A bout of Bell's palsy

Stress has a strange way of announcing itself. But it's just our alarm reminding us that we've been snoozing on our me time and sleeping on our zzzs.

African woman by Layers on Pixabay

My right eye has been twitching for about two or three weeks now.

Normally I’d just attribute it to a combination of stress and a lack of that good, good sleep and not think too much more of it. With the exception of late May, when I was out of town for a few overnights attending a graduation, it's been a minute since I’ve slept through the night. I have a tendency to wake up around 3 a.m., which both exhausts and irritates me. And maybe even alarms me a tad bit because isn’t that witching hour? But that’s a story for another day. Today, I just want to say that less than eight or seven hours of sleep accounts for the nerves jumping on one side of my face, except my lip occasionally quivers, too. Now that right there scares me.

Nearly ten years ago, I thought I was having a stroke. I’d just finished a week-long “shift” of hostess duties: drafting and emailing a wedding announcement to the local newspaper, ironing white tablecloths and chair covers, and decorating a spacious venue for the reception. This was in addition to pulling frequent near-all-nighters for a daily entertainment writer gig that I grew to hate and defaulting to a 24-hour nanny role for another family member that I never signed up for. I enjoyed the ceremony, though. I met plus-ones that I casually conversed with over the interwebs and I caught up with other guests whom I often cackled with over the interwebs. But I was beyond tired. I was actually ti’ed. So after the nuptials, I sat quietly, observant, near the dance floor in figurative retirement.

If I danced, I would’ve sashayed to the dance floor. But that’s not my thing. I don’t like to be watched and scrutinized, and as the tallest person on the dance floor, I’m almost guaranteed to attract more attention that I can ignore. However, being a wallflower was more noticeable, eliciting countless curved pointer fingers in my direction, every single “Come on!” elevating my blood pressure five millimeters of mercury each time. I remained at the front table with the purses, annoyed, while everyone else shimmied, shook, shuffled, slid, and two-stepped across the dance floor. 

But it wasn’t just the urging of me to join them that bothered me that evening. It was the repetitive question that folks always direct at me when I take a moment to myself to recharge. I’m an introvert. It’s not something that I lead with or use as a crutch, but it means that gatherings, even if they’re familial, literally overwhelm me. After a certain point, I need space to breathe and calm the jitters and the tightness in my chest. But others automatically think I must be upset every single time I choose solitude over too much togetherness. So they all approach me the same way.

“Are you okay?”

I had heard it at least eight times during the reception. I had had enough.

“If one more person asks me…” I say before I exhale. “YES!”

No one else inquired about my well-being that night, and not even the next day during brunch when my physical features continued to relax.

I happened to glance at my reflection in a car window as I carried my plate of breakfast. Since the inside of the house was still full of wedding guests and it was a  warm fall morning, some of us walked outside to roam the back yard and socialize while we ate. I saw an image that didn’t quite appear to be symmetrical, but I attributed it to distortion because doesn’t one’s face resemble that of a funhouse mirror whenever they look upon the side of a car? Still it didn’t sit right with me because I couldn’t help but to keep sneaking a peek at my reflection.

The bride’s mom decided to prepare made-to-order omelets for us guests. This time I sat in the family room to really enjoy my food because she makes some good damn omelets. One can’t walk and truly enjoy a meal the way one can when one’s seated. The wilted spinach and sautéed onion were tender, the sausage savory and robust. I licked my lips. My tongue touched the left corner of my mouth and slowly circled to my cleft before it got stuck; it couldn’t quite reach the right side, let alone the right corner. 

That’s strange, I thought.

I furrowed my brow, puzzled that my tongue felt as if it was somehow locked.

I attempted to complete another circle, this time starting on the right, but my tongue and lips still refused to connect! It wouldn’t budge! Immediately my face warmed – not from any physical symptom but with fear. I rushed to the bathroom mirror.

I turned my head left, then right, carefully searching for some abnormality. I still looked like myself.

Then a small voice says, Smile.

I watched my lips spread and curve upward – but only on the left side. The right side of my mouth didn’t move at all. 

What. The. Fuck.

I rested my face and repeated.

No change.

I tried to pucker my lips, but they only twisted to the left, lopsided like a pinwheel. My cleft moved off-center.

I tried to wiggle my nose.

It was just as rebellious as the right side of my mouth.

I told myself that this is reversible. Never mind what that refrigerator magnet I saw earlier detailing what to do in case you exhibit a specific set of symptoms said. I tried to convince myself I could stop this thing before there was any sharp pain or weakness in my left arm, dizziness and headache, or slur in my speech. And I figured if I didn’t verbalize what I thought was happening, then it wouldn’t manifest at all. There might not have been 100% physical movement in my tongue but there still was that other kind of power.

Mask by Jean-Louis Servais on Pixabay

I returned to my seat to finish my omelet because, at that moment, I didn't know what else to do. I was terrified but I was equally petrified of the attention, the commotion that nearly 40-50 family members and friends would make if they thought the same thing I was thinking. I took another bite and chewed in a way that no one else could detect a problem or, for the ninth time, ask if I was okay. I needed to think, to cool and calm down. I also reminded myself that I’m not that old.

