Diary of Bell's Palsy

| Before | Week One | Week Two | Week Three | Week Four | Week Five |
| Week Six | Week Seven | Week Eight | Week Nine | Week Ten |
|Week Eleven | Week Twelve | |Week Thirteen |Week Fourteen
| Week Fifteen | Week Sixteen | Week Seventeen |

There are few accounts of the day-to-day course of Bell's Palsy, Bill Rishsew has one and it has been a great comfort to me to hear his story of this annoying affliction. I hope I can be as much help to others as Bill's account has been to me. At the right is my picture taken on Jan 3, 1998. My droopy smile shows how Bell's Palsy has affected the left side of my face. At this time I was just beginning to feel some improvement.

Important! If you are reading this and think you have Bell's Palsy, but have not been diagnosed by a physician, turn off your computer - Go to the Emergency Room Immediately! Although Bell's Palsy is not a life threatening ailment, there are some major diseases which have similar symptoms. Furthermore, the few treatments and prescription drugs available for Bell's Palsy work best when taken as soon as possible. Nothing in the following account should be construed as medical advice.

By the way, it has been almost 2 years since I first developed symptoms of BP. I still have some residual paralysis and tinnitus, however I hardly think about this anymore and am surprised when a friend asks me about my face. Keep a positive attitude, this does go away!


Day (-1) Friday November 21. I am a 48 year old man, I am a traveling salesman, selling laboratory instruments to chemists throughout the country and world. I am happily married to Tris and have no children. I am in good health, although somewhat overweight, but no major health problems. I hike, jog, workout and play racquetball regularly. Today I played racquetball. On one backhand shot I missed the ball and pulled something in my ear. It hurt moderately for several hours and went away. I should also mention that last week I had some dental work on the left side of my face and the week before I had a bad cold which settled in my lungs. Thursday evening I drove from San Diego home to Northern California. I have supporting evidence for all the Bell's Palsy risk anecdotes.

Week One

Day 0: Saturday, November 22: Left side of my face was feeling strange. I ran my 10K in the AM. I think I might have traumatized something in my ear from racquetball last night. Tris, my wife is worried tells me to go to the hospital. I tell her I am OK and I'll wait until tomorrow morning if not better. We went to our usual movie in the Afternoon, I am having trouble seeing out of my eye because I can't blink my eye. The sound from the movie is funny and I hold my eye closed mostly with my finger.

I finally acquiesce and go to the ER, this means I am really frightened because I hate hospitals, but I am worried that I have a stroke. They diagnose Bell's Palsy, because I have facial paralysis and cannot lift my left eyebrow. Doctor prescribes prednisone and I take pills that evening about 10 PM. The nurse at the ER tapes my eye shut and gives me a roll of tape. I do some internet searches for Bell's and find some interesting sites. Slept with eye taped, uncomfortable and itchy.

Day 1: Sunday November 23. I take three prednisone in the AM with milk to aid in absorption. I am trying to adjust to a very irritated eye and I am very depressed because the prognosis is that this takes a minimum of several weeks to get better and a few people don't recover. I worry about work because there is a lot of stress and I have appointments to cancel. I am also worried about how I am going to drive and how to meet my goals at work. I am worried. One tip I got from the internet is to cover the eye with plastic. I wedge a plastic produce bag between my glasses and the eye. If I keep a small amount of space between the plastic and eye then this is reasonably comfortable. Taping the eye does not work when I am awake.

Day 2: Monday November 24. I take three prednisone in the AM. I drive to work holding my eye closed unless I need to judge distances. Fortunately, my work is only a few miles away, but rush hour driving is very intense. The plastic bag works well, but I look ridiculous. I cancel my appointments, maybe next week will be OK. I need to call on a customer who is having a minor problem. As a salesman how can I be enthusiastic with only one-half of a smile? I tell my customer and he is sympathetic. Life goes on. I go to my Doctor who confirms the diagnosis and reconfirms the bad news. He gives me a note for work. He tells me that the clinic sees about four patients per year with Bell's for a total of about 16 in the last 4 years. All of them have gotten better, but it may take two weeks before I see some sign of improvement. Encouraging and distressing at the same time. I tape my eye shut at night and still use plastic over the eye during the day.

