Bell’s Palsy

‘Bell’s Palsy’ is a term that strikes fear into the heart of most brass players, yet surprisingly, very few people are truly aware of the cause and high odds of full recovery of this condition.  This section aims to demystify Bell’s Palsy, through first-person accounts by brass players and non-brass players – even non-musicians – in order to educate and inspire.

Let me begin by stating that this section is not a medical reference, nor is the intention to discuss in detail the physiology of Bell’s Palsy.  There are numerous websites and resources for this (http://www.bellspalsy.ws/ is one of my favorites), and no information I could present would trump the wealth of these resources.  The focus of this webpage is, as previously stated, to offer first-person accounts of brass players who have or are currently dealing with Bell’s Palsy.

Why showcase stories about Bell’s Palsy?  The reason is simple: I was afflicted with Bell’s while in college, and at the time, there were no resources for me to gather information nor was I familiar with any other brass players who had dealt with it.  While I managed to make a full recovery, it would have been tremendously reassuring and inspiring to know about some of the people who suffered through Bell’s.  So, I offer the stories below as motivation, inspiration, and education to anyone who is currently battling Bell’s, or anyone who is simply curious.

My Story (Tim Smith)
Vincent Ellin , Former Principal Bassoon Winnipeg Symphony and Manitoba Chamber Orchestra
David Finlayson, 2nd Trombone, New York Philharmonic
Dr. Jessika Kissling, Obstetrician and Gynecologist; former French horn player
Rob Singer, Trumpet, “The President’s Own” United States Marine Band
Ron Turner, Atlanta freelance lead trumpeter and educator
Charles Vernon, bass trombonist, Chicago Symphony Orchestra
Michael Stroeher, Professor of Trombone and Euphonium, Marshall University
Further personal accounts can be read in the Comments section below

Useful Definitions

For you non-brass players reading this, here are some definitions of terms for which you may be unfamiliar:

Buzz, or buzzing: this is the vibration you create by blowing air through the lips.  Essentially, blowing a ‘raspberry’.

Embouchure: how the lips are formed in order to create a ‘buzz’

Aperture: this is the point in the embouchure where the lips vibrate.  Much like the aperture of a camera.

Corners: literally the corners of your lips, or sides of the mouth, which are an anchor point when forming an embouchure.

A Brief Definition of Bell’s Palsy

Bell’s Palsy in layman’s terms: it is a trauma to the main nerve bundle that controls the majority of facial muscles, which causes temporary paralysis of facial muscles.  Causes are viral or bacterial infections, most often Herpes, Lyme disease, and inner ear infections.  There are several other causes that you can find on the link above.  The best analogy I have heard regarding Bell’s is this: imagine cutting a phone line running through a residential neighborhood.  Now, tape it back together.  Some of the wires will be properly reconnected, other wires will be paired incorrectly.  This is what happens to the nerves in your face.  Your brain gives a command, but it gets crossed and goes to the wrong muscle.

In most cases, the onset of paralysis only affects one side of the face, and usually happens within a few hours.  Most patients find that after two weeks, the symptoms are gone or significantly lessened, and facial muscle/nerve function returns to normal.  For a full medical description of Bell’s Palsy, please visit the link embedded above.

It is important to note that no two cases of Bell’s are identical.  I have spoken with people who have been suffering for years, and I also know people who are back at full strength within a few weeks.  The “How and Why” is still a bit ambiguous, but the crucial point here is that full recovery is then norm, however, the time to get there varies drastically.  Again, visit http://www.bellspalsy.ws/ or run a web search for more specific information.

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My Story My experience with Bell’s Palsy was somewhat more extreme than most of my peers who have suffered with it.  Then again, I know some people who are still struggling to play their instruments years after their Bell’s diagnosis.  I remind myself everyday that I am very fortunate, and hopefully my story and the ones provided by my peers will help you through Bell’s as well.

After my freshman year of college (1999-2000), I came home to rural Pennsylvania to resume my summer job with a landscape and deck/patio construction business.  I worked for a couple weeks, then spent a week at the Rafael Mendez Brass Institute, which was put on by Summit Brass and hosted by the Cincinnati College Conservatory of Music.  During a mid-week practice session, I kept having hot and cold flashes, and broke out into cold sweats.  I didn’t think much of it, since we were constantly going between the hot outdoors and frigid A/C inside while at the Institute.  The following morning, I woke up with full-blown flu symptoms: upset stomach, lack of hunger, cold sweats, hot sweats, dizziness, urge to vomit – generally awful stuff.  I stayed in my hotel room all day, which was a tremendous disappointment as I missed all of the masterclasses, performances, and my trombone quartet coachings.  The flu symptoms only lasted one day, as I felt fine the following day…..until I tried to practice.  Every time I picked up the trombone, the cold sweats came back.  To this day, I cannot see the relationship!

