The Recovery

Patients with facial palsy just want to look like themselves again



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Tara Coles had her second bout of Bell’s palsy last year. Photo by Michael Ventura

Tara Coles had just put her toddler and 10-month-old twins to bed and was finishing up the dishes when her husband, John, looked at her and said her left eye was blinking more slowly than the other. “At first I thought, ‘What is happening?’ ” says Coles, an emergency room physician. “But I was so exhausted that I thought, ‘I’m just going to go to bed.’ ”

She woke around 2 a.m. with pain near her left ear, looked in the mirror and found the left side of her face drooping. She couldn’t close her eyelid. “In the back of my mind I knew what it was, so I wasn’t freaking out,” she says. Later that day she went to the Baltimore hospital where she worked and told colleagues that she had Bell’s palsy. A form of facial paralysis, Bell’s palsy is usually temporary and can occur when a facial nerve becomes damaged or inflamed, resulting in muscle weakness on one side of the face. The exact cause isn’t clear, but many scientists believe it could be related to certain viruses; it occurs more often in people who are pregnant or have diabetes. Coles thinks her Bell’s palsy may have been the result of undiagnosed Lyme disease, possibly picked up as a child on summer trips to deer-infested Fire Island, New York. At the hospital, the emergency room doctor prescribed anti-inflammatory and anti-viral medicines and advised Coles to tape her eye shut when she slept to protect her cornea. She kept going to work, and felt like she had to explain the situation to her patients. 

“Just so you know, I have Bell’s palsy,” she’d say. “My face isn’t working well. It’s not contagious, but it may be hard to understand me.” 

About six weeks later, strangers stopped staring. A few weeks after that, the twitching stopped, except when she was tired. Coles moved on with her life, working and raising four kids, and used her experiences to help with patient care. It seemed like at least once a month she’d have a patient with Bell’s palsy or hear of a friend who had it. “It’s not that uncommon,” Coles says. It never crossed her mind that it could recur—Bell’s palsy rarely does—but nine years later, in February 2016, it happened again. She walked into the dining room of her Bethesda home and John told her something was wrong with her face. “Your right eye is closing slower than the other,” he said.

Coles looked in the mirror. I can’t even believe it, she thought. 

The facial paralysis wasn’t as bad the second time, she says, but food and drinks still dribbled down the side of her mouth, and she kept biting the inside of her cheek when she ate. “You’re constantly aware of it,” says Coles, 47. “You don’t really appreciate what your face does until it doesn’t do what it’s supposed to do.” 

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