Day 3: Tuesday, November 25. Cut down to 2 prednisone today as per Dr.'s orders. My eye is still very irritated. I discover a diary on the internet from Bill Rishsew who lives in Idaho. This is comforting because I can see the course of his condition and it is good to know that this does get better.

I know now that BP although rare is not uncommon. It seems that everybody knows someone who has had BP. (How many people do you know that have won the lottery?)

Day 4: Wednesday, November 26. Two prednisone this morning. No real change or improvement. I talk funny, mumbling and my face is not drooping much. I need to do facial exercises. Am I doing enough medically to take care of this condition? Acupuncture, antivirals, homeopathy? No one knows! BP does get better by itself. I read about herpes simplex virus as a possible cause of BP. A small study showed that 11 of 14 patients had traces of HSV in a clinical sample. This study is small and after some internet research however this does not seem very significant, because 80% of the general population have HSV present. Another blinded study shows some significant long term results with an antiviral drug and prednisone 92% v. 76% with prednisone alone. Therapy prednisone or antiviral must begin on the first day to have any significant effect. I did get prednisone immediately so I am crossing my fingers.

I do think Bell's Palsy is due to a combination of stresses including - trauma, a cold, heavy work schedule and dental work. I have had all of these in the last three weeks. I am winding down my stress level. It is the day before Thanksgiving and I have some relief with the holiday.

Day 5: Thursday. November 27. Two more prednisone today. My spirits are up I will cook a turkey. My eye is less irritated, however I continue to put plastic over my eye to keep it from drying out. I often use artificial tears and lacrilube to protect my eye.

Cooked turkey dinner. I am using plastic bubble pack between my eyes and glasses. Works well. I am also beginning to develop a more positive mental attitude. This is the key to dealing with BP. Compared to people who have permanent paralysis or cerebral palsy or AIDS or teminal cancer this is a walk in the park.

I got an e-mail from Bill Rishsew, who urged me to keep a diary. I think I will do so.

Day 6: Friday, November 28. Cut down to one prednisone this morning. No signs of improvement. Driving is easier, but I get a little dizzy walking because I cover my one eye with plastic most of the time. I plan to run today. Ran 5 miles instead of six, it is extra work to keep my balance. My eye is very irritated this evening and I go to bed early.

Day 7: Saturday, November 29. One prednisone this AM. It is hard to tell, but I might be improved today, but I can not quantify the improvement, except that my lips and tongue don't feel as strange as before. The side of my face is aching, where the nerve is - I hope this is a good sign. I worked out this morning - used the plastic to protect my eye. The sweat and moisture soothes. The clerk at the club tells me that his aunt in Texas has BP, started a couple of weeks ago.

Week Two

Day 8 Sunday, November 30: One prednisone this AM. No improvement. I think my body is fighting something in my middle ear. I am very careful with my eye, taping it shut at night and covering with plastic as much as possible.

Day 9: Monday, December 1. One prednisone in the AM. No improvement on my face. However, today at work my attitude made a 180 reversal. Having reluctantly gone in so that I could just get back on track, I found some tricks to help compensate. I cut some smaller pieces from a thick plastic freezer bag, which sticks to my face and protects my eyes by holding in the moisture. This doesn't look as bad and I can almost see through the plastic clearly. When I answer the telephone, I hold my cheek to my face with my hand to keep from blubbering my B's and P's. Most importantly, I settled my appointments this week in San Diego and have a good sales plan, which includes a follow-up sales call. Day went from 2 out of 10 to 9 out of ten!

Day 10: Tuesday, December 2: One Prednisone in the AM. No muscle improvement on my face. The only quantifiable improvement is that the metal taste in my mouth is going away. I still have something going on in my ear. I have a few shooting pains in my ear when I go to sleep and I think I have a sore in my ear canal. I think this may be Ramsay-Hunt which is related to chicken pox/shingles. I will talk to the Doctor.

I think that I am 80% compensated for Bell's with the plastic eye covering. I will be able to wait this out. Tomorrow I fly to San Diego. Wish me luck!