I made it through the week of RMBI and returned home, and back to my landscaping job.  Roughly a week after my initial flu symptoms, I noticed that I was having trouble closing my right eye when I would blink.  Within the course of an afternoon, I could not close my right eye at all, nor raise the right corner of my mouth as you would when smiling.  Naturally, I was freaked out, but I figured it was some kind of temporary thing associated with my body growing.  Wrong.  Now would be a good time to mention that buzzing a mouthpiece was completely out of the question, as air would escape out of the right side of my mouth, as making a seal on the mouthpiece was impossible.

Three days of this paralysis went by, and finally I scheduled a doctor appointment.  I should also note that none of my previous flu symptoms returned – just the paralysis.  The doctor saw me immediately, and his initial hunch was that I had Lyme disease.  Bell’s Palsy was just being recognized as a symptom of Lyme disease, so he scheduled me for blood work and put me on oral medication.  The blood test confirmed Lyme disease, but did not say which stage I was in.  To my knowledge, there are three stages of Lyme disease, with the third being the most severe and often accompanied by heart problems and arthritic conditions.

For those of you unaware of Lyme disease, it is a disease transmitted through deer ticks.  Since I lived out in the woods, and worked in landscaping, I was at extremely high risk for picking up ticks.  At the time of my diagnosis, Lyme was primarily prevalent in the Northeastern/Eastern United States, but it has spread across North America and cases are popping up everywhere.  One of the most common symptoms of Lyme is a small bulls-eye rash at the bite site, which I never had.

Most Bell’s Palsy symptoms last roughly two weeks.  Towards the end of two weeks, I noticed that my muscle control was returning, and that the right side of my face was beginning to look and function normally again.  I was at work on a Friday afternoon, building a patio, and went to use the bathroom.  As I tend to do when looking in a mirror, I started to make faces and test out my recovery process.  To my horror, I noticed that my left eye and left corner of my mouth were becoming unresponsive.  For the next three hours, I returned to the mirror only to find it was getting worse.  I phoned my doctor, and he instructed me to go to the Emergency Room immediately for testing.  In retrospect, this was probably not a life and death situation, but at the time, 19-year old me thought it was!

Once at the E.R., I was given a spinal tap, EKG, MRI, and more blood work.  Honestly, it wasn’t so bad except for the trainee who was giving me the spinal tap could not get the needle between my vertebrae – and the anesthetic was starting to wear off.  Why a spinal tap?  I was told that the only way to verify which phase my Lyme disease was in was by testing the spinal fluid.  The other tests all came out fine, and the spinal tap confirmed I was only in the first stage of Lyme.  The EKG picked up what they initially thought was a heart murmur (symptom of Stage 2 Lyme, I think) but it turned out it was only my nerves.

While in the hospital for 3 days, a catheter roughly 2’ long was put in my left arm and run to just above my heart.  Oral meds were off the table now, and we were going with the heavy intravenous drugs.  I wish I could remember what they were.  For one month, I injected 4 different syringes of saline and medication into the catheter once a day.  The only part I can still vividly recall is that the medicine was kept in the refridgerator and I could feel how cold it was running through the vein.

During the month of intravenous injection, I was instructed to stay out of the sun, out of the woods (ticks – duh), and keep my physical exertion to a minimum.  So…no more landscaping, no more summer income, no swimming pool, no sports, and remember, I couldn’t play the trombone even if I wanted to…in short, no fun.  I used the time to read, most notably “Song and Wind” about Arnold Jacobs’ teachings, and Philip Farkas’ book “The Art of Brass Playing”.  My goal was to strengthen my concept of embouchure and air while I was unable to play.  (In a separate but related story, this didn’t work out the way I had planned.)

My face also started returning to normal functions (blinking, smiling, holding food in my mouth) during this month, though I still had little muscle control or strength for my embouchure.  By mid-August, which would have been roughly two months after my initial symptoms, I was able to buzz the mouthpiece again.  When I say buzz, I mean I could get the lips to vibrate for a few seconds before the strength of my embouchure gave out.  As you can imagine, this was incredibly frustrating.  After a week I had the range of a fifth within the bass clef staff, and tuning Bb was next to impossible to play.  Given that college ensemble auditions were only a couple weeks away, I gave up hope on making one of the top ensembles.

