When aphasia locks up your language

Dominion Post, The-August 22, 2005 Author: MACDONALD Nikki Aphasia affe ts a!out eight of the 20 peop"e #ho ha$e a stroke ea h %a& in Ne# 'ea"an%( )ith he"p, man& "earn to speak norma""& again( *MA+*N, "i$ing in a foreign ountr& #here &ou an-t speak the "anguage( .ou kno# #hat &ou #ant to sa& !ut &our thoughts an% #or%s are imprisone% in &our !rain( *magine there is no ke& to the prison e"" -- &ou an/t "earn the "anguage an% un"o k the %oor to ommuni ation( This is ho# Liana 0"anagan 1a spee h therapist2 %es ri!es the frustration an% iso"ation of aphasia -- pro!"ems #ith "anguage omprehension an% e3pression, ause% !& a stroke or !rain in4ur&( 5o& 6innear #a"ks from the %oor of her pea efu" 7pper 8utt house to the "ounge( There is no sign that she has ha% a stroke( 9he-s !right, "i$e"& an% mo!i"e( 9he %oes %rag her "eft "eg s"ight"& as she #a"ks( *t is on"& si3 #eeks sin e she ha% a sma"" stroke - this took a"" fee"ing from her "eft si%e( 9he has ma%e huge progress an% is up an% #a"king again(

The stroke "eft the :;-&ear-o"% #ith aphasia( 9he has on"& a mi"% form of the on%ition -- her spee h is a "itt"e sti"te% as she fum!"es for the right #or%( 9he o onfuses #or%s( <*t %oesn-t min% me 1#here * sit2,< she sa&s as #e take a seat in the "ounge( 5o& is positi$e a!out the out"ook an% "aughs at her o#n mistakes( 9he sa&s she ma& ompi"e a !ook of the no$e" #or%s an% phrases she has reate%( =ut she has ha% a frightening insight into the iso"ation of "osing &our a!i"it& to ommuni ate( On 5u"& > she #oke fee"ing <funn&<( 9he ha% ha% a fe# %a&s of hea$& tire%ness an% a rest"ess night-s s"eep( <* ou"% not rea""& %o an&thing( * ou"% not mo$e m&se"f( * #as 4ust sort of ?!"ah- in !e%(< 9he ou"% not fee" one si%e of her !o%& an% feare% the #orst( <* kept going "ike that to 9tuart,< 5o& sa&s - she tra es her han% un%er her hin to sho# utting her throat( <* thought * #ou"% !e para"&se%( M& feet ou"% ha$e !een aroun% m& ne k an% * #ou"% not kno#( That #as $er& s ar&( * #as sa&ing * %on-t #ant to !e "ike that( * think it #as the ne3t %a& or after that * rea"ise% * #as not para"&se%(< At the same time she rea"ise% she ou"% not e3press herse"f easi"&( To start #ith, #or%s fre@uent"& es ape% her - she #as asiona""& mi3es tenses or

for e% to use gestures( <.ou ha$e the #or%s up here,< she sa&s, pointing to her !rain( <=ut !& the time * sa& it, it omes out #rong(< 9he remem!ers, in hospita", asking for some more en$e"opes for thank &ou ar%s( <* #as sa&ing ?e"ephants-( ,$en no# * sti"" ha$e trou!"e sometimes( A"" those sorts of #or%s go funn&(< )hen an e3pression sti ks in her throat, she !ui"%s the #or% on her right knee - she arefu""& tra es the "etters #ith her finger an% mouthes the soun%s( Though 5o& 4okes a!out her on%ition, 9tuart ta"ks of the fear the oup"e first fe"t A the& thought the& ma& not !e a!"e to ommuni ate free"&( <*t #as a !ig sho k -- * a"#a&s thought 5o& #as the hea"th& one( Those first %a&s #ere prett& %ark(< Though 5o& un%erstoo% spee h, she #as una!"e to rea%( Aphasia p"a&e% ha$o #ith her !rain-s a!i"it& to pro ess an% un%erstan% #ritten #or%s( 9he remem!ers tr&ing to rea% the ne#spaper in hospita"( <* #as rea%ing ?the at on the mat-, !ut it #as not in m& house, m& hea%( After a!out a #eek * thought ?* #i"" tr& to rea% something in a !ook-( The first time * trie% * ou"% not %o it proper"&( After a oup"e of %a&s * trie% it again( * sat in !e% an% #as a!"e to ha$e this stor& in m& !rain( * kne# #hat the stor& #as a!out( That #as "o$e"& !e ause * "o$e rea%ing(<

