I have Bell’s Palsy: Part 1, I become a patient
I woke up a bit distressed and I think the experience might be valuable to document. It’s not often that we as doctors are patients – and we make bad patients – so I thought I’d chronicle (what is hopefully) my recovery. Baring my personal course will also help lend some transparency to the process of medicine, I hope.
My own doctor’s office is closed on the weekends. The only walk-in open on a Saturday is the clinic that I work in daily. I thought it would be weird to check in as a patient since I work there. Plus, patients with this usually go to the ER so the ER docs are probably more up to date on treatment strategies. I was embarrassed to take up their time, was pretty sure of what I had, but didn’t want to self-doctor. Plus, I needed someone to look in my ear (I’ll explain this aspect later).
(as it probably appears on my chart:)
ID: 25 year old female, resident physician, previously healthy
HPI: Noticed numbness in L tip of tongue yesterday. Last PM, had difficulty sleeping last night due to “funny” sensation in eyes. Awoke several times. At 0800 noticed dry L eye and not able to close it, L facial weakness, slurred speech, loss of forehead wrinkles, and some decreased sensation on L side. No diplopia or change in visual acuity.
Healthy until this week. Sore L neck this week secondary to fall at hockey, L sided occipital headache/migraine not resolved with usual Rx (Axert). Works in Family Practice office and was exposed to VZV (Chicken Pox) this week. Had same as a kid. No hx HSV.
Med Hx: Migraines x 12 yrs
Surg Hx: Tonsillectomy 2007
All: No known drug allergies.
Rx: Axert (a triptan – anti-migraine medication) 12.5 mg PO PRN, Oral Contraceptives
On Exam: Looks well, no distress. Slurred speech. No obvious droop
loss of forehead wrinkles on L, unable to shut L eye,
sl decreases sensation to light touch in L V1-V3
Cranial Nerves: EOM full, visual fields normal, PERLA
Assessment: Bell’s Palsy
Prednisone 50mg PO daily x 10 days
Valtrex 1000mg PO TID x 7 days
Follow-up with ENT (ear nose and throat doctor, aka otolaryngologist)
Return if diplopia (double vision), other visual changes, worsening headache, nausea, etc.
(photos, my thoughts, what is Bell’s Palsy, prognosis, etc in the next posts)