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August 08, 2019

When an olfactory scientist loses their sense of smell: A new interview with Nancy Rawson

Dr. Nancy Rawson is an Associate Director at the Monell Chemical Senses Center. She manages corporate relations at Monell, helping Monell scientists connect with research problems and clinical needs in industry. This means taking a hypothetical question and creating a research-based solution. Nancy has worked in nutrition and chemosensory science. A cell biologist, much of her career has been spent studying how olfactory neurons work. She says closest to her heart is understanding what’s going on inside our olfactory system. She is a self-confessed foodie, wine buff and keen gardener.

Nancy Rawson was the first person I interviewed for what was then the Smell Training blog. Her interview on how smell training works remains one of the most frequently visited of all my articles. I recently caught up with Nancy after I heard that she had lost her sense of smell after a virus.

CK: Nancy, I have to admit I had a sharp intake of breath when I heard that you lost your sense of smell. Can you tell us what happened?


NR: It happened in March of this year. I was having some allergy problems, and they got out of hand. I ignored things and then unfortunately I found myself in the grip of a terrible infection. I was in bed for a week with a high fever and barely got out of bed. My partner was away, otherwise, he’d have taken me to a doctor! I was in terrible discomfort with completely blocked upper airways. It took me some time to get to an ENT, after which I took a course of antibiotics and steroids.

Because of the congestion, it took me some time to realise that I was without smell. I was at the Philadelphia flower show with a friend and had a glass of wine. I realised it tasted terrible, just sour. My friend confirmed that the wine was delicious--then I knew. All I could experience was the astringency and the sourness. I panicked. I talk to people all the time about smell loss, but it was different, having the experience myself.

I tried to smell all the flowers at the flower show and realised I was getting very little or nothing. I did have a few brief whiffs and this felt like a tiny ray of light but that didn’t help the sinking feeling. It was horrible. I kept thinking over and over “what if it doesn’t come back? What if I have to go through life never experiencing the flavour of wine or the wonderful aroma of these flowers? As you say in your introduction, I love food, wine, flowers, gardens...I love gardens and love to grow herbs. It was just horrible. I was absolutely terrified.


CK: Do you think you would have had a different reaction if you hadn’t been working in olfactory science? Did you have any instant insights that made your reaction better or worse?


NR: I think I would have felt worse if I didn’t know so much about olfaction. I might not have understood that sometimes recovery is possible and that there are things you can do to help yourself. I knew people in the field I could talk to. Had I not known any of that, the devastation would have been worse. A lot of people don’t know how frequently this sort of thing happens.

On the other hand, I also know that I fall into an age and gender group that is more likely to experience smell loss where recovery chances start to drop off. Because I had let the infection go on so long, the statistics were stacking against me.


CK: So what happened next?


NR: Fortunately, my sense of smell returned. It’s been four months and my sense of smell seems about the same. I haven’t tested myself with any objective tests, but I do enjoy wine now and the smell of flowers. It came back slowly. I kept thinking about airflow. It wasn’t simply a question of blocked airflow to the right place in my upper airway. I don’t know whether the problem was due to changes or inflammation at the site of the olfactory epithelium. Was the inflammation causing compression of the olfactory neurons? Or was it due to inflammatory chemicals in the intercellular spaces that were altering the ability of the cells to respond, or a change in the composition of the mucus? I think that is one of the gaps in our knowledge now. What events precisely cause the neurons to stop functioning correctly, and also what are the optimal conditions for recovery. I don’t think it could be that all the mature neurons died and had to be replaced, but the smell loss persisted beyond recovery of airflow, so there must have been some neural component.

I was also curious whether I would get parosmia. Fortunately, I didn’t. One of the smells that came back first was the unpleasant smell of kitty litter. I remember cleaning out the box and thinking “Yay! I can smell something – I never expected to be happy about smelling dirty kitty litter!”


CK: What was your experience with doctors?


NR: I was lucky. Most everyone here knows something about Monell and our mission, and everyone was supportive and understood the extent of my worry.


CK: One of the things I suggest to people with smell loss is that they smell train (of course!) and keep a diary of their experiences. This can be helpful if they need to communicate with their doctor. Did you keep a diary? Smell train?


NR: Of course I know all about smell training and I took every opportunity to smell things in my environment throughout the day. As for diary keeping, no, I’m too busy for that!

I have a different perspective on smell loss now, and what it means. I have had colds before, and I’ve had a reduced sense of smell when the congestion is bad, but this was totally different. Losing my sense of smell completely, and knowing there was a chance it might never return, was terrifying.


CK: the last time I interviewed you, you ended with a great soundbite: go forth and smell! Do you have any other comments for us, as a person who has great knowledge of olfaction and has experienced smell loss too?


NR: I think I would say the same thing! I followed my own advice and right now that is the best thing we know to reset the system. The brain is remarkably robust and good at compensating for deficiencies. The brain can learn to interpret a much smaller set of signals and still perceive the same information. The sooner you help your brain to do that, the better. While the memory of red wine, cinnamon, and fresh laundry is still fresh, exercise your sense of smell to help yourself fill the gaps. The sooner the better, even if you think you aren’t getting anything. The brain is remarkable. Also, more for anyone reading this who still has a healthy sense of smell, or has recovered – don’t let an infection get the upper hand – go to a doctor sooner rather than later! It took two rounds of different antibiotics and two series of oral steroids plus nasal washes with steroids to finally get the better of this infection. If I had gotten on top of it sooner, I might not have had the same degree of loss. 

We also need more research to find better treatments for the conditions that cause olfactory loss, and a better understanding of the biology underlying it. I really appreciate the support of the community, and what you are doing through this site, Chris, to bring more attention to this field of research and the needs of the people experiencing anosmia and hyposmia. Thank you!  

I’ll tell you about an interesting piece of research on the sense of smell in rats. Their olfactory system is very similar to that of humans and so they are good subjects. In this study, the rats had a large portion of their olfactory bulbs removed, and they were still able to function. It just shows how much redundancy is built into the system. Of course, if you removed the bulbs completely, the rats couldn’t find the cookie. Incidentally, when scientists want to study depression in an animal model (that is, during a scientific study) they take rats and remove their olfactory bulbs. In other words, no olfactory bulbs = anosmia = depression. This speaks to the large impact on brain function this sensory system has, and how much we take it for granted.

So to sum up, I think we need to remember that adjusting to the damage of the olfactory system is best achieved through stimulation (smell training) so that smell signals can once again be recognised as odours and not background noise. The brain needs time and help to adjust to a system that has been affected by damage.


CK: Thanks, Nancy! We appreciate your time.