Do you speak Aphasia?

IV in place? Check. Rock-hard bed and pillows? Check. Blood draw every four hours? Check. Waking me up in the middle of the night to weigh me? Check. Yup, nothing like a hospital stay to rest and recuperate. I’m starting to wonder if it is part of the insurance companies’ conspiracy. If patients complain enough; exhaust enough; sick of the food enough; maybe they will beg to leave earlier than you might otherwise.

That first night I was confused, and very tired but as I mentioned even if you doze off they eventually wake you up for one thing or another. I was up early, around 5 AM. The parade of doctors started around 9AM. Internist, Cardiologist, Neurologist, Infectious Specialist and a speech therapist came in one by one wandering in the room. The business person in me wanted an Agenda.

I. Morale Booster Allison 12 hours 8AM-8PM
II. Introduction, Status Internist 15 Minutes 9AM-9:15
III. Heart status Cardiologist 30 Minutes 10AM-10:30
IV. Lunch Cafeteria Lady 90 Seconds 12PM -12:02
V. Neurologist Event Post Mortem 30 Minutes 2PM-2:30
VI. Speech Therapy Perky Speech Therapist 30 Minutes 3PM-3:30

For the sake of brevity I am not including the blood draws, medications, etc.
So here is what we knew at this point: I had an ischemic stroke affecting the left temporal hemisphere. Behind my left ear was a constant dull headache that wouldn’t go away. That, I would learn later, that this is where brain cells died. Medically they call in an insult to part of the brain. How appropriate.

An ischemic stroke results from restricted blood flow to portions of the brain. The majority of strokes (approximately 80 percent) are ischemic, according to the American Stroke Association. Blood flow to the brain may be restricted by a blood clot (thrombus) or by progressive narrowing of the arteries. People with high cholesterol, diabetes, or heart disease are at increased risk of ischemic stroke. (I had none of those medical conditions.) ‘Healthy as a horse’ the saying goes. Until of course until they break a leg and then need to be shot.

An ischemic stroke develops quickly. Brain cells begin to die within minutes of the interruption of blood flow to the brain. Prompt medical intervention minimizes cell death and may help restore partial function to damaged areas.

A stroke which occurs in the left hemisphere of the brain can produce one, several or all of the following disabilities, to varying degrees of severity:

• Paralysis on the right side of the body
• Speech and language problems (known as aphasia- see below)
• Cautious behavior
• Memory loss

Paralysis may be complete, an inability to move the right limbs, wiggle fingers or toes on the right side, or may be less severe. Many left-hemisphere stroke patients recover all or some of their right-side function, so that they may walk and climb stairs without assistance, although they may retain a numbness on the right side of their body.

Because the left side of the brain contains the "speech center" of the brain, individuals with left-side strokes often have difficulty understanding speech and written language following their stroke, a condition referred to as aphasia. Because this is such a common effect of a stroke, a special section on this page has been devoted to aphasia.

Some left-side stroke patients may exhibit a more cautious behavior than before their stroke, although others may find themselves reacting more spontaneously and/or intensely than before to outside stimuli.

Aphasia was the most obvious and immediate effect of the stroke.

Aphasia (sourced from Wikipedia) (pronounced /əˈfeɪʒə/ or pronounced /əˈfeɪziə/), from the Greek root word "aphatos", meaning speechless, is an acquired language disorder in which there is an impairment of any language modality. This may include difficulty in producing or comprehending spoken or written language.

Traditionally, aphasia suggests the total impairment of language ability, and dysphasia a degree of impairment less than total. However, the term dysphasia is commonly confused with dysphagia, a swallowing disorder, and thus aphasia has come to mean both partial and total language impairment in common use.

Depending on the area and extent of brain damage, someone suffering from aphasia may be able to speak but not write, or vice versa, or display any of a wide variety of other deficiencies in language comprehension and production, such as being able to sing but not speak. Aphasia may co-occur with speech disorders such as dysarthria or apraxia of speech, which also result from brain damage.

Aphasia can be assessed in a variety of ways, from quick clinical screening at the bedside to several-hour-long batteries of tasks that examine the key components of language and communication. The prognosis of those with aphasia varies widely, and is dependent upon age of the patient, site and size of lesion, and type of aphasia.
Good friends brought me movies, a video player, magazines and books. I also had with me a pad and pen. Unfortunately most if not all of those distractions were not helping. I couldn’t read more than a couple of words without getting confused. I was unable to follow the arc of even the most sophomoric sitcoms. Writing was harder than speaking and my speech was significantly compromised. Imagine for a moment that you were working on a file and in haste you saved the file, shut down the computer, went on vacation or on a trip for 3 weeks and then came back. You boot the computer up. And now you try to figure out where you saved that file? Where is it? This is how hard it is for me to find some words. In order to keep a conversation at a reasonable rate I would “dumb” it down rather than looking for the word I wanted or normally would use. This is the same reason which I avoided speaking on the phone.

More on my recovery next.

Did you know?

The risk of ischemic stroke in current smokers is about double that of nonsmokers after adjustment for other risk factors.

Atrial fibrillation (AF) is an independent risk factor for stroke, increasing risk about five-fold.

High blood pressure is the most important risk factor for stroke.