Wednesday, January 27, 2010

My Bout with Bell's Palsy

A week of so before my 40th birthday last August, I was struck with Bell's Palsy. Bell's Palsy results in a loss of facial muscle control, usually on one side, and is actually a diagnosis by elimination, ie, after the doctor rules out causes such as stroke or brain tumour, the diagnosis will be Bell's Palsy.

I started writing about my scary experience but never got round to posting it. But here it is, maybe it could help someone out there. According to my blog reader Mariposa (YY), who's a medical doctor, Bell's Palsy tends to strike those between 15 and 45, and also affects more pregnant than non-pregnant women. Er, no, I'm not and was not pregnant :P

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This was written on 28 August 2009

It all started a week plus ago. Probably Wednesday night when I felt an achy sensation behind my ear, near to my neck. Somehow I felt this wasn't my usual neck/shoulder ache.

Thursday:
Went for a massage in the morning with Hsien. The 2 hour Javanese scrub/massage was excellent but while it eased up the knots in other parts of my body, I noticed the ache behind my ear was still there. Wondering if it was an ear infection.

Friday:
Woke up with slightly numb feeling near my eye. Didn't have a good feeling about this. My friend Karen, who had given birth just 2 weeks back, was craving for sashimi, and we decided to go for Japanese buffet lunch at IMM. I wasn't good company cos I knew something wasn't right. My mouth was feeling numb, and so was my tongue, and when I told Karen about my eye, she noticed that my right eye was blinking slower than my left.

Called my friend Li Ping cos I remember a mutual friend of ours had a similar experience after she gave birth and for that friend, her face drooped completely and it took months before she recovered. I was getting worried.

Went to my friend Slim's house where she was having a session with our acupuncturist friend Dr Liu. Dr Liu said she's seen many cases in China and it's not a biggie. The Chinese believe this is caused by cold wind...I'll talk about possible triggers later.

Had an acupuncture session at Slim's place and went home feeling more at ease. When I told Hsien about what Dr Liu said about wind, she gingerly suggested that I sought a second opinion. Decided to sleep on it.

Saturday:

Woke up feeling worse than the previous day. Getting worried now. Walked to Paragon to see a GP, who said it was Bell's Palsy. Referred me to a neurologist but said I should go to Tan Tock Seng Hospital's A&E first. Went straight to TTSH A&E, my first ever experience going to an A&E in Singapore. Bloody expensive, $85 and I didn't even get to see a neurologist or any specialist, I still had to see a GP. Was given a blood sugar test, blood pressure, ECG and everything turned up normal. GP was a very nice Filipino chap and after a couple of tests, diagnosed it as Bell's Palsy and referred me to an ENT specialist. He said my case was very mild and he could hardly tell; I was given a 4-hourly anti-viral 10-day course medicine.

Sunday:

Face is as numb as the previous day if not worse. Nothing to do but take my medicine till I see the ENT specialist on Monday. My right eye was not closing well and I had to tape it shut when I went to sleep lest it became too dry.

Another acupuncture session, this time at Dr Liu's clinic near Tanjong Pagar.

Monday:

To TTSH again. Hearing test done, generally okay but not perfect. ENT specialist was a young and very cute doctor with excellent bedside manners. He ruled out Herpes Zoster virus as my inner ears were fine. Confirmed it was Bell's Palsy. Assured me mine was a very mild case and I should recover well. Gave me a 10-day course of Prednisone (steroids). I was concerned about the side effects but he assured me it's fine if taken on a short-term basis.

Another massage, a birthday treat from Li Ping at Beyond Beauty. Massage was good but I was distracted. Went for tea at Cedele after that, and talked to Li Ping with my sunglasses on the entire time. My eye was getting too dry cos it's not blinking enough and I even had to hold it down myself. At night, I continued to tape my eye shut to sleep. This is important to prevent cornea injury. Sunglasses is also important to prevent dust/particles from entering the eye. Ideally, stay home and don't go out lah.

Tuesday:

Feeling much worse. Very dry eye, face number than before. Ache behind the ear comes and goes. Kept going on the net to research more about Bell's Palsy, so that I'd feel better! Symptoms said to peak around the 4th-5th day after first symptom. I hoped this was the peak.

Taped my eye shut for the night.

Wednesday:

Not sure if it was the taping of the eye, but my eye was slightly swollen when I woke up. Felt worse than the previous day. Hsien dropped by in the morning to drop me a book and some toys for Sean and she said she could definitely tell the right side of my face was different, especially the eye. By late morning, my eye felt better but still very dry.

Lisa came by to pick me up for Japanese lunch. When I told her I had Bell's Palsy, she said she could hardly tell. She's had friends with Bell's Palsy and their faces drooped terribly. Lunch was good and I was starting to feel a little better.

By evening, my eye didn't feel dry anymore. I didn't tape it shut to sleep at night.

