TIAs and Aphasia are not to be confused with Tiaras and Asparagus. TIAs and Aphasia are serious indications of something going wrong in your brain. Let me ask a couple of questions to put this in context.

Have you ever found yourself short of words?  At a loss for words?  Have you ever had trouble thinking of the right word, or any word that will get your thought across?  And when you couldn’t string together three or four words that you could actually say, not even an “F” bomb, did you panic?

That’s aphasia! 

What happened?  Were you having a stroke?  Did you bump your head?

There are a couple of potential causes of the inability to speak you might want to stop and think about. There are more causes, but deal with these first.

Stroke

Stroke: the most common cause of aphasia is a stroke, which occurs when the blood supply to the brain is interrupted or reduced. This can damage the language centers of the brain, leading to aphasia. If you’re showing the signs of stroke get to a doctor!

Traumatic Brain Injury (TBI)

Traumatic Brain Injury (TBI): A severe blow or injury to the head can result in aphasia. This can happen due to accidents, falls, or any other traumatic event that affects the brain

I’m rarely short of words.  I always have something to say.  Well, occasionally it may not be true.

Tiaras and Asparagus

If it is not a full-blown stroke, it’s probably a ministroke, a TIA, and needs to be taken seriously.

I should probably start with definitions, so no one confuses TIAs and Aphasia with tiaras and asparagus.

Definitions

TIA is a transient ischemic attack which is a temporary disruption in your brain functions that mirror or echo, the effects of a stroke.  Symptoms usually resolve within 24 hours or even minutes.

Aphasia can be one of the symptoms of a TIA or any form of stroke.  Aphasia is a comprehension and communication (reading, speaking, or writing) disorder resulting from damage or injury to a specific area in the brain.

What?! 

It means you don’t understand what people are saying, what you may be reading, and you definitely can’t come up with the words to vocalize your responses.  You can use hand signals and other forms of non-verbal communication.

A temporary bout of aphasia has been noted amongst migraine sufferers during the aura phase of a migraine.  Watch out for the ocular migraine as it may be an indicator that something other than pain is coming.

I discovered in my research that there are several different forms of aphasia each with its own label, and characteristic patterns of language impairment.  All of them do affect a person’s ability to understand, express, and process language.

Gobsmacked is not one of them.  Gobsmacked is a colloquial term that means to be astonished or amazed, usually because of something unexpected or surprising. It is not related to any specific language impairment or communication disorder.

Here’s the list;

Broca’s Aphasia (Expressive Aphasia): People with Broca’s aphasia have difficulty expressing themselves through speech or writing. They may struggle to form complete sentences, speak in short phrases, and have limited vocabulary. Despite these difficulties, their comprehension of language is often relatively preserved.

Wernicke’s Aphasia (Receptive Aphasia): Wernicke’s aphasia primarily affects a person’s ability to understand language. Individuals with this type of aphasia may speak fluently and effortlessly, but their speech may lack meaning and contain incorrect words or made-up words. They often have difficulty understanding spoken and written language.

Global Aphasia: Global aphasia is the most severe form of aphasia. People with global aphasia experience significant impairments in all aspects of language, including comprehension, expression, reading, and writing. They may be unable to produce coherent speech and have limited vocabulary.

Anomic Aphasia: Anomic aphasia is characterized by word-finding difficulties. People with this type of aphasia struggle to retrieve specific words and may often pause or use generic terms to compensate. However, their comprehension and grammar skills remain relatively intact.

Conduction Aphasia: Conduction aphasia is characterized by difficulty with repetition. Individuals with this type of aphasia have trouble repeating words, phrases, or sentences accurately. They can understand language and produce fluent speech, but they may make frequent paraphrastic errors (substituting or rearranging sounds or words).

Transcortical Sensory Aphasia: Transcortical sensory aphasia is similar to Wernicke’s aphasia but with preserved repetition skills. People with this type of aphasia have difficulty understanding language and may produce speech that is fluent but lacks meaning.

Transcortical Motor Aphasia: Transcortical motor aphasia is similar to Broca’s aphasia but with preserved repetition skills. Individuals with this type of aphasia have difficulty with spontaneous speech production but can repeat words and phrases.

It’s important to realize that aphasia can vary in severity, and different people may exhibit a combination of symptoms from different types of aphasia. Additionally, therapy and rehabilitation can help individuals with aphasia regain language skills and improve their communication abilities.

In the spirit of full disclosure, I should probably share the reason why I am even aware of aphasia.

I had a hemorrhagic stroke in 2013.   I’ve had incidents of aphasia happen to me two or three times since then.   Once while I was sitting in a coffee shop with my older brother trying to discuss the next steps in moving the probate of my Dad’s estate to a close I just simply could not find the words I wanted to communicate my opinion on the subject.  Self-diagnosis suggests that it was Anomic Aphasia.

It took about ten minutes for the disruption in my brain to resolve itself so that I could talk.

