Tuesday, September 1, 2015

Lessons and Limitations

Funny how my normal isn't normal for anyone else... I can't even tell you how many times people forget that I can't smell, which is AWESOME, cuz I'd hate for it to be a thing, but then they ask me to smell something and I have to remind them or give them a look, and it becomes awkward all over again.
I hate the awkward.
Because this isn't actually that awkward. Just don't ask me to smell your lotion or taste your food, and don't be surprised if I randomly ask you how I smell. I promise, I'm not fishing for compliments, I honestly just don't know.
Know what else is weird? I have no idea if my breath smells. I usually assume it does, especially if my mouth tastes funny, but since EVERYTHING tastes funny, there's just no way to know that. So when someone offers me gum or a breath mint, my first thought is always "Oh, crap, I stink..." You're probably all just being nice and considerate and giving me free stuff, but the fear is there. Don't stop, don't say anything, just laugh at my panicked look, if you see it.

Something I love about my job is when I am in clinic and I work with people dealing with head injuries. I've had two now, and that last one was quite a doozy. I can tell them from experience how things feel, I can relate to them in a way that no one else can, and find a way to answer the questions they don't know how to ask. Happens every single time. Maybe I don't have to do that, but I do. I like for them to know that someone gets it. Someone knows exactly how concussion headaches feel. Someone knows the strangeness of struggling to think. Someone knows that sense of fuzziness, how you don't feel like yourself, how you wonder if you're going crazy, and that you can't find the words to explain what you're experiencing.
I love the relieved look on their face when I tell them "Everything you have just described is perfectly normal for this. I promise." Because it is. But nobody knows that.
Sometimes they, or their parents, ask me more questions about my concussions, and that leads to a discussion of this, which I am very firm on explaining is from the head injury, not the concussion, because nobody else needs to worry about not being able to smell when they are trying to deal with the scary concussion part.
What is the difference, you ask?
Don't worry, you're not being dumb. It's complicated. Ready for education?
A head injury is an injury to the head. [Was that too simple? Sorry...] A concussion is the bruising of the brain due to a head injury. I had a concussion BECAUSE of the head injury. My brain, floating in its lovely bed of fluid, sloshed back as I [insert choice of fell, slipped, tripped, whatever you want to imagine happened to me] and when my head hit the ground, shot forward because of impact and slammed against the front of my skull. As the soft squishiness of my brain came into contact with my ridiculously hard head, it bruised and blood began to pool up there. [Don't freak about that -- that's what bruising is! Sounds scary, but get your Quentin Tarantino imaginations under control.] The headaches, dizziness, nausea, balance difficulties [HA. More like impossibility, I distinctly remember holding onto walls and feeling like I was on a carnival ride. And when I went to Ireland this year, that feeling was revisited on the ferry on the rough sea. Drunken sailor, everybody, and I am as sober as they come.], emotional instability, sleep difficulties, etc, were all from the concussion, which was caused by the head injury.
My lovely anosmia was also caused by the head injury. The pooling blood had nothing to do with that. We know this because all of that blood and bruising and stuff has reabsorbed, and I still can't smell. The best we can assume is that when my squishy brain shot forward, the little tiny tendrils of olfactory [aka smell] nerve endings that hang down through the cribriform plate [part of the skull that looks like a grate, sort of, and is right above your nose, ish] got sheared off.
Mostly speculation, since no test or imaging is specific enough for that detail, but it's a dang good guess, so say all of the specialists I've seen.
So. Concussion. Anosmia. Both caused by the head injury. Not related to each other.
Why does this matter?
Because sometimes--most of the time, if the conversations from today are any indications--smell isn't tested in the battery of cranial nerve exams. Why? Because it's not as important as hearing and vision and all the rest. This is true, and I won't deny that. Also because it almost never tests negatively.
Apparently there is talk of bringing it back into the lineup.
I am very much in favor of this.
I have absolutely no proof that anything would have changed if my anosmia had been identified earlier. It might have taken some stress away, but ultimately, it probably wouldn't have changed anything. But people should be paying more attention to smell. People should be studying smell. And they aren't. They don't. And they really really should.

Funny story: I watched my nephew this weekend. He's 8 months old and the most adorable child on this planet, and I will fight anyone who says otherwise. He's also super easy, since he's so happy and laid-back and just does his own thing. But there was one teeny tiny little problem: I had no idea if he had a dirty diaper. I've been around kids and parents long enough to know that you can just pick them up and smell for it, and there's your answer. Well, Aunty Can't-Smell over here doesn't get that luxury, so I was having to regularly check in the diaper to see what the heck was going on, and I swear by the end, my nephew was looking at me in exasperation and going, "Dude, what gives?" Sorry, nephew! But thanks for only having the one dirty diaper our whole day and for keeping it tame. I'll love you forever for it.

To answer the questions: Yes, I am limited in my smell and taste, but I don't need anyone to worry about that. I'm just fine, I promise.
No, smell is not back, and I'm not looking for it. I am starting to react to some irritants, but very VERY rarely and there's no identification, just the sense that it's there.
Yes, things still taste weird. But weird is normal and I forget what normal is.
No, I am not eating healthier because of this. You would think that, but you wouldn't do it. Unless you have way more dedication and self control than I do. I still choose cheesecake over carrots. Every time.

Fun fact: Simply Jif tastes as good as regular Jif. And I would NEVER have thought that before. Ew. But oddly, not ew. Not ew at all.

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