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August 12, 2009

BehindTheMedspeak: Phantosmia

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Great word — it means smelling something that isn't there.

As with so many things, my formal medical education missed this one so I'm forced to do my CME using the New York Times.

There are worse sources.

Jane G. Andrews yesterday wrote about her many years with the condition, in a piece that appeared in the Science section; it follows.

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A Pungent Life: The Smells in My Head

I am in my kitchen smelling dirt. Three new plants — a white kalanchoe and two red begonias — sit on a stand at my window. It is April, nearly a decade ago, and I have bought them because it is finally spring. I admire their small, dense flowers and green, waxy leaves.

But I hadn’t planned on their powerful, raw smell. Working around the house, I try to think about something else. When I go upstairs, the smell follows me, earthy, pushy, almost wet. I wonder how it is that I can smell three small houseplants on the floor below.

That afternoon, at the grocery, I can’t shake their dank odor. Could the smell somehow have gotten into my clothes? A day later, miles away at my doctor’s office in Manhattan, I am shocked that it smells there, too. But she has no potted plants.

I finally get it. This assertive smell, my uninvited companion for almost two days, is inside my head, not out. Mortified, I think I must smell. Talking to friends, I cover my mouth with my hand. I brush my teeth more often, swish mouthwash compulsively. But my husband says I smell fine — no bad breath. I finally call my doctor.

I discover that I suffer from phantosmia. “Osmia,” from the Greek osme, means “smell.” Coupled with “phanto” (like “phantom”), it refers to an illusory sense of smell. I smell a smell when no odorant is present.

Inevitably, medical tests followed. I had an M.R.I. of my brain (ruling out a tumor), then a CT scan of my sinuses (looking for infection), and finally, an EEG (olfactory hallucinations do occur in epilepsy). The results were negative, and two rounds of antibiotics (was there a hidden nasal or sinus infection?) constituted my only — and fruitless — treatment.

One day a year later I realized that the earthly smell was finally gone. But to my dismay a new smell immediately took over. My husband had burned a big pot of chili. Burned chili became my new default odor. At least it smelled better than dirt.

Then, about seven years ago, a trip to Provence erased the chili. Lavender wafted in the air, becoming my new smell du jour. Southern France’s lavender-infested landscape — dried bouquets, scented soaps and candles, even flavorings for food — trailed me back home. Some might think me lucky — lavender is hugely popular. But I hated this smell that had squirmed its way into my brain.

I tried in vain to fool my nose. Holding lemons under my nose didn’t kill the odor. Smearing pungent perfumes and lotions around my nose didn’t work either. A powerful odor like ammonia might trump the lavender for a moment, but that cure is worse than the disease.

For a couple of years now, the smells have varied, some stronger than others. What’s new is that these smells are only fleetingly connected to the outside world. Hints of ammonia but definitely not ammonia. Touches of a paper mill in their assertiveness but not quite that paper mill stench. When I smelled burned chili, I knew chili was out there somewhere. When I sniff my current guests, I can’t connect them to the real world. They spook me like a phantom limb.

Sometimes I can’t tell whether a smell is inside or outside my head. Walking my dog, I cried as I smelled manure, convinced it would lodge in my head. At home, I rejoiced that the stink was gone. The next day, the horrid smell reappeared at the same spot. This time I noticed the warning sign: gardeners had spread fertilizer. Only then did I know the smell was real.

Avoiding gruesome odors is my first line of defense. There’s a coffee shop nearby that I simply won’t enter. It’s jam-packed with wooden barrels of reeking coffee beans; locals complain they can smell the roasting blocks away. I send my husband to buy coffee while I wait in the car with the windows up.

I’ve tried the opposite tactic, going out of my way to imprint favorite perfumes, fresh flowers, that wonderful bakery smell. Alas, my phantosmia specializes in the disagreeable.

That is typically the case, I now know. Dr. Donald Leopold, chairman of the department of otolaryngology at the University of Nebraska Medical Center in Omaha, has studied smell disorders for 30 years. In phantosmia, Dr. Leopold says, both the upper nasal passages and the brain play a part, especially the brain, “where the actual smell perception is generated.”

Almost always the patient has lost some ability to smell. Dr. Leopold says that the brain, “which has a propensity to make smell,” overcompensates by offering up odors, usually disagreeable ones, that may have existed previously but were suppressed. It appears that certain “traffic cop” neurons, which had worked to exclude such odors, turn off.

Though Dr. Leopold assures me that “treatment is available,” I haven’t tried the nasal saline drops, antidepressants, antiseizure medicines or sedatives recommended by one doctor or another. Mainly I try to think past the phantosmia, forcing my attention elsewhere. If that fails, I try to laugh at it, more absurd than awful. I win more of these skirmishes than one might expect.

