A few weeks ago, I noticed a slight change in taste. After a while I started to feel a migraine coming on. Then my ear began to hurt. No big deal, I figured I was just coming down with the flu or the H1N1 virus or something. I awoke the next morning to severe neck pain. After spilling my morning coffee all over myself while trying to drink, I realized that something was very wrong. A quick trip to a mirror confirmed that the right side of my face was completely paralyzed.
Fearing a stroke I went to the Emergency Room, where I was given the diagnosis of Bells Palsy. Sound familiar? It is for approximately 40,000 people in United States who are diagnosed with the disease each year. I expected the diagnosis; this is the second time I’ve had Bells Palsy.
The purpose of this article is to help educate those who are suffering from Bells Palsy, and offer practical tips for living with the disease. I am currently in my third week of living with Bells Palsy, and still have total facial paralysis. I hope that you can benefit from my own personal experience with Bells Palsy to make your recovery more tolerable.
Bells Palsy an Overview
Bells Palsy is a devastating disease that affects the C7 facial nerve, causing facial paralysis and numbing to one side of the face. Bells Palsy is a common and temporary condition that usually resolves itself in a few weeks or months.
The exact cause of Bells Palsy is unknown. Possible causes include infections of the Herpes Simplex Virus type 1 (HSV-1), or the Herpes Zoster virus (which is also responsible for shingles). HSV-1 is the cause of cold sores, while the zoster virus is found in people who have had chickenpox. The facial nerve itself swells and becomes compressed by the skull near the ear. The resulting trauma blocks the signals being sent to the facial muscles.
The facial nerve controls closing the eye, blinking, and tear production. Salivation and taste, as well as movement of the lips, face, forehead, and eyebrow all on the affected side. This makes eating, talking and most other things we take for granted very difficult.
The onset of Bells Palsy is rapid, often occurring overnight. It is not unusual to wake up and find that one side of your face simply will not move. Sometimes there are symptoms prior to the onset of Bells Palsy which can include: neck pain, earaches, headaches, and change in taste.
Bells Palsy can be also be extremely painful. Many people experience extreme headaches focused near the eye, neck pain, jaw pain, facial pain and earaches all on the affected side. Sensitivity to sound is another common complaint.
The prognosis for Bells Palsy is good. Most people have a full recovery within a few weeks or months, depending on the severity of the initial nerve damage. Sometimes however it can take a year or longer for full recovery. The general medical consensus is that there is no need to worry until after three months have passed without restored facial movement. The facial nerve itself regenerates at the rate of about 1mm a day.
Bells Palsy Diagnosis
Any time there is paralysis involved you need to see a Doctor immediately to rule out other things like a stroke. If another cause for facial paralysis can not be found, a diagnosis of Bells Palsy will follow. There are a few common symptoms that point to Bells Palsy, such as paralysis of the eyebrow, sensitivity to sound, and “Bells Phenomenon,” which causes the eye to roll upwards when trying to close the eyelid.
Bells Palsy Treatment
Since the cause of Bells Palsy is unknown, there is debate on how it should be treated. The most common Bells Palsy treatment is a combination of steroids and anti-viral medication. The steroids are believed to help relieve the inflammation of the nerve and help the patient recover faster. The anti-viral medication is proscribed due to the possible links to the HSV-1 and / or zoster viruses. I was proscribed both Prednisone and Aciclovir.
It is suggested that medication be started within 72 hours of onset to be the most effective. Many patients have recovered from Bells Palsy in as little as two weeks without treatment of any kind.
If you need pain medication, ask for it. I was proscribed both Lortab and Diclofenac. Non-Steroidal Anti-Inflammatory medications (NSAIDS) such as Aspirin, Ibuprofen, and Naproxen can interfere with prednisone, so it important to speak with your Doctor about pain management if you are given prednisone. Refrain from taking over the counter medication without medical consent.
Heat packs applied to the face can help with pain as well as massaging or gently tapping on the face. In cases of severe pain that will not go away, ask your Doctor about Neurotin. I haven’t personally used Neurotin but it has helped others suffering from Bells Palsy and other forms of paralysis.
