The word “Aphasia” was introduced in my vocabulary as a Physical Therapy student at the University of Mississippi Medical Center in 1992. During my clinical experience taking care of and treating a vast number of patients with neurological conditions (cerebrovascular accidents commonly named “strokes”, brain tumors, traumatic brain injury), I found more insight 3 years ago transitioning from clinician to patient. On May 13, 2014, I had an ischemic stroke with right sided hemi paresis, motor apraxia and aphasia.
Aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write. Aphasia is always due to a brain injury from a stroke, head trauma, brain tumors or infections. It’s more common in older adults, particularly those who have had a stroke.
Aphasia can be mild or severe dependent on the severity of the damage to language areas of the brain. People who have aphasia may affect the ability to retrieve names of objects, putting words together into sentences, reading, understanding words, finding the “right” words to complete their thoughts. They may also have problems with auditory comprehension (conversation, words or numbers), understanding written words or numbers and writing. More commonly, however, individuals with aphasia can have multiple aspects communication impairments. Unfortunately, I had all aforementioned speech deficits initially after my stroke and still have aphasia problems especially when I’m tired or emotional.
I had inpatient therapy at Baylor Rehabilitation of Dallas for one week and outpatient at Pate Rehab in Anna, TX. I participated in speech therapy 6 hours per day and 5 times per week for 8 months. My speech therapist, Anne, administered several assessments to determine the type of aphasia that affected me.
There are various types of aphasia and I have two of them: Expressive Aphasia & Anomic Aphasia
Other common types of aphasia are:
- Broca’s (Expressive) aphasia (non-fluent) – the person knows what he or she wants to say but has difficulty communicating it to others.
- Anomic aphasia – the person has word finding difficulties or struggles to find the right words to speak and write.
- Wernicke’s (Receptive) aphasia (fluent) – the person can hear others or read words, but may not understand the meaning of the message.
- Global aphasia– the person has difficulty speaking and understanding the meaning of the words. The person is unable to read or write. This is the most severe type of aphasia.
- Primary progressive aphasia – this type is rare where people slowly lose the ability to talk, read, write and comprehend what they hear in conversations over a period of time.
Coping with aphasia can be difficult and frustrating for many, but you must have strength to overcome. Having aphasia is a loss and grieving is key to heal mentally and spiritually during your recovery. It’s a battle to accept your impairments, to accept others & especially family to deal with your “new normal” and move forward in your life despite aphasia. Feelings of frustration, guilt and embarrassment at the inability to communicate can lead to anger, depression and avoidance of others. I stopped meeting girlfriends for lunch or other social events initially because I was embarrassed and felt I would not be involved in the conversation because my speech was not fluent. Hence, the barrier was me, not my friends.
People with aphasia may tire easily and show extreme emotional fluctuations particularly early in the recovery process. In fact, sometimes it overwhelms me to where I’m still mentally and physically exhausted. It is a lot of energy to find, write or correct words from sounds or sentences, read and speak your own name and phone number. Like writing this blog!
Family members may also feel strong emotions including anxiety, anger, confusion, depression and despair. A good support system of family and friends are important. As a person with aphasia, I understand family members may feel a sense of loss too, but practice patience. It is normal to go through a grieving process when the one you love develops aphasia. Support groups are valuable to help through this recovery and afterwards too!
If you have a loved one with aphasia, embrace them every day, allow them to keep their personality, laugh, cry and pray for them! Believe! Faith! Love!