A wine-loving friend's dilemna: head injury results in loss of smell

[Jenise]

About a year ago Jack was ice skating with his son and fell over backwards. As I understand it, the head injury involved extensive but not complete severing of the nerves that enable one's ability to smell, and the initial impact on his sense of smell was about 100%: everything smelled "like half-baked bread". Doctors were unsure of what he would regain with time: the damage could not be undone, but some nerves do heal.

Jack's a wine lover. When we met three years ago, in fact, he was in the process of digging out a portion of his basement for a subterranean cellar. And I ran into him just last night at a big local wine and food event. He can still smell just enough to get excited about certain wines but not all aromas get through and many are different than they used to be: big fruit's a plus as one would think, and so are oak-related flavors like vanilla and licorice. Surprising to me, he said his sense of taste is actually more acute.

On the phone just now, he asked me about those smelling kits. There's no therapy for his kind of injury, but he was thinking that maybe one of those kits would, if not act as some kind of ersatz therapy, at least help identify which aroma receptors are working. It occurs to me that he also might be able to use the kit to measure/monitor changes/improvements as and if they occur.

This kind of dilemna has been talked about in this forum before, and the brand I remember knowing about is called, I believe, Nez du Vin.

My/his questions for this group:

1) If there's more than one maker of these kits, can anyone recommend Nez or any other?

2) What experience have others had regarding this kind of sensory loss, and how have they dealt with it?

All information and encouragement welcome. Jack will be along, I believe, to participate himself in this discussion.

2) What experience have others had regarding this kind of sensory loss, and how have they dealt with it?

I can't offer any advice, only sympathy.

I got flu one year, and it knocked out my sense of smell completely for two weeks. And over the Christmas/New Year's holiday season, to boot.

Unless something like this happens, you don't realize that what we normally think of as the sense of taste is really the sense of smell. With the nose knocked out, all that's left is the primary taste sensations--like the vowels in the alphabet: sweet, sour, bitter, salty (and like "sometimes Y"--perhaps umami).

The Chinese food for New Year's Eve that I got by take-out from the premier Chinese restaurant in the area was odorless, and tasted salty. The Champagne I had with it was odorless and sour. One of the most depressing meals I've ever had, since I knew what it should have tasted like.

Everything tasted like cardboard for a couple of weeks. I was ever so glad that my sense of smell finally returned.

Boy, what a tragic loss. I hope your friend eventually recovers.

-Paul W.

Please express my sympathy your friend, Jenise -- the sense of smell is so important to a wine lover. A few thoughts:

1. We have some experience with changes in the ability to smell as the result of head trauma and would be happy to share some direct examples privately (although the cause was quite different in our case).

2. As a result I've done quite a bit of study in the area and can share some general impressions.

3. The sense of smell can change significantly over time -- one woman I met had her's return after five years, another person after three months, but one man I met had lost the sense 30 years earlier.

4. Sometimes people lose some but not all of the ability to sense smells. It's well worth while trying a wide variety of different smells to determine if the is a range in the palate that can be smelled. As you know, there are over 10,000 different scents that people can identify, and I find it very hopeful that your friend still likes certain wines with strong attributes.

5. It is tough to find doctors who take the loss of the sense of smell very seriously -- there are some side effects -- depression and loss of libido were two that folks mentioned to me, but doctors they consulted treated those problems and none were certain the problems were related to their loss of smell.

6. Two of the people I talked to consulted Richard L. Doty, PhD., Department of Otorhinolaryngology at UPenn: Head and Neck Surgery, Director, Smell & Taste Center, 215-662-6580. They both were very positive about him, but although I read a couple of his papers, I don't know him personally.

7. Janet gave me the Nez du Vin several years ago, including three subsets of aromas and flaws, and it is great fun to use. His idea of trying it is a very good one in my judgement -- here's a link to the US distributor: http://www.makescentsofwine.com/?gclid= ... GgodVzdkyw

8. The scents are very high quality and have lasted for over ten years since Janet gave me the first kit. The wine focus is excellent, of course, but he may find that he can identify a couple of scents that would lead him to other sources of scents.