Girl, just drink some water, my 40-year-old mind says. That’s it. It’ll flush out toxins and trigger some sort of reset.

I fetched a bottle and took a swig. I chastised myself for indulging in pork sausage as if I didn’t already consume bacon the prior hour; sipping one too many dark sodas; and depriving my body of frequent water intake. I knew my ass was pre-hypertensive. I finished the 16.9 ounces in a matter of a few gulps.

But I still panicked, wondering what if my face never returned to normal or if my failure to do anything at all would cause some extensive harm. Or death.

I looked up to reread that refrigerator magnet: In case of a stroke, act FAST.

Face. Arm. Speech. Time.

I finally decided I should really seek help so I tiptoed through the crowd to find the calmest relative. The even-keeled one who doesn’t show a range of emotions. One I could trust to not whoop and holler and agitate everyone else.

“I think I need to go to the emergency room,” I say to her.

I smiled for emphasis, evidence of said emergency.

She stared at my mouth for a few seconds, most likely processing my words.

“Lemme find my keys,” she says finally.

I had scared the shit out of her, too.

We sneaked out of the house, rode the 20 miles in practical silence, interjected with a few words of small talk within the final seven minutes of the trip. We didn’t discuss my face. We continued the idle chatter in the waiting room.

It was fairly quiet in the triage room, too, except when the first, second and third members of the medical staff entered and asked me to repeat my symptoms.

“Has anyone talked to you about possibly having a stroke?” the last person asks.

I paused before I answered.

My face flushed for the second time that day, only this time it was from what I perceived to be nonchalance on this woman’s part, plus I honestly wasn’t prepared for that to be my official diagnosis; I still wanted to hear something different. I hadn’t seen a doctor or taken a single test, yet here was this woman speaking a stroke into my existence.

“No,” I say instead, “but the thought did cross my mind.”

She left me to my thoughts, which lingered on my blood pressure reading. I beat myself up again, but later realized of course my numbers would be high! I was in freakin’ distress!

I disconnected myself from monitors at least four times because nerves and that sudden intake of water was way too quick and foreign for my body to retain. I grew antsy between bathroom breaks so I practiced making facial expressions again. 

Smile. Nope. 

Pucker. Still nah. 

Wiggle. No go.

How ‘bout blink. Wait, what?

I realized I couldn’t even blink my right eye without blinking my left one; I had to close them together. 

Time was passing. I wondered when someone was going to treat me for this stroke.

A young, petite woman sporting a long ponytail finally entered the room. She introduced herself as the doctor and asked me to repeat my symptoms for the fourth time and then to perform a series of exercises.

“Raise your arm,” she says. “Now make a fist.”

I lifted it with a swiftness and clenched my fingers with a tightness. I needed to prove there was no weakness or paralysis in these limbs. I could also raise my right leg and circle my foot.

My doctor informed me that she didn’t think I was having a stroke because my entire right side wasn’t affected – it was only my face that was uncooperative – and my speech wasn’t slurred. Unlike the previous staff member who uttered a premature diagnosis, my doctor preferred to hold her guess until after my CT scan.

I don’t like tight spaces. I’ve entered the tunnels twice before this time: One was opened with “windows” but the other one was completely closed. The latter makes me extremely uncomfortable with the blurs of buzzes and clicks and the closeness of the machine’s ceiling to my nose. I automatically feel like I can’t breathe. I want to blurt, “Forget it!”

I mentioned this to the man who administered my scan so he asked me about my weekend as he wheeled me down the hall. He told me to close my eyes before the base that I was lying on glided into place. It wasn’t as bad as I’d remembered.

The doctor and I reconvened in the same triage room.

“Just as I suspected,” she says. “It’s Bell’s palsy.”

I’d never heard of the disorder, although I later learned that I knew people who had been afflicted with it at some point: an aunt’s boyfriend, a best friend’s mother, some cousins, at least two classmates.

“I knew it!” says one of my cousins when I returned home. 

She had it in college and thought she detected it in me during the reception. But we had such a quick conversation and my words were so deliberate while my lazy mouth was more subtle. Mostly everyone else could only say that I seemed to be “talking funny.” Like me, they weren’t familiar with Bell’s palsy, either.

Named after Scottish surgeon Sir Charles Bell, Bell’s palsy occurs when the nerve that controls the muscles on one side of the face becomes inflamed and temporarily paralyzed, ultimately causing facial features to droop. The underlying causes can be a common cold, the virus that causes cold sores or shingles, or even stress. It is not related to a stroke.

Good reading, especially for those who are adamant that they don’t need much sleep!

The doctor told me to await the nurse for my prescriptions – an antiviral in case I picked up a bug and a corticosteroid to suppress the inflammation and simultaneously stimulate the nerves in my face.

The nurse told me she had been diagnosed with Bell’s palsy three times, although I read it’s rare a person relapses. But it does happen. She assumed it was unlikely I got this from a virus.

“Whatever stress you’re under,” she says, “I suggest you let it go.”

Eliminate it.

Press a stress-be-gone button.

Except I can’t because it surrounds me. It haunts me. I live in the midst of it.

