How to find a neurofacial therapist/ timing

[mandy721]

Hi,
My husband had surgery on Aug 4 and there is weakness on the AN side of his face.  I want to get some ideas here about neurofacial therapy prior to our visit with the surgeon next week.  How soon after surgery  do people start with it and how do you go about finding a therapist? 
Thanks,
Mandy

[Cheryl R]

Mandy,    The face needs time for the nerves to heal and the muscle will not work till the nerve is healing.      So you need to do nothing for now.                 In time you can see how it is doing once it gets movement.            One has to not do too much to the face as as the nerves heal they can sometimes cross wire and cause synkinesis and some muscles work wrong when move other parts of the face.  There are some exercises to help this in time.       Some therapists do not like to see people for many months to a year and it varies with each person situitation.               Some are saying you can now do light brushing of the face with fingertips as that was mentioned at the symposium recently.         The biggest issue is to make sure a person is doing eye care as there can be the dry eye when one has weakness and heavier drops and gel at night may be needed.     
     How fast the face recovers varies for each person.                  Cheryl R         

[4cm in Pacific Northwest]

Mandy,

Here is a great website for you to surf. Many of us had Bell's Palsy after surgery. We all recover differently and at different rates of time...

http://www.bellspalsy.ws/

For some it is just time that heals... others need more help.  It has only been a month since your husband's surgery... time is what is really needed for him at the moment.

If there are issues after month 5 then it is time to seek facial help/consultation and perhaps medical consultation.

•   Straws help for drinking (although for some getting their lips to suck took time too)
•   Nasal strips help the weakness in the nose- at night (and for some during the day)
•   Eye drops a must (Some tape the side of the undereye to keep the drops in)
•   Avoid hard to chew foods at 1st- as to not risk choking.
•   Know that weird taste buds are part of this and for most it improves- with time.


Know that we also have a caregivers link if you ever need to post there
http://anausa.org/forum/index.php?board=21.0

DHM  

[mandy721]

Cheryl and DHM,

Thank you for the replies.  I know that patience is what we need most now.   We are trying, but it is hard.

The Bell"s Palsy site was very informative.  Is the facial weakness/paralysis after AN surgery considered to be Bell's Palsy? 
So far, he has seen some progress in that he can now tightly close the right side of his mouth.  Prior to surgery he had some numbness on the right side, but now it is more pervasive.  He also mentions that he doesn't taste on the right side, so it must be those weird taste buds at work! 

He is taking good care  of the eye and our collection of eye drops is growing.    We learned that a bottle of drops must be in his pocket at all times.  Last week we went out on a bright day and had to make a drugstore stop for drops along the way. Some days the eye  is fine, other days it is a bother. 

Mandy

[4cm in Pacific Northwest]

Last week we went out on a bright day and had to make a drugstore stop for drops along the way. Some days the eye  is fine, other days it is a bother.  
y

I had this right after surgery too... my light sensetivity is still an issues at times... everyone is different.

Here is a link to a pair of sunglasses I bought that I wear over my regular glasses. These are great as the also give shade to the sides.
http://www.amazon.com/dp/B002I6VX1E/ref=asc_df_B002I6VX1E903270?smid=AKI1SEFJVR08O&tag=shopzilla_rev_10-20&linkCode=asn&creative=380341&creativeASIN=B002I6VX1E

I found mine a little cheaper at a department store.

DHM

[ToddH]

Mandy,
Facial palsy after an AN excision or radiation is not technically Bell's palsy. Bell's palsy is idiopathic, meaning "cause unknown" (however, I will contradict myself to say that most experts now agree it is caused by a viral infection).  Think of facial palsy as a general term and Bell's palsy a specific diagnosis. They both have the same effect, and that is what matters. Many doctors don't distinguish the 2 for this reason. Generally most Bell's palsy cases tend to be less severe than most AN-caused facial palsy cases, but that is changing because of improvements in microsurgery and radiation therapy , so less severe paralysis is more commonly seen nowadays. Again, I am speaking generally. As stated above, every one's case is different!
So, you can have "facial palsy" due to AN surgery, due to Lyme disease, due to trauma, d/t inner ear infection, etc., etc. On the other hand,  Bell's palsy comes on without a clear cause and is considered a diagnosis of exclusion (other causes ruled out).
Hope that helps,
Todd

[mandy721]

Todd,
Thanks. Your explanation helps a lot.
Mandy 

[Darlene]

Hi Mandy,

I had surgery 10 weeks ago and although I woke up with facial weakness, I have shown some improvement and that is why my surgeon recommended I see a facial therapist, he wanted a specific type of therapist, specifically someone who doesn't use any type of electric stimulation.  I had to go to a guy out in West Islip, NY  a two hour ride from my home.  The bottom line is that you should probably wait till your surgeon feels your husband is ready.   Good luck

Darlene