Parotid Gland Surgery #2
My Surgical Experience
I was unlucky with my surgical experience. It is difficult when seeking out a surgeon, to know how many parotidectomies they have performed. My experience of seeing Head and Neck surgeons over the last ten years, is that some surgeons in Ear, Nose and Throat, specialise in thyroid and parathyroid surgery. They have not always done a lot of parotid gland removals. In Oral Maxillofacial surgery too, some may have done skin cancer surgery, dental surgery and cosmetic facial reconstruction. They may not always a huge amount of parotid gland surgery. Whether it is cancer or benign disease, it is important to ask your surgeon how experienced they are with this surgical procedure.
I had a superficial parotidectomy in April 2018. My surgeon decided to do the operation without doing a scan first. He went in blind, and operated with no imagery at his disposal, only the knowledge that I had been having endoscopies to treat glandular malfunction.
I feel enormous remorse that I allowed this to happen. If my surgeon had done a scan of my parotid gland beforehand, he may have seen the pathology in its entirety, and if he had not been confident to remove the whole salivary gland, he could have referred me to someone who could. I may now be in a very different position.
My surgeon told me that he would not remove the entire salivary gland because he said that if he were to remove the deep lobe as well, the risk of permanent facial nerve damage was too high. I did expect, however that when he agreed to do a superficial parotidectomy, that the entire superficial lobe would be removed, and that the parotid duct, which my surgeon knew was thinned, would be cut and tied up. This didn’t happen.
I signed a disclaimer before surgery: I accepted the risk of facial paralysis, and the risk that I may still have symptoms with the remaining deep lobe. Post surgery, I knew the minute that I woke up in the recovery room that I was paralysed. Once they had removed the oxygen tube from my mouth the registrar, who was standing at the end of my bed, was shouting at me;
‘Blink, Felicia, wrinkle your nose, blow air into your cheeks.’
I couldn’t do any of it – and when I tried to speak, my mouth was drooping downwards. It was a shock- I won’t lie. I thought that the risk of paralysis was rare, but if it was, then I was one of the rare ones. I did not see my surgeon after the operation. His registrar, however, told me that they had tested the facial nerve, and that it had been preserved and was functioning fully. They were confident that my facial nerve palsy was temporary and that it would recover. My facial nerve paralysis got progressively worse during my three day stay on the ward, despite IV steroids being administered.
All five branches of the 7TH Cranial nerve were affected. My facial nerve damage meant that I could not shut my eye, smile, wrinkle my nose, or raise my eyelid. My mouth was also drooping. I did have some movement – I could still speak, eat and drink, but I did score IV on House-Brackmann scaling, which is moderate to severe palsy.
This was me post surgery. Go easy on me, please. I know I look like The Joker!
Recovering My Facial Function
I found a gifted physiotherapist at The Lindens Clinic, which is a Specialist Facial Rehabilitation Centre & Nerve Injury Rehabilitation Centre in Greater Manchester. She worked with me for five months. She gave me gentle exercises to do, which focused on raising my facial tissue and muscle upwards, and she taught me how to tape my eye shut at night, which I had to do before going to sleep every night.
It was a wonderful day when my facial function started to return. I was on holiday on the Greek island of Kos, where I spent a week in the sleepy town of Kefalos. Taping my eye and doing my physio exercises daily were part of my rehabilitation. I spent the time swimming in the Mediterranean Sea, eating lamb chops and chips and relaxing in the sunshine. On my last night, I was sitting out on the veranda where I was staying, with Martin and Belle, a couple who were staying next door. We were drinking Ouzo and watching the brilliant pink and red sunset. Martin told a joke. It made me laugh and without realising it, I smiled.
‘Your smile is coming back,’ Belle said.
After returning from Greece, my paralysis progressively lifted. Within five months, I had recovered my full facial function.
My facial function recovery took five months in total. That is quite quick. It takes many patients up to twelve months to recover. The only lasting damage has been a mild astigma in the affected eye. It becomes easily dry, and I have slightly blurry vision. This is managed with Carbomer eye gel, to keep my eye moist, and reading glasses.
Living With Facial Nerve Palsy
Living with facial nerve palsy is tough, because you cannot express emotion. You cannot smile or laugh, nor can you express when you feel sad or frightened – and you lose your looks. I missed my lovely smile, and when I looked in the mirror, it was tough because I could not recognise myself. Children on trains and buses asked what is wrong with her face, Mummy? It was upsetting, but I learnt to say, I have not had a stroke. It is just facial nerve damage, when I met anyone new.
Facial nerve palsy does not physically hurt and it didn’t actually affect the quality of my life. I still saw my friends and the essence of my character still came through. Feeling like a different person is part of having facial nerve palsy, but people said that I was still the same person. I was still able to eat, drink and articulate. Writing is a vital part of my life, and I could still write. I went on to self-publish my first novel even with facial nerve palsy.
I was delighted when my facial function returned. It was wonderful to be able to smile again, but when I look back at the five months that I was paralysed for, it was not all bad. I mostly remember how kind and compassionate people were towards me in public places; on buses, in shops and in hospital waiting rooms etc. People went out of their way to help me. That period in my life, when I had facial nerve palsy, it reminded me of the inherent goodness of people.
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