Ann Marie's Story

Avid gardener, traveler, and cook experiences sense of smell come back after 11 years.

Ann Marie Piwonski enjoys gardening, cooking and traveling. A commonality with each of these hobbies is that having a sense of smell is needed in order to enjoy them to their fullest.

In 2004, Ann Marie noticed nasal polyps growing in her nasal passages, and she would lose her sense of smell every so often. That year, she underwent two surgeries to remove the polyps, but in 2005 they grew back.

“I noticed after both surgeries my sense of smell would come back for a few weeks, but then go away again,” recalled Ann Marie.

Under the care of another local health system, Ann Marie’s ear, nose, and throat specialist told her that doing any additional surgery to remove the polyps would only add scar tissue and they couldn’t promise the smell would come back anyway.

For the next 11 years, Ann Marie would intermittently lose her sense of smell completely, significantly impacting her quality of life. She tried various nasal rinses and sprays, and home remedies – never experiencing success. Additionally, the nasal polyps made her subject to consistent sickness with sinus infections and congestion.

Ann Marie said, “Thinking back, I wish I would’ve gotten more opinions. I was losing hope and I just assumed because my previous doctor advised me not to do any more surgery, that this was how life would be from now on.”

The switch to Henry Ford Health

Ann Marie’s workplace switched health insurance companies, and the health system she was under the care of was no longer in her network – this led her to switch to Henry Ford Health.

When having her first visit with her Primary Care Physician, Dr. Rena Daiza, she explained how she lost her sense of smell and felt she was at a dead end. Dr. Daiza asked, “Do you mind if I recommend you to a good ENT in our system?”

Ann Marie was referred to Dr. John Craig, and he decided to perform endoscopic sinus surgery on Ann Marie, when her previous care team would not.

During endoscopic sinus surgery, polyps within the nasal passages are removed and the openings in each sinus and nasal space are made wider. This allows medications to be delivered there to prevent polyp recurrence.

Dr. Craig explained, “If patients are miserable, have objective evidence of sinus disease on nasal endoscopy, and fail medical therapy, sinus surgery is an excellent option to improve their symptoms and quality of life.” He also noted, “We guide our decisions based on best evidence to-date, but when it comes to smell loss outcomes after sinus surgery, evidence is mixed with regard to success of bringing smell back. Some surgeons could interpret this as further surgery being unlikely to bring smell back, but you have to treat patients on a case-by-case basis, and some patients’ smell will return brilliantly.”

For nasal polyps, the first surgical step is to create wide openings into each sinus so that topical steroids can be delivered to the sinus cavities to prevent polyp regrowth. Ann Marie’s first two surgeries were incomplete, and so topical steroids were unlikely to be delivered to the deeper sinus spaces where her polyps were regrowing from.

On September 18th, 2023, Dr. Craig performed surgery on Ann Marie and then saw her again on September 26th for her follow-up appointment. Initially, as is common after sinus surgery, her smell had not returned, and her hope was waning.

It takes time

Dr. Craig advised Ann Marie not to lose hope, but to begin the high volume topical steroid irrigations as are commonly prescribed postoperatively after surgery for nasal polyps. He also suggested that she could try smell therapy, where pungent smells (such as essential oils) are used to stimulate and re-train the olfactory nerves in the nose. By regularly sniffing in high concentration odors, any nerves that are still present and functional in nasal tissue may be stimulated to strengthen old connections to the brain

“Three to four times a day for four weeks I’d smell essential oils like peppermint and lavender. I’d look at what type of oil it was first to signal to my brain what I was smelling. I really do think that smell therapy made a world of difference in bringing my sense of smell back,” recalled Ann Marie.

“Experiencing everything in life is different.”

After trying smell therapy for several weeks, AnnMarie walked into her kitchen one morning and noticed she could smell a pot of freshly brewed coffee. Feeling shocked, she jumped up and down with excitement and ran outside to her garden to see if she could smell roses and anything else that was in bloom. Much to her surprise, she could smell everything.

This led Ann Marie to start experiencing life in a way she hadn’t in a long time.

“I look forward to everything – traveling, cooking and going out to dinner. I love being outside and being active whether it’s golfing, kayaking, or shooting skeet, trap, and sporting clays. Experiencing everything in life is different. It’s not just a sense of smell, it’s your entire psyche,” said Ann Marie.