Author Topic: facial paralysis  (Read 10597 times)

Karen

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facial paralysis
« on: January 26, 2007, 06:08:33 pm »
Do any of you with facial paralysis find that some times your face feels worse than others?  My trigeminal was effected so I have nofeeling, just the feeling like I have been to the dentist.  Anything to help?  I am going to Jackie Diels for facial therapy and am doing massages and some heat at night. 
Karen
     Surgery 12-17-03, nerve graft 1-04, 3.5 cm, facial paralysis, numbness and no hearing in left ear

amymeri

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Re: facial paralysis
« Reply #1 on: January 27, 2007, 07:36:18 am »
I have a similar situation with numbness in my cheek, chin, and the right side of my mouth and tongue.  I get some shooting/zapping sensations in these areas but the numbness has not abated.  Initially the right side of my face...top to bottom and my scalp...was numb but the forehead and scalp came  back in a month or so.  No luck with the rest, though.

My paralysis and synkinesis is pretty bad, also.  My nerve is mostly intact but so hypertonic that my face is basically frozen in a grimace.

I started facial stretches and exercises in November and Botox 3 weeks ago and I am slowly seeing a few changes.

I find that cold weather makes my face much worse and there are some days it is tighter and much more uncomfortable, like I have been punched in the face.

Amy

4 cm right AN removed restrosigmoid 4/13/06
Partial facial paralysis, SSD and trigeminal numbness for now

nancyann

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Re: facial paralysis
« Reply #2 on: January 27, 2007, 08:01:29 am »
Hi guys:
The only change I've noticed is a kind of 'tightening', almost like a clenching feeling just in front of my ear.
Still have total facial paralysis, right side;  hoping for some movement maybe in a year or so.
Since I have no movement, I haven't started any facial exercises.  I only massage the right side.
Incision site still feels numb.

This is really a bummer - 7 months with the facial paralysis,  I'm tired of it already, know what I mean ???
It just gets me so down sometimes ......
2.2cm length x 1.7cm width x 1.3cm  depth
retrosigmoid 6/19/06
Gold weight 7/19/06, removed 3/07
lateral tarsel strip X3
T3 procedure 11/20/07
1.6 Gm platinum weight 7/10/08
lateral canthal sling 11/14/08
Jones tube insert right inner eye 2/27/09
2.4 Gm. Platinum chain 2017
right facial paralysis

NH Karen

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Re: facial paralysis
« Reply #3 on: March 17, 2007, 09:45:41 am »
I continue to have paralysis on the Rside and my physicians do not feel that massage or exercises would be of any significance one way or the other.  As I am now 3 years post-op I am interested in learning more.

nancyann

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Re: facial paralysis
« Reply #4 on: March 17, 2007, 05:16:33 pm »
Hi Karen R, nice to meet you:   My doc also told me excercises won't be helpful until there is movement.
                                            Have you had any EMGs done post op to check for nerve generation ?
                                            Also, ask your doc about the 12/7 jump, AKA hypoglossianastamosis - they attach part of
                                            the tongue nerve to the facial nerve (they take a nerve from another area, neck, thigh, etc. to
                                            attach the tongue nerve to the facial nerve).
                                            I plan on having the 12/7 jump if I don't continue to show nerve generation.
                                            I hope your docs have told you about these procedures to help with facial reanimation.
                                            There are also other procedures that can be done to reanimate the face, but usually the 12/7
                                            jump is done 1st because if it takes there probably won't be any need for other surgeries.
Write back Karen for any other concerns, etc.   There are several of us here dealing with paralysis.   I knew NOTHING until I hooked up
                                            with these great folks.    Take care,  Nancy




                                       
2.2cm length x 1.7cm width x 1.3cm  depth
retrosigmoid 6/19/06
Gold weight 7/19/06, removed 3/07
lateral tarsel strip X3
T3 procedure 11/20/07
1.6 Gm platinum weight 7/10/08
lateral canthal sling 11/14/08
Jones tube insert right inner eye 2/27/09
2.4 Gm. Platinum chain 2017
right facial paralysis

ppearl214

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Re: facial paralysis
« Reply #5 on: March 19, 2007, 06:21:05 am »
I continue to have paralysis on the Rside and my physicians do not feel that massage or exercises would be of any significance one way or the other.  As I am now 3 years post-op I am interested in learning more.

Hi Karen and welcome. Where in the "granite state" are you? Many of us from the immediate NE area (I'm just outside of Boston).  Who has been your treatment team/where?  Many here locally may be able to chime in with dr recommendations for follow up as many locally have had microsurgery on their AN's.