5o&-s %iar& is a goo% in%i ator of her progress( *n the first %a&s after the stroke her #riting #as "ike a hi"% -- arefu" an% %e"i!erate, #ith #or%s an% "etters missing( =eef stroganoff !e omes ?!eef sturo off-( One time, she %re# a pi ture of her #a"king frame, !e ause she ou"% not sa& the #or%( No# the pages are fi""e% #ith a "egi!"e s ra#" -- sti"" neat, !ut shape% !& the persona" st&"e that omes #ith age( 9he has ome a "ong #a& !ut her spee h sometimes "apses #hen she gets tire%( <9tuart re kons *-m !etter on the phone( Ma&!e * shou"% go roun% #ith one of them a"" the time(< An% she has %iffi u"t& #ith num!ers( 9he sees the num!er !ut her !rain annot re ognise its meaning( 9he an remem!er her phone num!er an% age - !ut she an-t remem!er her !ank ar% P*N, #hi h makes "ife %iffi u"t( <* an-t get m& mone& out at the moment( Phone num!ers are 4ust hope"ess(< 0or 5o&, the prognosis is goo%( )ith ongoing spee h therap&, she is "ike"& to !e !a k to norma" #ithin a fe# &ears( =ut she is one of the "u k& ones( 0or man&, aphasia shuts them omp"ete"& out of ommuni ation, Liana sa&s( <*t is a!so"ute"& %e$astating for the patient an% fami"&( Most of them kno# e3a t"& #hat the& #ant to sa& !ut the& ha$e no a ess to the outsi%e #or"%( The& an-t un%erstan% the& ha$e ha% a stroke( The& %on-t kno# #hat has happene%( The& an-t

te"" peop"e #hen the& #ant to go to the toi"et(< <The& ommuni ate through gestures an% fa ia" e3pressions A it is not possi!"e to ha$e an& meaningfu" ommuni ation is prett& mu h impossi!"e(< At its #orst, aphasia is <"ike !eing in a foreign ountr& #ithout an& a!i"it& to speak the "anguage an% no a!i"it& to "earn it,< she sa&s( Aphasia an !e ause% !& an& t&pe of !rain in4ur& A usua""& on the "eft si%e of the !rain( This si%e %ea"s #ith the e3pression an% un%erstan%ing of "anguage( *t is re"ati$e"& ommon an% usua""& resu"ts from a stroke, hea% in4ur& or some forms of %ementia( A!out 20 Ne# 'ea"an%ers a %a& ha$e a stroke an% a!out eight of those %e$e"op aphasia( =e ause it affe ts un%erstan%ing, aphasia an affe t spoken or #ritten "anguage, Liana sa&s( <9ome peop"e an-t un%erstan% e$en sing"e #or%s( The& an-t rea%, #rite or speak( There-s a omp"ete shut%o#n of ommuni ation( The& %on-t re ognise a pi ture as a s&m!o" of "anguage(< 9ome annot e$en %o a !asi &es or no - the& %on-t un%erstan% the @uestion !eing aske%( There are four main omponents of aphasia:
1.

)or%-fin%ing pro!"em: this is the main s&mptom of aphasia( Peop"e kno# #hat the& #ant to sa&, !ut 4ust an-t get the right #or% out(

2. 3.

Comprehension pro!"ems( 0"uen & pro!"ems -- spee h an !e ome @uite ha"ting( The person often stops to fin% the right #or%( Bepetition(

4.

*ts treatment %epen%s on the se$erit& of the on%ition, Liana sa&s( The main goa" is to fin% a #a& for the person to ommuni ate( To he"p #ith the most ommon pro!"em of #or%-fin%ing, therapists tea h #or% asso iations( 0or e3amp"e, someone tries to think of the #or% for horse - he is to"% to think of the #or%s %onke& or farm as prompts( ,$er& person is %ifferent - the prognosis %epen%s on the e3tent of their !rain in4ur&, age an% attitu%e, Liana sa&s( 9omeone #ith a se$ere stroke ma& sho# "itt"e impro$ement in the first fe# #eeks( The& are "ess "ike"& to re o$er a"" their "anguage( .ounger peop"e #ith sma""er strokes, "ike 5o&, ten% to %o !etter( <.ou an ne$er pre%i t #ho is going to !e a!"e to %o #hat(< 9tuart !e"ie$es a "ot of 5o&-s impro$ement is a om!ination of #i"" an% goo% are( <9he has impro$e% tremen%ous"& - it-s 4ust un!e"ie$a!"e( * think a "ot of it is %etermination - the reha! unit #as a"so fantasti ( .ou "ook at peop"e an% think ?That person is ne$er going to get out of !e%- an% a #eek "ater the& #i"" !e #a"king(<

5o& has 4ust one message - she ne$er #ent to the %o tor so she ha% no i%ea she might !e at risk of a stroke( <* on"& use% to go #hen * #as rea""& si k( * pro!a!"& ha% high !"oo% pressure, * %on-t kno#( That-s the message -- te"" peop"e to go an% ha$e regu"ar he k-ups(<