Day 11: Wednesday, December 3: Last Prednisone. No obvious facial improvement. However, my tongue does not have the metal taste and my lips have a little tone. I can hold mouthwash in my mouth better than last week. I cannot tell changes day-to-day, however I am better than last week.

My trip was OK, accomplished what I set out. I uncovered my eyes during my sales presentation and had no problem, adrenalin I think. I hold the side of my face to enunciate my Bs and Ps. Nobody seems to notice, unless I tell them. I am convinced that this Bell's is associated with Ramsay Hunt syndrome and will see the Dr next week.

Day 12: Thursday, December 4: No obvious facial improvement. I visited my Doctor and he referred me to an otolaryngologist. Neither doctor found any evidence for Ramsay Hunt Syndrome, which is a relief. The EENT did a hearing test and both ears were normal. This eliminated the possibility of nerve compression. My ear symptoms are probably due to the severity of the Bell's.

Both doctors liked the idea of the plastic eye cover and did not recommend stopping. I continue to tape my eye shut at night.

Day 13: Friday, December 5: No obvious facial improvement. No more funny tastes. My left lip seems to work better when I eat. Normal day at work. I will crank up the heat for work next week.

Day 14, Saturday December 6: No obvious improvement. This is two weeks now, still impatiently waiting. I went to Tris' Christmas party. The disco music is painfully loud. There is an associated nerve which protects the ear from loud, high-pitched sounds, like female disco singers. Tris' and I left the party early.

Week Three

Day 15, Sunday December 7: A tiny amount of movement with my left eyebrow. I can close my left eye with less trouble than before. I am grateful for these very small improvements. I ran my 10K in the rain. I didn't need to cover my eye because the air is so damp.

Day 16: Monday, December 8: Imperceptibly better, my ear discomfort is nearly gone. No ringing. I can wiggle my eyelid slightly. My mind is now back to work, thank goodness and I can compensate for most of the symptoms. Patience, patience!

Day 17: Tuesday, December 9: I cannot detect any day-to-day differences, which is very frustrating. I can tell that I am better than last week. There is a tiny amount of movement in my eyebrow, my tongue feels mostly normal and the pains and discomfort in my ear has subsided. Very good day at work. Getting into the year-end push for sales.

Day 18: Wednesday, December 10: Same as yesterday, no obvious improvement. I drove farther today than before. Tomorrrow I travel to SoCal to finish business. I don't think about Bell's very much during the day as I am preoccupied with work.

Day 19: Thursday, December 11: No obvious improvement in my face. I still sometimes have ringing in my ears, but I think it is worse when I am tired or have had some wine. I continue to adapt to this condition. I flew back to San Diego to finish last weeks work and make a sales call in Irvine. Drove more than ever and mostly without the plastic cover. It was very windy but my eye is getting used to the irritation.

Day 20: Friday, December 12: No obvious improvement. I was very happy to resume racquetball. Felt slightly off balance the whole set, but I did win one game out of three. This is a significant piece of my life that I have recovered.

Day 21: Saturday, December 13: No facial improvement. Happy Birthday!: 49 Years Today. Guess what I wished for when I (half) blew out the candles? Tris took me to Al JazzBeaux Collins Memorial Count Basie Benefit. It was great, but I had to put my finger in my left ear to soften the loudness of the brass music. There is a nerve to the inner ear that dampens loud noises.

Week Four

Day 22: Sunday December 14: No improvement yet. I go to the Doctor tomorrow. I am sure he will tell me the same... Patience!

Day 23: Monday, December 15: No facial improvement. Doctor confirms - no improvement. Just wait. I will see him in January again. Ringing and discomfort in the ear has fully subsided.

Just a note about eye care. (1) I cover my eye during the day with Saran wrap or clear plastic squares that I cut from Ziploc bags. I can see fairly well through these and it keeps my eye from getting irritated. Please note that I do not let the plastic touch my eye. I also remove it about once per hour to allow moisture to evaporate from the plastic surface. (2) At night I tape my eye shut with Transpore(tm) 3M tape. (3) I use artificial tears whenever my eye is tired or dry. Usually I need these drops only about once a day. I have also found that if I am doing vigorous exercise I do not notice any irritation from my eye.