Again, welcome :)
Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

kate

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Re: facial paralysis
« Reply #6 on: March 21, 2007, 12:50:46 am »
Hi NH Karen,

Have you seen any doctors about your 3yrs. post-op paralysis? I am going on 7 yrs. and for now am living with it quite well, as I am used to it and it really does not define who I am.  though I am not necessarily recommending that approach to others. I was told at the 2 year mark to have the 12/7 graft. However, it did not make sense to me, since the best to be hoped for was an improvement up the house scale by 2grades, which in my case whould not have been a lot of improvement. Also, a neurotologist at UCLA recommended NOT having the nerve cut, since the nerve is still intact. He recommended what was at the time called National Centers for Facial Paralysis. I did not pursue that, since it was controversial, and not recommended by the other leading therapists in the field, such as Jacky Diels. I did have a couple years of facial therapy which somewhat improved "facial posture", and it is more relaxed looking most of the time, except when really tired or stressed out, once in a while. In the future I may pursue the National Centers (which has been recently reoraganized under a new name) since there really isn't anything to at this point. But most of the time, it just isn't a big issue for me anymore.  Good luck.  Kate
Surgery 5-1-2000,  3.9cm, Huntington Memorial Hospital, Pasadena, California. 
Gold weight first couple of years.
Palbebral eyelid spring 2004 by Dr. Robert Levine "saved my life."
 I  have been enjoying life a lot, even with a crooked face and one sided hearing.

kate

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Re: facial paralysis
« Reply #7 on: March 29, 2007, 06:09:43 pm »
Nancy,

I know how you feel, 7 months and still having parlaysis. I am now going on 7 years. I am actually used to it now and it is not having that bad an effect on my life. The early days were the worse, and back then I got a lot of support from people on this board who had been living with it longer than me at the time.

The reasons for why it has been 7 years are in my earlier post to Karen on this thread.

If you ever have any questions or want ideas on coping with it,  just let me know and will be happy to post ideas here. I do hope yours clears up soon, or responds to physical therapy when it is time to start that.

Kate
Surgery 5-1-2000,  3.9cm, Huntington Memorial Hospital, Pasadena, California. 
Gold weight first couple of years.
Palbebral eyelid spring 2004 by Dr. Robert Levine "saved my life."
 I  have been enjoying life a lot, even with a crooked face and one sided hearing.

nancyann

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Re: facial paralysis
« Reply #8 on: March 29, 2007, 06:30:55 pm »
Hi Kate:  Thank you so much for your post.   I do have a question (well, several, but...),  Since my Brackman 'score' is a 6 (in this case higher is NOT better !),
             was/is yours also a 6, total paralysis?  & if so, what kind of facial exercises/therapy CAN you do ?
             Also, my eye really is an issue, especially since I had to have the gold weight removed & am waiting till the lid heals before it gets replaced with a platinum
             weight,  what do you do for eye comfort ?   I am frequently putting in lubricant (drops aren't strong enough, don't seem to last but a few minutes).
             And (see, told you I have a few questions !), do you have any problems with taste, or lack of, & also this awful metallic taste ?   
             Also, does your cheek feel like it's right up against your teeth ?
             I've gotten real good at not biting my lips while eating, it was pretty bad in the beginning, one or the other was always bit into & bleeding, to the point of
             dreading food,  & I'M ITALIAN !!!!   Food use to be such a joy....
Hope all these questions aren't too overwhelming, would love your input..   
Thank you my friend,  Nancy
2.2cm length x 1.7cm width x 1.3cm  depth
retrosigmoid 6/19/06
Gold weight 7/19/06, removed 3/07
lateral tarsel strip X3
T3 procedure 11/20/07
1.6 Gm platinum weight 7/10/08
lateral canthal sling 11/14/08
Jones tube insert right inner eye 2/27/09
2.4 Gm. Platinum chain 2017
right facial paralysis

kate

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Re: facial paralysis
« Reply #9 on: March 30, 2007, 09:37:20 pm »
Hi Nancy,

I will try to answer your questions. I think my score was about a 6, and yes, it is total paralysis. I think they call it  flaccid paralysis. The other kind would be synkinesis (spelling?), where you have movement but need training in cooridinating the movement.

The ANA has a facial paralysis booklet with exercises which help with facial posture, and these can be done soon, you don't have to wait for movement. I remember them being mostly about getting the nonparalyzed side to relax more, so the face is less torked up looking.

