Stroke patient's smile restored after pioneering surgery

Jarmilla "Jarm" Hawes before and after a surgery that restored her smile 2.5 years after suffering a stroke.

A grandmother who "looked like a monster" after suffering a stroke has smiled for the first time in years thanks to pioneering surgery to move the nerves in her face.

Jarmila Hawes, 56, was told she would never be able to move the left side of her face again after suffering a serious stroke. The former Costco cashier, from Vancouver, Wash., couldn’t eat or drink without pain and strangers stared at her when she left the house.

Six months later she met Dr Myriam Loyo Li, who specializes in transferring existing facial nerves and muscles to other parts of the body to "reanimate" paralyzed areas.

He performed a nine-hour operation in which Hawes’ nerves were transferred from one side of her face and tongue to the other.

Four months later, she regained some movement in her mouth and then in March this year the nerves "took" and she managed her first smile in 2.5 years.

The surgery has transformed her life and even led her to marry her partner of 15 years last August.

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“I missed my face. I missed smiling. My facial expression was always the same. It was terrible. I thought I looked like a monster," Hawes said. “But it is wonderful to smile again, to be able to show when I am happy and not even think about it."

“I go out now. I go to restaurants, I walk my dog, I kayak. Last summer I went to Hawaii and I swam in the ocean," she said. “I even got married last year. I would never have taken that step when half my face was drooping.”

Hawes suffered the hemorrhagic stroke, the most deadly kind of stroke, in September 2015 while she was working on the shop floor in Costco.

“It was due to a spike in blood pressure. I was on the shop floor and I didn’t feel good," she said. “I went up to my manager and he took me into a backroom and called an ambulance.When I woke up in hospital, I couldn’t walk. I was numb down my whole right side."

It took four months of recovery for Hawes' to first notice the surgery's impact.

"The vision in my left eye was shot," she said. "The whole left side of my face completely dropped down. It affected my speech. I could only drink from a straw. I could only eat from a tiny hole in the corner of my mouth. I had to relearn everything. I was in a rehabilitation hospital for a month and I went to outpatient physical therapy for over a year.”

Although Hawes learned how to walk again, the left side of her face remained droopy and immobile.

“I was going to all different kind of therapies - speech, occupational and physical. All my therapists said that nothing could be done. I asked all my doctors and I kept looking it up online," Hawes said. "It was awful, every time I went to sleep I had to tape my left eye shut.”

In March 2016, six months after the stroke, Hawes was referred to Oregon Health & Science University’s newly created Facial Nerve Center in Portland, Oregon.

She was introduced to Loyo Li, who had worked on 25 people’s facial paralysis and seen improvement in all of them.

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The expert specializes in disconnecting hair-width nerves one by one and reattaching them elsewhere. The nerves grow and strengthen on new muscles and bring the face back to life. 

A month later, Hawes was wheeled into surgery for the operation. 

“I was nervous because nobody had heard about this surgery," she said. "There were no guarantees that the nerves would take, but I knew I had to do something. I didn’t have a choice.”

The grandmother is no longer in pain and gained confidence to marry her longtime boyfriend.

It took four months for the post-op swelling to subside and Hawes still didn’t know whether the surgery had been a success, until one day in September 2016.

“I had this huge operation but there were no signs that it had worked," Hawes said. "The nerves have to reattach and that takes a while. But then one day in September, I was taking a selfie and I saw a little movement in my upper lip. I was so excited. I was at home by myself and I thought, 'Oh my goodness, my lip moved.' To me, that was a big deal.”

Hawes continued to improve and in August 2017, she tied the knot with her long-term partner Ken, 63, a warehouse operative. 

“My boyfriend and I have been together for 15 years and I was with him for a long time without getting married," she said. "We had a simple courthouse wedding with just my granddaughter, Adena, 13, with us.”

And then in March this year, for the first time since her stroke, she was able to smile a close-mouthed beam. 

“I’m so excited to live now," Hawes said. "I don’t want to focus on my limitations and I don’t want to lose anything I’ve gained.”