No Use in Hiding It Anymore. I Have Aphasia.

Aphasia is one of those conditions you can't hide for long. You can say, "I'm having a senior moment," but when you say it all the time and you're a stroke survivor, you have to come to terms that it may likely be  aphasia.

Here's a quick rundown of the 2 million people, in the US alone, who have lost all, or part, of the ability to use words to communicate:

• Aphasia is an impairment of language that can affect both the production and comprehension of speech and impair a person’s ability to read and/or write.
• Aphasia is always caused by an injury to the brain.
• Stroke is the most common cause of brain injury that leads to aphasia.
• Other brain injuries from head trauma, infections, or tumors can also cause aphasia.
• Aphasia can be mild and only affect a single aspect of language OR it can be so severe that is incredibly difficult to communicate with the patient.
• Most commonly, multiple aspects of communication are impaired.
• Some people can recover from aphasia, but if they have it longer than 2 or 3 months it is unlikely they will recover.

Aphasia is defined as an impairment language caused by an injury to the brain, usually due to stroke, but it could happen from any type of brain injury.

Before April, 2009, I used to be a public speaker, communicating to crowds of people in an extemporaneous fashion, the words flowing with no effort, ad-libbing in an  impromptu fashion. Now, I know my limits and I'm scared.

Are there differences in types of aphasia? There surely are, and thanks to the UK Stroke Association for this quick guide:

Broca's aphasia (non-fluent aphasia)

Broca’s aphasia or expressive aphasia is when people find it very difficult to find and say the right words, although they probably know exactly what they want to say.

People with Broca's aphasia may only be able to say single words or very short sentences, although it’s usually possible for other people to understand what they mean. This can be very frustrating.

The features of Broca's aphasia are:

• Severely reduced speech, often limited to short utterances of less than four words.
• Limited vocabulary.
• Clumsy formation of sounds.
• Difficulty writing (but the ability to read and understand speech). 

Wernicke's aphasia (fluent aphasia)

Wernicke’s aphasia or receptive aphasia is when someone is able to speak well and use long sentences, but what they say may not make sense. They may not know that what they're saying is wrong, so may get frustrated when people don’t understand them.

The features of Wernicke's aphasia are:

• Impaired reading and writing.
• An inability to grasp the meaning of spoken words (producing connected speech is not affected).
• An inability to produce sentences that hang together.
• The intrusion of irrelevant words in severe cases. 

Anomic aphasia

The features of anomic aphasia are:

• An inability to supply the words for the very things the person wants to talk about, particularly the significant nouns and verbs.
• Speech that's full of vague expressions of frustration.
• A difficulty finding words in writing as well as in speech.  

Primary progressive aphasia (PPA)

Primary progressive aphasia (PPA) is a condition where language capabilities become slowly and progressively worse, leading to a gradual loss of the ability to:

• Read.
• Write.
• Speak.
• Understand what other people are saying.

Deterioration can happen slowly, over a period of years. Other mental functions such as memory, reasoning, insight and judgement are not usually affected.

It's important to get an accurate diagnosis for PPA. This is to rule out other degenerative brain disorders like Alzheimer's disease where language and memory and reason are affected.

The operative word here is "may." I have mostly Broca's aphasia, but I have no trouble with written expression. In fact, words come about easily through writing rather than speaking. 

I was a Communication prof so being able to say words clearly was important in my playbook. Am I disgruntled at my speaking ability? You bet. Would I ever accept the stroke? No way. But if I don't fall anymore, that would be good enough for me. 

Yes, You Should Use Global Warming and Stroke in the Same Sentence

If you haven't been under the proverbial rock, you have some idea of what global warming is. First, some background dummied down for the population--of which I was one.

The combustion of fossil fuels is the reason temperatures are higher now, that is, hydrocarbons heat up the planet to produce the greenhouse effect. As a result, it causes interactions between the Earth's atmosphere and incoming radiation from the sun. Thus, too many gases trap the radiation from going skyward again and heating up not only the earth but the seas and melting ice caps. 

Burning fossil fuels like coal and oil puts more and more carbon dioxide into the air. Too much of these greenhouse gases can cause Earth's atmosphere to trap more heat because the abundance of gases can't dissipate anymore and go back to the atmosphere.  

Here's an example. Carbon dioxide up to the second Industrial Revolution in the mid 1800s was about 280 parts per million. As of 2018, the  CO2 in the atmosphere was 407.4 ppm. And that's how bad the global warming is, and it will go up if we don't change our daily routine. 

There was talk in the 1990s about car-pooling so there wouldn't be so many cars on the road, but Americans (of which I am one) need the freedom to go wherever they want and when they want as I did, too, before the stroke so most of them drive their own damn cars.  There was also talk of solar and wind power. But much of that talk has died down. 

So we only have to blame ourselves because humans have been rapidly changing the balance of gases in the atmosphere. So where does stroke come into the picture? 

1. In one study from 2016, which used data from the United States and China because those two countries emit the most greenhouse gases, is one of the first to examine the interaction between air quality and the number of stroke cases.

Led by Longjian Liu, M.D., Ph.D., lead study author and an associate professor of epidemiology and biostatistics at Drexel University, across the two countries, researchers found that the total number of stroke cases rose 1.19 percent for each 10 micrograms per cubic meter of air increase of PM2.5 and also found that temperature had an impact on air quality and risk of stroke.

Thus, people living in the South of the United States had the highest prevalence of stroke at 4.2 percent compared with those in the West who had the lowest at 3 percent, Liu said.

Researchers also found that temperature had an impact on air quality and risk of stroke.

"Seasonal variations in air quality can be partly attributable to the climate changes," Liu said. "In the summer, there are lots of rainy and windy days, which can help disperse air pollution. High temperatures create a critical thermal stress that may lead to an increased risk for stroke and other heat- and air quality-related illnesses and deaths."

2. In a more recent study by Dr. Guoxing Li et al focused on YLL (years of life lost) and found that models used indicated projections to estimate temperature-related YLL in the 2050s and 2070s the monthly analysis to be a significant increase occurred in the summer months, particularly in August, with percent changes >150% in the 2050s and up to 300% in the 2070s. 

So future changes, beginning right now, in climate are likely to lead to an increase in heat-related YLL.

3. And from 2021 comes this: Dawn O. Kleindorfer et al, in a study which focused on lifestyle factors, such as a healthy diet and physical activity, are key for preventing a second stroke. [A second stroke. I can't even imagine.]

Low-salt and Mediterranean diets are suggested for reducing stroke risk. Patients with stroke also are at risk for prolonged sitting, and they should be motivated to perform physical activity in a safe way.

If THAT doesn't convince you.... So check air quality, stay cool, eat healthy, and get up once in a damned while. Have a good day, everybody!