Seeing patients is the best!

I really love my clerkship experience because, as I've pointed out, it puts what I'm learning in the classroom into practice. For example: Group B Strep and pregnancy.

Last week I saw a patient with Bell's Palsy affecting the left side of her face. As it turns out, this facial paralysis is thought to be the result of latent herpes viruses reactivating in the immunosuppressed mom. Pregnancy causes a reduced cellular immunity system (so the mom's body won't reject the baby) and latent viruses, such as Herpes Simplex 1, take this opportunity to do their thing. The virus in this case causes inflammation of the facial nerve leading to the symptoms.

Patient's with Bell's Palsy complain of weakness or complete paralysis of the muscles on one, or both, sides of their face. They can't blink their eye or smile on that side. The corner of their mouth droops a little. Eye irritation from a constantly opened eyelid tends to result. Interestingly, facial sensation is preserved. I touched both sides of the patient's face and asked if she felt the sensation equally. She said yes.

Bell's Palsy can occur in anyone at any time, but is seen more in patients who's immune system is not as strong and therefore allows the facial nerve to inflame. It resolves on it's own in 3 weeks to 3 months, but drugs to reduce inflammation of the nerve or antiviral drugs against the herpes virus should be used.

On a completely different note, I wanted to share a quick story about a couple who brought up adding something to their family medical history. The mom-to-be's brother was just diagnosed with leukemia last week. Dr. R. very kindly offered sympathy for the brother and said that the diagnosis of leukemia wasn't something that would impact the pregnancy, but would be something that might come into play in thirty years or so when the child is grown. A family history is always very important. But then the couple offered the real reason they were asking, "We've rethought our decision and we want to bank the umbilical cord-blood."

I'm not sure if they were considering the possibility of helping the woman's brother, or the baby's future medical needs, but I'm interested to learn more about the advantages and reasons to bank your newborn's cord-blood. Seeing patients is really great!