Bell's Palsy; Week Five

Well it has been a good week and I am now into week five. Clear and steady improvement and several, "If I don't look closely, you look normal!" comments.
A few random observations:

• I'm still not "all better," but I am better. The left (affected) side of my face is no longer slack and is moving more in synch with the right. The corners of my mouth move up a bit when I smile and my eyebrows move a bit. This helps my non-verbal communication
• Prolonged speech is still a chore. I gave a brief lesson where I talked for about ten minutes and by the end of it my speech started to deteriorate and I was significantly fatigued. Still, that is better than I have been able to manage a week ago
• Mornings are better, as I've noted before. That hasn't changed
• Massaging the afflicted side of the face seems to help - I'm not sure why. I will vigorously rub my face a couple of times a day for just a few seconds
• Before The Palsy, when my eyes would get tired, the eyelids would spasm. Then, that was a warning to me to rest for a few minutes. That same phenomena, but only on the left side, has become frequent in the last week
• It is funny to have people stare at my face to check on my progress. Good thing I don't have a bunch of zits going on!
• I'm able to tolerate reading more
• I am still getting fatigued. Again, I believe that's because I am improving so am pressing myself more. But I do believe that the more I press myself (and then get rest), the faster my recovery is going
• One of my (pardon the pun) bell-weather improvements is my ability to spit after rinsing toothpaste. That was one of my first symptoms. When I can spit well, then I am well

In all, I consider myself very fortunate. As I mentioned previously, my symptoms have not been as severe as other stories I've heard. The inflammation was only in the facial nerve and had no brain involvement. In the same way I seem to be making completely average progress in recovery. That is an answer to prayer and I thank God for that small grace. Really, if you have a choice of neurological impairments, I highly recommend Bell's Palsy. :-) It has worked out rather well for me.
Of course do not take that joke too seriously - I know that there are some rare cases where the condition is permanent, persists for many months, or a full recovery is not accomplished. For those people ... I encourage you to please extend a full measure of grace and support.

Bell's Palsy; Week Four

Not much new to report this week except that I am clearly making progress. People who saw me a week ago are commenting that I'm looking better. I no longer need the eye-patch at all and probably don't need to use eye drops during the day. I still need to tape my eye shut at night, but that may not be for much longer. My speech is clearer and I can make myself understood without holding my cheek up. Looking at me, I'm told that I look nearly normal - it is only when I am animated that one side is clearly not following along.
I have noticed that I've experienced some discomfort in my jaw; as if I have been clenching it while asleep. I'm not sure what that's about, but I report it for completeness sake.
I still get fatigued. It may be that because I am feeling better, that I press myself more and thereby tire myself out.
Progress is generally up, but variable. Yesterday was rather good but I could tell as soon as I woke up this morning that today was going to be a slight set back.
I continue to feel occasional twitching and - despite my very learned physician's comment - believe that phenomena to be a sign of improvement. For what it's worth: I rarely had twitching like this before being afflicted with the palsy; it is not occurring anywhere else on my body - only on the left side of my face; and once it began about two weeks ago, I started seeing improvement. So my conclusion is that there is some connection with the twitching and my palsy.

Bell's Palsy; Week Three

So now I'm in my third week and have settled in a bit.
One of the young men in our church is finishing up medical school and - providentially - did a presentation specifically on Bell's Palsy during his class work. He and I chatted after church yesterday and chatted about how my symptoms are playing out. It was fun to get geeky about the medical and physiological issues. I think my guy appreciated having a real case to observe closely rather than rely on the research he did for the presentation.
A couple of conclusions and observations:

• Due to the somewhat unknown nature of the condition's cause, treatment is a confusing thing. It is a case where if the condition is treated vigourously, it will subside in six weeks; but if left alone, it will take half a dozen. That is, there doesn't seem to be much correlation between treatment and outcome
• My case isn't as bad as some. There are stories of people who could not speak at all during the depth of their affliction. My speech has been distracting, not suitable for prolonged public speaking, and does not allow for careful conversation; but I have NOT been completely robbed of my ability to communicate
• There is some slight improvement to report. I am tolerating being without the eye-patch for most of the day.  Several people have commented that my face is not quite as flaccid as it was last week (though it's hard to say that objectively because 'church people' really like to be encouraging!)
• It is very possible that this could be temporary 'normal' for a couple of months. Most stories  indicate that's the typical length of the palsy
• Progress will be slow but steady. So slight improvement is a Good Thing - I'll take it. The big fear is that this is one of the rare cases where the condition becomes permanent. But - so far - that does NOT seem to be the case
• Eye drops are my new Best Friend. I keep my little bottle with me all day and probably apply drops about five times during the day
• Sight in my left eye (affected side) seems to deteriorated in some way. In some way that I can't describe, it seems that it is difficult for my right and left eyes to both focus on a thing. It is not double-vision, it is just ... not right. Pardon the pun, but I am 'watching' this phenomena for further developments
• The hearing effect that I described before (Day Eight) is a known symptom. My med student friend told me that is called, "hyperacusis." There is a muscle in the inner ear that contracts as a protection when a particularly loud noise occurs. That muscle is not working now and so I am sensitive to loud noises on the left (affected) side. See http://en.wikipedia.org/wiki/Hyperacusis
• I'm better in the mornings - my face sags more as the day wears on
• It is hard to work. Subtle conversation is impractical. It is even hard to read. I fatigue more quickly
• Because of the fatigue (above) and the fact that my body may be trying to fight off some sort of attack, I'm taking mid-day naps to keep rested
• Particular to me: I'm very word-oriented and a "verbal processor." When I can't speak clearly or smoothly, it slows my thought processing down which is frustrating. Because of that frustration, I am finding that I'm getting a bit grouchy