Day 24: Tuesday, December 16: No facial improvement. Routine day. Got an e-mail from a surgeon who suggests implanting a gold weight in my eyelid until the Bell's resolves itself. I'll think about it next year.

Day 25: Wednesday, December 17: No facial improvement. I am too busy to think about BP.

Day 26: Thursday, December 18: No facial improvement. We had our office Christmas party. I only notice my face when I laugh.

Day 27: Friday, December 19: No facial improvement. I keep forgetting that I have this plastic on my eye and I have to remind myself to explain what this is about to new people I meet.

Day 28: Saturday, December 20: No facial improvement. Occasionally I feel some twitches on my face. A good sign?

Week Five

Day 29: Sunday December 21: Oh Frabjous Day! I can make some conscious movements, although very small. I can twitch my left lip in a tiny smile. I have some movement under my eye. Some of these movenments are not independent of the right side of my face. I am very grateful for the smallest measure of improvement. The end of this is now in sight, although maybe six months away.

Today is the winter solstice. Every day for the next six months will be sunnier and sunnier. The weather is a Northern California dream - brilliant, sunny skies, temperature is about 50F. My attitude reflects the weather - brilliant.

Day 30: Monday, December 22: Tiny amount of improvement. Absolutely elated about the movement.

Day 31: Tuesday, December 23: Slightly more movement in my face. Progress is measured in millimeters, but progress indeed!

Day 32: Wednesday, December 24: Gradual Improvement.

Day 33: Thursday, December 25: Merry Christmas and Happy Holidays Everyone! I notice that my face, like the other muscles in the body, does not work as well when I wake, however over the day I improve and slightly exceed the previous days' movement. Improvement is very gradual and I see that at this rate this will take several months to improve.

Day 34: Friday, December 26: Gradual Improvement. More improvement in my eyebrow than my lips.

Day 35:Saturday, December 27: About the same as yesterday. Seems to be more movement after my workput.

Week Six

Day 36: Sunday December 28: Tiny, tiny improvement. I still tape my eye at night and use clear plastic over my eye. I can sometimes go for an hour or more without the plastic but my eye is pretty irritated without the cover.

Day 37: Monday, December 29: More of my face can move, but this is still very slow progress. I am getting ready to go back East to visit my parents, who are having a fiftieth wedding anniversary. I may be late in updating this for the next week.

Day 38: Tuesday, December 30: I can move my face just a little more. Packing for Chicago, I must not forget the tape and eyedrops. I will update next week. Happy New Year!

Day 39: Wednesday, December 31: Tris and I had a routine flight. Still very gradual improvement.

Day 40: Thursday, January 1, 1998: Gradual improvement. Happy New Year!

Day 41: Friday, January 2: More improvement in my eyebrow.

Day 42: Saturday,January 3: Happy New Year! We had a family photograph. I definitely look strange.

Week Seven

Day 43: Sunday, January 4: My parent's 50th wedding anniversary. I decided not to use the plastic eye cover and not bring attention to BP during their party and ceremony.

Day 44: Monday, January 5: More flexing to my cheek. My eyebrow is about halfway normal

Day 45: Tuesday, January 6: Still very gradual improvement. Definitely better than last week.

Day 46: Wednesday, January 7: Little improvement.

Day 47: Thursday, January 8: This is like watching grass grow.

Day 48: Friday, January 9: A very boring diary. By the way, there is a neurology web forum sponsored by the Neurology Dept. at Massachusetts General Hospital. I recommend following this newsgroup. I read it almost every day.

Day 49: Saturday, January 10: A family party. I left the plastic off of my eye for three hours without a serious problem.

Week Eight

Day 50: Sunday, January 11: I will give an eight week evaluation in more detail below.

