My question is for Dr. Josh or Dr. Das:
Doctors your credentials look good and I have asked a few others in this service their opinion and the opinions vary greatly. It is a complex question. I am midway through specialist and hospital visits this week and next so your opinion helps.
Situation: I have sharply decreased smell, resistance to breathing in nose without mucous, no sensation of moisture in nose (cannot feel steam in shower eg) voice painful to speak and raspy.
Background: in winter diagnosed with sinus infection and proscribed oral decongestants and nasal steroids which I took for 6 weeks. I was already dehydrated and take drying medication. I am a smoker. I had no congestion, no sinus pressure. I did have pain ranging from discomfort to sharp icepick like pain in my nose. That pain varied by environment (office - painful, home- discomfort, outside in fresh air no pain. We setup an ENT appointment for two months away. In the meantime I was off work and pain worsened. My wife procured an Asian remedy of smoking dried lotus leaves. I did this for about 10 minutes maximum one evening. It hurt slightly so I stopped. This was a very idiotic thing to do and I have asked myself since what was wrong with my brain. The next morning the sharp pain in the nose was gone but it was replaced by a sharply decreased sense of smell (can sense household items like coffee, perfume, cleaners but mild odors especially outside such as grass, trees, flowers I cannot smell unless I hold them to my nose), lack of moisture sensing in nose, hard to breathe through nose. ENT visit came. On the clinical report he checked 'normal" for nose endoscopy but wrote "wonder if he has damaged nose with chinese medicine". For throat no lesions but "laryngitis
with vocal fatigue
". CT scan just done last night. X rays negative. 11 weeks later the symptoms are the same. My voice continued to worsen over this time and I feel overpoweringly dry in nose and throat.
1) something was definitely not right with nose before the "smoking leaves episode". Is it probable some olfactory nerves or receptors are killed or more likely they are irritated or damaged? No change in smell these three months - no better, no worse. Is there another explanation? It was just a few minutes of smoking these leaves but appears to be a lifetime of damage. What might be prognosis?
2) is it likely the nerves that sense moisture are killed or possible they are just injured or covered in tar, tobacco from decades of smoking. This change was immediate however, after the smoking episode and is unchanged. When in the shower I sense only vague feeling of congestion. I cannot sense dew on the grass, rain etc. Wondering how it can be that these nerves could be damaged despite ENT saying mucosa "normal".
3) I feel like I am breathing through a thin straw. Very difficult to get a full breath through nose. I use a netipot or I did until this week and the water flows through quite well but I feel even more congested after using it. Any thoughts here? Could I have edema of the mucosa. It is likely it is damaged although the ENT said normal.
4) on the voice. It feels very dry all the time. Feeling like the combo of being dehydrated and decongestants may have contributed? I am vaping now as opposed to smoking. Will this help? Any treatment suggestions? I drink plenty of water and sip as often as I can.
There, rather a complex situation and pretty tragic for me at least. Would appreciate your insight.