Aphasia, I Haz It

     The second neuro-doc told me that I have mild expressive aphasia, or more specifically a phonemic paraphasia [N.B. which some professionals characterize as being entirely separate from expressive aphasia] with pragmatic and substitution errors.  I also have the associated right-sided weakness that a physical therapist recently pointed out as still being evident a decade after my head trauma.

     I am conscious of my speech errors.  I know when I've substituted a sound for another sound at the beginning of a word.  I figure that if the person that I am conversing with understands what I am endeavoring to convey, no correction of my pronunciation should be forthcoming.  A few other people appear not to agree.  Sometimes I've said to them, "Do you understand what I mean?"  After their response in the affirmative, I've told them to s.t.f.u. about it then.  I've become less defensive about this than I used to be.  Now I will repeat the correction out loud and visualize it cementing itself in my brain.

     I also get irritated when I cannot think of a specific word that I want to use in conversation.  That appears to be an anomia and anomia is central to almost all aphasias.  [Note to testers:  Many of your test subjects know that if you point to the thing on your wrist, the correct answer is "watch" and when you point to the writing implement, the correct answer is "pencil."  Just so you know that, I thought I would tell you that].  Fortunately, I am able to hunt through my brain for a similar word.  Although the substituted word is not exact to my intended nuances of meaning, I get my point across.  The vast majority of people that I interact with do not recognize this sort of thing when it happens unless I point it out to them.  I despise the blank that happens when my brain blocks a word from me however I do know that my ability to pick a different word is evidence that my cognitive slowing has speeded up a bit. 

     Another difficulty that I have appears not to be part of expressive aphasia or of paraphasia.  When people talk too fast-- and I think this chiefly happens when a store clerk or someone on the phone wants me to agree to something (like "buy this object" or "agree to this contract")-- I lose the gist of what they are saying.  I've learned to tell them to slow down.  If they don't, then I tell them that I have a brain injury and that if they want me to understand them, they must slow down.  A second failure to slow down results in my termination of the interaction, or less frequently a request to speak with someone else like a manager.  I've resorted to taking someone with me to a store or having someone listen in on an important telephone call if contracts are involved.  I describe the second person as "my disability advocate" because it then becomes more difficult for the other party to dismiss the presence of my helper-friend.

     Like all of the complications that I've had due to my traumatic brain injury, I continually work on improving those difficulties that I can identify.  Movement is especially important to me.  I substituted my [severely lacking] motivation with motor-vation.  Social interaction [including interaction with other folks on the web], adequate rest and nutrition, and challenging my brain on a daily basis has become a lifestyle.  I do not believe that the majority of improvement after a traumatic brain injury occurs during the first year.  I've had significant improvement throughout because I keep practicing everything.  That which cannot be fixed [and with a t.b.i., there are things that cannot be fixed] can be worked around.  My philosophy is not one of "attitude" or "surrounding myself with 'positive' people."  Action is the word that sums it all up, with periods of rest so that way I have the energy to take repeated action. 

sapphoq healing brain damage says:  I would have gladly settled for a less-challenging life.  I am not "better off" because of my brain damage.  Certainly, I am financially much worse off and my career (that I fought so hard to have) ended.  I have not found any evidence that a god "did it" or even "allowed it to happen."  I have found that it takes courage to dream new dreams and even more courage to take action on the stuff that I say I want.  Anyone can make a list for Santa Claus.  Very few people will want to even attempt to drive a sleigh hooked up to a bunch of grumpy overworked reindeer.


A few links:

http://www.aphasiahope.org/

http://www.aphasia.org/

http://preview.tinyurl.com/n8r6zc6    [Neuro-psych Central, a pdf on aphasia assessment tools].