When I was in physical therapy, probably a year or more after AN, it focused a lot on mirror work, practicing trying to move the paralyzed side, while carefully watching, so you would stop as soon as the other side took over. I would not recommend doing this without training/supervision. Since you are still new, and there is hope that movement will return, the best bet is probably patience. Also getting the ANA booklet to help improve facial posture, to make the most you can of getting through this time of paralysis.

I had an eyelid spring put in a couple years ago, by Dr. Levine in Los Angeles. He is affiliated with the House clinic. I heard him talk at a support group and also read his article in an ANA newsletter, then I began harrassing my insurance company to go out of network for this. That was after my gold weight had failed.

Before the eyelid spring, I was using Celluvisc eyedrops frequently throughout the day, and a Lacrilube ointment at bedtime. The Celluvisc is the heaviest eyedrop available. I used the single use vials, which do not have preservatives. This is recommended for frequent and long term use, so the preservatives won't iritate your eye worse. You will have to get used to having your vision somewhat impaired, since the Celluvisc is heavy and does tend to build up. But the trade off is that it will help protect your cornea from damage. Hopefully, you are being monitored by an opthalmologist, to "keep an eye" on your cornea.

After getting the eyelid spring, I use the Celluvisc at bedtime, instead of an ointment. During the day, I now use Tears Naturale Free, which is much lighter than the Celluvisc.

Oh, I just re-read your post, that you are already using lubricant during the day. One of the things that really helped, prior to the eyelid spring, was using a contact lens to protect my eye. This lens was also mentioned in the ANA newletter article by Dr. Levine. It is one that can be left in for a month at a time by regular users, and I think was changed every couple weeks in my situation. It you can't find the article, let me know and I will try to see if it is somewhere in my files. At the time, my opthalmologist refused to consider the contact lens, and gave me all the "reasons" why it wouldn't work for me. I brought in the ANA article, and finally he did prescribe it. I think quite a lot of ANA folks were using that method.

Another recommendation for the eye was a moisture chamber. Look in the eyecare forum on this listserve and see if anyone mentions a distributor. At the time, I could not find one to purchase, and was covering my eye at night with saran wrap, using a hyp allergenic tape from the first aid department, to  hold it in place.

During the day, I sometimes used a black eye patch, also availbable at the drugstores. For a time, when it was really bad, I was putting an optical bandaid on instead. These are found at the drugstore with the eye supplies or with the bandaids. I think they are made for people getting over surgeries, but it also helped keep the air out of my eye.

Luckily I did not have the troubles you had with eating. I am glad you are no longer biting your lip when eating. That must have hurt. I don't really remember the metallic taste. The worst trouble I had with chewing was that the food was landing between my cheek and my gums, and not getting chewed or swallowed. Had to manually pull it out and toss it (sorry to be gross!). But that cleared up with time.

My understanding is that even if the paralysis continues long term, there is quite a bit of improvement that happens with time, in the first year or year and a half. What encourages me to this day is an ANA friend in Australia who continues to improve, with exercise, and her improvement did not really start until after about five years.

I love food too, and sympathize with you if you are still not able to enjoy food. Maybe serve up something you really love, and just slowly and very carefully enjoy and relish it! Enjoy each moment of tasting it! Hmhh, how about some nice ice cream? Think I will go fix dinner now. Let me know if you have any more questions, or need more details about any of these suggestions.  :)
Surgery 5-1-2000,  3.9cm, Huntington Memorial Hospital, Pasadena, California. 
Gold weight first couple of years.
Palbebral eyelid spring 2004 by Dr. Robert Levine "saved my life."
 I  have been enjoying life a lot, even with a crooked face and one sided hearing.

nancyann

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Re: facial paralysis
« Reply #10 on: March 31, 2007, 06:29:58 am »
Hi Kate : WOW !!!  Thanks for ALL THE ANSWERS !!!!!
             I recently bought a pair of moisture goggles from EyeEco, but since the skin around my eye is still sore, I'm holding off
             using it at night; I'm awaiting a platinum weight.   What is the 'spring' that's in your eyelid made of ?
            My doctor is opting for platinum....
             I'll look for Celluvisc, no preservatives sounds good since I use lubricants so much.
             My docs haven't discussed the contact lens;  I think with the way my eye is now, sore & all, it would be difficult for me (I'm one of those who
             never liked the idea of a lens over my eye anyway...).
             Unfortunately, ice cream hardly has any taste, same thing with hamburgers (one of my favorites),  I know what you mean about
             the food pocketing between gums & cheeks, I do try to eat on the left side to avoid this.
             I'll look and see if I have the ANA pamphlet on facial retraining - when I first joined they sent a bunch of pamphlets...
Thanks again my friend,   Nancy
2.2cm length x 1.7cm width x 1.3cm  depth
retrosigmoid 6/19/06
Gold weight 7/19/06, removed 3/07
lateral tarsel strip X3
T3 procedure 11/20/07
1.6 Gm platinum weight 7/10/08
lateral canthal sling 11/14/08
Jones tube insert right inner eye 2/27/09
2.4 Gm. Platinum chain 2017
right facial paralysis

chrissmom

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Re: facial paralysis
« Reply #11 on: April 01, 2007, 12:57:13 pm »
Nancy,