When I returned to campus, I had roughly two octaves within relative control, and I played a rough audition for ensembles.  I was disappointed – though not surprised – to learn that I placed last chair in what the students perceived as the bottom-tier band.  I think I was 2nd Chair, 3rd Trombone or something like that.  It was demoralizing after having an extremely productive Freshman year and having dreams of placing in the top ensemble.  However, I got over my disappointment and took on my 3rd Trombone folder as a challenge:  what a terrific opportunity to learn to play the Bass Trombone!!  My low register came back quickly after the Bell’s, and I was still developing the upper register in the practice room.  But, for all of my ensembles, I was most comfortable on the bottom.  I finally got a taste of what most bass trombonists experience at sometime, which was a good-natured reprimand from the conductor for “being a pig”.  Playing 5th Trombone in jazz band was perhaps some of the most fun I’ve ever had playing trombone.  For a brief time, I considered switching to bass permanently, but there were so many tenor solos that I wanted to work on, not to mention more employment opportunities, that I kept my focus on the tenor trombone.

Only in the last two years I’ve rekindled my love of the bass trombone, and 10+ years after our initial affair, the instrument is still teaching me about embouchure, breathing, and relaxation.  If it wasn’t for Bell’s Palsy, I doubt I would have ever picked one up.

My full recovery back to pre-Bell’s Palsy strength took almost a year.  Luckily, I was a student and not yet making a living on the instrument.  I was also young, naïve, and for the most part, positive about the experience.  Unfortunately, I was also too young and ignorant to fully incorporate some of the ideas I read about in the books by Farkas and Jacobs.  Much of my graduate school career was spent breaking down the physicality of my playing, and developing ease and efficiency.  This is something I still struggle with today – but then again, don’t we all?

Regarding long-term effects – known in the Bell’s world as ‘residuals’ – I certainly have my share.  In fact, I’ve noticed that my residuals became more pronounced roughly 8 years after the onset of Bell’s.  For example, my embouchure is grossly assymetrical.  Sure, this is somewhat common, but my corner anchors are very different from each other in location and strength.  My left eye also closes a bit when I’m playing, especially when playing in the upper register.  I’ve gone through varying degrees of paranoia regarding this, but all the notes come out, so why fuss with it?  I have also become more light-sensitive than most, which is a common result of Bell’s.

I can say with the utmost certainty that my experience with Bell’s gave me a higher appreciation for playing, a wiser approach to playing (though that came later), and a heightened respect for my peers who have dealt with any kind of detriment to their playing.  If you are currently dealing with Bell’s, I know how scary it can be.  Take comfort in the fact that the odds of a full recovery are on your side, and many people have dealt with this before you.  Please take some time to read the personal accounts from some of my peers and leading artists in our field – their humility in sharing their stories is tremendously appreciated, and I have the utmost respect for them doing so.  If you have a Bell’s story that you’d like to share, please let me know so I can add it to this page.

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Vincent Ellin, Former Principal Bassoon Winnipeg Symphony and Manitoba Chamber Orchestra

My story starts with a huge ear infection and blocked sinuses in 2001. I first noticed problems the day of a concert run-out in February. I was having trouble with endurance and hearing during the concert, and the next morning when I woke up, one whole side of my face was almost totally slack. I definitely freaked and I immediately called  my orchestra as I was supposed to be playing a concert that morning. The personnel manager still wanted me to come in, but my wife took me to the emergency at the nearest hospital. I am thankful that in Canada we have such good health care that latter that day I got my diagnosis.

It was a real shock, as I knew it could be career threatening. I didn’t know of anyone who had ever gone through this, and I was afraid that it would be permanent. Much to my relief, the doctor assured me that in about 99% of the cases the only permanent scar would be the inability perhaps of raising one of my eyebrows more than a few millimeters. That I could live with.

My ear infection was really bad. I couldn’t stand any loud noises because I had so much fluid in my inner ear, and I was in bed for many days. I was given very strong doses of medications to get the swelling down as quickly as possible. My right ear was almost totally swollen shut. My recovery was slow, but by three months I started to get back a significant amount of control. When I started relearning playing I couldn’t hold an embouchure for more than a few seconds. Consequently, I waited for a good year and a half, before considering going back. My orchestra was unrelenting in wanting a definite date that I would be at one hundred percent, and I wanted very much to get back. Unfortunately for me they had no provisions for a partial return or any other flexible terms. I also would have NO assistant for more than one or two weeks….that was it.

Eventually I did return but I was still not back totally, and it was a mistake on my part. My orchestra thought that even after 30 plus years of distinguished service, it was just interested in “canning” me. I was dogged with controversy for those following years, despite many people commenting on how good I sounded, and even writing to the orchestra about it. I think the management and the music director just thought I was “damaged goods”. I eventually left the orchestra in 2006, and I have continued to perform successfully in solo and chamber music.

