The Significance of the Human Smile

The Significance of the Human Smile

Trauma out of the blue, it can affect anyone, at any time. Imagine waking up one day unable to move your face!

The date was Saturday April 27, 2002. I awoke around 12:00 p.m., awaking so late because I had a late night out with friends the night before. When I woke up I did a few chores around the house, noticing that I was fatigued rather easily and also incredibly hungry. Around 1:30 p.m. I threw on some clothes and a hat, and headed out for some lunch.

I went to a diner for lunch, ordering a glass of water and a burger. I sat there and began drinking the water, noticing that I couldn’t drink out of the glass without some of the water dribbling down my face. It felt bizarre, like I couldn’t quite seal my lips around the glass enough. I was starting to get a little aggravated, shortly my food arrived.

I started to eat, observing that I couldn’t fit the burger in my mouth; it felt as though my lip was in the way. It felt like I had just been to the dentist and was injected with a huge amount of Novocain. My entire mouth was numb and it felt like my tongue was too big for my mouth. I struggled through to finish my meal; I seemed to have struggled so much that I was starting to break a sweat just trying to eat! How strange was that? I must have sat there trying to eat for close to an hour. When I got up to leave I felt exhausted.

Arriving at home I just tried to forget about the odd ordeal that I just had merely trying to eat a meal. I went to my office to try to relax. I sat at my computer and some research. Soon enough I had forgotten how hard it was and my mind felt at ease again.

Shortly thereafter I started feeling this immense pain in the back of my neck, as though my neck could hardly hold the weight of my head atop. I chalked all the feelings of frustration, anxiety, pain and fever to the ear, nose and throat infection that I was diagnosed with four days prior.
After some probing around on the computer I was again exhausted and decided to lie down and get some rest that I was sure I needed. I must have fallen asleep for a brief time, but was shortly awoken again by a phone call from a friend. I invited the friend to come over even though I was not in the mood for company.

When my friend arrived I asked him if he noticed anything different about me. His response was a simple, “no.” Obliviously he mustn’t have been paying close enough attention. Although he did mention that I was talking to him as if I had a handful of marbles in my mouth. After my company spent about an hour at my place I politely asked him to leave, because I had grown tired again and wanted to sleep some more. The thoughts in the back of my mind were that I might have Mononucleosis (Mono); a condition that I have heard very little about. However, what I do remember, from a friend that had been diagnosed with it several years back; was that you sleep- a lot.

I lied down once again, this time awaking in pain. I couldn’t seem to find a comfortable position to lay my head in without severe pain, associated with a migraine and pain behind my ears. I stood up and went to the restroom. As I entered the washroom strait ahead was a mirror. In which I caught a quick glimpse of my face. All day I had not even once gazed into the mirror, if I had I would have probably noticed my condition much sooner.

When I looked at myself in the mirror I noticed that my face had a droop to it; it is drooping to one side. When I would smile only one side, my left side, would rise and form a smile. I quickly began poking and prodding at my face as though I could make it work, nothing was happening. More than anything, it is nerve-racking, literally!

I quickly telephoned an urgent care center and explained my condition; no one knew what I should do. The only thing I could think to do is to go into an emergency room.

I hurriedly showered, rather, tried to shower. When I attempted to wash my face and hair I noticed that all the water and soap was running into my right eye. I was terrified, what’s happening to me? I can’t close my eye!

I quickly got into my car and rushed as fast as I could to get to the closest emergency room. By this time it was after 7 o’clock at night. It was a dark, rainy and gloomy night. I could barely see to drive to get myself to the hospital.

When I arrived at the emergency room I tried to the best of my ability to describe the symptoms that I was experiencing to the receptionist. The woman must have thought I was crazy; the things that I said must have sounded so extraordinary.

I was quickly admitted and checked over. The next step was a cat scan of my brain. From what I hear, most people in this condition feel that they might have had a stoke. A stroke was soon ruled out after the results were returned. The next hour or so consisted of a battery of testing. The assessment that I underwent was similar to the sobriety tests that police officers give to accused drunk and drivers along side the road. More than anything I was getting agitated, curious to why they were making me do the experiments that they performed.

After approximately three long hours of testing, waiting, more testing and more waiting; a physician’s assistant came to me with my discharge papers. “Ma’am- you have Bell’s Palsy (BP)”. Tears rolled down my face. I suppose the only word that I caught in her sentence was ‘palsy’. Nearly everyone has heard of Cerebral Palsy, I though I was going to be paralyzed for life!

The physician quickly informed me of the diagnosis as, “nothing to be excessively worried about”. Gave me my discharge papers, prescriptions and sent me on my way. I went to the hospital pharmacy and retrieved my medications, got into my car and ‘tried’ to drive myself home. The doctor had put drops into my eyes and covered one eye, the eye that would close. Now I had to drive with just that one eye. The five minute drive home felt like an hour.

When I arrived home I called my mother to notify her of what had happened. I was in emotional disarray. My mother had all sorts of questions for me; many of which I could not answer, because I didn’t get any of the questioned answered for myself at my trip to the hospital. There began my journey.

That evening was a Saturday. All I was told from the hospital to do for follow-up care was to see an eye doctor and my family physician as soon as possible. And, of course, start my medications. They didn’t inform me how my life was about to change.

The next morning I went to breakfast with my family. The initial hardest thing was trying to simply speak my order to the waitress; next, the inevitable task of eating. I began eating at 9 o’clock in the morning; we didn’t leave the restaurant until after 11:30 a.m. It had taken me over two hours to consume my breakfast. Not to mention, no one told me that I would have to drink my hot coffee with a straw!

For a long time the origin of Bell’s Palsy (BP) was unknown, however scientists believe that BP results from a viral infection that inflames the facial nerve. The condition was termed as an idiopathic facial paralysis. Pathologists use the term ‘idiopathic’ to describe an ailment whose cause is not well understood, and which is treated by addressing the symptoms rather than the underlying problems. The term ‘idiopathic’ also refers to any condition that is personal and distinct. BP is thought to be caused by a viral infection of the facial nerve (7th cranial nerve). However, BP has many other ‘possible’ causes such as trauma, nervous system disease, metabolic, tumors, or toxins. BP is a non-progressive, non-contagious, neurological condition that presents the severe, yet temporary, onset of weakness on one side of the face.

BP is generally preceded by fever, pain behind the ear, stiff neck, weakness, numbness or stiffness of the affected side. When the muscles are paralyzed you cannot smile, you drool slightly, you sometimes bite your cheek when you chew, you cannot close your eye, and quite possibly, you slur of your words.

Possible complications
Probable outcome

Treatment, medications, acupuncture, e-stim,

This rare disorder afflicts about 40,000 Americans each year. Approximately half of all newly diagnosed BP patients recover in a short period of time, the remaining recover within a year. The recurrence rate is between 10-20%.