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Trust me, you need these Stroke Disorder resources

  Image from www.strokeawareness.com

In addition to Better Hearing & Speech Month and Brain Cancer Awareness month, May is also Stroke Awareness Month.  According to the CDC, strokes (CVA) are the leading cause of long term disability.  (https://www.cdc.gov/stroke/facts.htm)

As a speech language pathologist working with adults, stroke patients have been a significant part of my caseload over the years.  Depending on the part of the brain where the CVA happened, a person’s cognition, language, speech, swallowing  and voice may be affected, requiring a speech language pathologist’s help.

One of my most favorite practicum placements in graduate school was in Nazareth College’s Aphasia Clinic.  I got the honor of working with individuals who had suffered a stroke and required adult speech therapy, and were gracious enough to let us graduate students practice our skills on them.  I had 3 different clients, who presented with very different symptoms!  Each client had the same frustrations: people didn’t have the patience to let them take the time they needed to get their message out.  

That planted a seed in my brain; that what I wanted to do, as I grew professionally, was to increase the public’s awareness and understanding of aphasia –  and other communication disorders- to improve the quality of life for the people that are living with these disorders.  The longer I have practiced speech language pathology, the more I have realized that people & professionals alike (including myself!) have no idea about the number of resources available to us for such disorders.  And so, the Resurgence Neuro Rehab blog was born!

Now, let me talk a minute about Aphasia.  It is an adult acquired language disorder, meaning the person had already developed all the language previous to the stroke.  

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 injury to the brain-most commonly from a stroke, particularly in older individuals. But brain injuries resulting in aphasia may also arise from head trauma, from brain tumors, or from infections.” (https://www.aphasia.org/aphasia-definitions/)  The National Aphasia Association does an incredible job explaining all the pieces to and different types of Aphasia.

The bottom line is that people who have aphasia were able to communicate, and all of the sudden, now, are not able to communicate.  I had a person who had such difficulty comprehending other people’s speech, s/he would dominate the conversation.  I had a person who couldn’t say the word s/he wanted to say and therefore hated going out to eat, because ordering food was traumatic.  Another person thought s/he knew what s/he was saying, but made absolutely no sense to the listener.  I’ve also worked with folks who could only say one word or phrase over and over, and worked with people who suffered cognitive deficits, which affected their ability to attend to their intended message long enough, that they couldn’t formulate the language to communicate.

Aphasia can affect more than spoken language.  It can affect a person’s ability to read and/or write!

In addition to aphasia, a person who has had a stroke might suffer from dysarthria; a weakness in their muscles used for speech.  They may have one sided facial droop, slurred speech, a change in their voice, and/or run out of breath when they are trying to talk.

Other people may be diagnosed with apraxia of speech, which is a motor planning deficit.  They know the word they want to say, but the words they intended to say came out different; sometimes, not at all.  Typically these folks make inconsistent errors and have a harder time with longer words.  It’s almost as if the person can’t get his/her mouth to move to make the correct pronunciation.  

What I have worked with most of all for people who have had strokes, is dysphagia (otherwise known as trouble swallowing).  A person who has one-sided paralysis or weakness has had damage to their motor nerves to the muscles on one side of their body.  And, muscles in our throat & face are made of the same fibers and muscles in our arms & legs.  Your throat & face muscles can be strengthened just like your arm & leg muscles.

 

It is possible that a person may have arm and leg involvement without throat or face involvement, because it all depends on where the CVA occurred in the brain. However, anytime I see a person with one-sided weakness, I want to evaluate their swallowing!  A stroke can also damage a person’s ability to feel things, so I don’t trust a patient’s report that their swallowing is fine.  It might not be fine and they just can’t feel that it’s not fine.

The National Foundation of Swallowing Disorders has an amazing webpage, full of information and resources regarding dysphagia. (https://swallowingdisorderfoundation.com/about/swallowing-disorder-basics/)  The president, Ed Steger, was recently on one of my favorite podcasts, “Swallow Your Pride,” (https://podcast.theresarichard.com/) speaking about his own journey with a swallowing disorder.  The NFOSD webpage has links to swallowing support groups, which they sponsor.  These support groups are designed to help people diagnosed with dysphagia, along with their caregivers, have a safe place to talk about their journey with dysphagia as well as receive education and resources to improve their quality of life.

I, along with a colleague from the Raleigh/Durham area, Nancy have started a swallowing support group through the NFOSD!  Our first meeting will be 5/25 at 6pm on zoom!  If you are interested in attending, please RSVP to SSGCarolinas@gmail.com

Stroke is a type of brain injury and one aspect of stroke that doesn’t get enough attention, as it does in brain injury, are the cognitive deficits.  Now, I want to preface this piece with:  Just because a person has a speech, language, or swallowing impairment does NOT mean they have a cognitive impairment!  Again, depending on where, in the brain, the CVA happened, there may be some attention, memory, sequencing, problem solving, judgement, or emotional deficits may become apparent.  You can find more information about brain injury here: https://www.bianc.net

 

The signs and symptoms of stroke are incredibly important to be recognized.  The quicker we can get medical attention to a person having a stroke, the better their chances of a faster, fuller recovery.  The stroke awareness website lists the symptoms in a lovely acronym, so we can remember it better!  BE FAST!  And I like the acronym because it’s a nice reminder that the less time we spend thinking about what to do here, the better!  If you notice any of these signs, call 911 immediately.

B= BALANCE- sudden loss of balance

E= EYES- changes in vision

F=FACE- facial drooping or severe headache

A=ARMS- weakness or numbness (or not being able to move the arm)

S=SPEECH- trouble speaking or confusion

T=TIME TO CALL 911! 

Time is of the essence-

Don’t call to ask family what they think (as my family was guilty of).  

Don’t call the doctor.  

Don’t’ pass go, don’t collect $200 

CALL 911!

 

Let me say it again – CALL 911 FIRST.

I have spoken to EMT’s and emergency room personnel.  They would MUCH rather have it be a false-alarm, than for you to be suffering and not come in.

Remember, the faster you can get medical attention, the better chance you have of recovering!

And as much as I want a chance to help everyone in the world, I would rather not have to help you under those circumstances.

I hope you have found this information useful, helpful, & somewhat entertaining.  Please feel free to comment below to suggest upcoming topics!

Until next time,

Cheers! 

Michelle Hill MS CCC-SLP is a speech language pathologist and Owner/Founder/CEO of Resurgence Neuro Rehab.
She has been performing adult speech therapy for 10 years, specializing in cognition, language, speech, swallowing, and voice. To learn more about Michelle, visit https://resurgenceneurorehab.com/?staff=tom-stafford