I am happy to say I am fully recovered now, and I have more endurance and control than I ever had when I was in the orchestra. I think this is largely because I had to re-learn everything twice when I was recovering. There are a number of tools that I have found useful that brass players use far more frequently than wind-players do, that are very helpful as a regular regiment.  The old adage “if it doesn’t kill you, it will only make you stronger” is definitely true for me. I was surprised at the numbers of musicians who have had this ailment, including oboists, bassoonists and even flautists.

Click here to vist Vincent’s Ellin’s website.

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David Finlayson, 2nd Trombone, New York Philharmonic
from email correspondence, February 2009

Dear Tim,

Please forgive my delay in answering your email. I have waited with my reply hoping for the time to write a response that is detailed and comprehensive enough to give you the solace you may be needing with regard to recovery from Bell’s Palsy.

I, too, contracted Bell’s Palsy just two months after my final audition with the Philharmonic. I was the associate principal with the National Symphony in the summer (July) of 1985 and enjoying a 4 week vacation. My wife had just given birth to my son and sleep for mom and dad was in short supply. We were also dealing with the stress of making our move to New York which involved selling and buying a house. I believe the general lack of sleep and continued stress lead to getting Bell’s.

It took me at least 10 weeks before I felt confident enough to play with the band again. I did travel to New York in November of  1985 to record Mahler’s 7th with Bernstein. This was a month before my official start with the orchestra. In retrospect, I should not have done the recording. I just barely made it through each rehearsal and concert. The left side of my face felt as if someone had slugged me. Somehow, I got the work done.

As you probably know by now, most people are effected on the left side of their face. I believe the statistics are in the 80% range to the left side. I also suffer from the same after effects of a closing left eye when I contract the muscles of around my mouth. Of course, this happens when making an embouchure. This is the result of damaged nerves now healed and traveling a different path to the face from the brain. I am not terribly bothered by this and most people don’t notice unless I make them aware of it.  This has been the only lingering effect of the Bell’s for me.

In the way of advise, don’t really worry too much about the eye “thing” and how it may be received. Most people will probably never notice. I took the whole experience as a wake-up call to change my life. Do what you can to reduce the stress in your life. Eat well, sleep well, exercise etc…Easy enough to say: putting it in practice is another email.

It is late here in New York. I do need my sleep. I know you will forgive the brevity of this email. Call me anytime if you would to discuss any of this over the phone.

All the best and continued good recovery,
David Finlayson

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Dr. Jessika Kissling, Obstetrician and Gynecologist
high school classmate of mine

The summer before my senior year of high school I was diagnosed with Bell’s Palsy.  After approximately 6 months of recovery I was able to gain almost complete recovery of my muscle function on the left side of my face.

I first noticed something was wrong when other people were telling me ‘I wasn’t smiling right’ and that my left eye was really dry.  The day prior I had played in a horn recital and felt something was off with my embouchure but just thought it might have been fatigue or poor practicing.  By the end of the day, I could no longer close my eye or even create a sound with my mouthpiece. Panicking, we took an emergency trip to the doctor that yielded a diagnosis of Bell’s Palsy.  At this point the etiology was unknown as lab testing for Lyme was negative, and I was told ‘it might be viral’.  The doctor gave me rather unsettling news, it could resolve completely or could leave me with a permanent deficit in muscle function but there was no way to tell.

I spent the next months taping my eye shut at night, using eye drops to avoid a corneal abrasion, taking fish and flax seed oils (my mother swore this would speed recovery), performing daily facial exercises to see if the muscles would move, and avoiding soups because they would just spill out my mouth. I even saw a neurologist who prescribed a week of steroids.  Slowly by the time I returned to school in the fall I started to notice slight movements in the facial muscles.  I still couldn’t play the French horn and had to rethink plans for my senior year.  By fall I was able to play for very limited periods of time but had to retrain my embouchure to play and would become fatigued very quickly.  I even used masking tape to keep the corner of my mouth closed, allowing me to play for longer periods of time.  Eventually I was strong enough to play in the groups I did previously, but it took almost 6 months before I felt things were back normal.  There are still times if you get a photo with my eyes closed you can see the left eye doesn’t close all the way, or if you look at my smile you can tell it’s a bit crooked, but in the end that’s all that is left!

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Rob Singer, Trumpet, “The President’s Own” United States Marine Band

In early August of 2008 I started noticing some strange sensations. One day I felt a slight pain and stiffness in front of my ears. The next day my tongue felt slightly scalded or numb. I had eaten a lot of garlic that day, so I didn’t think much of it. My trumpet playing that day felt stiff, but like the feeling in my tongue, I didn’t worry about it.

