Doctors' Answers to "Frequently Asked Questions" - Senses

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Perverted Taste and Smell [posted 1/14/99]
Question: I got a bad cold in July 1997. Initially I lost all taste and smell. Then, I got it back, but everything tasted and smelt the same and very bad. I had post-nasal drip, but no runny nose, itchy eyes, sneeze, etc. I had nothing to blow if I tried to blowing my nose, it felt deeper. I started Claritin D and Nasonex in Nov. 1997. Now, after taking numerous antibiotic courses of Amoxicillin, Cefzil, Zithromax, Biaxin (5 months), and Ciprofloxacin, with no culture ever being done, my taste and smell are different for each sensation, but are still 'off' from what I knew them to be. I've had normal CAT scans and MRI's (brain and sinus) and allergy testing (except slight allergy to large quantities of dust). I periodically get sinus headaches, but they are straight behind my nostrils (not above the eyes, etc). I also feel congestion localized there in the morning before I get up. I drain better if I lay on my back, which was how the MRI was done. I was off Nasonex (but still Claritin D) for about a week recently because it seemed tied to the onset of my headaches and my taste and smell seemed to get somewhat better very slowly. My dripping stopped too. Exactly one week later, while I was still on an upswing taste recovery-wise, I got one of the sinus headaches. Since then, my taste/smell distortion problems got worse again and I wasn't able to smell/taste as much in general. I'm thinking that the vehicle in Nasonex may have caused the off smell and taste and the active ingredient wore off later, so my headaches returned. Is this possible? Previously to the short-term recovery without Nasonex, I'd seen three ENT's (and a nerve doctor) and they refused to prescribe an endoscopic exam. They always revert to the virus damaged nerve theory. But since the episode with no Nasonex, I know there is better taste/smell possible, if not a full cure. Could it be that Claritin D and now Atrovent are the root cause of the problem and I should just stop taking everything for a while? What do you think my next step should be? Should I try to get a referral to some place like the Mayo Clinic?

Answer: One sensory organ that doesn't get much press for its dysfunction is taste/smell. These two are intertwined and almost always go together. The frequency of loss of smell/taste is about the same as loss of hearing (an organ that is more obvious and for which there is some treatment). However, in general, there are limited treatment options for loss of this sensory organ. There are specialty clinics that specialize in loss of smell. However, of the 5-8 patients whom I have sent to these clinics, I have never had much luck in treatment success (diagnosis yes, treatment no). I suspect that would be the end result at Mayo or any other clinic. On the other hand, there are few other options and if it were me, I would get a specialist in this area to evaluate my problem. Stopping everything would certainly make sense.

5 Senses [posted 8/13/98]
Question: My son is doing a science project in which he is trying to prove which of the 5 senses is the most dominant. He thinks it's the vision. What can he do in his experience to prove/demonstrate that?

Answer: I guess the first question is what is defined as dominant? I think the definition of dominant would limit this study.

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