, that it did not work. I might also have subjected myself to a life on steroids. I persevered with the medically accepted route for two years with intermittent and at best only temporary respite, before giving up on it. Instead I followed a tentative lead to a harmless common food supplement called Lipoid Acid. Six months later my sense of smell was returning. Getting on for two years now, and its sharpness can at times astonish me.

But Dr Google is for sure an unreliable healer. He will tell you what you want to hear. Is my condition incurable? Yes/no, he says, depending on what you want to believe. Will this or that cure it? Yes/ no, he says, again depending on what you want to believe. Life threatening? Ditto.

There is no substitute then for a circumspect approach, one that values only the evidence of a verifiable efficacy. But here we find the skepticism of science overwhelmingly biased against the hope of myth, and old-wifery, dismissing it in its entirety as nonsense when actually there may be useful snippets to be gleaned. As a rule we must be suspicious of anything that costs us money, avoid also the inane chatter of vexatious forums and other online support groupery. Instead seek the accounts of those who have done things, who have tried this or that, and written about it in detail, and aren’t trying to sell you a cure. I found my own crock of gold in the writings at No Smell No Taste, judged it to be a reliable source and followed my nose (pun intended).

So it was partly from the sea of online myth the stories of Lipoic Acid arose. It was also a degree of faith and determination that guided their application, and eventually saw me through to a re-connection with a sensual experience I had not dared hope I’d ever know again.

The varieties of fragrance of women at a wedding is astonishing, as I had reason to notice last weekend. There are so many commercial perfumes, and I had forgotten how unique they are, and how they play upon the senses, how they tickle the emotions – some of them darkly erotic, some playfully sharp, dancing light upon the night air like the faery folk, and all obliterated now and then by the heavy sweetness of a cigarette, an unwholesome troll of a scent that can have me compressing my lungs in defence at twenty paces. Yet, but a few years ago, I would not have smelled a cigarette even had I been holding it myself.

The realisation doctors do not know everything is a salutary lesson, and something of a shock to the layman. Certainly they know much more about a thing than you or I, but to own a condition like Anosmia is an education in itself and qualifies you by default for intelligent study and comment. And it is through study we might understand it, and by understanding come either to terms with its incurability, or aid our own recovery.

With anosmia, a complicating factor is no one knows how the sense of smell works, how it takes the airborne molecules of the scented thing and reads them in a way the mind can interpret a signature of the scent of that thing. We can guess it’s something to do with the mucous membrane and the way the sensory nerves lie within it. We can look suspiciously at invasive polyps – cut them out if they are sufficient in number to actually block the nose. But I still have polyps, yet also a keen sense of smell, so polyps, although much maligned and blamed, and to be honest a flipping nuisance, I conclude, are not the cause of anosmia.

My own feeling is that inflammation of the mucous membrane is the cause, that polyps are a symptom of this as much as anosmia, that in swelling of the membrane the nerves within it are stretched and lose their ability to do whatever it is they do. Reduce the inflammation and the nerves recover their mysterious function, and the sense of smell returns.

The scent of a cupboard when you open it, the scent of shoe polish, the musky sweetness of WD40, the sharp repellent tang of petroleum, and metal polish. And in the garden, a rose, or lavender, or rosemary, the interior of an old shed containing a mad cornucopia of scented stuff. The scent of a car under a hot sun. The scent of a handful of copper coins. A newspaper. A chip shop.

All these things are to be marvelled at adding incalculable layers of meaning to the world that is also seen and felt and heard, and without which the world is not complete.

[PS the garden featured in the photo isn’t mine, but once belonged to William Wordsworth]

 

 

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girl smelling flowers 2Can Alpha Lipoic Acid help restore your sense of smell?

Anosmia. No sense of smell. Mine used to be normal, though seasonally attenuated by an allergy to pollen. I seem to have been without it forever now, though I suppose it must simply have grown more intermittent over the years until I realised I couldn’t remember what anything smelled like any more.

Doctors? Well, yes, you should always go see the doctor, see what pills he can prescribe for you, but my own doctor isn’t the most hopeful nor encouraging of healers – his most endearing mannerism is his slightly leaden patience, his least endearing a sorry shrug of the shoulders and the phrase: “There is nothing we can do.” Over the years he has conditioned me into believing the same of all ailments, that the best I can hope for is that the body will heal itself in those cases where it can, and that we have to simply adjust to living with those cases where it can’t.

