A life without taste or smell seems unimaginable, but for Caroline Buchanan — and many thousands of others — it is the grey reality.
Caroline, 58, a counsellor and author, lost these two vital senses after hitting her head last March. She’d been alone in a rented holiday cottage when the accident happened. “I was walking down the stairs carrying a pile of books when I missed my footing. I remember tumbling and hitting my head hard on the bannister as I fell,” she says. “As I landed in a heap, my head was spinning from the impact.
“Staggering to my feet, I felt woozy, but it passed in a few minutes. Anyway, my dog Billy needed a walk, so off we went. With hindsight, I was badly concussed, so much so that I actually got lost while out and had to ask for directions to the cottage.”
When Caroline got back she felt terribly queasy, so went to bed. Her husband, Simon, 56, a GP, was working back in London.
Next morning, when a friend came to visit, she found Caroline had been violently sick and had a severe headache. Hearing about the fall, she immediately rang for an ambulance. A scan at hospital revealed Caroline had suffered an extradural haemorrhage — bleeding between the brain and skull. She had emergency surgery to relieve the pressure which could have proved fatal.
Although the three-hour operation saved Caroline’s life, her olfactory nerve, which is responsible for the sense of smell, was damaged. And because our sense of smell also provides 95 per cent of our taste, the effect has been life-changing.
“You don’t realise how important these things are until they are gone,’ says Caroline, who has a daughter, Francesca, 25. “I can’t smell my daughter when I hug her, or my husband’s freshly laundered shirts. I go out for meals and everything has a bland, metallic taste. I try hard to remember what things used to taste like. If I’m presented with a steaming bowl of tomato soup, I dredge my memory for that tangy taste. I’ve tried to will my taste back.”
This condition is called anosmia, the clinical term for loss of smell. Forty per cent of these cases are caused by sinus and nasal problems (most commonly, sinusitis, but nasal polyps can also affect smell). A further 30 per cent of cases are triggered by head injuries.
“Sometimes the impact from a head injury can damage the olfactory nerve fibres that connect the nose to the brain,” explains John Rubin, a surgeon at the Royal National Throat, Nose and Ear Hospital in London.
Our perception of flavour is largely due to the nerves and parts of the brain involved in smell, adds Nicholas Eynon-Lewis, an ENT surgeon at Barts and the London NHS Trust. “While our taste buds identify if something is sweet, sour, bitter or salty, most of our taste comes from the additional information from our sense of smell.”
Our sense of smell is triggered when microscopic particles released by substances are breathed in. Cells in the nose then send a signal via the olfactory nerve to receptors in the brain in an area known as the olfactory bulb. These receptors give us our sense of taste.
As well as injury, certain medications, such as long-term use of nasal decongestants, can damage the olfactory nerve.
Up to 30 per cent of pregnant women suffer a temporary reduced sense of smell because high levels of oestrogen cause the blood vessels in the nose lining to swell. Ageing also affects our sense of smell — up to 25 per cent of those over 60 may suffer from anosmia.
Unfortunately, if the olfactory nerve is damaged by a head injury there is no treatment. Nerves do regrow in about 40 per cent of cases, although this can take up to three years.
As Caroline recovered in hospital, she was initially oblivious to her sensory loss — as she didn’t have much of an appetite anyway.
“Then, a couple of weeks after being discharged, I suddenly realised I didn’t seem to be able to smell much,” she says. “I asked Simon to bring me a bottle of my perfume — and I couldn’t smell anything. I panicked, thinking that I’d had some kind of brain damage that had robbed me of my sense of smell. Then I began to realise food tasted bland, too. I put it down to getting over the operation. But as the weeks passed it didn’t matter what I ate, it was all tasteless.
“For someone like me who loves the taste and rich aroma of food as well as scents such as fresh flowers, it was like losing a huge part of my world. My specialist said it could be a side-effect of the kind of accident or surgery and that there was no treatment. I was devastated.”
Losing taste and smell can have an extremely distressing effect on patients, says Eynon-Lewis. “I’ve known patients who’ve suffered with depression because they can’t smell or taste anything.
“Patients also report worrying about their own safety. They can’t smell a gas leak or taste whether food is off. So they panic about becoming a threat to themselves.”
In the months after the accident, Caroline says she did suffer from depression. She also had to give up doing most of the cooking.
“On a practical level, I’ve no idea if what I’m making is any good. I remember making a simple lemon cake by following the recipe exactly, yet it didn’t taste right according to Simon. It was a bit floury and not sweet enough.
“On the rare occasions I still cook, I am frantic about things being “off”, because I simply can’t tell. Anything that’s near the sell-by date gets binned. And I’m paranoid about whether meat is fresh.”
Like many sufferers, Caroline now has to take pleasure in the colours and textures of food.
“Simon makes casseroles with loads of colour or texture. I like crunchy roast potatoes as they give me some sensation when I eat. Or I try very spicy curries — food I’d never previously have — just because I can. I don’t get a sense of flavour, but I can feel something of the hotness.
“I also developed a craving for Maltesers ice lollies — I liked the combination of the cold ice cream and the crunchy chocolate.”
Some might think that losing your sense of taste would be a marvellous way to keep slim — but Caroline says she still follows the same snacking habits as before. “If I’m in need of something comforting, I’ll have chocolate. I can’t taste it, but it’s strange how I still want it because of the association.”
Caroline hopes she might be one of the minority who do eventually recover their senses. Encouragingly, in the past few weeks she’s experienced a glimmer of hope. “I had a sip of Simon’s tea which had sweetener in it,” she says. “I always drink unsweetened tea and I could tell the difference — it was subtle but it was there. I’m just praying this is the start of something.”
Daily Mail
