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Old 02-25-2013, 03:12 AM   #1
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Slight bells palsy - diagnosis?

Hi, I am experiencing symptoms which sound like bells palsy

If I have it the most likely cause is from when I lost an inch squared worth of skin/flesh on my chin when it was grazed off and subsequently given stitches by a doctor, which happened when I was 13 or14. This involved stretching the skin together top to bottom closing about 3/4 of an inch gap.

Since that time I have had facial tensions on the right side of my face which have been steadily getting worse.

No doctor wants to recommend me to a specialist because they say they can tell by looking at me i'm fine and they don't want a specialist laughing at them.

So my question is, how would you diagnose bells palsy if it was only a slight case?

I have read it can be triggered by surgery (cosmetic) around that area, so how is it diagnosed when it is a side effect of cosmetic surgery?

I get the feeling if you only have a slightly droopy mouth and slight changes in wrinkles, then for a clinical (appearance?) diagnosis, this would be put into the category of normal facial asymmetries or general wear and tear from work and lifestyle as well as mental attachments influencing expression.

I was told by a doctor no one is able to get a referral for nerve conduction testing on the face, it;s just not done. Is this true? Is there any other test or specialist I should see? Skin specialist? Nose specialist? Neck specialist?

(ps you can ignore my last thread or any mod can delete it if they want, this is the updated one)

Last edited by monkface; 02-25-2013 at 07:10 AM. Reason: "13 and 14" changed to "13 or 14"

 
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Old 03-01-2013, 06:44 PM   #2
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Re: Slight bells palsy - diagnosis?

I would highly suggest you make an appointment with a neurologist. Bells Palsy is a neurological condition, which can be caused by surgery, if the nerves are affected, but is more likely associated with a nerve disorder. I have never seen a nerve conduction study done on the face, but it is possible to do so.

I cant imagine that any doctor is afraid a specialist will "laugh at them", but it does appear the doctors you are going to, arent overly concerned about this. However it is YOUR face, and you need to feel good about yourself- can you get someone to refer you to a Neuro, or simply make the appointment yourself?
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Old 03-03-2013, 02:26 AM   #3
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Re: Slight bells palsy - diagnosis?

Thanks for the reply, I really appreciate it.

Yeah i guess I will go see a neurologist. I saw a private one already and he seriously took 3 minutes to look at me then told me i need botox injections and got really angry when i took a few seconds to think about it so I left without paying, hopefully next time he wants to act like a power-tripping child he will think of the $350 dollars lost and instead show respect So yeah I think I made a mistake going to the private neurologist he seemed on a quest to make $100 per minute.

I did make an appointment with a public neurologist but after 4 months of waiting for my appointment I got a letter saying it had been pushed back another 6 months so I cancelled the appointment, but now it's looking like it's my only option. So I will have to wait another 10 months I guess. Pretty lame.

And yes, I have been told some stupid things by doctors and that the "specialist will laugh at them" is a common line used by Australian GP's. I have heard it a few times from different doctors. One doctor told me I had zero chance of nerve damage, as she could tell by looking at me. I asked for a referal to a specialist but she said the line above, they will laugh at her. So I asked her to put in writing what she just told me, that i had zero chance of nerve damage, but she refused and instead wrote "nerve damage unlikely"... So i told her she could either give me a referral and have specialists laugh at her, or give me in writing "zero chance of nerve damage". She went with the latter option "zero chance", which is cool, coz if i do have nerve damage i will come back to get her fired.

But yes I have a million entertaining stories from quacks. The first doc I saw, I explained my symptoms and chin injury... said I had tension in my mouth, nose and eyes, "Ha!" she said (She knew I was wrong earlier but she didn't have anything to back it up with, she now had her proof) "the chin is in no way connected to the mouth, nose and eyes" she told me. Diagnosis? All in the head. Prescription? Antidepressants.

