Why Are You So Tired With Bells Palsy

[bhobba]

Hi Guys

I normally post over on the QM section but recently came down with Bells Paulsy.

I seem to be making a slow recovery and, fingers crossed, it continues. Will start physio Monday week - wanted things to settle a bit before doing that.

But my God I am tired. I normally go to a restaurant to eat but now I find the driving very tiring and don't feel safe doing it. I have to go to a club down the road whose food isn't as good nor as healthy - you get lots of chips and gravy etc which I mostly leave.

I have read its pretty normal to be tired with it, and sometimes it can be nearly as bad as chronic fatigue syndrome but I don't understand why. All I can think of is some think its caused by a virus and that's what going on.

Oh and the other thing is my doctor hit me hard with Prednisone which is the usual treatment these days. But it seems the studies use 50mg tapered over two weeks. He gave me 25mg tapered over two weeks, I was nearly going to ring him about that, but decided against it - he is a good doc. I suspect its because I also have diabetes and you need to be careful using Pretnisone with that.

Actually I have read people with diabetes are 4 times more likely to get it. I suspect I have been a bit slack in managing mine over Christmas/New years. I must really dedicate myself to being really careful with it. I saw a dietician for quite a while to manage it - I think I need to go back.

Thanks
Bill

 

[Greg Bernhardt]

All I can think of is some think its caused by a virus and that's what going on.

I seem to remember my dad being very tired for a few years and then had some sinus surgery and they found lots of unrelated minor infections (which they cleared). Once he was recovered from the sinus surgery he much more energy. It was thought he was spending lots of energy fighting these cronic infections he never knew he had.

 

[lisab]

I'm sorry to hear it! You're correct, Bell's Palsy has been linked to various conditions, including viruses. From NIH:

The disorder has also been associated with influenza or a flu-like illness, headaches, chronic middle ear infection, high blood pressure, diabetes, sarcoidosis, tumors, Lyme disease, and trauma such as skull fracture or facial injury.

http://www.ninds.nih.gov/disorders/bells/detail_bells.htm

From WebMD:

The cause of Bell's palsy is not clear. Most cases are thought to be caused by the herpes virus that causes cold sores.

http://www.webmd.com/brain/tc/bells-palsy-topic-overview

I've known so many people who have had Bell's. My former boss's wife had to take a leave of absence from work, she was totally wiped out for several weeks. She did recover fully - I hope you do too!

 

[bhobba]

I've known so many people who have had Bell's.

Interestingly 1 in 60 people get it, and when you look at it that way you realize its not that uncommon - its just a bit less that getting things like Rheumatoid Arthritis and my doctors say that's fairly common. I also have Psoriatic Arthritis and that has about the same probability although it is thought that disease is way under-reported being called the queen of arthritic conditions - it stares GP's in the face and they never twig to it. A Rheumatologist however takes one look at you and without even looking at the blood tests diagnoses you straight away.

Anyway the upshot here and why I mention it is a lesson on statistical inference. With Bells Palsy the incidence is about 30 people in 100000 get it in a year. So it is tempting to say its quite rare. But convert it to the probability of getting it in your lifetime and it tells a different story.

Thanks
Bill

 

[cremor]

Hi Guys

I normally post over on the QM section but recently came down with Bells Paulsy.

I seem to be making a slow recovery and, fingers crossed, it continues. Will start physio Monday week - wanted things to settle a bit before doing that.

But my God I am tired. I normally go to a restaurant to eat but now I find the driving very tiring and don't feel safe doing it. I have to go to a club down the road whose food isn't as good nor as healthy - you get lots of chips and gravy etc which I mostly leave.

I have read its pretty normal to be tired with it, and sometimes it can be nearly as bad as chronic fatigue syndrome but I don't understand why. All I can think of is some think its caused by a virus and that's what going on.

Oh and the other thing is my doctor hit me hard with Prednisone which is the usual treatment these days. But it seems the studies use 50mg tapered over two weeks. He gave me 25mg tapered over two weeks, I was nearly going to ring him about that, but decided against it - he is a good doc. I suspect its because I also have diabetes and you need to be careful using Pretnisone with that.

Actually I have read people with diabetes are 4 times more likely to get it. I suspect I have been a bit slack in managing mine over Christmas/New years. I must really dedicate myself to being really careful with it. I saw a dietician for quite a while to manage it - I think I need to go back.

Thanks
Bill

Your vitals (were) checked out ok? No peaking in blood pressure, ecg changes, saturation ok? Cranial nerve status otherwise normal? No funky skin rashes lately?

I understood that it's the first time you've caught this facial paresis symptom? Personally, I'd be a little careful with diabetics presenting with bell's and extreme tiredness. Tiredness can be associated with Bell's, but it's not a common symptom, especially that severe. Tiredness could be associated perhaps with the corticosteroids ramping your glucose levels up (excessive diuresis etc -> tired), but often times corticosteroids themselves during use they make the user feel quite the opposite. You don't live in an are where you could have been subjected to a tick bite? How are your glucose levels?