The next day I taught a lesson in the morning and my playing just didn’t feel right. I got more tired than I usually do and I had trouble playing in the upper register. That night I spent some time doing easy fundamentals, but things still weren’t working.

The following morning I practiced at home prior to a rehearsal. I could barely play a C in the staff and within minutes I couldn’t even form an embouchure. I knew something was wrong and I immediately went to the doctor. After ruling out the possibility of a stroke, I was diagnosed with Bell’s Palsy and given and antiviral medication and a steroid to reduce swelling.

I was initially very worried as thoughts about my career and my family raced through my head. Would I ever be able to play the trumpet again? What could I do for a job?

By the end of the day, however, I was a lot calmer, as I did some research and also discovered several other brass players that had dealt with Bell’s Palsy. Through the stories they shared and the advice they gave me, it seemed like just a matter of time before things would get better.

Physically, many things were difficult. The left side of my face was not responsive; I could not move it. While it did not hang down, that side would just stay limp when I tried to smile, wrinkle my nose, or raise my forehead. I couldn’t close my left eye completely so I had to tape it shut when I slept. I used eye drops to keep it moist during the day. Shaving, brushing my teeth, and eating were all difficult – and messy! Water would spew out of my mouth if I tried to swish. Overall I felt tired. We had a one-year-old at the time and I had not been getting very much sleep. I had also been training for a marathon that summer and the lack of rest probably made me more susceptible to illness.

Because I needed my body to heal, I made it my first priority to get more sleep. I tried to go to bed earlier and also take naps. Open to anything that might help, I actually went to see a spiritual “healer”. I’m not sure if that visit helped or not, but it seemed like a good experience. I did do lots of meditation and visualization, trying to imagine the nerves in my face healing.

Instead of practicing, I used my time to explore other facets of my musicianship. I did a lot of listening and really thought about the kind of trumpet sound I wanted. I read Kenny Werner’s book Effortless Mastery and tried to boost my confidence by always thinking of myself positively and as a masterful performer. I visualized myself performing and thought about what it felt like to play – hoping to spark some kind of nerve growth.

I didn’t do anything special to facilitate the re-growth of my nerves. Some people recommended electro-stimulation (like holding an electric toothbrush to my cheek) to help regenerate the nerves, but I was concerned about “cross-wiring” them, or having them grow back in a way that may have caused problems for my embouchure. In general, I just tried to rest, think about improvement, and be patient. Less time spent practicing meant that I had more family time, which was great.

After 3 or 4 weeks, I hadn’t tried to play trumpet, but I was gaining some movement back in my face. I went to see a speech pathologist, who was very helpful. She gave me a list of facial exercises I could perform that would strengthen and coordinate the muscles in my face. Up until this point, I had avoided trumpet playing for fear of creating bad habits, but with more success with the facial exercises, I viewed practicing as just another exercise.

Once I started playing again, I was very careful to play with great form. For the first several days, all I could manage was 12 whole notes. After those long tones, I’d feel like my embouchure was going to collapse. I would stop playing immediately because I didn’t want to do something strange just to get the notes out. As time went on I was able to do 2 or 3 sessions per day, but no longer than 5 minutes each! I started to introduce parts of chromatic scales (like Clarke #1) with very limited range. I only went as high or as low as I could without losing a “perfect” embouchure.

Now practicing was actually an exciting opportunity. Re-learning to play was like teaching a beginner who already had a great ear, and would do anything and everything I asked. Over the next several weeks I gradually added range, dynamics, and articulation to my practicing until I was fairly back to normal. In fact, in some ways I was actually better. My sound was more rich, my posture was better (although that didn’t last), and I became a smarted player. I’m more aware now of the muscles involved in forming an embouchure. I’m better at knowing when I need to stop practicing or what I need to do to get more balanced.

I was really lucky to be playing in the Marine Band while going through this illness. I was given all the time I needed to heal, and was never pressured to get back to work. I was afforded the opportunity to rebuild my playing the right way and never had to rush things to meet a deadline. When I finally did return to work, I was able to ease into the schedule. I started off playing easier parts, or parts that were often doubled. I had days of rest between my playing responsibilities so that I had time to recover and evaluate how I was progressing.

My episode with Bell’s Palsy was initially very scary, but in the end it turned out to be a positive experience. I was fortunate to be able to talk with many professional brass players that have dealt with this illness. Their compassion and advice comforted me and helped me through a troubling time. No one should ever feel inferior while struggling through something like this. Many players encounter some kind of physical ailment at some point in their career. I’m always happy offer my support and to help in any way I can.