Eighth Week Status of Left Facial Palsy
Function % Comment
General 10-20% No more pain in my ear, no equilibrium (dizziness) problems. Occassional tinnitus, no reflex blink, however the eye is less sensitive to drying. I can go as long as 1-3 hours without eye protection. My eyelid is taped shut every night. I am fully functional and have found ways to adapt to this annoyance. I anticipate that this will take another few months for significant recovery.
Eyebrow 40% Most recovery. Can raise eyebrow voluntarily. Forehead lines beginning to return.
Eye Blink 0% No Reflex Blink. Eyelid is taped shut at night. Clear plastic squares (Saranwrap) cover the eye during driving and work activities. I leave it uncovered during exercise and social activities (I am sick of talking about this).
Eyelid 30% I can sometimes (60% of the time) voluntarily close my eyelid when the right eye is closed. I cannot wink with the left eyelid.
Taste 80% Metal taste has gone. Salt crystals, when placed on both side of my tongue, give nearly same level of salty taste.
Cheek 10% No smile yet, but there is some muscle tone. I can flex and twitch the cheek voluntarily. Some facial lines are returning. I can make a dimple in my cheek.
Lower Lip 0% No movement, but sometimes the muscle under my lip cramps in the morning.
Salivary 90%? No dry mouth. Definite secretion of saliva from the left side of my mouth.
Hearing 60%? My ears are much less sensitive to loud and high pitched noises. Like the taste sense, I don't know if I have adapted or the nerve function has returned.

Day 51: Monday, January 12: Visited Doctor today. He confirms that there is motion which I attribute to recovery. Nice to have confirmation.

Day 52: Tuesday, January 13: Just Waiting. I had a cramp on the muscle under my lower lip. Some muscle wants to work.

Day 53:Wednesday, January 14: Had a big business dinner meeting. Resisted the impulse to tell my business associates about BP. It is hard to project my voice in a noisy restaurant.

Day 54: Thursday, January 15: Same as before, just waiting.

Day 55: Friday, January 16: I read a posting that heat helps nerve regeneration. I agree. If I leave the heater in my car on high, I can feel twitching and tingling in my face.

Day 56: Saturday, January 17: Off to a tradeshow. Will update next week.

Week Nine

Day 57: Sunday, January 18: Drove I-5 to San Diego. Stopped outside of LA last night. If I put the car heater on High with Full Fan on my cheek, I can feel tingling in my lips and these muscles twitch a little. When the heat is off, the tingling goes away. I did this several times on my drive. I think it might have helped my recovery.

Day 58: Monday, January 19: Several hours at the Lab Automation 98 Conference without eye protection. Sometimes I have to hold my cheek to talk to customers.

This is a fascinating scientific and technology meeting on high throughput technology which is being adopted and developed for the biopharmaceutical industry. Most people don't realize that the revolution that started about twenty years ago in biotechnology is going to pay off in the next few years. The completion of the Human Genome Project by the year 2005 will dramatically and fundamentally change the way we live. High throughput technology will result in many billion dollar pharmaceuticals that will make the pharmaceutical industry very, very rich. I predict that within 3 -5 years most cancers will be cured with a drug or gene therapy which will be dramatically less toxic and more effective than the chemo or radiation therapies common today.

On the down side, I don't think that BP will be addressed for several decades. That is because nerves are such specialized and complex structures and BP is not a life threatening disease . The pharmaceutical companies can not make a lot of money on BP therapeutics.

Day 59: Tuesday, January 20: I can feel more movement in my cheek.

Day 60: Wednesday, January 21: Drove home during the day. This is about a nine hour drive. The plastic cover makes this possible.

Day 61: Thursday, January 22: My friends can observe an improvement in my face. They tell me that my eyebrow doesn't droop like it did and I can show them more movement in my cheeks. If improvement continues at this rate I think I will be nearly normal in 2 months.

Day 62: Friday, January 23: Improvement varies during the day. It is easier to close my left eye and I go without eye protection longer.

Day 63: Saturday, January 24: This past week has shown the greatest increment of improvement.

Week Ten

Day 64: Sunday, January 25: I ran for the first time in several weeeks. I had some tinnitus after the run. Puzzling?