And here I was thinking that the chin was connected to the mouth and to the nose and eyes. But that's why I am just the lowly civilian without medical authority, because according to this doc, the chin, mouth, nose and eyes all float through the air independently of each other with no physical connection whatsoever, yet somehow remain in the arrangement of a face.

Seriously, how do you spend 5 years studying to be a doctor and not realise the mouth connects to the chin?

The past 2 years has been wasting so much tax payer money going to see like 20 different GP's who all refuse to give me a referral or help me in any way, unless it's botox or antidepressants.... and they all can tell this in a few seconds of looking at me.

One doctor I had been talking to for 10 minutes and mentioned I had a wide graze stitched up which you aren't supposed to do as a doctor. I had mentioned this 5 or 6 times during the 10 minute convo when she cuts me off and asks me "wait, they stitched up a graze?" I'm thinkin' lady, if you only just heard that, what was going through your head the first 10 minutes??

I got a referral off her for a neurologist but I had to seriously argue for it... like.. it was a serious heated argument as she was plain refusing... just to get a referral to a neurologist which is well within my rights to ask for. Again she was "scared of what the neurologist would think of her"

And the only reason I got the referral to the private neurologist is because the doc was gay and based on a few things he said, was interested in me. But yeah that makes me awkward to go back but at least he'll probably give me a referral if i need it.

There's a nice glimpse into the Australian medical system for you.

Might seem amusing in retrospect but never have I experienced so much disrespect, lies, manipulation, anger and child-like tantrums as from doctors. Each time I walk into a docs office I feel like I have been transported back to primary school, or maybe a primary school 50 years in the past, with WW2 having just finished and the dream of putting a man on the moon starting to develop.


 
Old 03-03-2013, 06:41 PM   #4
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Re: Slight bells palsy - diagnosis?

Thanks for your reply, i really appreciate it.

Just so you know, i have been told those exact words by 2 different doctors... "I don't want the specialist laughing at me"... and I have been told something similar by other doctors too, they don't want the specialist to look unfavorably on them.

I have also been told there is zero chance of nerve damage because the chin is in no way connected to the mouth, nose and eyes, and as that is where my tension is, it proves there is no nerve damage! (seriously... the chin is in no way connected to the mouth??) You can't make this stuff up

The other thing doctors do is tell you zero chance of something, but then if you ask for it in writing they try write "chance unlikely" instead... surely that boarders on fraud.... tell you one thing... write another... to protect themselves legally in case they are wrong.... which gets confusing after they have spent 10 minutes telling you they are 100 percent sure.


what a world

 
Old 03-04-2013, 09:09 AM   #5
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Re: Slight bells palsy - diagnosis?

So it turns out what I had was not a graze but more technically an avulsion.

Having spoken to 15-20 doctors I am quite surprised none of them have recommended me to any specialist nor do they see any problem with my injury being given stitches at such a young age.

I have been searching all over the internet and all I seem to find is information saying you can't stitch an avulsion (an avulsion is a deep graze with loss of skin and tissue... a graze or abrasion on the other hand leaves most of the skin intact.

Let me be one of the first to let the internets know, you CAN stitch an avulsion. It was done to me.... What I believe is more correct to say, is that you SHOULDN'T stitch an avulsion.

But I cannot find any information on why you shouldn't stitch an avulsion and the consequences, all i seem to be able to find is the same line repeated that you "cannot stitch an avulsion".

But not one doctor has seen a problem with my chin avulsion (4cm across and maybe 1.5cm high) being stretched and stitched close at the age of 13 or 14

So the internets says you cannot stitch an avulsion. The doctors I see in person say you can and it's all good. They are right you can stitch an avulsion, but I am skeptical of the opinion that it is fine to stitch one.

My question is, WHY should you not stitch an avulsion?? Are there any medical writings I can show Australian doctors to convince them you are not supposed to stitch an avulsion?

It could even be common practice to stitch avulsions in Australia, contrary to other western nations. We can be backward here such as the government maintaining there is no lymes disease in australia, contradicting the many people who have tested positive for lymes and yet never left the country.