Easy to speculate what it is and what it could be over the internet naturally, but bottom line, it's not going to help you (99% odds it'll make you feel more worried) and extreme tiredness such as you describe, is going to ring a doctor's bell since you have diseases which ramp up risk factors for other things to occur. One of them being bell's paulsy. If the tiredness symptom was already present and you checked out otherwise ok, perhaps it's just a benign idiopathic palsy. But I can't think of a doctor getting irritated of a patient presented with such symptoms and asking about it.

 

[bhobba]

Hi Cremor.

Thanks for your very detailed reply - its appreciated.

Now the strange thing is this - it all of sudden just stopped. I was fine driving to my regular restaurant today. Strange. The only thing different is I am on the Pretnisone taper so maybe it was that. I know with Diabetes Pretnisone will raise glucose levels which I am sure my doctor knows and why he only gave me 25mg. I can usually tell when that happens though because I pee a lot - which was not happening. But he was keen for me to take them when I mentioned the double blind tests showing while it doesn't reduce how long it lasts but does increase the chance of full recovery. He knew that - but was happy I checked. He took blood pressure looked for non psoriatic rashes etc - the easy stuff - all of no concern. He even had a trainee doctor there and called her over and asked what she thought. She said - stoke. He smiled and said - how would you check. She thought about it - Bells maybe. What's the test - then she twigged - the forehead.

He can run more tests if I want but his view is its likely a waste of time - but will do if it doesn't start to clear up - which it is. Today I saw a big improvement. Yes I live where there are Ticks - lots of them in fact - in Brisbane Australia. I know about Lyme but the problem is here in Australia - and I am ashamed to say this - they don't actually recognise Lyme disease. Its bizarre. One of our greatest tennis players, Sam Stoser, who is on the Gold Cost near where I am got it - and doctors here don't recognise it.

I know and trust my doctor - he is very very good. The best thing will to chat about it when I see him next .

Again thanks so much for your detailed reply.

Thanks
Bill

 

[cremor]

Lyme's is one of those conditions that keeps doctors awake at night and pondering (and end up in self-loathing;). It's easy to exhaust the local lab resource and end up none the wiser. Symptoms are basically anything anywhere, the rash and paresis symptoms being common ones, but on the other hand it can mimic a lot of conditions. Basically the correct way to diagnose it is to suspect it and treat it empirically with antibiotics. Very rarely a tiny stroke localized in the brainstem presents as a full facial paresis: Only way to see it for sure is an mri scan, ct can maybe show it as the lesion gets older. The lesion in this case occurs in the immediate vicinity of the proximal ends of the facial nerves in the brainstem. But it's one of those very rare conditions and also your blood pressure should have been peaking, should you be having a stroke (unless you have severe diabetic autonomous neuropathy and I kind of get the impression that's not the case).
Stress on the body in the form of a subclinical infection for example can sometimes cause transient heart rhythm aberrations, the risk of which increases with advancing age and diabetes. The symptoms you described could be manifested in numerous combinations by all of the aforementioned diseases. Obviously I have no clue about your specific health records, so you should take my considerations more as ideas being thrown around - your doctor seems to have things in hand.

All in all, relief of symptoms is a very good sign. It's not an advise generally given, but you could learn to palpate your pulse from your wrist and discern if it beats in a rhythmical monotonous fashion. Should you start feeling a bit queasy again, palpate it and try to feel if the rhythm has become uneven. It could be indicative of a problem with the heart pacing itself the wrong way, and it can happen in paroxysms. Most important of all is not to worry yourself sick about it and make sure you have your vascular disease risk factors in good order (on the management of which I heard a quote from someone once: "all the good things in life become prohibited";)

 

[bhobba]

Hi Everyone

I just wanted to give an update.

Bells is about 80% resolved. Still feeling tired but not as bad. Have a bit of a dull headache and sinus but I often got those before anyway.

Really mucked up my eye though. Used Cellufresh which turned out to not be good enough and I got exposure kerititus and a small corneal ulcer. Saw an ophthalmologist and it resolved but I was l left with a small scar and some thinning. Using he correct stuff now.

Started seeing a neuropsychiatrist who has seen a lot of Bells. He is good a explaining stuff about it such as its normal to be tired and in his experience it takes about 6 months to fully recover.

Just one last thing. I am on Methodrexate for psoriatic arthritis. Been a bit slack with the regular blood tests. Provided they come back OK I can see its just a matter of time.

Thanks
Bill

 

[Evo]

Hi Everyone

I just wanted to give an update.

Bells is about 80% resolved. Still feeling tired but not as bad. Have a bit of a dull headache and sinus but I often got those before anyway.

Really mucked up my eye though. Used Cellufresh which turned out to not be good enough and I got exposure kerititus and a small corneal ulcer. Saw an ophthalmologist and it resolved but I was l left with a small scar and some thinning. Using he correct stuff now.

Started seeing a neuropsychiatrist who has seen a lot of Bells. He is good a explaining stuff about it such as its normal to be tired and in his experience it takes about 6 months to fully recover.

Just one last thing. I am on Methodrexate for psoriatic arthritis. Been a bit slack with the regular blood tests. Provided they come back OK I can see its just a matter of time.

Thanks
Bill

Good luck in your recovery!

 

[bhobba]

Good luck in your recovery!

Much appreciated.

Thanks
Bill