The surgeons at the ENT department were a little more hopeful, offering me a handful of steroids and saying that if they didn’t work they could remove the nasal polyps their cameras had also revealed. (Polyps are harmless little outgrowths from the mucus membrane). The steroids worked, restoring a supernormal sense of smell in a matter of days, but this only lasted a few months, then it was back to anosmia as usual. As for the surgery, I know people who’ve had their polyps removed. They say it hurts, you’re on sickpay while it heals, it doesn’t work, and the polyps grow back in a few years anyway. The ENT surgeons gave the same pessimistic prognosis, so it didn’t take me long to decide on that one. If your polyps are so big you can’t breathe through your nose, then it’s worth doing, but otherwise,… probably not.

I think nasal polyps are a red herring anyway. True they often accompany anosmia, and are sometimes cited by medical professionals as being the cause of it, but I think they’re more likely a symptom. I still have polyps, but my sense of smell can be restored by steroids, which work by reducing inflammation. Ergo, I believe the cause of anosmia is inflammation, probably of the mucous membrane, which also contains the nerves that help us smell. Perhaps as the membrane swells, it stretches the nerves or even damages them, I don’t know, I’m speculating now. That would be my avenue of research if I were a medical man, but I’m not. I just want my sense of smell back.

Of course, you can’t live on steroids. Taken in the longer term they’re nasty things. Indeed I’m of the view it’s a bad idea to be on any kind of pharmaceutical for life, unless you’d be dead without it. What you need is something more natural and for which there are no known side effects, that the aim should be to kickstart the body’s own healing mechanism, not to find a permanent crutch for its apparent failings.

Fortunately, there are no end of “natural” methods for curing anosmia. Unfortunately I must have tried all of them, but to no avail. Then, about six months ago I came upon information about Alpha Lipoic Acid (ALA), a common, inexpensive food supplement that’s used as a natural anti-inflammatory. Medical reports, whilst not conclusive, were encouraging, that boosting your intake of ALA could help in recovering the sense of smell.

I’ve been taking it now, as the title of this piece suggests, for 200 days, and have experienced some welcome improvement. I can no longer say I have no sense of smell whatsoever. It’s intermittent, present for some parts of the day absent for the rest. I’ll go for a few weeks without anything, and then a few weeks intermittently smelling things again. The improvement is small, halting, tentative, but seems to be gathering strength. As of now, even at it’s best, I have to say the sense is still severely impaired, responsive only to the strongest of odours, also curiously selective. By contrast Steroids will reveal to me the richly varied texture of background odours as I move from place to place. Such things are still beyond my grasp, but there is movement in the right direction. I’m taking nothing else, so it has to be the Alpha Lipoic Acid.

Results were not immediate. I began taking it at the start of 2015, and noticed no improvement for the first 100 days. Then I began to get my first inklings.

The medical studies involved a dose of 600 mg per day. The recommended daily maximum (as a food supplement) is 200mg. I didn’t want to exceed the recommended dose that much, so compromised on 400 mg. (200 in the morning, 200 in the evening). I take it in capsule form, with food. If you take it on an empty stomach it’ll give you indigestion.

So anyway, yes, it’s taken a long time, and even after 200 days it’s still mostly a blank with just the occasional heady rush of scent, but welcome all the same. I’ll report back in another 100 days, and let you know if there’s been any further improvement.

One other thing I should mention here, as I’ve mentioned elsewhere in this blog, is the effect of alcohol. This may not effect everyone, but in my case at least, drinking it will set back recovery by days or even weeks. I can get away with it provided I don’t exceed the medically approved limit of 1 unit ABV per hour, and a maximum of 4 units per day. Any more than that and the body struggles to metabolise it. I can only speculate it’s causing an inflammation of the mucous membrane. If you’re struggling with anosmia then, it’s worth going tee total for a couple of months to see what happens. It’s not easy I know- most of us who like a drink are more hooked on alcohol than we suspect – that is until we try quitting, and then we realise it only too well. I’m down to a bottle of wine a week now – but not all at the same time.

The only other thing I found that helped with Anosmia was acupuncture. It took about 5 sessions but my sense came back quite strongly – again acupuncture is an effective anti-inflammatory. In my case it didn’t last very long though, but I was also drinking more than the medically approved guidelines at the time. I hadn’t made the link back then, but I’ve no doubts about it now.

If I was starting out again, looking for a cure, I’d say, for the quick hit, quit drinking and get some acupuncture. You should see positive results after five to ten sessions. Any more than that and it isn’t going to work. But start drinking again, and you’ll lose the benefits. For the longer road, quit drinking and start taking Alpha Lipoic Acid. You should see the first (modest) results within three to six months, but keep drinking – even modestly – and the results will be choppy to non existent.

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