Thursday:

Woke up feeling better. Another acupuncture session with Dr Liu. Love these sessions, very relaxing. Brian checked and said he can no longer see the white of my right eye when I close it.

Friday:

720am now, woke up feeling better than yesterday. Numbness still there but I believe the worst is over.

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Different people have been telling me what they think are the causes but no one really knows for sure:

1. Dr Liu says it's due to a sudden wave of cold air blasting against my face. Can't rule this out cos I was sitting while surfing the internet in a position in my room with the air conditioning blasting against my right side. She said she sees partial facial paralysis cases often during winter in China.
2. Lisa says a friend of hers who lives in Australia opened the door of his refrigerator one day and after a blast of cold air from the fridge, felt his face droop immediately.
3. A doctor says it's a latent virus which remains dormant till triggered when my immunity is low. Possible since a couple of weeks earlier I was down with flu, which I suspect was H1N1.
4. My own suspicion which has no proven medical basis...it's a side effect from the Tamiflu I took for the H1N1 I had two weeks earlier.

Bell's Palsy takes 2-3 weeks to recover from for mild cases, and up to 3-6 months for more serious cases. It is self-limiting, ie, patients recover even without medicine, but for some patients, there can be permanent residual effects.

I'm grateful that it took only about 3 weeks for me to recover fully. I prayed really hard for healing and trust me, it was a very humbling and scary experience. Scary cos you wonder if you'd ever recover and if you'd recover completely. Humbling cos we often take our health for granted, and when something like this happens, you no longer are preoccupied with the trivial things in life like money or possessions, you just want to get all better again.

Here's to good health for all of us!

22 comments:

mariposa said...

Interestingly, one of my cousins also developed Bell's Palsy around the time of her delivery. At that time I was quite young and I thought she must have 'popped a vein' from 'pushing too hard'. Haha! Actually it's still not known why pregnant women get it more often than nonpregnant ones.

She came to visit my parents during the baby's muah-guek and I could distinctly notice her right droopy side. I was quite worried that there was something very wrong with her.. but later she made a complete recovery.

YY.

monlim said...

So glad you're feeling better. Just reading your account made me tense up. It must have been such a worrying encounter. I've always heard the old fogeys telling me to stay away from cold wind especially with wet hair, and not to drink cold water. Maybe some truth in these old wives' tales afterall?

Lilian said...

YY & Mon: Yup, maybe what the Chinese say about Wind is true. That's why they insist on women staying indoors and not washing hair during confinement. My friend who got facial paralysis during confinement was really depressed, sought lots of treatment, including acupuncture and it took more than half a year for her to recover.

Anonymous said...

Lilian, it must have been a scary experienced. I agreed with Mon that sometimes there is some truth in these old wives' tales.

Please take care and I hope you have a speedy recovery.

Chris

Anonymous said...

Gosh, sends me the chills when I read it.... It sounds scary indeed. Glad that you have recovered from it. May God bless you a full recovery.

Yeah good reminder to me not to take health for granted....appreciate each beautiful day no matter how hard it may be on some days.

qx

Lilian said...

Yes, everyone take care...health scares are no fun.

During my first confinement, I sneaked in a shower and hairwash after a few days, my mum was livid! I think she was so mad she almost wanted to storm back to Malacca. Till now, when I complain about body aches, she gives that knowing, smirking "I told you so" look...

mariposa said...

Hmm... I have a theory about the 'cold air' thing. You see before a nerve goes numb (='anesthesia'), it goes through a brief phase of abnormal sensitivity or hypersensitivity (='hyperesthesia').

So during the hyperesthetic phase it could have been hypersensitive to temperature changes (e.g. blasts of cold air) so that the patient became acutely conscious of that cold air just before noticing that numbness & drooping of face.

It was like when I got my shingles, before the pain came on there was a period of tingling and itching (=> abnormally sensitive to normal sensations of contact with clothes, etc).

This is just my postulation, not mentioned in medical literature! You see in western culture people don't have the concepts of 'heatiness' and 'coldness' in their medical paradigm, so they don't attribute causal theories to 'heatiness', 'coldness' or 'winds'. Hee... :-)

YY.

Lilian said...

:) Interesting...wonder if anyone has ever done a thesis reconciling western medical knowledge with Chinese belief in wind, cold, heatiness...

Actually, I pooh-poohed much of this confinement superstition, till I had Sean. During this 2nd confinement, I tell you, I had to wear thick socks at night, and hide under the duvet, and I was in Singapore!! Aircon turned off...and even ceiling fan had to be at the lowest speed...I could feel coldness in my bones! Even with all the 'por' and heaty stuff, like ginger, wine, I still felt cold at night.

mariposa said...

Hmm.. my theory about this would have to do with basal metabolic rate changes.

