Author Topic: Facial Physical Thearapists  (Read 3383 times)

LADavid

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Facial Physical Thearapists
« on: February 20, 2008, 11:58:24 am »
So many questions.  I noticed that a lot of you have referred to working with Facial Physical Thearapists when dealing with Facial Palsy.  Is that the normal thing to do?  The House Clinic never mentioned it.  I have a list of exercises from the Bells Palsy Assoc. taped to my bathroom mirror that I run through 3 or 4 times a day.  I haven't seen any sign of progress but it seems like a good way to wake up the nerves. Any thoughts or suggestions?  Thanks.
David
Right ear tinnitus w/80% hearing loss 1985.
Left ear 40% hearing loss 8/07.
1.5 CM Translab Rt ear.
Sort of quiet around here.
http://my.calendars.net/AN_Treatments

lori67

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Re: Facial Physical Thearapists
« Reply #1 on: February 20, 2008, 01:09:07 pm »
Hey David.

I think it depends who you ask if it works or not.  Some say it does, some say it doesn't.  If the nerve is going to heal, it is going to heal with or without a therapist - the nerves seem to have a mind of their own and start working when they are good and ready and I don't think anyone has found a way to make that happen any faster.

I think the most important part of using a therapist when you do start to get some movement is to minimize or avoid the synkinesis that can occur.  It's easier to make corrections when things are moving at the wrong time if you can catch it early and re-train your brain to get the correct muscles going.  Nerves also seem to be set in their ways and once they get wired in there - it's hard to change.

I would think in your case, it would be important since you would want your face cooperating when trying to work!  You can't play a very tough guy if you're winking at people when you try to talk, and you can't make a very convincing minister if you're snarling at people when you try to smile!   :D

I would ask your doctor about it.  Sometimes I think they just don't think about telling you it's an option, but if you ask them about it, they'll usually give you a referral without question.  The Bell's Palsy website has a list of trained facial therapists, and I'm sure there are some in your area.

Lori
Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.

LADavid

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Re: Facial Physical Thearapists
« Reply #2 on: February 20, 2008, 10:08:27 pm »
Thanks Lori.  Sounds like something I don't need to stress over.  I'm still hoping that they decide to make a Pirates 4 and I'll be in perfect shape to do it.
David
Right ear tinnitus w/80% hearing loss 1985.
Left ear 40% hearing loss 8/07.
1.5 CM Translab Rt ear.
Sort of quiet around here.
http://my.calendars.net/AN_Treatments

4cm in Pacific Northwest

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Re: Facial Physical Thearapists
« Reply #3 on: February 20, 2008, 11:18:34 pm »
LA David,

It has only been a couple of months for you… give it time.

My first movement (1 mm in the corner of my mouth) came at 5 months and 3 days (not that I was counting or anything)  ::)… this face thing is a real test of patience for the patient.

Cheers,

4


4cm Left, 08/22/07 R/S 11+ hr surgery Stanford U, Dr. Robert Jackler, Dr. Griffith Harsh, Canadian fellow Assist. Dr. Sumit Agrawal. SSD, 3/6 on HB facial scale, stick-on-eyeweight worked, 95% eye function@ 6 months. In neuromuscular facial retraining. Balance regained! Recent MRI -tumor receded!

sgerrard

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Re: Facial Physical Thearapists
« Reply #4 on: February 20, 2008, 11:46:54 pm »
David, can you get extra points with the casting director of Pirates 4, since your eye patch is actually needed, not just a prop? If you explain the trouble you went through to make it real, they should be very impressed... ;D

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

Kaybo

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Re: Facial Physical Thearapists
« Reply #5 on: February 21, 2008, 08:17:44 am »
David~
Good Morning! I agree w/ Steve, I think you should get EXTRA pay for AUTHENTICITY!!!  As I sit here listening to Kendie watching "Curious George" and I am wondering if you have ever thought about doing voice overs or cartoons??  Just a thought...
Have a good one!  I plan to -- I "THINK" I actually get to leave the house today!!!  YEA!!
K
Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
SSD
Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!

vcschaub

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Re: Facial Physical Thearapists
« Reply #6 on: February 21, 2008, 09:09:28 am »
Given time, the nerves can repair completely. However, sometimes the nerve strand ends reconnect to a incorrect strand. This results in synkinesis. That is where a facial reanimation, physical therapisit, comes in. There is a whole thread about this. The therapy is sometimes combined with Botox to paralyze the errant nerve/muscle. This allows for retraining in the correct movement.

I had facial weakness develop 2 weeks after surgery. Facial reanimation therapy was never suggested. However, I did my own research and ended up consulting and being treated by Jackie Diels at the University of Wisconsin. She is a medical advisor to the ANA board and is highly regarded. Much of her research is on the Bell's Palsy site.
« Last Edit: February 21, 2008, 09:13:04 am by vcschaub »
6mm
Middle Fossa November 8, 2005
Drs Brackmann and Hitselberger
House Ear

4cm in Pacific Northwest

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Re: Facial Physical Thearapists
« Reply #7 on: February 21, 2008, 10:44:10 am »
vcschaub ,

RE your synkinesis … how much resolve did you get with the errant nerve/muscle. How much normalcy did you regain in your face after therapy?

4

P.S. I e-mail Jackie Diels at the University of Wisconsin... and never heard back from her.
4cm Left, 08/22/07 R/S 11+ hr surgery Stanford U, Dr. Robert Jackler, Dr. Griffith Harsh, Canadian fellow Assist. Dr. Sumit Agrawal. SSD, 3/6 on HB facial scale, stick-on-eyeweight worked, 95% eye function@ 6 months. In neuromuscular facial retraining. Balance regained! Recent MRI -tumor receded!

lori67

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Re: Facial Physical Thearapists
« Reply #8 on: February 21, 2008, 12:51:58 pm »
David,  I think if you get cast for Pirates 4, I should come along to make sure your eye patch is on straight.  And if Johnny Depp needs any wardrobe assistance, I can help with that too!

Gosh, I'm always thinking of others....   :P
Lori
Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.

vcschaub

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Re: Facial Physical Thearapists
« Reply #9 on: February 24, 2008, 03:17:37 pm »
=4cm:

I sent you a private message with contact information for Jackie Diels.

Also, in answer to your question, my synkinesis was pretty mild but it still improved noticeably, but I now need more Botox shots. My eye still closes slightly when I smile broadly, but the tearing ended and my mouth is symmetrical.
6mm
Middle Fossa November 8, 2005
Drs Brackmann and Hitselberger
House Ear