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18 July, 2018, 01:46:34 pm
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WELCOME TO THE ONLINE FORUMS FOR THE BELL'S PALSY ASSOCIATION | Charity Reg. 1094039


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| |-+  GENERAL DISCUSSION - Open To All
| | |-+  Day 40 Report
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Author Topic: Day 40 Report  (Read 291 times)
DetroitMan
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« on: 25 May, 2018, 04:01:50 pm »

Day 40 today since the onset of facial palsy. Caused in my case by the Zoster virus reactivating without other manifestations of shingles.  So the similarity with BP is the ear pain at onset and the quick facial paralysis.

Signs of recovery: Lips appear straight. Affected cheek moves 50% when I talk, improving clarity. Eye blinks 50% in tandem with the good eye, which reduces need for tear drops. Have occasional tingling in the cheek area, giving me hope that the nerve endings there are starting to receive signals. Able to drink out of a cup or glass, except for the last few sips where the cup has to be lifted up to a higher angle.

Still waiting for improvement: Eyes do not close fully, so need eye ointment and mask at night. Eyebrow is not level, but since I wear glasses the viewer is likely to think I have my glasses on crooked! Lips pull to the good side when talking or eating. Smile is restricted to the good side.

Need to watch progress / cause for concern: Cheeks are tight - can feel the muscle tension in spite of heat pad application a few times a day. I do not massage or force any movement through exercise. Eye closure gap of 4mm hasn't improved at all. Top eyelid is folded in - may need weight sewing surgery if it does not recover in a few months.

Have returned to work over the last one week. Coworkers have been sympathetic and understanding when I explain what happened and why I hold one cheeck with my hand when talking.  If one on one with a female coworker, I declare upfront that one eye does not blink or shut normally. 

Posting the above in hopes that others take enouragement from my progress and sustain hope. Wish you all well.

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DebbieL
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Posts: 461


« Reply #1 on: 25 May, 2018, 05:17:47 pm »

Good report, thanks ever so much for sharing and best wishes and high hopes for more and more recovery
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DetroitMan
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Posts: 22


« Reply #2 on: 26 May, 2018, 01:16:36 pm »

Thanks DebbieL.  Wish you and others in this Forum too a speedy and full recovery.  I'll provide the next update in two weeks appx.
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Bernadette
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« Reply #3 on: 27 May, 2018, 10:17:58 pm »

Hi!

Good to see you are seeing some recovery. One paper I read said that the mean time to recovery with Zoster sine herpete was 10.5 weeks.

Having the steroid and anti-viral with Zoster sine herpete seems most important. In one study all thirteen people receiving those medications recovered completely https://www.ncbi.nlm.nih.gov/pubmed/10980741

Fingers crossed that you have a complete recovery!
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DemiG
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Posts: 15


« Reply #4 on: 28 May, 2018, 12:17:53 am »

I am at 8 weeks and 3 days. My recovery is slow.  My cheek still rather flat and no wide smiles for me - pity I am surrounded by good people who make me laugh!!! 

My eyelid comes down only ever so slightly and I'm far from healed.  My eyebrow is almost level but there is a lovely fold of skin still obscuring my eyelid. The droopy skin under my eye continues to look better again every so slowly.  The non blinking is the hardest part. I no longer play my weekly tennis game or do anything without regard to my eye and do I even want to get out of the house.

In 3 weeks I have an appointment for cosmetic filler to even out my cheeks somewhat so I'll be interested in what the doctor says - ie if its viable or otherwise. There isn't a lot about filler on the internet, only botox.
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DetroitMan
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Posts: 22


« Reply #5 on: 28 May, 2018, 02:59:33 am »

Thanks Bernadette for the additional information and the link. That was encouraging.  Using the mean statistic of 10.5 weeks, I'm a little past the half way point as of now.  Hopefully the recovery curve will be steeper in the second half.
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Bernadette
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« Reply #6 on: 28 May, 2018, 08:21:40 am »

Hi!

There is a great deal of variation in how fast people recover. If the nerve damage is quite minor then much recovery occurs in first three or four weeks.

Generally, in Ramsay Hunt syndrome with the Herpes Zoster virus it takes longer for recovery because there is more nerve degeneration and therefore more nerve regeneration has to occur. Recovery time is variable - in this particular patient with Zoster sine herpete (who had had a kidney transplant) the recovery time was 10 months https://www.ncbi.nlm.nih.gov/pubmed/22310640

Demi - 8 weeks (or 11 weeks) is still early days if significant nerve regeneration has to occur - are you sure filler is a good idea before the nerve has had an opportunity to regenerate? I would have thought aim for a very good nutritious diet which is quite low in refined sugars, get as much sleep as possible and do some exercise (go for a brisk walk by yourself if you don't feel like socialising)

Wishing you both a good recovery!

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DemiG
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Posts: 15


« Reply #7 on: 30 May, 2018, 02:29:39 am »

Hi Bernadette

No, I'm not sure filler is a good idea.  I'll certainly be asking some questions so won't be doing so unless I feel confident.  At least I am familiar with this doctor so I don't believe he'll do anything if he feels the same.

I have been a lot more careful with my diet, more sleep and I do brisk walking. I am usually active anyway (I like a cardio class called 'body attack' but alas, I can't do this with one eye taped, and even if I tried, I don't think I could cope with the pity stares or the whats wrong and where have you been questions while still looking unwell.

My lip is starting to curl up ever so slightly.   There is definite progress.   Though I did notice today, eating and wiping away the crocodile tears.    Does this eventually go away?

 
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Bernadette
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« Reply #8 on: 30 May, 2018, 07:59:15 am »

Hi Demi!

The fact that you lip is able to curl up sounds wonderful progress! Hope you get some more soon.

I had dreadful eye watering myself at first - I was very lucky that this stopped very quickly and early on - I actually felt a small sensation (like a tiny electric shock) in the area of my tear duct and the watering stopped for good.

Sounds like your lacrimal gland is overreacting  - when only the salivary gland should be active, the lacrimal gland is responding too - possibly the nerve impulse is overshooting its target. This may stop of its own accord. However, at a later stage of your recovery, if this is really troublesome, then they can inject Botox in the lacrimal gland to stop the problem at least for some months. Then the Botox might have to be repeated.

Great that you are looking after yourself well!
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DetroitMan
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Posts: 22


« Reply #9 on: 04 July, 2018, 02:24:50 pm »

Here is an update to the day 40 report.  Today is day 80 appx. and I haven't seen much improvement in the areas I had listed since day 40.

Developments since then:
- Visited ENT. Examination ruled out Ramsey Hunt Syndrome or ear damage. Hearing test was conducted by an audiologist as a part of this visit - results were OK. So the neurologist's diagnosis of Zoster sine herpete is essentially confirmed. The ENT was surprised however that the anti-viral drug was stopped after a week or so, and how has me resuming the same for a month more to hopefully eliminate whatever traces are left of the Zoster virus.
- Booked appointment for an electromyography ( EMG ) based on my concern that cheek tightness over the last three weeks may be the start of synkinesis.
- Booked appointment for eye surgeon past the four month point, in case eyelid droop does not cure itself by then.
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Bernadette
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« Reply #10 on: 06 July, 2018, 05:04:45 pm »

Sorry you haven't seen further progress. However, still early days at less than 3 months.

This is what the NHS website says https://www.nhs.uk/conditions/bells-palsy/

So in the UK would be looking at another 3 months before any other treatment is considered.

Do hope you see some more improvement very soon!
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