High-Risk Pregnancy

Facial Weakness and Bell's Palsy

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Hi all.


If you?re reading this, chances are you suspect you have Bell?s Palsy during pregnancy or you?ve been diagnosed with Bell?s during pregnancy. I was shocked to find out that this is a somewhat common pregnancy complication ? women in their third trimesters are over 3 times more likely to develop Bell?s than the regular population.


As soon as I was diagnosed with Bell?s, I began reading everything I could about Bell?s and pregnancy. There?s not a lot out there, and what is out there can be somewhat scary. So, I thought I would share my thoughts and experience with you. Please do understand that this is my personal story and not professional medical advice?if you are having facial weakness go to the ER or contact your doctor immediately.


I first noticed that my face wasn?t responding like normal in the morning. It was just a general feeling, and I contributed it to the fact that I was super swollen. Beginning about halfway through my pregnancy, I developed moderate to heavy swelling in my hands, arms, neck, and face. I had pregnancy induced carpel tunnels (which was really painful and definitely interfered with my functioning), and sometimes when I woke up in the morning my eyes were nearly swollen shut and my lips were so swollen that speaking was difficult. Thankfully preeclampsia and hypertension never manifested, but my doctors were on the lookout for these conditions as they can correlate with this type of swelling. As the day went on, my facial weakness became worse, and I realized it was affecting one side of my face more than the other. When a co-worker said something to me about it, I knew it was time to contact the doctor.


At that point, the right side of my mouth and some of that cheek were not moving symmetrically with the left side of my mouth and cheek. When I called my OB, a nurse directed me to call my primary care physician. When I called by PCP, the entire office was on holiday. When I called my OB back, the nurse said to call back and talk to a doctor tomorrow if my symptoms didn?t improve. At this point, I called my husband (who is a physician) and he said I definitely needed to see a doctor now, and that he would meet me at the ER. Again, this isn?t professional medical advice, just my opinion: if you have facial weakness that you can observe in a mirror go to see a doctor immediately. The nurse I spoke with did not check with the physician before telling me to just call back tomorrow, and this could have ended badly for me, for my baby, and frankly for her. If you have facial weakness, you could be having a stroke and you need to go in immediately. Plus there are other things that could be going on that are neither Bell?s nor a stroke ? and it takes a medical professional along with resources at the office or hospital to diagnose these things. There is no need to chance it, especially when your baby is at risk as well as you!


After ruling out several other possibilities, my doctors decided that I had partial Bell?s, and I was discharged. Over the next four days, the Bell?s continued to manifest; by the end of the fourth day, it was nearly complete with paralysis continuing up the nerve to the point that I could not move my right eyebrow. My husband was actually really happy about this (I was not), since he said it just confirmed my diagnosis and that I didn?t have something more serious or life-threatening happening. However, when you are super pregnant, having facial paralysis on half of your face does not feel like something to be happy about. This all happened to me at 32 weeks exactly. I also had a super big baby, who was measuring 35-36 weeks at 32 weeks actual. Now, I?m at 38.5 weeks, and my facial paralysis is completely healed. Most people?s Bell?s will heal. Try to stay positive, although it?s really hard when your outcome is unknown and you feel terrible!


Over the next two weeks, I had a flurry of follow-up doctors appointments: OB, PCP, Neurologist, and High Risk OB. Bell?s was confirmed and I began taking an 18 day course of Prednisone, decreasing the dosage every 3 days. Something I learned about Bell?s is it has been correlated in some studies with increasing chances of hypertension and preeclampsia. Prednisone can also increase your blood pressure. This didn?t end up happening to me, thank goodness, but we were on the watch. Prednisone also can kick up your blood sugar levels. While I wasn?t diagnosed with gestational diabetes, I monitored my blood sugar because of my very big baby. My blood sugar skyrocketed within hours of taking my first dose of Prednisone. Thankfully, I was monitoring this and was able to catch it and act accordingly. My doctors seriously thought about putting me on insulin injections, but they went with strict dietary restraints instead. I drastically reduced my intake of sugar, carbs, and salt, and I continued to monitor my blood sugar levels in the morning, then three times a day one hour after eating. This worked for me and my baby (as far as we know ? since we haven?t delivered yet, we?re not positive about her actual size, but she seems to have slowed down and not gained even more weight because of the blood sugar fluctuations).