Day 65: Monday, January 26: Tinnitus gone. I can see more of my left cheek when I exercise (three spelling errors in "excersize")

Day 66:Tuesday, January 27: No progress. In fact seems as if there is less movement in my cheek than yesterday.

Day 67: Wednesday, January 28: One step back, two steps forward. Today I feel my whole cheek flex and there is more motion than yesterday or the day before. Progress is accelerating. Tinnitus back, however.

Day 68:Thursday, January 29: About the same as yesterday.

Day 69: Friday, January 30: Not quite as much movement as Wednesday. Progress for BP is not linear

Day 70: Saturday, January 31: I can close my eye much easier now and I can leave the plastic off of my eye more.

Week Eleven

Day 71: Sunday, February 1: I continue to massage my face and tape my eye shut at night. My sister ent me the family photo taken during my parents' wedding anniversary this past month. I do not like my picture. I will try to scan it and put onto this page.

Day 72: Monday, February 2: Happy Groundhog Day. About the same condition as yesterday.

Day 73: Tuesday, February 3: Not much change. I use a heated back massager on my face.

Day 74: Wednesday, February 4: A little more face movement.

Day 75: Thursday, February 5: About same as yesterday.

Day 76: Friday, February 6: A little more face movement.

Day 77: Saturday, February 7: Worked out this AM. More movement in my cheek.

Week Twelve

Day 78: Sunday, February 8: A twelve week status. Eyebrow at about 70% recovery. Cheek is at 30%; I can pull my left lip up slightly to form a slight smile. Food does not get stuck inside my lip as much and I can drink fluids much more easily. I cannot whistle and I can not blink involuntarily. I can close my eye lid voluntarily about 80% of the day. I look less droopy. Occasional tinnitus. At this rate of recovery it will take about 1-2 months more to be 90% normal.

Day 79: Monday, February 9: Routine day, little change, still tape eyes at night.

Day 80: Tuesday, February 10: Getting more movement in cheeks.

Day 81: Wednesday, February 11: I can make a small smile on my left side.

Day 82: Thursday, February 12: Continued incremental improvement.

Day 83: Friday, February 13: Best movement in my cheek so far.

Day 84: Saturday, February 14: Continued incremental improvement. Coming up to 3 months. Brandon at the club told me his aunt recovered in one month this past fall.

Week Thirteen

Day 85: Sunday, February 15: I am getting behind in this diary and each day is not significant in results, so I will continue entering my BP results every week.

Week Fourteen

Day 85: Sunday, February 15: I am getting behind in this diary and each day is not significant in results, so I will continue entering my BP results every week.

Week Fifteen

Day 92: Sunday, February 22: I have started a new job this week. I am not really paying much attention to the BP. I can blink my eye when I concentrate. This helps because when it is irritated I will close the eye for several seconds and it becomes less irritated. I still tape my eye shut at night.

Week Sixteen

Day 99: Sunday, March 1: I attended a large tradeshow in New Orleans. I did not use plastic during the meeting or during social dinners during the evening. My eye became a little irritated during the late afternoon when I was tired, but wit a little rest it was fine. Only people who already knewthat I had BP asked me about my condition.

However, one of my colleagues, who did not know about my BP, asked me what was wrong with my face. I explained that I had Bell's. He told me that many years ago in China his father also suffered with facial paralysis. He was ostensibly cured quickly with some herbal packs that were applied to his face for two days. The treatment was proprietary to another family, who had over the centuries become professional herbal healers. The story is interesting because the "cure" was a secret family treatment and his father could not be left unattended, because they were afraid that this secret would be stolen. I wonder....?

Week Seventeen

Day 106: Sunday, March 8: Visited the ENT on Monday. He told me that I have about 25% recovery in my cheek. I think he is underestimating my progress. I think I am 35-40% recovered.

| Before | Week One | Week Two | Week Three | Week Four | Week Five |
| Week Six | Week Seven | Week Eight | Week Nine | Week Ten |
|Week Eleven | Week Twelve |Week Twelve |Week Thirteen | Week Fourteen
| Week Fifteen | Week Sixteen | Week Seventeen |

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Note: I travel sometimes and I may be late to update this page, but please be patient.