Author Topic: what are some PT exercises??  (Read 6370 times)

calimama

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what are some PT exercises??
« on: July 15, 2008, 08:38:43 pm »
I saw PT exercises mentioned in the post about how long it takes to get some facial movement.

I am wondering at what point it makes sense to start therapy (i am 6 weeks out from surgery) and if there are some examples out there of some exercises i can start until I can get a referral to someone.

Thanks!

tRISH
Left 2.9cm CP Angle AN discovered Jan 2008. Retrosig surgery June 2, 2008 Toronto, Canada. Facial paralysis and numbness, double vision (4th nerve), SSD. DV totally recovered in 4th month; palsy started to recover slowly around month 7. Had twin boys 13 months after surgery. Doing great.

saralynn143

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Re: what are some PT exercises??
« Reply #1 on: July 16, 2008, 06:02:45 am »
Trish, I am also six weeks out from surgery (microvascular decompression for hemifacial spasm, not ANA, but the results on the facial nerve are the same). My GP told me to massage the muscles of my face with my fingers, but most everything I've read here is to wait until you have seen a therapist to avoid causing unwanted movement. Therapy starts once there is movement, which may be four to six months down the road or longer. I have my first appointment at the Facial Nerve Center at Washington University in St. Louis in two weeks. If I learn more then I'll let you know.

Sara
MVD for hemifacial spasm 6/2/08
left side facial paresis
 12/100 facial function - 7/29/08
 46 - 11/25/08
 53 - 05/12/09
left side SSD approx. 4 weeks
 low-frequency hearing loss; 85% speech recognition 7/28/08
1.8 gram thin profile platinum eyelid weight 8/12/08
Fitted for scleral lens 5/9/13

Cheryl R

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Re: what are some PT exercises??
« Reply #2 on: July 16, 2008, 07:34:34 am »
Trish,   Nothing should be done until there is movement.    You can do some massage.      The muscles will not work until the facial nerve has healed enough to get them to work.   Facial muscles are not like muscles in the rest of the body and will not atrophy from lack of movement. 
Jackie Diels in most cases does not want to see pts until it is a year past surgery and by then there is a pretty good idea of what the nerve is doing.                 Other facial therapists do see pts much earlier.               No electrical stimulation should be done.                I know it is hard to just keep waiting.        I don't think some drs have a clue about this and what to tell patients.
         I have been thru it and well know waiting is not fun.
                                                   Cheryl R
Right mid fossa 11-01-01
  left tumor found 5-03,so have NF2
  trans lab for right facial nerve tumor
  with nerve graft 3-23-06
   CSF leak revision surgery 4-07-06
   left mid fossa 4-17-08
   near deaf on left before surgery
   with hearing much improved .
    Univ of Iowa for all care

Debbi

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Re: what are some PT exercises??
« Reply #3 on: July 16, 2008, 05:49:40 pm »
My neuro said to try to isolate the smallest movements (and believe me, small doesn't begin to descirbe my facial movements!).  He said to basically perform one small movement on my "good" side and then try to replicate it on my AN side.  So far, I've got a small muscle under my eye that will move - I can move it by trying to squint - and the muscle on my cheek next to the corner of my mouth (my Mona Lisa smile).  He stressed that I needed to really concentrate on small movements. 

I am also using a Z-Vibe which was recommended by the PT I saw.  In brief, it is a ballpoint-pen sized vibrator that I can use to gently massage my face and the inside of my cheeck and tongue.  My neuro wasn't sure that it would help, but he did say it wouldn't hurt.

I'm curious as to what else people are doing.

Debbi
Debbi - diagnosed March 4, 2008 
2.4 cm Right Side AN
Translab April 30, 2008 at NYU with Drs. Golfinos and Roland
SSD Right ear, Mild synkinesis and facial nerve damage
BAHA "installed" Feb 2011 by Dr. Cosetti @ NYU

http://debsanadventure.blogspot.com

calimama

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Re: what are some PT exercises??
« Reply #4 on: July 21, 2008, 09:17:41 am »
Thanks guys for this helpful info. I don't have movement yet, so will just patient. I will be seeing the surgeon on Aug 6, 2 moths post surgery so i will see what he says, and through that info the mix here.

hanging in there....

Trish
Left 2.9cm CP Angle AN discovered Jan 2008. Retrosig surgery June 2, 2008 Toronto, Canada. Facial paralysis and numbness, double vision (4th nerve), SSD. DV totally recovered in 4th month; palsy started to recover slowly around month 7. Had twin boys 13 months after surgery. Doing great.

saralynn143

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Re: what are some PT exercises??
« Reply #5 on: July 21, 2008, 10:02:40 am »
Trish, I just noticed we had our surgeries the exact same day. Mine was in Detroit. My husband and I spent an afternoon in Canada the weekend before, spending a little time in Windsor and visiting Fort Malden. It's always fascinating to me to read about history from a non-American viewpoint.

Anyway, I'll be interested in watching your progress, since it is on the same timeline as mine. I had several friends remark on how much better I looked this past weekend. I don't see much improvement, but that may be because I see my reflection every day so the change is not noticeable to me. I also saw my family for the first time yesterday, for my brother's 50th birthday. They all said I looked much better than they had expected.

Did you wake up with the facial paralysis? I did.

Sara
MVD for hemifacial spasm 6/2/08
left side facial paresis
 12/100 facial function - 7/29/08
 46 - 11/25/08
 53 - 05/12/09
left side SSD approx. 4 weeks
 low-frequency hearing loss; 85% speech recognition 7/28/08
1.8 gram thin profile platinum eyelid weight 8/12/08
Fitted for scleral lens 5/9/13

mimoore

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Re: what are some PT exercises??
« Reply #6 on: August 08, 2008, 03:59:53 pm »
Looks like the three of us are on the same timeline...how did your appointment go Trish?
Lets keep in touch.
Michelle  ;D
Retrosigmond surgery on June 4th, 2008 for an AN. 100% hearing loss and facial paralysis (was not prepared for facial paralysis). Size: 2.3 cm, 2.1 cm, 1.8 cm. some tumour remains along facial nerve. Pray for no regrowth. Misdiagnosed for 10 yrs.

