Healthy Lifestyle

The smell of coffee ? frequently celebrated as one of life’s most pleasurable experiences, even by people who don’t like the taste ? nauseates American Kathy Kurland.

“Coffee is the worst smell. I can’t even describe it,” she said.

Other smells, such as freshly made popcorn, used to make her physically ill. Now, thanks to medication, she can tolerate it.

Kurland has a range of olfactory disorders that block some smells, turn innocuous or pleasant smells offensive and produce phantom smells that can last for days.

Kurland said a chemical caused the condition. It started about three years ago and progressively worsened. “I thought I was going to have to live in Alaska by myself, where there were no smells,” she said.

Her condition is not imagined or psychological. It is real. It has a name and a growing cadre of doctors and researchers are devoted to it.

There are support groups to help people like Kurland ? those who have lost their ability to smell, a condition known as anosmia, those whose sense of smell is distorted, called parosmia, and those who smell things that are not there, phantosmia.

Kurland’s research led her to one doctor who prescribed a medicine that made the condition manageable, but it has not eliminated it.

When organisms first swam in the primordial sea, the ability to smell chemicals is what kept them alive. Smell is the first bond between baby and mother. A scent can transport us to a place or time, draw us in or warn us of danger. Yet of the five senses, smell is the least studied and least understood.

Many things lead to smell loss or dysfunction ? chronic sinus disease, chemotherapy, chemicals, medications and head injuries. But researchers are not sure precisely what causes the condition because of the unique function and location of the olfactory nerve cells that transmit information to the brain.

Losing the ability to smell could have far-reaching implications that are just beginning to be explored. The most obvious consequence is the effect on the ability to taste.

Although it is a separate sense, taste is irrevocably linked to smell. About 90 per cent of taste comes from smell.

Smelling disorder recovery rates are not high, but recovery can occur, sometimes years later. The improvement can be gradual or sudden.

FOR many years, James*, 25, suffered from excessive perspiration. He had sweaty palms and was always
embarrassed to shake hands with people whom he met at social functions or at work. Often, he also had a
strong odour emanating from his armpits, especially after participating in sports activities.

During his teenage years, James’ excessive sweating subjected him to embarrassment and ridicule from his
peers. Over time, he realised that he was distancing himself from potentially embarrassing situations, including dating. He feared that he was losing his confidence when it came to interacting with others.

Perspiration occurs naturally for many of us, but some people, like James, suffer from hyperhidrosis or
excessive sweating. Not only do they suffer from the social embarrassment caused by sweaty palms and wet patches around their underarms, but the situation can be serious enough to affect their social and professional lives.

For James, the stress accompanying an important interview or presentation accentuates the problem. In severe cases, even air conditioning does not help and the sufferer perspires excessively especially during stressful situations.

Treatments such as topical applications, iontophoresis (a process where electrical currents are applied to hands soaked in a chemical bath) and botox injections may relieve the symptoms — but only temporarily. For example, it may take several injections of botox to achieve the desired results. The injections are painful, expensive and only have a short-term effect.

There is a permanent and painless solution for sufferers of hyperhidrosis. Last month, James underwent a minimally invasive procedure known as needlescopic thoracic sympathectomy. The procedure requires two or three small incisions (between 2 and 3mm) under the arm and involves clipping the nerves that carry messages from the sympathetic ganglia, or nerves hub, to the sweat glands. The procedure is done under general anaesthesia and takes about 30 minutes.

People who undergo this procedure get immediate relief from excessive sweating in the palms or underarms.
In James’ situation, the sweat literally dried up from his hands and underarm regions.

In some cases, however, there could be increased sweating in the chest, back and lower body to compensate for the lack of it on the underarms and hands, but almost 97 per cent of the patients find this an improvement over the previous situation. For many, a warm dry handshake makes it all worthwhile.

The procedure is a micro-invasive, high precision intervention that allows almost immediate recovery and little downtime from work.

For James, what makes it most rewarding is his newfound confidence to shake hands firmly without any embarrassment.

Excessive sweating can lead to these complications:

• Fungal nail infections — this can cause the nail to discolour, thicken and develop crumbling edges.
• Athlete’s foot — skin can begin to itch, burn and crack.
• Jock itch — this will cause a burning sensation around the groin region.
• Bacterial infections and warts — these can develop around hair follicles or between the toes.
• Heat rash or prickly heat — red spots or bumps on the upper back, chest or arms may appear.

Source: Raffles Hospital