Some people have side effects with Prednisone. The only side effect I had was terrible night sweating. I would wake up and literally be covered in sweat to the point my hair was wet. Overall, I felt much better and noticed a decrease in my overall swelling, a decrease in my carpel tunnels pain, and I was sleeping a lot better.  Who really knows if this was because of the Prednisone or because of other factors and/or lifestyle changes I made after getting Bell?s. In your third trimester, the risks for Prednisone harming your baby are reduced. However, be certain to talk to your doctor about the risks. I would absolutely take it again if the same situation were to arise.


They don?t really know the root issues that cause Bell?s Palsy. However, I knew I was under too much stress at work and at home. I took about two weeks off entirely, then decreased my working hours drastically and worked from home when I could.  I really do think eliminating my stress and giving myself a minute to relax and take a few deep breaths increased my recovery outcome and my recovery time. Any way it goes, if you?ve been diagnosed with Bell?s, you need to relax and give your body the time it needs to heal.


It took a month to see any real improvement in my facial paralysis. Improvement started with my mouth and ended with my eyebrow. Six weeks after onset, I?m almost completely back to normal. My right eye closes when I yawn, but this is the only thing I can notice that is different than before. At first, dealing with the paralysis just added another layer of awfulness to pregnancy ? I mean, we already deal with enough just being pregnant! It was really hard to eat, to shower, to do normal, everyday things. I used artificial tears as necessary to help with my eye, which would barely close. At night, I used lacri-lube. I also tried to avoid staring at the computer screen, tv, books etc. as this seemed to agitate my eye, since it could not blink appropriately. Also, my ear on the affected side was crazy sensitive to sounds. I went to a movie during the second week after onset ? bad idea. My ear hurt so, so much I had to cover it with my hand and my right eye basically cried the whole time because it couldn?t blink and regulate itself. After that, I tried my best to rest my eyes and ears.


Eating and drinking was equally as problematic. I gave myself an extra long time to eat and avoided eating around people, since it?s both messy and takes forever to cut your food into tiny bites to fit through the unaffected side of your mouth and to chew. I drank through a straw that I put in the unaffected side of my mouth, and that seemed to work just fine. Also, taking showers and washing my face became a lot harder, since I couldn?t tighten my eye on the right side. I switched to using a more benign shampoo and conditioner, in case it ran into my eye. I also stopped washing my face in the shower all together. I switched to Cetaphil for sensitive skin, which you apply then wipe off. I used a damp washcloth to blot it off my face. I never found a way to effectively deal with the talking issue ? I talk to people all the time for work, and obviously we talk to people all the time to complete everyday tasks. I put my phone on the unaffected side of my mouth, but even then communicating was difficult at best. Face-to-face was easier (although more embarrassing) because people could look at my mouth and tell what I was trying to say. All these things get better as your paralysis improves. Also, your doctors can help recommend alternatives like physical therapy or acupuncture to help you if your recovery isn?t progressing as you?d like.


Also, I had several showers and social events scheduled. This was problematic. I cancelled one, and didn?t attend several things like weddings etc. that were early after the onset of my Bell?s. I was sad to miss these life events, but the stress it would have caused me outweighed the benefit of going. When it came to stress reduction, I was all in and took it very seriously! I did have a close friend and family shower and also a shower with closer work friends. I felt very comfortable with all the people at these events, and their support and kindness truly helped me feel much, much better about being so sick and so pregnant. Support systems are awesome, and you should feel free to call on yours during this time! Also, I ended up getting some good photos of my husband and myself at these events. I had my husband face the camera and smile, and I looked up at him sideways so the unaffected smiling side of my face was facing the camera. The photos turned out to be really sweet, and I?m happy to have a memory to keep from this time of my life that reflects the happiness I felt about welcoming a baby into our family instead of the terribleness of the pregnancy issues I had to face.


One last thought to end this mega-post, my doctors didn?t expect my Bell?s to improve until after I had my baby ? since swelling was such an issue for me and they thought the swelling was constricting the nerve. However, it did improve, and my baby is just fine given all that we?ve been through over the last couple months! It?s hard, but just try to take a deep breath, relax, become ok with the fact that you won?t know if you?ll fully recover until much later, don?t obsess with what will happen if you don?t recover (this was hard for me), be happy that it isn?t something worse, and continue to live life. I know that?s a tall order! However, life moves forward and you will adjust and adapt as necessary. Plus you have a baby to look forward to! Best of luck!!



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