Wolfgang Wolf, a disabled blogger and counsellor living in New Zealand, shares his experience of living with the neurological conditions aphasia and apraxia that affect speech and communication.
After 30 years it hit me again. At first, I didn’t want to believe it, but then I thought, they must have been right when they said it can hit you at any time, anywhere, at any age – I’m talking about another stroke I had in 2020.
30 years ago I had a haemorrhagic stroke (from a burst aneurism), then two years later a TIA (Transient Ischemic Attack – often called a mini-stroke), and this time, on 10th December 2020, an ischemic stroke (caused by a blood clot).
Responding to the doctor who told me what it was, I said, “It didn’t surprise me since I was in the process of collecting the complete set”.
The doctor replied, “Good to see you’ve still got your sense of humour” and I answered, “If you’re in a wheelchair you need a bloody good sense of humour.”
This was the scan that clearly showed where the blood clot was – the red spot on the right.
I felt quite lucky, only two weeks in hospital. This was nothing compared to the four and a half months I was in hospital after my first stroke.
Not only in length of time but also in severity and the amount of damage done. While my first stroke put me in a wheelchair and left me with several other disabilities. This time the only lingering impairments I have are my aphasia and my apraxia. I have mild versions of both, which means I can still communicate, but slower.
To other people, however, it appears more severe. So, for example, I was denied entrance to a restaurant because of my slurred speech as they thought I was drunk. Plus, I have the added annoyance of involuntary mixing up German and English words in writing and talking.
What is aphasia?
Aphasia is a language disorder where the brain cannot find the words. You know what you want to say but it won’t come out or you don’t know how to spell it.
In severe cases, it can occur as a person only missing the odd word, having difficulty putting together a sentence, or, in severe cases, not being able to talk at all.
There is, in most cases, no problem with comprehension – the person understands what the words mean, they just can’t name them, which is the level of aphasia I live with.
Ellen, my speech therapist, gave me an excellent analogy of how aphasia could be explained.
Imagine a bookshelf full of different titles. They are in alphabetical order, which makes them easy for you to find. A sudden earthquake throws them off the shelf and they are in a heap on the floor. The books are still there, but for you to find a particular title it takes longer.
A similar process happens to your brain if you have aphasia with words and letters. They are still there but it takes longer to find them, meaning that the person still has the Intelligence they had previously, but it takes longer to access.
Types of aphasia
Although there are several types of aphasia, it’s important to mention the two most common ones:
Broca’s aphasia
Situated on the left side of the brain, consequently Broca’s aphasia only affects people who have had a stroke on the left. Sometimes they can only speak (or write) some main words, but not all the words necessary to form a grammatically correct sentence.
You might wonder how I managed to write this article, having Broca’s aphasia myself. The answer is very slowly. My problems seem to be that I sometimes can’t think of a word, disregard part of a sentence, or don’t know how to spell a word, and occasionally I involuntarily use German words or grammar. Very annoying! Consequently, a lot of proofreading is involved. This is also the reason why I can only write about two or three paragraphs a day.
Wernicke’s aphasia
This condition, on the other hand, is characterised by the loss of the ability to understand what is being said or read. Contrary to Broca’s, Wernicke’s aphasia involves total or partial loss of comprehension. People can talk, but most of the time it does not make any sense.
What is apraxia?
Apraxia is a motor speech disorder where the brain sends the wrong signals to the muscles so the sounds come out incorrectly. A friend of mine had this problem. He talks perfectly, but sometimes he comes to a word he can’t pronounce, but he can write it. He always carries notepads with him to write down the words he can’t pronounce.
He writes down the word he can’t pronounce and says: “One of these”, pointing at the word. Then he continues his sentence as nothing had happened at all.
Using speech apps during my stroke recovery
Anyone can lose their voice through an accident, cancer, a brain injury, a stroke or from conditions like Motor Neuron Disease. People who have Aphasia can tell you how frustrating it is not to be able to communicate.
Back to my hospital days, the first few days I could not talk at all. The free app I used during these days was Alexicom Tech AAC. Admittedly, this one was a bit too complex for me at first, so, a nurse helped me a lot. However, after a while, it worked much better. You can use the app to talk, write text and show symbols. So many symbols, in fact, that I had difficulties learning them all at this early stage.
Like with all apps you will have to spend some time with it (with a nurse, or speech therapist) and test it to see whether it is suitable for you.
As I recovered my needs changed. I missed my social contact. Even though at this stage I could talk a little bit, people couldn’t understand me. Particularly in a noisy environment like the hospital café. My voice was just not strong enough. Consequently, I used another text-to-speech app for communicating. It is simply called Text to Speech!
At first, I couldn’t talk at all and my writing was not that great either. So, again I asked a nurse to write for me. In my case, the most important phrases were “one Espresso please” and “one Cappuccino please”. But first I asked people to ask me only questions that I could answer with “yes” or “no”. This was to save me the frustration of not being able to reply if a longer answer was required.
All questions are simply saved and moved to your favourite folder. Whenever you need it, you touch your sentence and the app will do the talking for you.
I’d also like to mention another accessibility tool that might be helpful for some of you – Voice Banking. How it works is simple. Before losing the use of your voice, you can record keywords and phrases and later they will be used in a computer program to enable you to use your own voice. There are several companies offering voice banking today – worth checking out. If you’ve already lost your voice, you can use a friend’s voice.
To make the hunt for the ‘right’ app a bit easier, you can check out this link to the Aphasia Software Finder. Here you find not only a comprehensive list of apps but also many other links and resources.
Lastly, I recommend you visit The Aphasia Recovery Connection. It has weekly virtual meetings, tools, resources and even a very popular cruise, plus much more. You can also get a taste of what else the organisation does on its YouTube Channel.
You can find out more about Wolfgang Wolf, his counselling services and public speaking engagements by emailing him at wolfgangwolf@xtra.co.nz.
Do you live with aphasia, apraxia or another language disorder and can relate to Wolf’s experiences? Let us know in the comments box, on social media or contact us to tell your personal story.
