THE NEWSLETTER OF THE BUREAU OF HEALTH SERVICES • COUNSELING SERVICES UNIT • FDNY Vol. 2 • No. 3 • January 2004

The FDNY BHS 9/11 Behavioral Health Screen
The FDNY BHS 9/11 Behavioral Health Screen is once again being sent out to UFOA members who did not fill it out the first time and to both UFA and UFOA retirees. The purpose of this health screen is to evaluate the impact that 9/11 has had on you and your family. We are continuing to send it out so that we can have an understanding of a wider segment of our FDNY family. The UFA has supported our efforts to reach the UFA retirees with this survey. The UFOA has supported this program for all their members active and retired. This document remains an important means to have your voice heard. The surveys are being mailed to members and retirees. They should be sent back as directed. Answer as many questions as possible or as many as you feel comfortable.

The questions help us understand how you are doing and will help us develop services that can continue to help you, your family and your co-workers. The confidentiality of this information remains intact with a government protection that exists beyond our lifetimes. Rebuilding this department cannot occur without understanding what we have experienced, how we experienced that grief and how we are continuing to struggle with past remembrances. Each person has had a unique perspective with a shared understanding. This health screen can serve to help us provide programs now and in the future for our members and our retirees. It can help us understand how the members of this department have coped with adversity and how they continue to deal with problems. Thank you for taking the time to complete these health screens. BHS and CSU remain committed to programs that monitor the health and well being of our members.

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Bells' Palsy Case Review
BHS is aware of the recent stories with regard to the number of Bells' Palsy cases, which have occurred in both Engine 76 and Ladder 22. These stories have highlighted medical problems at both of these houses and the adjoining NYPD Police Precinct. BHS has looked at the number of Bells' Palsy cases in all of our FDNY members. A specific diagnosis code for Bells' Palsy was added to our database in the year 2000. Prior to this year, the general code for "OTHER NEUROLOGICAL" could have been used. Since 2000, our records indicate 13 cases of Bells' Palsy; 12 in firefighters, 1 in the ems service. The cases involved members from 10 firehouses, in 4 of the 5 boroughs. There were NO clusters of cases, which are defined as three cases at one time. In three firehouses, 2 cases have occurred. In one firehouse, the cases occurred several months apart. In one of the firehouses, the cases occurred over a year apart. In the 3rd house, 2 members had the disorder at the same time. The members affected live in all five boroughs as well as other counties. Members have recovered and returned to full duty. The 13 cases were tracked from 2000 through 2004. Two cases occurred before 9/11/2001. The remaining cases occurred after 9/11/2001. Bells' Palsy is a neurological condition that causes the facial nerve to weaken or become paralyzed. The condition is named for Sir Charles Bell, a Scottish surgeon who studied the 7th cranial nerve commonly called the facial nerve. This nerve controls the movement of the facial muscles, the muscles that control eyelid movement and movement of the cheek and mouth. This condition affects 40,000 Americans each year. Both men and women are affected equally. Worldwide statistics show a .02% incidence, or 1 of every 5000 people may get this disorder. All ages can develop this condition. Groups at higher risk include:

• Pregnant women
• Individuals with diabetes
• Individuals with influenza
• Individuals with colds or other upper respiratory illnesses

 

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Other conditions such as sarcoidosis or any conditions that compromise the immune system will increase the odds for facial paralysis. Viral and bacterial infections as well as autoimmune disorders appear to be the most likely cause of Bells' Palsy. Herpes Simplex 1 virus is seen as the most frequent cause of Bell's Palsy. We are exposed to this very common virus in childhood. It may take the form of cold sores or an acute viral infection. This virus can then enter into a dormant state, residing in the nerve tissue. At a later time, this latent virus reactivates along the facial nerve and the immune system begins to produce antibodies, causing an inflammation. Along the canal where the facial nerve resides, there is little room for swelling or expansion. As the nerve inflames, there is compression of the nerve and it shows signs of weakness or paralysis.
Triggers for reactivation of the virus prior to the onset of Bells' Palsy may be:

• stress
• lack of sleep
• minor illness
• upper respiratory infections
• long standing problems such as autoimmune syndromes or diabetes

Treatment for Bells' Palsy includes rest, Prednisone (cortisone), and antiviral medication. Wearing eyeglasses and ensuring that the eye does not get dry is also important. This condition is NOT considered contagious. The time for recovery is usually a few weeks. For others, the time frame may be longer as regeneration of a nerve may occur over a time period of a year. This condition recurs in 5-10% of individuals. BHS remains committed to the good health and well being of our membership. We will continue to review all charts coded "OTHER NEUROLOGICAL" prior to the year 2000 for Bells' Palsy incidents. We will share our findings on a future issue of Connections.

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