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Ron Turner, Atlanta freelance lead trumpeter and educator

In March of 2007 I came down with a case of Bells Palsy. Bells Palsy is believed to be caused by the same virus that causes cold sores (Herpes Simplex 1) and it attacks the 7^th cranial nerve. The nerve travels through your skull for an inch or two then once it reaches your face it breaks into thousands of nerves that control the muscles of your face. The opening in the bone where the nerve passes is very small, only large enough for the nerve to pass and when it gets inflamed, the inflammation has no place to go, so it puts pressure on the nerve and it shuts down so you lose feeling on the side affected. Luckily my case was mild or I got to it with the medication quick enough so I wasn’t affected to badly.
    I first noticed embouchure problems on Saturday, March, 3 2007. About 4 or 5 days before that I had extreme hypersensitivity to sound in my left ear when I was playing the show. Man, my sound bouncing off of the stand was very painful but I thought nothing of it. Another city, another pit I thought.
    Also about 10 days before the hearing problem, we were in a city where the weather was very cold. I noticed that my left eye would tear very badly on my walk to work of about 1/3 of a mile. The tearing lasted for a while after I got to the theater and returned the next time I went out. I don’t know if this is related but thought I would mention it. I have since been told that cold can be a factor.

I went to play the Saturday matinee on March 3^rd and noticed things were harder to play and I had a little leakage around the left side of my mouthpiece. I was home for the first time in almost a year & we were working where I live, so I figured my problem was being too busy, burning the candle at both ends, and not practicing. The second show Saturday night was harder to play & I started to think I was getting a cold sore but had NO symptoms such as pain, swelling, blisters, etc. I went home and thought I was just beat up and I would be better by the Sunday matinee. That didn’t happen. It was even harder with thinning out sound, air leakage and much more pressure to be able to get the job done but I managed to get through it. By the Sunday night show I had to pass a few parts to the 2nd trumpet player and I barely got through the show. When I got home I took 2 grams of Valtrex just in case it was a cold sore beginning. I had Monday off and a travel day to another city. I rested my chops all day Monday and finally got out my horn about 11pm just to see if I felt better. I didn’t. I took another 2 grams of Valtrex. I have never had chop problems other than an occasional cold sore and can mostly play through them because they are on the right side of my lip. They are uncomfortable but manageable.
    Tuesday, March 6th and we have a 10am rehearsal. I got to the rehearsal early and tried to warm up but nothing was working. I played 2^nd and could barely do that. I immediately got on the internet and ran down my symptoms, called my Dr. and explained to him what was going on and he agreed with me that I had Bells Palsy and called me in a prescription for Prednisone. I also called to set up an appointment with an Eyes, Nose and Throat doctor in the city I was in. I could not play the show Tuesday night.
    Wednesday, I went to the Dr. and he also agreed that I had a mild case of Bells Palsy with my only symptoms being, a weakened upper and lower lip, my left eye was hard to close but I could close it and I had a slight pain behind and in my left ear. He also agreed on the Prednisone and Valtrex treatment which was to last about 12 days. I could not play the rest of the shows that week.
    It is Sunday now, my eighth day and so far I see very little signs of improvement. I could play a middle G to about a middle C. I could hold out the notes for a few seconds and that was all. I could not play. That was the end of my first week and wake up every day hoping for any sign of improvement.

March 12, 2007

Week 2

Ten days have passed since I first got symptoms and it is Tuesday, March 13, 2007. I woke up and felt a little better. I got my horn out and could play from low G to top space G. So far the best day of playing but I hope I didn’t do too much. Endurance was limited to seconds not minutes and I would quickly get air leaks. But, I felt encouraged and thought that my repair was finally (hopefully) underway. Wednesday was about the same as Tuesday, maybe not quite as good.  
    Thursday, 3/15/07 there was a little more improvement. I played to a high C weakly but over all I felt there was more improvement. But I could not have played last chair trumpet in a middle school band. I practiced very softly, long tones, not overdoing it and decided to  begin several practice sessions a day, being careful not to over do it or overexert myself. I practiced 3 or 4 times a day for about 5-15 minutes. The main purpose now is to just to start and rebuild and to get a set on my embouchure realizing that I haven’t worked or played in 11 days.
    Friday, 3/16/07, a little stronger than yesterday and the high C’s are a little easier, but endurance is still virtually nonexistent. Saturday I was able to play weak D’s and lip slurs were a little easier. Nerves are still hampered though and full lip and eye function is far from normal. Sunday was about the same as Saturday.
    The problem is two fold. Not only do you have to rebuild from not playing for a while but you actually have to retrain the affected muscles to function properly.  I took Monday off.