LADavid

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Re: what are some PT exercises??
« Reply #7 on: August 08, 2008, 07:57:47 pm »
Hi Trish
I don't really know what the answer is to the exercise therapy.  I came across a list of exercises on the Bells Palsy website and I started doing them about 6 weeks post-op.  No one told me anything about the do's and don'ts.  I eventually got some movement but very soon after that developed synkinesis which is what I am stuck with today.  I believe the exaggerated excercises may have caused the synkinesis -- although no one will tell me for sure.  My advice -- approach facial exercising with extreme caution -- and get professional advice on it.

David
Right ear tinnitus w/80% hearing loss 1985.
Left ear 40% hearing loss 8/07.
1.5 CM Translab Rt ear.
Sort of quiet around here.
http://my.calendars.net/AN_Treatments

jazzfunkanne

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Re: what are some PT exercises??
« Reply #8 on: September 03, 2008, 09:33:42 am »
Hi all, no one has ever told me the rights and wrongs on facial exercises either, i am in scotland and i got referred to a physio at 1 month post op, at two months post op i got the loan of a facial machine , i agree i think these exercises to early can cause cross wiring of nerves. David what synkinesis do you have, my bottom eye lid moves when i smile.
« Last Edit: September 03, 2008, 09:35:34 am by jazzfunkanne »
over 4.5cm AN removed dec 06

Tamara

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Re: what are some PT exercises??
« Reply #9 on: September 03, 2008, 10:08:18 am »
I too was anxious to begin to "do something" to help my palsy.  I spoke with Jackie Diehls, widely regarded as an expert in facial therapy, and even though I'd been managing a Mona Lisa smile, she said it was way too early to even think about therapy.  I had my surgery June 12, and she said she'd see me at the end of the year if I hadn't made any further progress.  She also said to not push it, not "work" on exercising any parts I could move, even though my dr had advised this, and just let everything heal.  She made the analogy that you can't do therapy after a bone is broken;  you have to let it heal first.  Hard to hear for those of us not blessed with patience!

best wishes,
Tammy
7 mm AN left side
translab 6-12-08
postop issues including CSF leak, eye issues, and facial palsy.  All issues resolved at 9 mos. except slight facial palsy & weakness.  Continuing to improve...

jazzfunkanne

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Re: what are some PT exercises??
« Reply #10 on: September 04, 2008, 03:02:35 am »
Hi Tammy, wonder why there are so many different views, one clinic over here in the uk  say you should exercise soon after the op as  the muscles become weak and they should be exercised daily, i wish i had a magic wand with all the answers.
over 4.5cm AN removed dec 06

Tamara

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Re: what are some PT exercises??
« Reply #11 on: September 04, 2008, 05:45:58 am »
JFA -
  I agree that there are probably different views - heck, even my dr told me to practice moving the parts that I can.  I'm going to try to heed Jackie's advice though, since this is really her area of specialty.  I've actually progressed to having some teeth show when I smile, so I think there's been some progress.  The thing is, if I go see Jackie, I want it to be before the end of the year so that my insurance will pay for it in entirety.
  I saw earlier that you live in Scotland.  I've been there 3 times - love the country!  My husband (and therefore children) are part Scottish - we took our sons to visit in 2006.  Where do you live?

Tammy
7 mm AN left side
translab 6-12-08
postop issues including CSF leak, eye issues, and facial palsy.  All issues resolved at 9 mos. except slight facial palsy & weakness.  Continuing to improve...

jazzfunkanne

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Re: what are some PT exercises??
« Reply #12 on: September 04, 2008, 06:39:29 am »
Hi Tammy, is your husband scottish, i am from paisley near glasgow, where did you visit when you were here.x
over 4.5cm AN removed dec 06

Tamara

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Re: what are some PT exercises??
« Reply #13 on: September 04, 2008, 07:04:11 am »
JFA -
  My husband is partly of Scottish descent - not from Scotland - but we really enjoy all things Scottish.  My eldest son who is 16 even plays the bagpipes. On our last trip (with our boys) we rented a cottage outside of Stirling and took the train to Edinburgh for the Tattoo and Botanic Gardens and Castle, and to Glasgow (we went to the Piping Museum and the Tall Ship).  We went to Loch Lomond, and Doune Castle.  We visitied Stirling Castle and the Wallace Monument and went the the Highland Games in Bridge of Allen.  Then we drove up to Inverness and back down along Loch Ness into Kintyre, all the way to Southend, staying at various B&Bs, then back to Glasgow.  It was an absolutely fantastic trip!

Now I'm wishing I was traveling again.  We didn't get to vacation this year because we were paying medical bills for the AN surgery instead (sigh).  Guess I'll have to heat up my can of haggis and make some tablet  :)

Tammy
7 mm AN left side
translab 6-12-08
postop issues including CSF leak, eye issues, and facial palsy.  All issues resolved at 9 mos. except slight facial palsy & weakness.  Continuing to improve...

jazzfunkanne

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Re: what are some PT exercises??
« Reply #14 on: September 04, 2008, 07:43:42 am »
guess we have alot to be thankful for having the nhs over here, we go to loch lommond alot its only 1/2 drive from where i live, we manage to go to spain this year ibiza (the quite part lol) my sons are 14 and 10.
over 4.5cm AN removed dec 06