Just as anecdotally, during pregnancy many women describe feeling 'hot' & 'breathless', sometimes even having palpitations, that can be explained by increased metabolic rates during this intense 'growth' phase that the body enters into (imagine the 1st gear of a car engine).

Then right after the baby pops, this engine suddenly goes idle, or 'neutral'. The metabolic rate plunges and hence the mother feels 'cold' all the time.

People who have hyperthyroidism (excessive levels of thyroid hormone) have increased metabolic rates, hence they feel hot & sweaty all the time ('heat intolerance'), and are easily excitable and 'antsy'. People who have hypothyroidism (too little thyroid hormone) have reduced metabolic rates, hence they feel dull & cold all the time ('cold intolerance'), and can actually become slow in responses and depressed.

There is actually a condition called 'Postpartum Thyroiditis', in which women who have delivered undergo thyroid fluctuations during the 1st year. They sometimes go through a 'hyper' phase followed by 'hypo' phase, before returning to normal. But a proportion of sufferers describe only 'hyper' or 'hypo' phases. However this condition is more commonly experienced a few months after delivery, not in the 1st month.

YY.

Lilian said...

Wow YY, you really know a lot haha...so much knowledge being imparted here! Thanks :)

mariposa said...

To fine-tune my previous assertion:-

Well in premodern western medical paradigms there HAD been theories that were similar to the Chinese 'hot', 'cold', or 'wind' theories. It's called the 'humor' theory. [You can see an incomplete list here:http://en.wikipedia.org/wiki/Category:Obsolete_medical_theories]

There are also other defunct theories; you might have heard of leaches & blood-letting--a practice that had been popular since ancient times, and which had been postulated to contribute to the death of George Washington.. http://en.wikipedia.org/wiki/Bloodletting

YY.

mariposa said...

Eeks, my knowledge is abysmal in many other practical matters, like money! Luckily I'm married to a great funds manager and clever businessman..

YY.

Lilian said...

haha...yes, very clever...you take care of his physical health and he takes care of your financial health...perfect combo!

Charmaine said...

Hi Lillian, interesting read about your experience with Bell's Palsy. I guess what the elderly Chinese say about 'wind' and 'cold' is true.

Lilian said...

Hi Charmaine, yup, I guess it's better to err on the side of caution and where practical, go along with what the old folks say :)

Yun said...

Hi Lilian,

I was searching for more info on Bell's Palsy and chanced upon your article. Thank you for sharing your experience as it's indeed helpful.

My mum had Bell's Palsy for about almost 3 months already. Her condition has improved but she has not fully recovered. We are worried that if she takes longer than 3 months to recover, we are not sure if there are any further implications / effects, eg. loss of facial muscles etc?

As such, we like to explore if acupuncture will help to speed up the recovery. Will it? If so, do you have any recommended good acupunturist specialising in Bell's Palsy?

Hope someone can share some thoughts on this.

Thank you in advance!
Yun

Lilian said...

Hi Yun, sorry to hear about your mum. I can imagine how distressing this must be for her. Personally, I would try TCM for such things, so yes, I think acupuncture may help. I did acupuncture almost immediately. Not really sure if it was the acupuncture or if my case was really a mild one, but I recovered fairly quickly.

The TCM doctor I saw was Dr Liu, a Taiwanese practitioner, she is located on the corner of Duxton Hill and Neil Road. Give her a call and see what she says. Her number is 90038258.

All the best to your mum. Take care.

Anonymous said...

im having bell's palsy now...for about a wk now. it's so depressing...all the confidence in me jus ran out. and steroids r making me fat and swollen with water retention. cant wait till it's all over. shall go for accupunture since it seemed lik it worked for most ppl :)

Lilian said...

Hi Anon, it's been about a week since you dropped your comment. I totally understand how depressing this can be. I hope you're feeling better now. Take care.

Tobi said...

Hi there,

thanks for your post. I came across it while googling for Bell's Palsy. I have just been diagnosed with it on Tues and on prednisolone and Chinese acunpuncture now. I can feel your words especially when you mention it's a humbling experience. I am taking this time to reflect on my life and put my trust in God. There is no more intense fear as compared to how I felt on my 2nd day. I feel peace and comfort from Him. Mine is a mild case with left face affected, my mouth is a little affected and I thank God that I can seek support from Him and friends and family around me.
Thank you again and all the best :)

Cheers,
Tobi

Anonymous said...

Hi just wanted to comment on the wind theory. I had bells palsy October last year and still have some loss of use but nobody but I can tell. I firmly believe that it was bought on by the fierce air conditioning blowing directly on my face from a bus that i was travelling on. The resulting Bells Palsy was instant and face dropped. I was prescribed prednisolone and antiviral and Aciclovir. The main symptoms went in about 5 weeks. The right side of my face is now just slightly slower than the left...

Lilian said...

Looks like we really should avoid cold air blasting on any part of our body. Esp since you said the effect on you was instant. Hope you recover completely in time.