So, seeing as I am likely in this for a long haul, I will slow down my frequency of updates here on the blog. As new things come in the next week, I'll update this entry and then begin a new one in about a week.

Bell's Palsy; Day Eleven

Well, another pretty stable day.
Spent most of the day with the eye-patch off and experienced some spasms.
Went to my primary physician and he told me most of what I already knew. Interestingly, he's also had the condition so was sympathetic. I asked him about recovery and he said it could be a couple of months. But if it goes beyond six weeks, I should let him know.
As he has experienced the condition, he is up to speed on the science. He said that the core problem is nerve inflammation - that is why application of steroids is helpful. But the idea that said inflammation is caused by a virus is not conclusive. The condition is "idiopathic." OK, I am a Big Words person; what does idiopathic mean? He said it means that 'physicians don't have a clue.' Check this out: http://en.wikipedia.org/wiki/Idiopathic . I appreciated his honesty.
I asked him about the spasms that I experienced Monday night and what that might mean for recovery. He told me it really doesn't mean anything. Analogously, the real 'proof of the pudding is in the eating:' my muscles will be more responsive to my commands. Recovery will be slow and (hopefully) steady: my smile will become more and more symmetrical, for example.
He reiterated my care: eye taped closed at night for as long as my eye will not fully close, use of lubricating eye drops, particular care for my teeth, etc.
So the whole theory about using the NSAIDs to reduce the nerve inflammation didn't get any traction with him. My experience of using Ibuprofen and then experiencing the spasms were serendipitous coincidence - not cause and effect. And, just to report here, after about 36 hours of use, I didn't experience any noticeable increase in supposedly helpful twitching.
Summary: Just have to ride it out and treat secondary symptoms.

Bell's Palsy; Day Ten

So this is the magical tenth day where recovery *might* begin. But it didn't.
Last night I started thinking about what might have been different on Monday that wasn't true yesterday. What I remembered is that I had a bit of a stress headache and took an Ibuprofen for it. Later that night, I started experiencing the spasms. So I did some Wikipedia research and realized that Ibuprofen is one of the NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). OK, I was prescribed a steroidal treatment during the first few days specifically to reduce the nerve inflammation  I wonder if NON-steroidal anti-inflammatory drugs might be helpful and did I accidentally discover this on Monday?
So I began a self experiment. I treated myself to 12 hours of Ibuprofen during the day. Then I will take a Naproxim Sodium for the night (12 hour dose) and see if there is any effect by tomorrow morning. Now I do need to tell anyone reading this that I'm willing to do this because it is a low risk thing for me. I am a large man (6'3" and 280 lbs) so any toxicity from those drugs is mitigated by my body weight. If I were more petite and frail, 'self-medicating' like this would be a Bad Idea. I am NOT recommending this. And I'll likely get yelled at by my physician when I meet with him tomorrow.
Stay tuned for the results.
In other areas, I spent much of the morning meeting and talking. By the time lunch rolled around, I was exhausted. I went home to rest my eyes. Three hours later, I woke up. The lesson: I can function with most of my life stuff, but I am fatigued far more than normal.
But, on the plus side, I was able to go without the eye patch for all day. Later in the evening, I did have to put it back on.
I did receive a couple of very nice "get well" gifts: one was an 'edible arrangement' and the other was a gift card to a nice local restaurant. So I'll definitely be getting my daily servings of fruit for the next couple of days and it'll be nice to treat Barb to dinner.

