Question: I'm a 36-year-old woman. One morning recently, I woke up with saliva at the corner of my mouth. Then I felt strange face sensations. I realized I could not close my right eye. There was a scary numbness. When I looked in the mirror, the right eyelid was drooping. I could not make a smile, and I couldn't straighten out my drooping mouth corner. Whoops, I thought - stroke. Later that morning, I saw the doctor. It was Bell's palsy. I thought for sure I'd had a stroke. I've read up some on Bell's palsy but still cannot understand why it happens. My recovery has been OK.
- Mrs. J.L.
Answer: You describe a typical case of Bell's palsy.
It is not a stroke. What happens is a one-sided failure of the nerve that controls eyelid and facial muscles.
No one can say why it happens, although recent speculation involves a viral infection. In a few cases, the problem has been traced to infection by the Lyme disease organism.
I hope you continue to do all the things needed for your recovery. You need an eye patch to compensate for the inability to close the lid. Wear it during the day, and tape it closed at night to avoid drying out of the eye.
Unfortunately, you don't mention treatments. It is always appreciated when a reader lets us in on current therapy for various illnesses.
Massaging the facial muscles helps some Bell's palsy patients. And some doctors start their patients on prednisone to hasten nerve healing.
Most patients recover completely in a few weeks or a few months. A few have lingering problems with the nerve.
Question: I have pernicious anemia. About all I know is that it is a B vitamin deficiency. I am taking B12 shots, which are supposed to help my low red cell blood count. I got the Schilling test. Can you tell me more?
- J.W.
Answer: Deficiency of vitamin B12 causes pernicious anemia, but the principal cause is a lack of the stomach's intrinsic factor. That's what permits absorption of B12 in the body. It is the ferryboat, if you will, that carries B12 across the stomach tissue to blood vessels.
Without the intrinsic factor, the vitamin piles up on the dock. Meanwhile, red cell production, which requires B12, wanes. Nerves and the spinal cord, which depend on B12 for health, suffer.
The B12 shots bypass the stomach. In our labored metaphor, it helicopters the vitamin directly to the blood.
You should experience quick improvement. You probably will need to continue with the B12 shots in the future.
The Schilling test demonstrates the intrinsic factor lack, ruling out other known causes of B12 deficiency, such as pancreas trouble. Establishing the intrinsic factor lack permits confident institution of B12 injection therapy.
For more information, see the "Understanding Anemias" pamphlet. For a copy, write: Dr. Donohue - SR152, Box 5539, Riverton, NJ, 08077-5539. Enclose $3 and a self-addressed, stamped (55 cents) No. 10 envelope.
Question: I have very dry and flaky ears in the outer ear canal. I have tried baby oil, Vaseline, etc., but nothing has helped. What can I do? Are there any over-the-counter medicines to help this?
- P.W.
Answer: Infections, seborrheic dermatitis and allergies are just a few causes of dry, flaky ears. You really need to be examined to be treated appropriately.
Often, a simple over-the-counter cortisone cream will suffice to correct the situation.