Transcription:
What is Aphasia and What Do You Need to Know

Announcer: This is Hello Healthy, a Dignity Health podcast.

Deborah Howell (Host): Lately, we've heard more in the news about a disorder called aphasia, since Bruce Willis's family has started talking about it publicly. Let's find out more about aphasia, how it's treated and what you need to know with Jill Busby-Avila, Rehabilitation Services Manager, and Speech Language Pathologist at Bakersfield Memorial Hospital.

Welcome Ms. Busby-Avila or would you prefer Jill?

Jill Busby-Avila, MA, CCC-SLP (Guest): Oh you can call me Jill. That would be just fine.

Host: All right, then let's dive right into our topic. Jill, what is aphasia?

Jill: So aphasia is actually an acquired language disorder, so it affects a person's ability to be able to communicate, the key being here acquired. So it's not something that someone is born with. It can affect all the areas of language, including reading, writing, listening, and speaking. So basically what I typically explain to my patients and their families and caregivers, aphasia affects the ability to be able to not only speak language, but the ability to understand language, and within that, there are different types of aphasia too as well.

Host: Oh, interesting. Do we know what causes it?

Jill: Aphasia typically occurs most commonly after stroke, or it can also be results of the head trauma or, some sort of injury to the brain. Most often it's typically sudden onset. However, it is important to note that there are some form of aphasias that are what we call gradual onset. So those could be due to a brain tumor or some sort of progressive degenerative disease.

And definitely the severity of aphasia, depends on the cause. It depends on the location and it also depends on the degree of damage that has occurred to the brain.

Host: Got it. Now, are there any signs and symptoms?

Jill: Yeah. Aphasia, I think that the, main distinction between that is the aphasia is typically a sign of a condition. So such as a stroke or a brain tumor, like we talked about. So a person aphasia may have symptoms where they speak slowly, sometimes laborously, short, incomplete sentences. Sometimes they'll say like me, um, a water. Where they're kind of a little bit more non-fluent, while others may speak in sentences that really just don't make sense. So, they can also speak an unrecognizable words. We also call that jargon. So whoop and flip and flop. So it just kind of depends like I said, on the location, and what type of aphasia they have. People with aphasia can also have difficulty understanding others' conversations. And they can also have difficulty writing, sentences and actually write sentences that really just don't make sense.

Host: Yeah, that's got to be so hard on the families. Right?

Jill: Absolutely.

Host: So how does stroke play in with the risk of aphasia?

Jill: Like we talked about earlier, stroke definitely is the most common cause of aphasia. So a stroke is caused by typically either blockage or a rupture of brain vessels in the brain. So the loss of blood flow to the brain or bleeding in the brain can lead to damage or death in the areas of the brain that control language. So the ability to speak and process language. There are three main, cortical types of aphasia. We call those Broca's aphasia, Wernicke's aphasia and global aphasia. However, like I said, it is important to note that brain tumors infections, or also degenerative disease, it can also cause aphasia. One type of aphasia is called primary progressive aphasia or PPA and that is something that can actually develop over time.

So, PPA, can progress into more generalized dementia, and other things like that. Some individuals also just may have temporary episodes of aphasia, so that typically can be caused by transient ischemic attackss or TIAs we call them or a mini stroke. Sometimes even seizures or even migraines can also cause temporary moments of aphasia.

Host: That is so interesting. Even a migraine can cause temporary aphasia.

Jill: Yeah. It just kind of depends on the circulation and everything like that. Just of what affects the brain and the location.

Host: Well, that speaks to my next question then. Can you recover from aphasia and are there treatment options?

Jill: Yes. So, if the damage is mild, a person may recover from aphasia without any treatment needed at all. However, if the damage is more extensive to the language centers, individuals may require language rehabilitation with a speech language pathologist such as myself. The type of treatment really does depend on the severity and location of the stroke or the brain damage that has occurred. Some individuals with mild aphasia, they may benefit from therapy. We typically go ahead and have them engage in conversation. Sometimes utilize strategies to help them remember words. Some patients experienced what we call anomia, which is word finding difficulties. So we'll work on strategies to kind of help them with that.

Other therapy consists of utilizing even just simple yes, no questions. Naming pictures or objects, or utilizing what we call augmentative or alternative communication, which is AAC. AAC can, be like a communication board where there's a set number of pictures, that might, be more specific to the patient.

So there might be a cup, to indicate that the patient would want something to drink and so that they would go ahead and point to those pictures to be able to go ahead and communicate. But definitely the primary goal for speech-language treatment is establishing what we call functional communication.

So we want it to be functional and definitely individualized to each person or patient. I think that the most important thing to always remember is what is going to be good for one person might not be good for another person. So we really need to make it specific, to each person, the family, the caregivers, and really what their needs are to be able to effectively communicate their needs and wants.

Host: So this really primarily affects language. What about physical? I mean, as a person with aphasia, can they do a treadmill exercise routine or what do you do physically with people that have aphasia? I know everybody's different, but can you speak to that?

Jill: It's definitely the more physical deficits would lend more to physical therapy or occupational therapy. So physical therapy works more on gross motor and occupational therapy works more on fine motor, with any sort of physical deficits. So the brain is responsible for what we call the contralateral side.

So if a patient sustains, for example, a stroke in the left side of the brain, where most of the time, the speech and language centers are, and most right-handed and most left-handed patients, it can affect physically the right side of the brain. And it really just depends on the severity of the physical limitations and that is actually, more diagnosed and treated, with a physical therapist and an occupational therapist.

Host: Okay. Working hand in hand together.

Jill: Correct. Yes. Yeah. We're definitely a rehabilitation team and we all work together as a unit and to go ahead and, and try to get patients being able to go ahead and speak, but then also be able to physically be able to move and work towards their activities of daily living and function as close as possible to what they were before they had their brain injury and it really just varies from patient to patient. And it depends on the severity and location.

Host: Do you have support for family members?

Jill: We do definitely offer community support here locally within Bakersfield. But there are also some great, online aphasia support groups. You can go ahead and go to different websites to be able to go ahead and access that, but, yeah, there's definitely, good support.

I've actually participated in some patient and family support groups here locally, where we provide education similar to this regarding language and speech, but then also too, as well as swallowing disorders, after a patient sustain a stroke.

Host: I'm sure that's greatly appreciated by the families. Jill is there anything else you'd like to add to our conversation today?

Jill: Yes, I really can't stress enough that if any person is having difficulty speaking, trouble understanding speech, difficulty, you know, remembering their words, problems with reading or writing. You know, we really, if at all possible can, should seek medical attention immediately.

We definitely have time sensitive medications that can be administered in the hospital that can help not only with survival that can also, help with long-term disability, such as aphasia and just being part of our stroke team and, being a stroke center of excellence, it is something that, is really important, to go ahead and share that message, that the earlier the treatment and intervention the better the possible outcomes.

Host: Time is brain.

Jill: Yes, absolutely.

Host: Well, Jill, thank you so much for being with us today. What a pleasure for all the great information to have you on the podcast today.

Jill: Oh, you're very welcome. Thank you so much for having me. I really appreciate it.

Host: And to learn more, go to dignityhealth.org/bakersfield/stroke. Oh, and if you like what you heard, please share it on your social channels and make sure to check out our full podcast library for topics of interest to you. This is Hello Healthy, a Dignity Health podcast. I'm Deborah Howell. Thanks for listening and have a great day.