Jokingly I’ve said that my brother was probably enjoying the break from my constant onslaught.  I can be very chatty.

Most recently I was ambushed by the phenomenon in April of this year.

Let me share the scenario.  As a grandfather, I’ve taken on some responsibility to help out my daughter who is a single mom by routinely driving kids to dance classes and soccer games.

While driving one of my granddaughters to my home after dropping her older sister at dance class I took a phone call on the car’s hands-free phone.  Within moments I knew I was in trouble.  I had difficulty in understanding who was calling, although after the fact I did figure out that it was a fundraiser from one of the charities I support.  Ironically, it may have been the Stroke Foundation.  I excused myself with a brusque “I can’t do this right now!” and hung up abruptly. 

I stopped at a red light and debated whether I should continue driving.

I’m not sure that self-evaluation to make that decision was the correct decision.

Visuals were good, a quick self-assessment of cognitive functions suggested I should get out of the intersection and get my granddaughter somewhere safe.  Home was close and basically a straight line.

Arriving at home I tried to explain to my wife that things felt ‘wrong’.

She welcomed our granddaughter while I took another call, this time from the on-duty mother responsible for the kids that night. 

My wife overheard my fragmented side of the conversation and knew I was in trouble.  She started asking questions which included several things including the names of her sisters, my brothers, and our grandchildren.  I failed the quiz miserably, especially the part about her full name.  Oops!

Sequencing gets confused at this point.  Gail (my wife’s name) did call 811 to speak to a nurse, who advised her to call 911.

Details I do remember include the ambulance arriving, the paramedics, Cheryl and Kyla, and the frenetic rush to get the right boots, coat, and stuff to take to the hospital.  And yes, I checked the charge on my phone. 

There was a brief visit from a fire truck; the local protocol is to always try to send a truckload of firefighters to back up the paramedic/ambulance attendants.  They were waved off before they got out of the truck as I was ambulatory.

So, what the hell had happened?

The ambulance team took me to the local hospital to see if they could figure it out.

It is no great secret that our health care system is ‘in crisis’.  What happened at the hospital was indicative of some real problems.  However, to someone’s credit, I’m not sure who, either a nurse or one of the doctors, a key component of my diagnostics happened quickly.   Someone was obviously scanning the triage statements, and although I wasn’t going to be seen by a doctor anytime soon, they shortcut the system and arranged for a CT scan before I had been examined by a doctor.  That saved a huge amount of time.

That’s great STROKE protocol!

What followed was a lot of faffing about, like ten hours worth most of which I was in a holding pattern. Things that were going on included behind-closed-doors consultations with the on-call neurologist that I wasn’t part of, except vicariously.

I was discharged with the tentative diagnosis that I had suffered a TIA.  There was almost a sigh of relief from the attending physician that the pre-emptive CT Scan did not show any physical damage.  The doctor discharged me with a prescription for low-dose aspirin, a requisition for an ultrasound of my carotid arteries, and a referral to the stroke prevention clinic.

The ultrasound showed that my carotid arteries are clean.

My referral to the Stroke Prevention Clinic didn’t bear fruit for two weeks.  It took that long to get an appointment to be assessed.  The professionals at the clinic confirmed the tentative TIA diagnosis.

Physical evaluation at the stroke clinic included all the usual neurological tests.

Strength in limbs, ‘follow the finger’ with your eyes, “say the following words”, and that sort of thing.

Conversations with the stroke prevention team

Conversations with the stroke prevention team included all the usual buzzword recommendations.

Stop drinking.  That seems to be the go-to recommendation for everything these days.  Brewers, distillers, and winemakers can’t be happy about that.

Minor exercise uptick.  The weather had been so bad that I’d stopped my daily walks.  I was advised to start again, and there was an oblique reference to light weights, and at my inquiry confirmation that yoga or tai-chi wouldn’t be a bad idea.

Watch your diet.  The staff Dietician presented me with a pamphlet on soluble fibres that should be included in my diet.

Next steps

What we did next;

The first thing the team decided to do was to focus on the heart to see if there’s something there that had been missed.  There was a requirement to wear a Holter monitor for a day after a round of stress tests and echocardiograms.

We’ve done the ECG, spent 24 hours wearing the Holter monitor, and had the echocardiogram.

I’ve also had the phone call from the doctor to tell me what he thinks.  They’re going with TIA but can’t find a reason for it.

There was some lingering doubt as to whether the incident was simply an echo of the previous hemorrhagic stroke.

If you even think that you’re experiencing a TIA, or aphasia, its time to get things checked out.

Bumping into TIAs and bouts of aphasia should demand that you get it all checked out.

Its probably not fair that I didn’t list some of the other causes. Here’s a short summary.

Common causes of aphasia are:

Stroke–I mentioned that earlier.

Head injury–a.k.a. TBI

Brain infection

Slow growing brain tumor

A degenerative disease that damages the brain tissues such as Alzheimer’s disease