Even now.

“I know,” is all I can say.

She explained the purpose of the antiviral and steroid along with its potential side effects. 

“You have to take this on time, exactly as prescribed” because you have to wean yourself off of it in 10 days and not abruptly stop after 10 days.

She also recommended that I buy an eye patch for my protection since I couldn’t blink or make tears. I later found that the elastic hurt the back of my ear and the patch itself protruded a little and blocked the line of sight in my left eye. I suffered from an occasional headache, and my vision blurred as my right eye attempted to focus whenever I removed the patch. Argh! Consequently, I gave up electronics for a few months.

After I got home, I found a little bit more information on Bell’s palsy, a clue or two that indicated the illness was about to strike. In retrospect, the dull throb behind my right ear a day or so before the wedding rehearsal was one of the first signs.

I was at another relative’s house for the rehearsal dinner. As I stood in her kitchen complimenting her spaghetti, I caught myself still massaging the area behind my lobe.

“There’s this weird pain behind my ear,” I mentioned to her. But I brushed it off as an everyday ache and pain.

Earlier that day, another cousin and I stood in line at Walmart discussing a quick run to our favorite bakery. I happened to be chewing gum when I bit down on the inside of my lip – hard – for the third or fourth time that morning. By the time I got my donuts, I had given myself two blisters. The lip-biting was yet another sign.

After reading up on the illness, I performed a more scrupulous inspection of my face daily. I stood in the mirror practicing my smile, looking for any sign of improvement, willing my mouth to expand the way Uma Thurman’s character willed her big toe to wiggle in Kill Bill. I attempted to puff out my cheeks but my lips made the sound of a deflating balloon because they didn’t seal. I dribbled when I drank because my bottom lip didn’t fully grip the rim of a glass. I sipped through a straw for several months.

Around the same time every evening, my face would again flush but it was a different type of heat from before. It was like a slow burn under my skin but without any pain. It was as if my face was straining with all its might to perform some action but the best my right side – particularly my lip and cheek area – could do was involuntarily twitch like that of a dog when he’s exercising his keen sense of smell. I assumed that was a sign of my nerves reawakening.

My eye was the first feature to start functioning again. I was ecstatic to finally ditch the pirate patch, but it wasn’t until the winter before my smile fully returned. 

I never learned how to prioritize my wants and needs over everyone else’s. Their can’t dos become my can dos, their fires, mine to extinguish. There’s always this strong sense of obligation or quid pro quo that convinces me that I have to step in to help or return a favor, perpetually, otherwise I’ll feel guilt – a deep guilt that ultimately causes me to self-sabotage because my brain gets stuck on how I just told someone “no” so I still neglect to fulfill my wants and needs. Yet I tell myself that God has punished me for putting myself first. Crazy, huh.

I realize it’s one of those things many of us carry from childhood. We’re taught to sacrifice our well-being because choosing otherwise is selfish and unChristian. Any scars, trauma or illness is merely a badge of honor of doing what’s right. We’ll be rewarded for it one day.

What pisses me off is the idea of establishing boundaries and saying “no” indicates weakness and thin skin. It’s a sign that we’re somehow built differently than those who preceded us. We’re more fragile and sensitive. But if we were designed to be superheroes and human punching bags and doormats, I don’t think our bodies would rebel and shut down. We wouldn’t require peace, rest or actual sleep, which is the time designated for our bodies to rest and repair itself. In his book, Why We Sleep: Unlocking the Power of Sleep and Dreams,” sleep scientist Dr. Matthew Walker writes, “Routinely sleeping less than six or seven hours a night demolishes your immune system” and other necessary processes our bodies undergo at night. Not to say other factors don’t contribute to chronic illnesses, but lack of sleep increases our risk for cardiovascular diseases and other ailments. Not to forget, stress disrupts our sleep cycles and patterns. And contrary to popular belief, sleep isn’t something we can “catch up” on. Once we missed our window, that moment of physical repair is gone. Our bodies do indeed keep score.

It’s fascinating how stress can manifest and react in our bodies; it’s not always displayed as wild-eyed hair-pulling or nail-biting. And it’s usually not an instantaneous thing that happens, either. I’m confident stress physically affected me twice – weird physical reactions that were unexplainable to doctors and specialists such as temporary weblike markings on my calf that weren’t varicose veins  – before it escalated to Bell’s palsy. No amount of trying to ignore or hide stress will erase its existence. A decade later, coupled with an official hypertension diagnosis, I’m taking my health – and my sleep – more seriously. I want to be here for a long time because there are so many things that I’m still destined to do and I’m gon’ still be blessed. 

Amen? 

Amen.

Whenever I feel a twinge or even as much as an itch behind my ear, I often flash back to the lip-biting, drooping and drooling. Yes, I still get scared. Immediately I start to contort my face to be sure all its parts move and return to their proper resting places: Can I make an “O” with my mouth? Can I curl my bottom lip? Can I chew without biting my bottom lip? Can I wiggle my nose? Can I wink? And then I remember to breathe and count a few more sheep at night and acknowledge that once again I might be doing way too much. Today I remind myself that I need to be doing more me.