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21st February 2017

Living in a scent-free world

Working in a restaurant is an unfortunate way to learn that you’ve lost your sense of smell, says Alahree McDonell.

“I was around 19 at the time,” recalls Alahree of the day she realised, quite by accident, that she couldn’t smell anything. “I’d put cream on a dessert which was served to a customer, but I didn’t know that the cream had turned. The chef was furious.” That experience put an end to her dream of becoming a chef, but it was the beginning of a new journey into a life with anosmia, the medical term used for the inability to smell ‒ and the most common type of olfactory disorder, according to UK-based charity Fifth Sense.

Nobody knows for sure, but it’s estimated that about 5% of the population may suffer from severe hyposmia (reduced sense of smell) or anosmia, which can have a number of causes. In about 1% of cases, it’s congenital, meaning people are born with it. Some 70% of cases, including Alahree’s, stem from sinonasal disorders and allergies. Alahree has asthma as well as a condition called chronic rhinosinusitis (CRS), an ongoing inflammation of the nasal passages that interferes with mucus drainage. Other main causes include viruses (11%) and head injuries (5%). In around 6% of cases, no cause is ever determined.

“It’s not nothing”

Over the years, Alahree has tried to find possible solutions like the steroids she takes for her CRS and asthma, surgery to remove nasal polyps (teardrop-shaped swellings of the nasal lining) and even adjusting her diet, but she mostly just focuses on living her life. “There’s an acceptance. What can you do? You can’t live life in a heightened state of pity,” she says. Nevertheless, Alahree notes that anosmia does have a large impact on a person’s quality of life. She points out, for example, that about 80% of flavour comes from your nose. She can distinguish between the five main tastes ‒ salty, bitter, sweet, sour and umami (savoury) ‒ but she cannot tell the difference between strawberry and chocolate. “There’s no point taking me out to an expensive restaurant. All the subtleties are lost on me,” she says, noting that she relies on other things like texture and spiciness.

Of course, safety is another issue. “There have been a few dangerous incidents, like when my neighbour’s house was on fire and when my car overheated,” neither of which Alahree was aware of. Fortunately other people were around to do the smelling for her, but “you never adjust to how you pre-empt that kind of danger,” she says. And, as a mum, one of the most upsetting things for Alahree has been missing out on knowing the unique scents of her three children.

In her opinion, the healthcare system could do better at addressing the condition. “It’s seen as superficial compared to loss of other senses, but it’s not nothing,” she says. “They’ve overlooked the way it does affect you. It can contribute to things like depression, for example.” The Monell Center in the US wants to change that. It’s carrying out various scientific projects including testing whether healthy stem cells can be grown into functioning olfactory receptor neurons. Another ongoing study aims to identify the genes that cause congenital anosmia. This could allow scientists to learn about the underlying causes and potentially identify treatment options. Researchers have also been looking into “smell training”, a technique used to stimulate the sense of smell by repeatedly/methodically introducing odours, akin to how perfumers learn to distinguish among scents.

Alahree keeps an eye on new research findings, but at the same time she refuses to let anosmia get in the way of life. “I’m fortunate that I have all my other faculties. It’s just as well that I didn’t train to be a chef, but people are actually amazed that my cooking tastes quite good,” she quips.