June 9, 2016, Thursday, started out like any other day. As I put on makeup that morning I mapped out my day. Which work assignment do I begin with? Which colleague will most likely pester me with rush work today? Will I do well in my practice Japanese listening test this afternoon? Will it be a good day? Where shall my husband and I go for dinner? As usual, I dropped by Starbucks to get my soy cappuccino to wake me up properly. When I got to the office, I almost immediately began typing away on my computer.
That normal day began to take a different shape around lunchtime. It started with a small discomfort in my left eye, as if there was a grain of sand lodged in it. I attributed it to my contact lens drying up and reached for an eye drop.
As the afternoon progressed towards evening, that discomfort worsened to an inability to close that left eye. This was accompanied by a throbbing pain emanating from my left molar, which spread to my ear and the back of my head. My ear lobe felt like I’ve been wearing a clip on earring that’s too tight for several hours. Because I’ve had a problem with my left molar and chronic sinusitis, I thought that either my tooth or my sinuses, or both, were acting up again.
That evening, I had dinner with my husband and was able to eat properly, no drooling, no spitting of wine or soup, and no problem in chewing and swallowing. I did start to feel a difference in my lips; the right side of my lips felt thicker than the left side. But I saw no reason for alarm. I spoke normally, I had no numbness or pain anywhere on my left shoulder, arm or leg, and I could feel my face. Hence, my husband and I ruled out a stroke. I went to bed hoping things would better in the morning.
My symptoms did not disappear come Friday morning. In fact, they had intensified. The left side of my face had become swollen overnight, I couldn’t flare my left nostril, and the difference in my lips became more pronounced.
I got in touch with my GP who immediately scheduled me in. My GP asked me questions, checked my vitals, asked me to make various movements with my face, and gave me other tests. His diagnosis? Bell’s palsy, a form of temporary facial paralysis. He immediately referred me to a specialist. My GP emphasized the importance of seeing the specialist and starting treatment immediately.
The specialist saw me on short notice. After a few more tests, he confirmed my GP’s diagnosis. I have Bell’s palsy.
The specialist and I discussed treatments. Apparently, the most popular course of treatment is steroids. But because steroids have strong side effects, including hyperglycemia, I would have to be closely monitored in the hospital during the entire treatment of at least one week, more so because I’m diabetic. After talking about the pros and cons of available treatments, we decided not to go the steroids way (which I could still opt for if I change my mind a couple of days later). The doctor, however, echoed my GP’s directive to start treatment immediately. He stressed several times during consultation that I must take the meds as soon as I receive them from the pharmacy and to take them strictly as instructed until I see him again next week.
When I reached home, I did a quick search on Bell’s palsy. I have learned a lot which I shan’t repeat here since the medical sites online can do a much better job. But I learned that among those susceptible to Bell’s palsy are people with diabetes, people between 15 and 45, people with upper respiratory infections or compromised immune systems, and pregnant women. Of course, the word diabetes jumped out of my computer screen. Here is another possible complication or risk to which diabetics are exposed.
Why are we vulnerable? From the materials available, it could be because diabetes can damage the nerves (neuropathy), and Bell’s palsy involves the facial nerve. My condition could be due to a virus or a complication of diabetes (something called diabetic mononeuropathy, which involves only one nerve or nerve group).
According to a study, there seems to be a relationship between the severity of Bell’s palsy and abnormal HbA1c value (6.5% or higher) but the prognosis of diabetics does not seem to be worse than nondiabetic patients (http://www.jabfm.org/content/25/6/819.full). Good glycemic control is important in both prevention and treatment.
I could speculate until the sun burns out as to why I was struck with Bell’s palsy and never get an answer. So, I’m not going there. What I do know is that Bell’s palsy can be treated and I can recover from it. Despite the extreme possibility of lasting facial asymmetry, most patients recover well. The good news is that diabetes does not worsen my road to recovery.
In the meantime, I have to accept this and live with my new albeit temporary face. The difference in my face is massive, although my husband says it’s not as much as I make it out to be. I know, he’s being kind and supportive (and I’m so grateful for that). But the fact remains that I now grimace when I try to smile.
(Pardon the unkempt hair in the photos taken today.)
I don’t know how I’ll deal with this. Only yesterday, outside our apartment, we bumped into a young girl who lives in the same building. I was very conscious of how I must have looked when I smiled.
When I woke up this morning, I had to force myself to look in the mirror and see my face. I know what it’s like to look in the mirror and ignore what I see. More than a decade ago, I had to exert extra effort to accept and feel comfortable with the face, the body, the person staring back at me in the mirror. Now, after all these years, I am tempted to withdraw that acceptance. I want to reject the misshapen face scowling back. That face is not me. Or is it?