I learn that this disorder is best kept private. Some friends squirm when they hear about it, as if I were crazy. For that matter, phantosmia is linked to certain psychiatric disorders (schizophrenia, depression, Alzheimer’s), but I don’t have them. I do wonder, though, what it means to hallucinate smell. Those neurological explanations aren’t entirely satisfying. There’s nothing plainer than the nose on my face, but nothing more mysterious, either.

August 12, 2009 at 04:01 PM | Permalink | Comments (2) | TrackBack

Sweet Cake Tub

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From the website:

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Sweet Cake Tub

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Made from sturdy polyethylene (6 cm thick),

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thus making it suitable for indoor or outdoor use.

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70cm Ø x 27cm H; Weight: 5.5 kg.

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€149.

[via The Daily What]

August 12, 2009 at 03:01 PM | Permalink | Comments (0) | TrackBack

Futbol hoy: USA v Mexico

Huge game at 4 p.m. ET today in Azteca Stadium in Mexico City, with Mexico's back to the wall in terms of whether they'll even qualify for the World Cup.

Long story short: It will be on DirecTV channel 410 and Comcast Cable channel 178, with the mun2 broadcasts beginning at 3:45 p.m.

An aside: It took my crack research team a long time to track down the correct time and channel numbers.

So elusive is this information online (don't even bother looking in the newspaper, they can't even get the game time right) that you'd almost think U.S. Soccer didn't care if anyone watched it or not.

But I digress.

How big is this game in Mexico?

Let's just say that if the U.S. somehow didn't qualify for the Olympics in basketball, that would be about 1% of the shock to the sports systems of the respective countries.

Former U.S. footballer Alexi Lalas, who played at Azteca, said it's kind of like playing in Thunderdome, but a hundred times larger, noisier and hotter, with eye-searing smog and air pollution thrown in.

Oh, yeah, don't forget that the stadium's elevation is over 7,000 feet above sea level and the U.S. team flew in yesterday, so there's zero chance of acclimatization.

Mexico last week changed the game's start from 7 p.m. to 4 p.m. so as to make conditions as difficult as possible for the visiting U.S. team.

Then there's the piquant fact that the U.S. team has never won in Mexico City: its record is 0-18-1, with the (scoreless) tie back in 1997.

I can't wait.

And for those who, like me, can't get enough when it comes to sports, Pedro Martínez returns to the big leagues tonight with the Phillies, in his first major league start since he started his downward spiral from the heights several years.

8 p.m. ET on ESPN.

August 12, 2009 at 02:01 PM | Permalink | Comments (2) | TrackBack

1935 was a very good year

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Commented Randy Latocki on last Friday's post on the fan with cloth blades, "Check out the 1935 Singer Ribbonaire" (above).

The Flickr caption: "This amazing object is a redesign of the less-streamlined 1931 original. The blades were made of grosgrain or elastic ribbons, making the usual wire cage dispensable. Made in the U.S. by the Singer Sewing Machine Company, it was molded of Bakelite. This one was found in great shape and in perfect working condition, but unfortunately the original grosgrain blades had to be replaced by elastic ones. It is 34 cm high, including the blades."

Good call, Randy.

August 12, 2009 at 01:01 PM | Permalink | Comments (0) | TrackBack

Best commercial on TV

If you make something wonderful, instead of muting the sound and averting our eyes we'll actually seek it out and watch it again and again.

Nota bene, those responsible for the awful Caveman and Flo GEICO spots.

August 12, 2009 at 12:01 PM | Permalink | Comments (8) | TrackBack

Shadow Chair

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Designed by Chris Duffy.

From the website:

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Shadow Chair

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A chair that integrates shadow into its structure.

At first glance it is a simple chair that seems to defy gravity by standing upright while only having two front legs, but on closer inspection the shadow is part of the chair and made from steel, which is attached to a metal frame built inside the chair.

Steel and birch, in Natural or White.

85cm H x 45cm W x 60cm D.

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£795.

August 12, 2009 at 11:01 AM | Permalink | Comments (0) | TrackBack

Live interactive global ship traffic map

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"Ahoy."

[via Milena]

August 12, 2009 at 10:01 AM | Permalink | Comments (1) | TrackBack

Camera Cube Level

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"Simply point at your subject and align the

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three bubbles to set up a straight frame."

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"1" x 1" x 1" cube attaches

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to any hot shoe."

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$14.95 (camera not included).

August 12, 2009 at 09:01 AM | Permalink | Comments (2) | TrackBack

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