Dr. Pellegrino is a leading fibromyalgia specialist and author who has had fibro himself since childhood and sees patients in his office at the Ohio Pain & Rehab Specialists Center. This article is extracted with kind permission from his book Fibromyalgia: Up Close & Personal.*
I've always had a keen sense of smell. I assumed it was hereditary.
Although no one else in my family could ever sniff out a Reese's peanut butter cup in the back of a sock drawer... If anyone had spoiled milk or bad meat queries, questions regarding body odors, or needed confirmation if someone had smoked something, I (my nose) was consulted. I was the Ann Landers of Olfaction.
As I trained to become a doctor, I learned that some diseases produced a characteristic odor that nasally-astute doctors could recognize. Fruity acetone breath smells are common in diabetic ketoacidosis or starvation acidosis. A curious musty odor can signal severe liver disease, and so on. It wasn’t until I was diagnosed with fibromyalgia at the end of my Physical Medicine and Rehabilitation residency that I learned of a reason for my extranasal perception.
Most individuals with fibromyalgia have a dysfunctional autonomic nervous system which can cause hypersensitivity to smells.
Odor-producing molecules come into contact with the nasal membranes and generate a nerve signal that travels from the olfactory nerve to the smell center of the brain. The autonomic nerves convey sensitivity and intensity characteristics to the smells, so fibromyalgia people with hypersensitive autonomic nerves will notice odors more.
In layman’s terms, fibromyalgia is why I get sick if I wear cologne.
My hypersensitive sense of smell has not interfered with my medical practice. From time to time, I would have an acute pheromone attack in the office which temporarily interfered with my clinical abilities (it is very difficult to see my patients if the eyes are flowing like the Mississippi River, or to talk to them if the larynx is narrowed like the Isthmus of Panama).
I can remember my most nasally challenging patients: The two-pack-a-day smoking housewife who oozed Chanel Number 5 from every body cell, the beer drinking construction worker who lunched at a Mexican buffet, the owner of horse stables who didn’t have time to change before her appointment, and the sweet elderly lady I saw in January who owns a wood-burning stove that she uses to heat her house in the winter.
No matter what happened in my office, odorously speaking, I knew I could always count on home being a safe haven for smells.
A place where I could relax without worry of uncontrolled or unexpected nasal attacks. If some magazine advertiser wanted me to scratch and sniff, I never scratched. I decided what I would smell. That is until one day when my home was invaded by the sample scents.
I’ll never forget the first time it happened. I was leafing through a magazine when suddenly my eyes began to water, my throat felt scratchy, my nose began to itch, then became stuffy, followed by a wave of nausea. I noticed a harsh aromatic scent and immediately realized that foreign odor molecules were attacking me.
I leapt into action, reconnoitering the terrain for any enemies.
I checked the trash can, the garbage disposal, and ther refrigerator – negative. I looked for those darn plug-in scents and found none. Then I retraced my steps back to the magazine and spotted the intruder – a sample perfume scent insert in the magazine. This pheromone-packed insert was potent enough to cause me an allergic-type reaction.
No one else in my family noticed these smells. Only I suffered from the unwanted invasion of my personal space. I removed the insert that day and have done so innumerable times since. I learned inserts usually arrived in pairs, so I routinely sought out these two in each magazine that entered my house, wrapping them up in newspaper, disposing of them, then washing my hands. Afterwards, I would read the magazine if I was still interested and wasn’t too tired…
Undoubtedly, something other than nausea was the intended reaction of these scented pieces of paper, so I'm sure the scent manufacturers didn't have me in mind when they concocted their marketing campaigns...
Humans can distinguish up to 4,000 different odors, including Lysol’s Disinfecting Spring Waterfall scent. If fibromyalgia is amplifying them all, well… that stinks! Call me old fashioned, but I prefer the simpler times and smells. I guess I prefer old-fashioned olfaction, and so does my fibromyalgia.
* This article, first published in Fibromyalgia Frontiers, is extracted with kind permission from Dr. Pellegrino’s book, Fibromyalgia, Up Close & Personal © Anadem Publishing, Inc. and Mark Pellegrino, MD, 2005. You may purchase a copy of the book by contacting Dr. Pellegrino's office at the Ohio Pain & Rehab Specialists Center (Phone: 330-498-9865, Toll-Free: 800-529-7500).