I’ve been grappling with whether it was worth my energy to write a post about this subject, not out of embarrassment, so much, but… OK out of embarrassment. I am embarrassed that I am taking the energy to write about something that comes from my breaking the first rule of the internet.
Never read the comments section.
More succinctly, never read the comments section of an article where you are part of the subject matter. Nevertheless, I read them. One comment – it was the first one, naturally – hit a nerve.
The comment – and here I’m paraphrasing,
it has since been removed – referenced how the look on my face made it seem like I wasn’t happy to be there. On Opening Day. On my wedding day. It was, needless to say, the farthest thing from the truth. Inside and out, I was beaming, and in spite of my most tenacious of efforts, the right side of my face could only supply a faintly bemused smirk, because of my palsy.
EDIT: The comment is still there, but is from an earlier version of the story – here’s the link: http://www.washingtonpost.com/blogs/dc-sports-bog/wp/2013/04/01/nats-fans-get-married-go-to-opening-day/
I’ve had time to ruminate on the comment, and while it is not worth perseverating upon, it wouldn’t be me (or HDIB?) if I didn’t take the time to write about the moments in my life which live in the interface between my love of baseball and medicine. So let’s all learn a little more about Bell’s Palsy, yes? I urge you to click the above Bell’s Palsy link, as well as this one here for more thorough information; for the purposes of this article, I’m going to just riff off of what I’ve learned from my personal and professional experiences with the affliction, FAQ-style. Onward!
So what’s Bell’s Palsy (BP)?
– It is the paralysis of the facial nerve and its branches, which causes the muscles that are innervated by the nerve to weaken and droop against gravity.
How the heck did that happen? Does it hurt?
– There are a number of ways to become afflicted with BP, but they are commonly of viral origin. Exposure to a virus and the weakening of your immune system seem to allow an opportunistic neural infection and swelling to occur. While nerve palsy can occur from other causes, such as a stroke, tumour, or even Lyme Disease, when the paralysis occurs independent of other conditions, it’s called BP.
For me, I had a month-long flu virus that is likely the cause of my BP. While most of the time it doesn’t give me pain, there are occasions when I will get shocks that run down my face that are consistent with the course of the marginal mandibular branch of the facial nerve, as well as occasional spasms of the obicularis oculi muscle of my eye. The obicularis oculi muscle gets its neural input from the zygomatic branch of the facial nerve.
Does it go away?
– BP is normally a transient thing, lasting a few weeks to a few months. Some unfortunate folks are permanently afflicted, but it is rare.
Is it treatable?
– Yes. For my BP, I received a course of steroids to help strengthen the facial nerve against the infection. Antiviral medication can also be prescribed, but the research available isn’t very convincing that it provides a significant benefit over steroids alone. For the most part, between a brief period of meds, time is the best treatment, along with some physical therapy of the paralyzed facial muscles. A surgical procedure called a bony decompression can provide some relief through widening the opening in the skull that the facial nerve comes out of (called the stylomastoid foramen), but is not recommended due to the risks involved with the procedure.
Sounds pretty benign. How’s life different for you?
– Overall, it’s benign. Aside from the visual aspects of having BP, most can live without much hassle. For me, my eyelid doesn’t close all of the way, so I am constantly teary-eyed and have to be careful of the sun as well as not poking my eye inadvertently. I also have to be super vigilant about my nose running or drooling out of the affected side of my mouth, but again, it’s more to do with vanity than living with a handicap. Eating can occasionally be a challenge, especially when done in front of people. Overall, it is the ocular aspects of BP that are the most complicating long-term, with respect to protecting the eye from injury and blindness. All in all, it’s not terribly debilitating, it just makes me look funnier than I did before, when I had full function of my face.
OK, so what about the baseball slant?
Bell’s Palsy, in a nutshell. Thanks for playing along.
In ending, I’ve always prided myself on my slanted view of the world, especially baseball.
I guess my face is finally catching up with the rest of me.