BELL’S PALSY

Bells Palsy is caused by acute inflammatory damage and subsequent compression of the 7th cranial nerve. This results in the muscles of the face becoming weakened or paralyzed. It is usually a unilateral phenomenon, affecting either the left or right side.

The etiology of most cases is unknown, however theories point to either a viral or inflammatory cause. As in my case, it is also four times more common in the third trimester of pregnancy, which is when it struck me.

85% of all patients completely recover in a few months, however 15% are left with permanent damage ranging from mild to severe. Unfortunately, I fell in the severe category, the rare 0.5%, leaving me with extreme muscle weakness, paralysis, and synkinesis from aberrant nerve regrowth. This resulted in constant muscle contraction and hypertrophy leading to pain and dysfunction. There are also laryngeal effects due to the impact of both the digastric and stylohyoid muscles which cause intermittent choking and asymmetry (I lost about a major 3rd in the top part of my range).

There is no cure for Bells Palsy. Most cases do heal on their own. But for those who suffer from permanent damage, nerves either fail to regrow or are mis-wired to the incorrect muscles and cannot be recovered. (Stem cell research anyone?). The only hope for regaining any function or symmetry is through retraining and physical therapy. However, studies have been minimal and inconclusive as to their effectiveness. In my case, central neuroplasticity reined supreme to navigate the changes.

Aside from the physical complications of Bell’s palsy (ranging from eye dryness, to muscle soreness, to ear ringing, pain, stiffness, eating complications, unable to blow bubbles, balloons, kiss, suck a milkshake through a straw, etc.),

the psychological effects are often left undiscussed, yet can yield the greatest overall trauma.

What does it mean to lose your face?

For me, it has been a journey. I have learned more about myself with my disability than the many years without it.

On the superficial level, I have found new ways to communicate in this state (thankfully, my children are no longer asking “are you angry Mom?” when I am actually very happy...they see my smile in other ways...). I have also re-learned how to sing and how to express with my voice, body, and half a face. In a way, it has made me more musical. I also learned about the neuroscience of vocalization, which has changed my way of singing and teaching.

On a deeper level, it has also shown me what is really important. It has shown me who I am beyond my face.

And to that, in a strange way, I am indebted to my palsy. 

It is my hope to create awareness for this disability, which affects 1 in 4000 people. Although many fully recover, those months when they are without their faces requires a unique understanding and empathy which goes beyond the physical. And for those of us who have it for a lifetime, you are not alone.

I want it to be a life of joy, not shame.

I have been blessed to have recently received life-changing surgery. I have chronicled my recovery on Facebook and I am so indebted to all who made it possible…

...I FEEL PRETTY, OH SO PRETTY…

RESOURCES

GENERAL RESOURCES: 

bellspalsy.ws
the most comprehensive
bellspalsy.net
good for news updates
facialpalsy.org.uk/inform/what-is-facial-palsy
I used this wonderful group for support
dundee.ac.uk/bells/index_files/hbscale.htm
rating scale for severity
en.wikipedia.org/wiki/Bells_palsy
and
en.wikipedia.org/wiki/Facial_nerve_paralysis 
good ol’ wiki

EXERCISES:

bellspalsy.ws/exercise.htm
content.nejm.org/cgi/content/full/357/21/2206
Mirror Therapy

ADVANCED CARE:

facialparalysisinstitute.com
stanfordhealthcare.org/medical-clinics/facial-nerve-center.html
(Dr. Pepper performed my surgery and he was amazing!)