DroopyFace

Back when we were working our way through our microbiology block, I wrote a post called “We Are All Going To Die.” If you remember back that far, it was about a phenomenon called medical student syndrome, where nervous medical students think they have the diseases they are studying. Depending on the day, I either had Ebola, anthrax, hookworm, a particularly virulent strain of E. coli, or a face-eating fungus called blastomycosis. It’s a miracle I stand before you today on my psych rotation.

Alas, not all is well in the world of Nate. You see, in one of the great all-time ironies of medical education, your writer has managed to contract a somewhat common condition known as “Bell’s palsy,” or in fancy medical words a “peripheral seventh cranial nerve palsy.”

Unlike medical student sydrome, I actually have this one. (Standard disclaimer for relatives and loved ones: I am fine, it is not permanent, I am not sick, do not send brownies/cookies/baked goods, and yes I am sure you know someone who had it thank you for telling me.)

Here’s what happened:

About two weeks ago, I woke up with ear pain on one side, which is a little weird for an adult with no hearing loss. Two days later, I noticed Chipotle just didn’t taste the same — and neither did anything else. Appropriately concerned, I did nothing.

Last Saturday, as I watched my beloved Ravens blow a sizeable lead to the Patriots in the 4th quarter (don’t start with me) I noticed one half of my face felt strange. Numb, like when you go to the dentist. Now, I know I’m given to fits of uncontrollable rage during sporting events, but I didn’t think I had spiked my blood pressure high enough to stroke out my 26-year-old arteries.

I went into the bathroom to check it out and realized my face looked a little odd. I did a quick neuro exam on myself. When I tried to smile as big as I could and raise my eyebrows – a test for a nerve called, appropriately, the facial nerve –  I saw this face staring back at me: IMAG0315I am not smirking on purpose. Because we had company and the game was close, I didn’t say anything, but obviously I knew something was wrong. After the game ended and everyone left, though, I went over to my roommate Ryan and told him I was going to smile. “NO F**KING WAY DUDE YOU HAVE BELLS PALSY?” was his response.

Yup.

(Ryan likes neuro things; I haven’t seen Ryan that animated since a ‘roided up defender with mommy issues got in his face during our flag football season. When Ryan was on the stroke service for neurology, he came home every day with a huge grin on his face yammering about the location of some burst blood vessel. Love you too buddy.)

Because we are mere second years, we sought diagnostic confirmation — so we called another student in our class living upstairs. She took one look at me and goes “WHOA YOU HAVE BELL’S?” So, yeah, it’s an easy diagnosis to make. Now what?

To the internet we go. If you’re interested, most of the time there is no obvious reason why anyone gets this. The current best guess is that a virus that likes nerve cells, like the chicken pox, reactivates and causes swelling around the nerve. Bell’s palsy has no real treatment; the best the medical community has to offer is early steroids. Typically, the palsy goes away (or at least starts to) on its own after a few weeks.

So the next day, I went to the ER on a Sunday to take my medicine. The resident physician that morning walked into my exam room and says, “Nate?! What the hell, man?”

We were on trauma together.

I explained my paralyzed face. After ruling out weirdnesses like stroke, Lyme disease, and brain tumors, he agreed with me, gave me some prednisone, and sent me home. A week later, I am no better.

The doctor I followed up with at student health emailed me yesterday to say she wanted to put me on much higher doses of steroids, which I reluctantly agreed to; high doses of steroids over time give you what’s called a “cushingoid” appearance, which looks like this:thumbnail_2_f8090640_v1 Wait, no, that’s wrong. This is cushingoid: Cushings-syndrome-1 If we’re being honest, the steroids probably won’t do a whole lot besides make me look like Quasimoto. So if you see The Hunchback skulking around campus, wave and say hi. I’ll smile back with my good side.

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6 thoughts on “DroopyFace

  1. AHHHHHHHH.

    The true test of humor: if you could make ME, the mother, bellow with laughter at this current situation, you’re really writing well.

    Well done, Quasimoto.

  2. Nate, after you finish the steroids, please take at least a two week course of probiotics… Steroids mess w/gut bacteria. Also, get a lyme test – I know you said they ruled it out in the hospital, but I doubt they ran the Western Blot…

  3. Oh my gossssh! You’re so funny. With that smirk. But, I mean, I’m very sorry for you all the same.
    I thought I had Bell’s sometime last year, but it turned out it was just a postdrome from a migraine (which, IMHO, is infinitely more scary because MY BRAAAAAIN!) but anyway. Sorry to hear the steroids aren’t working yet though. I know that for some people it takes a while longer to kick in. Hope it works quickly and in the meanwhile, keep up that stellar sense of humour!

  4. Pingback: High Elopement Risk Today | Laughter is the Best Medicine

  5. NATE/GREAT/FATE When you finally decide that medical practice sucks, which is inevitable with someone as intelligent as you, you will have something to fall back on for an income stream so you may continue what you love. Keep writing. At least there’s a future in that!

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