Aphasia: The Nightmare You Cannot Erase

Imagine you are trying to communicate, but your abilities are impaired. You try to formulate words, and nothing comes out. You understand language yet cannot express any writing. This seems like you are coming from a bad dream where communication is completely gone from the face of the universe. To be honest with you, it is real and ready to attack when you have brain damage. This neuronal damage is commonly caused by a sudden stroke or a head injury which affects communication skills. You might be asking, “What disease are we referring to that can cause such detrimental consequences?” It is ‘aphasia.’[i] There are multiple types of aphasia that vary based on the location of damage, the time of onset, the age of the individual, and other multifactorial causes. The Aphasia Center-Intensive Treatment Program provides a list of cases with different presentations, ages, type of aphasia, and treatment programs. [ii] To give an example of a case:

Type of Aphasia: Severe Broca’s Aphasia with Severe Apraxia

Age: 59

Time since stroke: 9 months

George was a retired legislative councilman and worked part-time at a sporting goods store. He was regularly active with his family and enjoyed outdoor activities. His past medical history included a craniotomy leading to subsequent surgeries. Eventually, George presented with a stroke that impaired his speech. The six-week treatment following his stroke incident consisted of serial assessments focusing on speech rehabilitation. After completing treatment, George had regained almost 50% of his communication abilities, which included responding to open ended questions, repeating a conversation, naming things, writing dictated words, and overall speech improvement.

This case sounds like great news, but what caused him to be in this condition in the first place? Most likely, it can be attributed to his craniotomy and multiple surgeries; but, how can you explain the sudden appearance of aphasia? It could possibly be a result of having a poor diet, genetic factors, or environmental factors. It is difficult to say. What we do know is that aphasia is only one of the numerous symptoms following a stroke which can be pretty terrifying and something that we want to prevent altogether. The CDC states that 80% of strokes could be prevented through maintaining a healthy lifestyle and treating other health risks associated with strokes.[iii]  Experts at Harvard give several recommendations that can decrease the risk of strokes: lowering blood pressure, weight loss, increased exercise, drinking alcohol in moderation, treating atrial fibrillation, treating diabetes, and smoking reduction. [iv]  Of course, all these recommendations are important in stroke risk reduction, but why can’t we lower the rates of these risk factors? It appears to be an easy solution, but the issue lays on the lack of education about this silent killer. [v]

The key to preventing what happens to those who experience a stroke is diet, diet, and diet. If we cannot change the statistics by providing education and medical advice, then the next step would be to create changes at a higher level through policies and legislation, such as enforcing food chains to reduce salt content, increasing access to healthy food options, and educating children at a younger age. [vi] All of these approaches can make a significant impact on the fight against strokes where one day, we can see a life with less chronic conditions. Let us try to create and implement lifestyle modifications to prevent strokes so that you won’t have to endure such an alarming experience as the one that George had to go through.

[i] Marcelo L. Berthier, “Poststroke Aphasia : Epidemiology, Pathophysiology and Treatment,” Drugs & Aging 22, no. 2 (2005): 163–82, https://doi.org/10.2165/00002512-200522020-00006.

[ii] The Aphasia Center, “Case Studies,” The Aphasia Center, January 8, 2018, https://theaphasiacenter.com/aphasia-case-studies/index.html.

[iii] “Preventing Stroke: Healthy Living Habits | Cdc.Gov,” January 31, 2020, https://www.cdc.gov/stroke/healthy_living.htm.

[iv] “7 Things You Can Do to Prevent a Stroke,” Harvard Health, June 1, 2013, https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke.

[v] “Knowledge of Stroke and Its Risk Factors among Stroke Survivors: A Hospital Based Study. – Abstract – Europe PMC,” accessed June 15, 2021, https://europepmc.org/article/med/33830117.

[vi] Institute of Medicine (US) Committee on Public Health Priorities to Reduce and Control Hypertension, Introduction, A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension (National Academies Press (US), 2010), https://www.ncbi.nlm.nih.gov/books/NBK220095/.

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