Bell's Palsy Experience - Ann Riggs


Surgery performed by:   Dr. Fred G. Barker II
Surgical Location:         Massachusetts General Hospital, Boston, MA (USA)
Surgery Date:                December 14, 2007


I had my MVD on Friday, December 14, 2007 at Massachusetts General Hospital in Boston, MA (USA), performed by Dr. Fred G. Barker II. I cannot imagine a better surgical experience. I awakened "SPASM FREE", and the pain was not bad. The worst part of it was a brief period of motion sickness when I got out of bed for the first time, in the wee hours of the next morning. I went home on Sunday evening, delayed by bad weather earlier that day.

My post-op period was going very well, until Thursday, 6 days post-op, when I had to be readmitted to the hospital for a cerebrospinal fluid (CSF) leak. I was still in the hospital on Saturday, when I noticed I difficulty rolling my lips when I put on lip balm. Sunday I had some facial weakness on the left, and by Monday I pretty much had complete paralysis. I got eye drops to use at the bedside and a CAT scan of my head to make sure nothing else was wrong. Nobody really knows why some patients get this, but there are three plausible explanations making the rounds in the medical community, and I was also put on three drugs, one for each possibility:

  • Valganciclovir, an antiviral agent (some think that surgery activates viruses dormant in the body);
  • Nimodipine, a drug for vasospasm (some think that microvascular vasospasm in the operative area is the cause); and
  • another round of Decadron (a steroid, some think that continued inflammation from surgery causes it).

I was discharged the next day, Tuesday, December 25. On Sunday, I sang with a small group at church, and realized only then how difficult it was to make ‘p’ and ‘b’ and ‘m’ sounds – any consonants that used the lips. I was surpised at how much energy and concentration it took to just talk, to carry on a conversation of any length. I had to drink out of a straw on the right side. I used eye drops during the day and an ointment with an eye patch at night. The eye drops did not seem to help much at first, but I noticed that the kind I had contained benzalkonium chloride as a preservative. I remembered that when I wore contact lenses, I had the same kind of eye irritation with solutions that had that same chemical in it, so I switched to preservative-free eye drops for moderate-to-severe dryness, and everything were fine.

The paralysis was complete for about a week, when I noticed a very slight movement in my left eyelid. There was rapid improvement over the next 2-3 weeks, then the recovery curve slowed down. By then, my face was functionally normal, although there were obvious areas of weakness when I did the facial exercises. I was told the exercises were not really necessary but didn’t hurt; I liked the reassurance that doing them gave me – I could see the progress. Dr. Barker told me that recovery would continue for a year or more. I have a very minor residual weakness that is only apparent upon clinical exam – or when I try to blow up a balloon!! I can do it, but I have to seal the left side of my mouth with my finger. I no longer do the facial exercises, except for an occasional check on those movements for the residual weakness (left lower lip, for example) that continues to resolve. I expect that even these minor areas will recover completely.

I did notice that as the palsy resolved, I developed significant tingling in my face, similar to what I used to have with spasms. There was one day when the tingling seem to just burst, and I had some wild and crazy (but not hard or tight) facial spasms for a few hours, then they disappeared. For a few days after that I had some mild tingling from time to time, followed by a very light flutter. I tended to associate all this with the recovery of the paralysis and have not experienced any flutters or twitches significant enough to make me resign my membership in the SFC.


Permission granted the HFSA to post Bell's Palsy Experience on website.
Ann Riggs, April, 4, 2008

 

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