Bells Palsy Eye Care
Proper eye care is critical. I can not stress enough how important it is to keep the eye protected and lubricated at all times. Bells Palsy patients are unable to blink or close their eye, so there is risk of permanent damage to the retina. Eye care is your first priority.
Lubricating eye drops are essential. I have found that GenTeal Gel Drops work wonders. Gels remain in the eye longer than liquid eye drops, and the GenTeal brand allow me to see much better than with other types of gels that blur your vision. Dry eye symptoms include: stinging, burning, itching, and blurry vision. Stay away from eye drops that contain preservatives.
Pirate style and disposable eye patches are both effective and inexpensive. The tradeoff is that you obviously will not be able to see out of the covered eye. Eye patches are great when you need to protect the eye and give it a rest.
Sunglasses should be worn anytime you are in the sun. Wraparound style sunglasses form a better seal to protect against wind and dust. I often wear them inside to keep moisture in. Solar Shield sunglasses can be found at most pharmacies around $20 a pair. They are designed to fit over regular glasses and do an excellent job of protecting the eyes and keeping moisture in. Even if you don’t wear prescription glasses, I would suggest getting a pair of the Solar Shield glasses as soon as possible. You can thank me later.
The eye should be taped shut when you sleep at night to prevent it from drying out or being scratched accidentally. Surgical paper tape works the best for me. Taping the eye shut is more difficult than it sounds. While you can do it yourself, I would advise getting another person to do it for you. Taping the eye closed is uncomfortable, but provides excellent relief to the eye when it is sore, and good protection while sleeping.
Moisture Chambers are the best option and some can be fitted to prescription glasses. They are designed to form a seal around the eye, and still allow you to see while keeping moisture in, and dust out. Moisture Chambers are not sold to the public. You will have to find a local ophthalmologist who can order them for you. Others have made them using plastic wrap taped to the face. Swim goggles can also be used.
If you can not find eye relief, see an ophthalmologist.
Eating and Drinking with Bells Palsy
Straws or “sippy cups” are the easiest ways to drink. With practice you can drink from cans, bottles, and glasses with no problem. Take small sips. Keep a napkin nearby since liquids tend to drool out if you are not careful. Watermelon cut into bite size pieces is great for hydration.
Eating can be difficult. Bells Palsy can numb parts of the tongue, and affect the production of saliva. Care should be taken while chewing, so as not to bite the tongue without realizing it. Take small bites, and chew food thoroughly on the unaffected side of your face. Soups and soft foods like eggs, pasta, and fruits are by far the easiest to eat.
The change in taste has been hard for me to deal with. Foods that I used to love now taste unrecognizable or just plain terrible. Experiment and find things that are palatable to your newly changed sense of taste. One of the common side effects of prednisone is hunger, which makes the situation all the more awkward.
Wear dark colored clothes until you get the hang of eating and drinking with Bells Palsy. I’ve ruined more than one white shirt due to accidental drooling and spillage.
Other Tips for Living with Bells Palsy
Avoid exercise, and in general just take it easy. The facial nerve has suffered severe trauma and possibly an infection. Get lots of rest and give your body time to heal.
When my eye is really bothering me, I’ve found that hot showers or baths provide near instant relief. The steam and water vapor in the air does a great job of rehydrating the eye.
Bits of food can easily become trapped between the cheek and gums without your knowledge, so it’s important to brush regularly.
Take a good multivitamin. B Vitamins are essential to proper nerve function.
Do not keep trying to make your face move. Repeated straining can cause other muscles to pick up the slack and create bad habits. Check for movement daily, but leave it at that. Give the facial nerve time to heal and grow along its original path. Be patient.
Let’s face it (pun intended); being stricken with sudden facial paralysis can take a heavy psychological toll. Smiling becomes impossible, and things we take for granted like talking and eating become challenging at the very least. If you need help dealing with emotional issues, find a support group or someone to talk to. Take heart in the fact that Bells Palsy is a temporary condition. Thankfully for us, things will return to normal in time. Others, such as stroke victims, are not always so lucky.
Sources:
http://en.wikipedia.org/wiki/Bells_palsy Wikipedia
http://www.bellspalsy.ws/ Bell’s Palsy Infosite & Forums
http://en.wikipedia.org/wiki/List_of_famous_people_with_Bell%27s_Palsy Wikipedia