Bell's Palsy; Day Nine

Well the hope of last night has dissipated  I was kind-of hoping that I'd go to bed last night and wake up all better. Nope; didn't happen. Today was much like most of yesterday. No more tingling and no more twitching spasms. Though a friend told me that they had once experienced facial paralysis due to a migraine and they had experienced the spasmodic twitching before their recovery. So that seems to be a legitimate sign.
But. None today.
Huh. What happened? What was different yesterday that wasn't true today? Don't know - yet.
I have noticed that the area where I'm told the cranial nerve exits the skull is a bit tender which fits with the supposed underlying cause for Bell's Palsy being an inflammation of that nerve.
Got several Get Well cards in the mail today which was thoughtful and appreciated. OK; random thought: all the Get Well cards had glitter on them. I do not know what the linkage between the thought of "get well" and "sparkly" is.
Tonight, I had a meeting at church and the other guys let me shape the agenda so the bits that I needed to participate in were up front. That left me free to leave the meeting early. And I needed it: I was fatigued.

Bell's Palsy; Day Eight Plus

Just wanted to capture a couple of thoughts before the end of the day.

• Physician's appointment: When I was in the Emergency Room, I was told I had to check in with my primary physician within the first week. So a few days after the ER visit, I called the office, left a message, and said "Hi. I'm checking in." Why was I so cavalier? Well, there really isn't anything my physician can do. This is a viral thing and there are no drugs or treatments (that I can afford, anyway) that can be prescribed. What else is my physician going to tell me? "Yep. You got exactly what they told you at the hospital. Your recovery will not be accelerated in any way by your visit today. That'll be $200." From where I sit now, Thursday's visit to my physician (who, by the way, I really like and believe to be Very Very competent) seems like a waste of his time and my money
• What does recovery look like? Nobody has discussed this with me and I can't find any clues on the internet. By the way, that is one reason why I'm taking so much time with this series of blog posts. For others out there who will contract this condition, it can be nothing but helpful to compare and contrast their own experiences with mine. Still, I don't know what it's supposed to look like, feel like, or ... whatever when (if?) I start recovering - there is not any information
• Related to that last point; maybe I do know. This afternoon I related in the last post how I'm able to endure significant amounts of time without the eye patch. By this evening, I was rather comfortable. Hmmm ... that looks like 'improvement.' Sometime earlier this evening I started experiencing a new sensation: my facial muscles on the left side started twitching. You know, like those uncontrollable sort of random movements you can start making? Well it is like that. At times, it got to be a bit annoying. AND my facial muscles on that side started 'talking' to me - a slight soreness, as if I'd been smiling or laughing hard for a long time. ADDITIONALLY, my face started 'feeling' different on the left side. The sensation was as if my face were just a tad warmer on the left than on the right.

Summary: improvement detected; cautiously optimistic.

Bell's Palsy; Day Eight

Today started well in that I was able to go without my eye-patch for significant stretches of time. This is a good thing as the patch is beginning to irritate my skin. Going without the patch worked better in the morning. I don't think this means I'm getting better, though.
I wear the eye patch to gently hold a cotton 'round' against my eyelid and keep the eyelid closed. I do that because my eyelids were not fully closing and to prevent dryness and actual pain, it seemed better to keep one eye closed.
Going for times without the patch allowed me to drive short distances and regain depth perception. However, when I went too long without the patch (about a half hour), then I would experience tearing, dryness, and pain. Getting the patch, the cotton, and the strap placement right is tricky and takes a while to get right.
Once on and stable, taking it off again was immediately uncomfortable. It takes some time to readjust the eye as it has been pressed on and somewhat deformed so it's immediately out of focus and sensitive. Taking the patch off leads to an immediate sense of dryness and pain. Both eyes star tearing up, the tears run down the face and into the sinuses, I need a facial tissue to clean myself off and blow myself off. It seems to take about five minutes of care to get the eye so that it can go without being fussed with. Cupping my hand over the eye seems to help. Then I'm good for a half hour or more.
I went walking at the local mall both last night and this morning to stretch my legs. Walking the mall is something I do three times a week - I know it well. I found that walking with the eye patch takes concentration and found myself feeling fatigue after a walk that should have just gotten my heart going.
I had a breakfast with close friends and then a meeting at my office - again, people who know me well - and found that my capacity for conversation was lower. It is plain ol' physically more taxing to speak when half my face is just flopping along. I found myself fatigued by even pleasant conversation and realized I was beginning to get a stress-related headache.
By the way, to make my speech clearer, I have found that I can hold my hand up to my face. My technique is to place my finger tips on my cheek near my mouth and then press a bit up and back. That seemed to give the best effect - your mileage may differ.
One last thing that I have neglected to mention before: my hearing seems to be more sensitive in the left (affected side). For example, when I sneeze the sound seems nearly painful in that ear. I causes me to wonder if there are affected facial (7th cranial nerve) muscles that contract in response to loud noises to somehow lessen the impact of that sound.
Summary: symptomatically stable.