I started residency slightly over two months ago. Although I have survived, my facial nerve has not. About three weeks ago, I woke up to find the right side of my face was paralyzed. I couldn’t smile, raise my eyebrow, blink, or puff up my cheeks… all on the right. I thought it quite unlikely I was having a stroke, which left me with Bell’s Palsy as the most likely explanation. At this point, I was juggling a couple of notions in my head.
…. Do I need to go get something prescriptions? There is no medicine that ‘cures’ Bell’s Palsy, but there are a few things that can shorten the length of time and/or improve the likelihood of recovery. Yes, I should get some prescriptions. But… it’s a Saturday, I don’t have a primary care doctor, … I’ll need to go to the ER. Nice timing on these new health benefits / insurance. When should I go? I can’t go now, because…
…. I still need to get to work. I’m still in the Neonatal ICU, and I’m supposed to show up in about 30 minutes. I can’t call in sick for this; I can still write, type, talk, and think… theoretically, that’s all I need to do my job… plus, this won’t go away any time soon, I might as well get used to working with it. I’ll go to the ER after I get off.
…. Why do I have Bell’s Palsy? I don’t remember any tick bites (thinking of Lyme disease). I don’t remember any abnormal ear pain or facial weakness when I was going to sleep last night. I haven’t mysteriously lost weight or anything else that makes me think there’s a tumor somewhere in my skull. I haven’t felt -that- stressed… ugh, if this is the first month of residency, am I going to be in a full-body cast by the end of next month?
So, I went to work. I stopped to get some coffee and a bagel on my way in, and I felt like a sad clown trying to eat it as I quickly found out the amount of lip and mouth dexterity needed to eat/drink anything. Anything more than a tiny sip was more likely to end up on my chin than my stomach (I’m going to need to start using straws.). Eating the bagel felt like trying to land a plane; unless I tactically angled it into my more capable left side of the mouth, it was more likely to crash and mash against my right lip and face (I’m going to be using forks a lot until this is over.). It wasn’t taking long to realize that looking and feeling awkward was but one of several tribulations I’d be facing.
I arrived at work. It went as smooth as work can go when it looks like you’re winking at everybody. A couple of hours later, I was sent to the ER by the other members of the team and told to take the day off. (Oh boy, my first visit to an ER as a patient.). When I told the front desk my complaint, I quickly had my vitals and blood sugar checked then was put in a wheelchair despite unimpaired walking. I was wheeled through the ER and past a variety of people who looked and I felt were in much more distress than I was. (They’re treating me like I’ve had a stroke.) I arrive in a trauma bay. An ER attending and a resident come in. He gives me a quick neurologic exam, then he looks at me and says to his team, “You’re not having a stroke. Let’s get you out of here, away from the gunshots and car crash victims.” His resident comes to the bedside while they prepare to move my bed. She introduces herself and tells me she’s a third-year resident. “I’ve been to this ER three times as a patient. Don’t be embarrassed!” … (Too late.)
It went pretty smooth after that. I had some blood drawn to check for Lyme (came back negative), got an EKG (also normal), got to monitor my own vital signs for a while and then was sent home with a couple prescriptions and a bag full of saline drops I could use to moisturize my eye.
Fast forward to now. The prescriptions are done. I haven’t seen any significant improvement, but it hasn’t gotten any worse. I’ve gotten a lot of support from my family, colleagues, and friends. It’s becoming easier to be lighthearted about, even though I’ve found the asymmetry gets really pronounced when laughing. I’ve gotten a lot of practice at smirking. Outside of the day I was sent home, I’ve been working as usual. I had a couple more days in the NICU before transitioning to the Pediatric ICU. The next couple of months will be a lot easier schedule-wise as I’ll be on Adolescent and Psychiatry (year 1 schedule) and I’m pretty excited to have two of the more heavy parts of the schedule behind me.
I’m hopeful it won’t be much longer before this palsy is behind me, too.