March 19, 2007 
Week 3

I am beginning to feel better and was able to play up to a high E, weakly, on Tuesday. Wednesday my sound was returning and I am able to play comfortably up to high C even though I am weak and my endurance is limited do to the lack of playing and the nerves are still not fully repaired. The nerves, if I had to guess, would be about 70% repaired. They repair at about 1-2 mm/day. There is no air leaking except when I play longer passages. Thursday, I played a couple of high G’s and I feel I am getting stronger for short bursts. I am practicing 3 times a day at about 20-25 minutes a time. I am practicing long tones, Clarke Technical Studies, Colin Lip Flexibilities, and Caruso Studies etc. Friday & Saturday were about the same as Thursday, but feel I am making progress. Sunday I played an Ab and F’s and G’s are easier, but I am still weak endurance wise with air still leaking after playing relatively long passages

March 26, 2007
Week 4

Monday I was able to play a few high A’s. I am increasing my practice to 1 ½  hours a day still in 3 sessions. My nerves are still not fully recovered and I cannot tell if they are improving on a daily basis or not. My embouchure was still weak on the left side. I can play in the upper register for a short time only but my middle register endurance is not too bad. 
    Tuesday I felt much better and my embouchure was much improved. I played some good high A’s, a couple double B’s and my endurance was much better. Though not 100% yet I do feel that this was a huge improvement and am very encouraged by today’s practice. Wednesday was about the same as Tuesday. Thursday I felt more improvement with better endurance, and a couple of double C’s. I was able to play with better flexibility too. Friday, I took the day off. Saturday I felt weaker because of the day off and realized that I am still not recovered. I still feel mashed when I play high even though the range is coming back. My endurance is still way down. I feel about 75% recovered and I understand what that remaining 25% means. I am starting to wonder if I will be ready to play 100% of the lead book when I go back to work on April 10^th.  
    Sunday I felt MUCH improved & now I felt about 90% recovered. My chops were strong today, double C’s many times, and the endurance was much improved. What a difference a day makes. I have read that recovery comes in spurts and I did get several of those during my recovery.

April 2, 2007
Week 5

My chops are about normal now and I feel that I am almost recovered. My upper register was not quite back but almost. Again I want to restate that I read that the muscles not only have to rebuild from not playing for a while but they also have to be retrained from the nerve damage. This being said, I could play high A’s and double C’s but not with the consistency I had before. I know that this is just a matter of time though and feel that I will be back to 100% very shortly. I can play the show with no problem and return to work next Tuesday, April 9, 2007. Today is April 3^rd, 2007 and I feel that this is about the end of my dilemma. I want everyone to know that this is about the worst thing that could happen to a brass player but also want everyone to know that it too shall pass,
so hang in there if you ever have this happen to you. Keep a positive attitude,
look for minor improvements and hope for major spurts of improvement.  
Also there will be a time of little improvement and sudden major improvements. I returned to work on April 9^th, 2007 and everyone thought I haven’t missed a beat in my return. I was as strong as ever and more importantly, I have a renewed love for the instrument, as you never realize what you have until
you lose it 
     I want to thank Chase Sanborn for his help. I found an article on the internet detailing his experiences with Bells Palsy. He took over 4 months to fully recover and had it years earlier than I did. I am sure the improvements in medication were helpful and the Internet was helpful in helping me define my symptoms. But be aware that there is a lot of garbage on the Internet too.

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Charles Vernon, bass trombonist, Chicago Symphony Orchestra

Back in May of 2011, Memorial Day – a Sunday as well, I woke up very dizzy and I couldn’t shake it. I couldn’t walk very well and felt pretty bad. Since it was a holiday I could not get a doctor and all I could do was go to the Emergency Room.  I spent 6 hours going through every possible test to find out what it was not!  EKG, XRay, neurology test, blood…everything. A neurologist came in and finally told me I had Vertigo and to see my doctor. I saw him a few days later and he agreed with the verdict, but I don’t remember any medication.  I found out later in the summer that Vertigo was an infection of the inner ear and a symptom of Bell’s Palsy.

So, back to early June.  I went on a vacation with my family to North Carolina while I was heavily preparing for two big recitals at the ITF [International Trombone Festival] in Nashville and practicing my butt off, pushing more than I have in years.  While on vacation I was noticing a direct pain in the back of my head as well as what felt like a severe swimmer’s ear.  My left eye hurt for a week before it happened. Neck hurt etc. I thought it was the bed and pillow, and took painkillers. On Fathers Day, I was running through my pieces and suddenly felt a sharp pain in my top lip.  For many weeks I had been really pushing myself and all of the sudden I thought, “Woah, never had that pain before” and stopped playing for 2 days, which was then my car drive from Asheville, NC to Nashville, TN.  Looking back on this, the pain and just straining myself had nothing to do with what happened next.

