Living with aphasia and the long road to regain language capabilities
Aphasia is a disorder that results from damage to portions of the brain that are responsible for language. It impairs the expression and understanding of language as well as reading and writing.
FALLS CHURCH, Va. — Bonnie Poe pulled up to a drive-through window. She ordered her meal and asked for her favorite condiments. The woman behind the counter responded, but Poe had trouble understanding what was said. She asked the woman to repeat herself slowly, but again, the response sounded like gibberish.
“I wish they could just hold on a second,” said Poe, who suffered a stroke in 2014 at age 40. She was diagnosed with aphasia, which impairs a person’s ability to express themselves or understand speech, or sometimes both, as a result of damage to parts of the brain responsible for language, according to the National Institute of Deafness and other Communication Disorders, or NIDCD. Poe often asks people to repeat what they say because she can only understand bits and pieces, which can be aggravating, she said.
“Sometimes people talk so fast you can’t understand, and it’s not them, it’s my reception,” said Poe, who described herself as talkative and a social butterfly before her stroke occurred. “You just sort of feel trapped, like you can’t have a conversation with anyone.”
Cynthia Zmroczek, a speech language pathologist at the Fort Belvoir Community Hospital Intrepid Spirit Clinic in northern Virginia, said aphasia impairs the expression and understanding of speech. The disorder can be diagnosed as fluent and non-fluent, and many various types exist within these categories, she said.
“There are different parts of the brain that have different functions, so when the blood flow is cut off to that area, damage can result in those areas,” said Zmroczek, adding that the type of aphasia that occurs depends on the area that’s damaged and the extent of the damage. “The damage can be mild, moderate, or severe, and that determines how the person will be able to progress.”
Poe was diagnosed with mixed, non-fluent aphasia. People with this form of the disorder can have difficulty understanding what’s being said and also have trouble finding the words to express themselves.
“You know when you’re in conversation and you have someone’s name on the tip of your tongue, and you can’t remember what that is? That is how normal words in a sentence are for me,” said Poe. “It’s like reaching for words. It’s like the word is on the tip of my tongue, and it’s a normal word that shouldn’t be on the tip of my tongue.”
Other common forms of aphasia are Broca’s and Wernicke. A person with Broca’s aphasia, also known as non-fluent aphasia, can understand what’s being said, but has trouble finding the words to express thought. Wernicke aphasia, also known as receptive or fluent aphasia, can cause difficulty understanding written and spoken language. According to NIDCD, a person with Wernicke aphasia may speak in long, complete sentences that have no meaning.
The disorder can also be diagnosed as anomic or global aphasia. Anomic aphasia can cause a person to have trouble finding words in speech and writing, while the ability to read and understand remains intact. A person with global aphasia, the most severe form, can have very limited abilities to express or understand speech.
Roughly 1 million Americans currently have aphasia, and nearly 180,000 Americans are diagnosed with it each year. Zmroczek said most cases occur suddenly following a stroke or serious head injury, but others can result from neurological diseases, such as Alzheimer’s disease.
“The damaged parts of the brain can heal to some extent over time,” said Zmroczek. A person can get better with the help of speech and occupational therapy, but it takes continuous help in and outside of therapy, she said. Treatment involves various tasks and activities to meet the needs of each specific form of aphasia. NIDCD says individual therapy can be catered to a patient’s specific language needs, while group therapy and activities, such as a club or art class, allow patients to practice communication skills and build confidence. Technology, such as the use of speech-generating applications on devices, can also help patients communicate.
For Poe, treatment includes word-building tasks. She’s been in and out of treatment since 2014, and now enjoys using applications on a tablet to practice expressing words.
“Communication is the most important skill we have,” said Zmroczek. “If we didn’t have communication, we wouldn’t be able to connect with anyone in our lives and develop relationships. Improving communication truly is life-enhancing.”