Bell’s Palsy

In January 2015, I woke up one normal Friday morning and noticed that the right-hand side of my face had ‘dropped’ and was becoming increasingly numb and paralysed. I promptly made my way to the local hospital and the Doctors very quickly confirmed that I hadn’t had a stroke, but had suffered a case of Bell’s Palsy.

They were unable to determine the cause and I was prescribed the standard steroids (Prednisone) and anti-virals (Aciclovir). Over the next three days, the paralysis got gradually worse until, by the Monday I had no control at all over the one side of my face.

Squash

Despite the classic Bell’s Palsy symptoms (difficulty to speak, eat, drink, smile, or close my affected eye), I felt absolutely fine in myself, so I continued to go to work and to play squash. I was absolutely determined to remain positive and not to feel a victim of this condition. In fact, I increased my squash games from two or three times a week to four or five, in order to keep myself fit and to counter any potential weight gain from the steroids. Interestingly, my squash improved! I joked that this was down to the steroids, but it was more likely because my one eye wouldn’t close properly, which meant I had to concentrate harder on watching the ball – exactly what you should do when playing squash!

B12

I did what we all do these days when we or someone we know is diagnosed with a condition—I ‘Googled’ everything I could find out about Bell’s Palsy. There’s obviously a lot of nonsense out there, but also a tremendous amount of valuable information and support too. One thing I soon discovered, was the recognised benefit of increasing your vitamin B12 intake (in the Methylcobalamin form). In some countries it’s routinely prescribed as a course of injections for Bell’s Palsy sufferers, but it can be easily be bought over-the-counter in a high-dose lozenge form. B12 has been found in several studies to help in the repair of nerve damage in these cases.

YouTube

There are a huge number of great YouTube Bell’s Palsy ‘recovery diary’ videos, which I found particularly helpful. Seeing people encountering the same symptoms and difficulties and observing at what stage they improved was greatly beneficial and encouraging. I also found it really valuable to record my own daily videos (not publicly uploaded) just to track my progress and document the very gradual improvements as they occurred.

The support offered by the on-line videos really inspired me and gave me the confidence to put my own together (above). As I was unable to find any trumpet player specific diaries, I decided to see if I could compile the kind of video which I’d been searching for and which I would have found so useful at the beginning. This was all part of my determination to create something positive from the experience.

Trumpet

I discovered that most people do make a full recovery, but it can take months or even years. Many described long-lasting residual after effects, which I imagined ordinarily you could learn to live with on a day to day basis, but could potentially prevent you from being able to meet the physical demands of trumpet ‘chops’. Critically, the specific nerve damaged by Bell’s Palsy (cranial nerve 7) is the exact same motor nerve brass players use to form an embouchure and to play our instruments.

I found videos of a trombonist and a euphonium player who were recovering well from the condition, but also read about a trumpeter who could no longer play at all and a soprano cornet player, who in the end had to switch to an instrument with a larger mouthpiece.

This obviously increased my concern that the focused compression and control necessary to play a small mouth-piece instrument might be no longer possible. Thankfully, as an ex-professional, I wasn’t relying on playing the trumpet to pay the mortgage!

Trying & failing to get a note on Bell's Palsy day 20

Trying & failing to get a note on Bell’s Palsy day 20

It was nearly a month before I could get a first note again on the trumpet and nearly two months before I could be confident that I was actually going to be able to play again at the level I had done before the onset.

I was always mindful of taking it slowly and not pushing the recovery process by exercising the face too soon, or (once I was able to finally get some notes) playing for more than five or ten minutes at a time.

By week 9 I felt I had more-or-less fully recovered. My face still ached a little when I was tired and my eye felt a bit uncomfortable in bright sunlight. Also, my ‘chops’ were certainly less symmetrical than they were before Bell’s Palsy (the Palsy side now slightly lower), but it was only slightly and thankfully not so much as to cause me any loss of range or stamina. A huge relief! After six months, I had completely recovered and can now detect no signs of having had experienced the condition.

A Theory

I have a theory—it’s only a theory, as I’m obviously not a doctor! I believe that brass and woodwind players might actually have a better chance of making a speedy recovery from Bell’s Palsy than would otherwise be the case. The damaged neural pathways perhaps ought to re-trace and repair themselves more easily if helped by the ‘trained’ muscular memory in the face. As a brass musician, your face knows better than most what it needs to be able to do.

Vocalise

On the cold January morning that my adventure with Bell’s Palsy began, I’d been planning on practising a trumpet arrangement of Rachmaninov’s ‘Vocalise Op 34’, but instead found myself rushing off to my local A&E.

The music became something of a theme tune for my recovery – I often listened to the sublime Yo Yo Ma classic cello recording and I fancifully thought I would consider myself ‘fully recovered’ once I could finally play the piece.

On 24th March, 67 days after the Bell’s Palsy onset, I was able to record ‘Vocalise’ as background music for the recovery video I was putting together.

Top Tips

So, my top tips for dealing with Bell’s Palsy would be:

● seek medical advice and take the steroids and antiviral medication, which may help

● remain positive and believe that you are going to get better

● rest when you need to, but also keep yourself fit and eat as healthily as possible (e.g. look up which foods are especially anti-inflammatory)

● Google ‘vitamin B12 methylcobalamin’ and learn about the benefits for nerve damage repair

● take it very slowly with the chops and don’t rush the process and over exercise them. There is strong evidence to suggest exercising too soon can cause mis-wiring of the nerves (synkineses)

Finally

The video and the information on this page is intended to provide encouragement to any fellow brass or woodwind players currently suffering with Bell’s Palsy. I’ve tried to create something that I would have found useful when first diagnosed and so I really hope you find it beneficial and wish you well in your recovery!

Please share and feel free to leave feedback on the YouTube page or contact me on this site.

I was asked to write a piece for the wonderful brass website 4barsrest and my story was also featured on Norman Lebrecht’s SlippedDisc.


Timeline

January 2015
16th – Initial onset and diagnosis
19th – Right-hand side of face fully paralysed and as bad as it would get
29th – First small sign of movement in eyebrow and nostril
31st – Able to move eyebrow independently

February 2015
3rd – Eye closing slightly more easily
4th – First signs of cheek movement
7th – Eye fully closing on blinking (not full speed yet)
8th – Able to whistle.
12th – Able to wink again. Realised I’d gone a whole hour without thinking about the BP
13th – Played a note of the trumpet for the first time
18th – Only really notice BP now if I make a big smile. Can play notes up to ‘e’ at top of stave. Cheek inflates and chops are quite asymmetrical

March 2015
2nd – Been practising for 5-10 minutes per day. Improving daily, but cheek still inflating when tired
20th – 9 weeks today. Embouchure much stronger and no longer inflates
24th – Able to record Vocalise as a backing for the YouTube recovery video

Other Links

There are many fantastic sites giving a great wealth of information about Bell’s Palsy and offering valuable support. Here are a few to get you started:

http://bellspalsy.org.uk/

http://www.facialpalsy.org.uk/

http://www.nhs.uk/conditions/Bells-palsy/Pages/Introduction.aspx

A great page for brass players, published by trombonist Tim Smith, can be found here:

http://timsmithtrombone.com/bells-palsy/