Actually one of the reasons I really want to get this sorted is I got the sterotypical bullseye rash and fever associated with lymes [edit: this was after removing a tick while drunk using 2 knives as tweezers... don't laugh, we have no lymes or tick education in our public system and since then it has become more well known with many news stories and documentaries].... so I don't really want a weak spot in my nerves for bacteria to take hold. But getting help or diagnosed for lymes will literally be a million times harder in this country than for my current tribulations, and I say this after 1.5-2 years of seeing 15-20 doctors without one doctor seeing a problem with the stitched avulsion. I am also far too poor for an international lymes test.

I unfortunately have to wait 10 months to see a public neurologist so if anyone knows of any other specialists that could be relevant please let me know. Is there a neck specialist??

At least I have gotten to share my story and people on the internet seem to care so thank you

Last edited by monkface; 03-04-2013 at 09:16 AM. Reason: Edit noted above

 
Old 03-04-2013, 09:30 AM   #6
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Re: Slight bells palsy - diagnosis?

Heres a photo of a chin avulsion I found on the internet... this is not me.. blood warning for the squeamish

https://dl.dropbox.com/u/32308739/413290_3659868457571_1765246340_o.jpg

So this was someone falling on concrete. I came off a bmx and face planted ashphalt so it is likely I fell harder and faster and onto a rougher texture, but for a vague idea, you can imagine this injury but much wider and more gruesome, spanning from the center of the chin to the right side of it.

And it was then stitched top to bottom closing that gap of about 1.5cm

[edit: this person was told his avulsion could not be stitched]

Last edited by monkface; 03-04-2013 at 09:34 AM. Reason: bonus trivia

 
Old 03-04-2013, 09:39 AM   #7
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Re: Slight bells palsy - diagnosis?

I have a few thoughts I'll share. Bell's palsy symptoms tend to fluctuate in severity, with the drooping most noticeable when fatigued, stressed, etc. If your drooping is intermittent, then it could be Bell's. Lyme can cause similar symptoms. If the drooping is constant, more like a pulling from below where the avulsion occurred, this could be a result of the scar tissue in chin shrinking over time., which scar tissue tends to do. In that case, a couple of things could be done. A plastic surgeon could revise the avulsion scar by removing it freeing up the adhesions pulling on the facial tissue, and replace the skin with a graft. OR a tissue expander could be used to stretch out the skin and scar tissue to loosen it and relieve the pulling on the face. It is a gradual process. A little balloon like device is inserted under the skin and gradually filled up with more fluid until the desired stretching has occurred. This works well on normal skin but may be harder where there is scarring, as scar tissue is very tough and fibrous. Bell's will involve one sided eyelid drooping (intermittently). Hope that helps some. Lyme testing should be done anyway, with your history being so suggestive. Were you treated for it at the time? If not you may still have the infection and it could do further damage.

 
Old 03-04-2013, 09:50 AM   #8
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Re: Slight bells palsy - diagnosis?

PS The reasons an avulsion shouldn't be stitched, if it is very large, is simply mechanical. The overstretching that it takes to close a wide gap distorts the surrounding tissue and the stitches are pulled so tight the wound often pops open a few days later, and then there is nothing you can do but let it heal in with scar tissue, which is a cosmetic problem and can take forever, lead to keloid formation, infection etc. A large avulsion is best treated by cleaning up the jagged damaged edges of the skin and putting in a nice clean graft from an area that matches color and texture-wise. It is really a judgement call on the part of the surgeon, and results depend on the elasticity of the skin, healing process, etc of the patient.

 
Old 03-09-2013, 03:03 AM   #9
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Re: Slight bells palsy - diagnosis?

Hey thanks for the replies, it is strange to hear people approach the issue with logic and reason.

I guess I'll wait the 10 months to see a neurologist but I don't have much faith in them or the system.

If I fail to receive proper advice or discussion on the issue again I think I will just take a chance and graze off my chin again, let it heal naturally, and see what happens.

If you want something done in this world you gotta do it yourself.

 
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