We visited the Facial Nerve Center, in Pittsburgh last week.  Christopher's doctor sent him there and were we ever impressed!  I didn't even know a place like that existed.  These people are incredibly knowledgeable.  We certainly learned alot.  They placed sensors on his face, (not electrical probes) and we were able to see the results of the anastomosis on the monitor.  He was also able to raise his eyebrows too which indicated that his own facial nerve is beginning to come back.  Chris was given exercises to do and massage but it is extremely specific and requires exact control.  That kid is working diligently at it twice a day and exactly as he was told and we are seeing results....rapid results.  I can't believe it. 

nancyann

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Re: facial paralysis
« Reply #12 on: April 01, 2007, 01:49:22 pm »
Hi Rita (Did I get it right Chrissmom?  I can't remember if Rita is your name but I think so - let me know if I'm wrong please !!!)
Anyway,  that is GREAT NEWS !!!!!    Do you know if the Nerve Center has offices in other states ?   I need to look into this
if/when the time comes.   
Denise is also having great results from the 12/7 jump.
My next EMG is May 29th - I am so glad to know if my nerve doesn't continue to regenerate on its own that this procedure
is a success !!!!   I tell you, I was considering NOT getting it done, you know, so scared about another major surgery,
but after hearing how successful it's turning out for Chris & Denise,   I'm not so scared anymore.
Thank-you for the great news & inspiration,   say Hi to Chris,   wishing you both all the best !!!!   
Your friend, Nancy

ps:  Rita, I just checked thru google re: The Facial Nerve Center - seems the one you guys went to in Pittsburgh is a biggy.  There doesn't seem to be one down here in Miami, but Amy had emailed me about a place in Orlando, which I saved.  Also seems to be a place in Tampa.   When I see my surgeon after the next EMG,  I'll be sure to
ask him about facial retraining,  can't start to early with this.   Thanks again for the great news !!!!
« Last Edit: April 01, 2007, 02:00:33 pm by nancyann »
2.2cm length x 1.7cm width x 1.3cm  depth
retrosigmoid 6/19/06
Gold weight 7/19/06, removed 3/07
lateral tarsel strip X3
T3 procedure 11/20/07
1.6 Gm platinum weight 7/10/08
lateral canthal sling 11/14/08
Jones tube insert right inner eye 2/27/09
2.4 Gm. Platinum chain 2017
right facial paralysis

kate

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Re: facial paralysis
« Reply #13 on: April 02, 2007, 01:51:59 pm »
Nancy,

I just read your thanks for my post answering your questions. You're welcome! Hopefully some of it is helpful. What is my eyelid spring made of? I forget, it is some modern material. Very lightweight. When I saw it before it went in, it is more like a thin wire and does not look like a spring.

I think the springs are for more long term paralysis, since it is a longer and more involved surgery than the eyelid weight.

Good luck with everything! :)

Kate
Surgery 5-1-2000,  3.9cm, Huntington Memorial Hospital, Pasadena, California. 
Gold weight first couple of years.
Palbebral eyelid spring 2004 by Dr. Robert Levine "saved my life."
 I  have been enjoying life a lot, even with a crooked face and one sided hearing.

chrissmom

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Re: facial paralysis
« Reply #14 on: April 04, 2007, 12:43:33 pm »
Nancy,
The facial nerve surgery is easy.  It is nothing like the tumor surgery you had.  The doctor said that he could do the jump graft as an outpatient procedure too but since Chris's surgery was late in the day, he kept him over night and we left early the next morning. Now there is a big, long neck scar.  Just like my parotid gland surgery but the scar fades with time.  Try to get the surgery within 1 year of the tumor surgery because studies show that the sooner it is done, the better the outcome.

Good luck, I didn't even know about the Facial Nerve Center here but it is well known and has a good reputation.  Most of their clientele are people who live far away.  Miami is too far but you are correct in saying that you need to look at facial retraining because you don't want synkinesis to occur.

Rita