9. I represented a small scent company in France, Camille la Rue located near Cannes in the south of France. The salesman (who made much more money than anyone else in the company) carried a kit of scents -- probably 1500 or so -- that were used to make new perfumes. If your friend could make the acquaintence of such a person, he might be able to increase his range.

10. He should also seek out other sources of odors of all types -- flower shops, horse stables, etc. One lady I met was able to regain a portion of her ability to smell after she got a job in a pizza parlor cutting and boxing pizzas for take-out.

11. I know there is a support group for folks with this disability -- if he would be interested, I'll contact one of the folks I've mentioned and give him a couple of leads.

If Janet or I think of anything else that might be helpful, I'll revert.

Regards, Bob

PS: NIH has recently greatly expanded its website devoted to smell/taste problems, primarily because older folks often suffer from them -- it can be a sign of Alzheimer's, for example.

[Wine Lover Fact: Thomas Jefferson started griping about how wine didn't taste so good several years before his death.]

But the info is topflight and much of it is applicable to younger folks, especially those suffering from head trauma -- http://www.nidcd.nih.gov/health/smelltaste/

Jack could also contact one of their researchers, who will give him a list of current resources -- this group was set up in 1991 and it is an excellent resource for people with many sorts of health problems. http://www.nidcd.nih.gov/health/misc/clearinghouse.htm

B.

Wow. I have nothing to offer at the level of Bob's post (which was really a good one). I do think the Nez du Vin sounds like a very worthwhile idea - it certainly can't hurt.

Best of luck to your friend Jack. I don't know much about this sort of thing, but the fact that he can still enjoy a good bottle of wine makes me think there's some hope of getting his full sense of smell back.


Mike

[Jenise]

Bob, wow, thank you very much for your comments. I believe I understand who and under what circumstances the situation you refer to was about, and I'm so glad things are better now. Thanks for the recco and link to the Nez site.

To you, Paul and Mike I should stress that Jack does not feel sorry for himself. Rather, he's extremely grateful to survive that kind of injury with only this loss, and he's quick to make you understand that he's been given the gift of a far higher sense of appreciation for everything life offers than before this happened.

Well, everything except garlic.

Anosmia and hyposmia (loss of smell/decreased snese of smell), which are often reported by the patient as impaired taste as well as smell, occur following injury to olfactory filaments as they enter the brain through the cribiform plate. Other causes include damage to the nose, sinuses, or both with a mechanical obstruction to odorants, contusion to the bulb, and contusion or destruction of the olfactory areas of the cerebral cortex.
While recovery occurs in about one-third of patients, loss of smell is likely permanent if present one year after the injury. Another study revealed only 10 percent of patients with olfactory loss due to head trauma showed improvement over one year in a series from a university outpatient smell and taste clinic -- not what you and your friend want to hear.

this is the same injury that famous wine writer, harry waugh, suffered.

[Jenise]

Anosmia and hyposmia (loss of smell/decreased snese of smell), which are often reported by the patient as impaired taste as well as smell, occur following injury to olfactory filaments as they enter the brain through the cribiform plate. Other causes include damage to the nose, sinuses, or both with a mechanical obstruction to odorants, contusion to the bulb, and contusion or destruction of the olfactory areas of the cerebral cortex.
While recovery occurs in about one-third of patients, loss of smell is likely permanent if present one year after the injury. Another study revealed only 10 percent of patients with olfactory loss due to head trauma showed improvement over one year in a series from a university outpatient smell and taste clinic -- not what you and your friend want to hear.

Bucko, I certainly got the impression that Jack understands and accepts that. He's just grateful that there's been some improvement and is interested in the fact that he can smell some things and not others. One of these kits could shed more light on that.

Jenise,

I suffered from anosmia for over 4 months and was miserable.
But the sense or smell came back.

I hope it does for your friend too.

Alex