So I started out in the car — eye, head, and ear hurting – and began the 6 hour drive. I always buzz the mouthpiece when I drive on trips, this one especially since all of the high pressure concerts [at the ITF] with the world premieres, etc that were coming up the next day. I was worried about my strained upper lip, so relaxed buzzing in mid-low register was in order for the next few hours.  Almost immediately my mouth felt strange and I was having trouble buzzing. I have always been able to buzz the mouthpiece with a good, full, centered sound but something was going on: the left corner of my mouth was collapsing taking the right side of my mouth with it!  It got worse and of course I was freaking out big time. When I arrived in Nashville, everyone was excited to see me — old and new friends as well as my pianist. I was to immediately have a rehearsal with Joe Alessi and my pianist, Yoko Yamada.

I told everyone “Give me a few minutes, please” and went with my bass trombone to a corner of the big instrument display room.  I played the first notes of each piece I was supposed to play and nothing good was coming out — as a matter of fact, nothing was coming out at all!  I stopped, lost it for a moment and turned around to a stunned bunch of friends. I told the director that I could not play and I have to cancel everything except the class I was to give. I broke down a bit, because in 45 years I have never NOT been able to buzz the mouthpiece or play the trombone.  Jon Bols knew a doctor trombonist who he had call me right then and we set up a hospital visit the next morning with a specialist who was also a trombone player!!  After talking to the first doctor, he believed it was Bell’s Palsy and the next morning the specialist (after many tests) determined that it was Bell’s and proceeded with the steroids (maximum amount for a week and Valacyclovir).  The doctor told me that 97% of the time there is 100% recovery!  This made me feel a lot better.  I was taken care of VERY well and am so fortunate to have those great doctors helping me get through this ordeal.

The first night I talked to my old friend Dave Finlayson [read Mr. Finlayson’s Bell’s account below], who agreed with every symptom that I was having. I am convinced that the Vertigo that I had was the beginning of this whole thing. Maybe if I had the medicines at that time it would have not happened!  At least now I know what to look out for.

I tried to buzz the mouthpiece a few seconds a day for two weeks and nothing was happening.  During the almost 4 weeks of no strength on the left side of my face, there was no buzz, my mouth and eye were drooping, and I had to eat by moving food from side to side pushing my cheek!!  The worst was my left eye; it would shut by itself and I had to hold it closed later in the day because it hurt so bad all the time.  It was dry (I needed drops) and a drag!  In 5 weeks I could buzz and play. It was rough so I waited two more weeks and then came back to the last week of Ravinia with the CSO.  It took a few months for the middle register to come back to normal.  The high and low registers came back quickly.  I think I learned not to keep pushing in the middle register when I am getting tired — that was just a lesson for me.

No stroke and no career ending dystonia, thank God.  If I can help anyone with this, don’t hesitate to write.

All the Best,
Charlie Vernon

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Michael Stroeher, Professor of Trombone and Euphonium, Marshall University

I came down with Bell’s Palsy when I was 28 after getting my Master’s in performance from New England Conservatory and was in my first college teaching job at Idaho State University. My in-laws came out to visit and we went on a two-day ski trip in the Grand Tetons. I was out in pretty extreme cold most of the time, and when I got back home and picked up my horn to practice I couldn’t hold the right side of my mouth together. I made the mistake of trying to keep playing since I was principal in a regional orchestra, had received a big scholarship to the Aspen Music School, and was interviewing for other jobs. My embouchure at this time looked like one half of Dizzy Gillespie. As a result I developed some extremely bad habits and response problems, so a career in performance and applied teaching was pretty much out the window. I taught middle school band for three years, saved my money and went to graduate school, getting a PhD in Music Education from North Texas. While I was there, thanks to a lot of help from Vern Kagarice, the playing started to come back, but it took a total of about ten years. Now I’m back to playing better than I ever have and I rarely miss a day of practicing; there’s always that haunting fear that it might happen again. The advice I can give people is to cover your face when you’re out in the cold, and if you do get Bell’s Palsy, don’t try to play until the nerve function is back, but don’t give up, either.

I recently had a student contract Bell’s Palsy, and she got better in a couple of months with electronic stimulus to the facial muscles, so the other piece of advice is to see a doctor immediately.