New idea to have doctors be able to detect the odor - request a stress test to work up a sweat
I had a post the other day with an idea of having some member of the medical community spend up to a week or two with a person so they can observe the odor, since it is likely intermittent in nature. I thought a bit more, and I have a new, and much easier idea, that was largely inspired by a reply to my post. The idea is to request a stress test. A stress test is when someone runs on a treadmill, and a doctor monitors their heart looking for any issues. This is usually done when someone complains of chest pains.
This would be a simplified version, where the heart does not need to be monitored, and the whole point is for the person to work up a sweat so the doctor can actually detect the odor. I have talked before about how for most people, it is likely their sweat that smells bad. The correct medical term for this would be Bromhidrosis, not TMAU, as I have said in an earlier post about visiting a doctor about this.
A stress test to work up a sweat should allow the doctor to detect the odor. If the medical community has the opinion that this issue is often really just a delusion, then no resources are going to be devoted to it. This is why this is so important. A doctor is not going to order all sorts of tests and devote expensive resources to you if they think you really have a delusion.
One of the possible reasons for doctors claiming not to be able to smell someone is that there is a major mental barrier to telling someone they smell bad right to their face. I think a stress test will reduce the odds of this to the point where it should not be much of a concern. The doctor would be saying that it is your sweat, not you who smell bad, and if they actually are ordering up a stress test and standing right there, I don't think they are going to lie. The mental barrier to telling someone that their sweat smells bad should be a lot lower than the barrier to telling someone that they smell bad - does that make sense?
If you have bad smelling sweat, than working up a huge amount of sweat through exercise should be enough to have the doctor detect the odor. If the doctor still can't smell anything, you need to think long and hard about if there is any possibility at all that you could be mistaken that you really have a malodor condition. Realize that it would be a GREAT thing if this was the case. This would mean that you actually don't have a devastating, lifelong malodor condition after all!
I have a long post (see my profile if interested) on how to easily distinguish TMAU from ORS. The bottom line is that you MUST be able to clearly hear people making comments about you smelling bad. Ideally, you have at least some comments made right to your face, but at a minimum you need to very clearly hear these comments being made about you in your presence. The comments must be ongoing or at least fairly recent - if they stopped years ago you have to ask if that is because your problem ended long ago. If you can clearly hear people making comments about you smelling bad, and there is no reason to suspect you have schizophrenia and are actually hallucinating the comments, then you don't have ORS.
Other possibilities would be that the condition is intermittent, but is actually not created by sweat, but is really coming out directly though the pores, and so sweating may not make the odor apparent. It is possible that only the apocrine sweat is responsible, and so nervousness is the trigger for it, and sweating from heat or exercise will not bring out the odor (apocrine sweat is released during states of nervousness and certain types of excitement). I think that for most people though, sweating through exercise should be enough so the doctor can actually detect the odor.
The way you approach the doctor is important - you can't just demand a stress test, you have to persuade the doctor it is needed. Tell the doctor that your condition is intermittent, and is likely a result of bad smelling sweat, and so working up a sweat through exercise should allow them to detect the odor. Say you want the treadmill part of a stress test done for this purpose. Mention you don't need the heart monitoring parts that normally go with a stress test. If you do this, and the doctor can detect the odor for the first time, please report that back on the subreddit!
