“Brain Attack” Excerpts

By Polly Perez





The following section on aphasia is excerpted from the book, “BRAIN ATTACK: Danger, Chaos, Opportunity and Empowerment” by Paulina Perez, Cutting Edge Press, 2000.  The book is available from the publisher, 802/635-2142, Amazon.com and through local libraries and books stores.



Due to a stroke, Ms. Perez suffers from both aphasia and apraxia.


The stroke I had on an ordinary December morning was sudden and unexpected, and the blood clots in my brain jumbled not only my thoughts but also my life. The damage to the neurological connections in my brain presented me with unique challenges and dilemmas as well as with unique opportunities.


The language center of my brain suffered the greatest damage. I am now one of the one million people in the United States who have aphasia (uh-fay’-zhuh) and apraxia (uh-prax’-ee-a) as the result of surviving a stroke. Aphasia is an inability to articulate words. Apraxia is an inability to perform a well-known purposeful action in spite of having normal mobility, attention, and comprehension. I know the word I want to say, but by the time the word reaches my lips, it has changed in whole or in part to something else.


The severity of aphasia and apraxia can range from mild to severe. My apraxia and aphasia were severe, and they forced me to change the way that I communicated. Before the stroke I was a public speaker, so spoken language was my life. Not being able to speak was sheer terror. There is no cure for aphasia, but it can be treated and ameliorated with speech therapy. Wresting my speech back was the hardest thing I have ever done.



I want you to read how it feels when your world changes, and the things that were on the bottom are on top. My words were abducted, and a life without words altered my perception of reality. Think of what it would be like to have stripped away from you the simplest capabilities that you take for granted, like writing, talking, or even adding up a check at a restaurant. I wasn’t stupid; I just had difficulty saying words. I could read, but I couldn’t write. I wasn’t mindless, just wordless. I wasn’t uneducated, but I couldn’t talk right. My identity was more than what I could say; inside I was the same person that I was before the stroke.


Read my story, and step through the doorway of a stroke victim’s life. Journey with me through the changes a brain attack victim faces. You will find, as I did, that there are many intense physical and emotional feelings ahead. Experience the feelings and honor them. Those of us who were damaged by a brain malady have had to do just that.



Where have my words gone?


The ability to communicate with words is a human characteristic, and aphasia, or impaired communication, can affect every aspect of a person’s life. Aphasia includes: impairment in speaking, trouble understanding speech, and difficulty with reading and writing. Intelligence is typically unimpaired. Communication difficulties depend on where and how severely the brain was damaged. People with aphasia may have trouble conveying their thoughts because they have to formulate their thoughts and then find the words to express those thoughts. They may have trouble keeping in mind all the words they want to say at a particular time. They may be unable to understand what they hear because they have trouble keeping in their minds everything they heard until the speaker is finished. They may have difficulty using little words such as "the" and "of."


It is estimated by the National Aphasic Association that approximately 85,000 people become aphasic each year, most often from a stroke or head injury. About one million Americans currently have aphasia. Although there is no cure for aphasia or drugs to treat it, speech therapy and hard work can overcome many of the difficulties. There are three types of aphasia: nonfluent, fluent, and global.



Approximately 80 percent of the studies of aphasia therapy concluded that therapy produces a significant improvement for most people if treatment begins early in the recovery process. Factors that influence the amount of improvement include the cause of the brain damage, the site of the damage, the extent of the injury, and the age, health, and motivation of the patient. Patients with a high level of social support make greater and faster improvements than patients without a support system. During recovery, the aphasic person’s abilities to speak may fluctuate from day to day or even from morning to night. Very few individuals with chronic aphasia will return to the job or position they had before the stroke. Exceptions are self-employed people or people in a position to make adjustments in the workplace. Speech therapy facilitates the return to work by targeting work-related communication skills. It has been reported that people who are motivated to return to gainful employment and are willing to make adaptations can go back to work regardless of the severity of their aphasia, but the return to work typically takes two to three years.




American Speech-Language-Hearing Association

10801 Rockville Pike

Rockville, Maryland 20852

(888) 321-ASHA



24 hours a day 7 days a

week automated information available

(800) 638-8255


ASHA Action Center

8:30am-5:00pm ET,

(800) 498-2071

TTY (301) 571-0457


National Aphasia Association

156 Fifth Avenue, Suite 707

New York, NY 10010

(800) 922-4622



National Stroke Association

96 Inverness Drive East, Suite I

Englewood, CO 801222

(303) 649-9299

fax (303) 649-1328

(800) 787-6537



SAFE - Stroke Awareness For Everyone

8906 E. 96th St., #311

Fishers, IN 46038


FAX 317-585-9563


Stroke Connection

American Heart Association

National Center

7272 Greenville Avenue

Dallas, TX 7523

(800) 553-6321



Internet Resources

American Heart Association http://www.americanheart.org/

Aphasia Center of California http://members.aol.com/rjelman/

Aphasia.com http://www.aphasia.com

Aphasia Hope http://www.aphasiahope.org

Aphasia- Language http://faculty.washington.edu/chudler/lang.html

Courville Speech Therapy Site http://members.aol.com/acourville/index.html

National Institute of Neurological Diseases and Stroke (NINDS) http://www.ninds.nih.gov/

Neurological Resource Center http://www.span.com.au/nrc/stroke.html

Stroke http://www.stroke.org

Stroke Journal http://www.strokejournal.org

Stroke Matters http://www.strokematters.com

University of Michigan Communicative

Disorders Clinic http://www.umich.edu/~comdis/geninf.html

We Media http://www.wemedia.com

Stroke-TIA Organization http://stroke-tia.org/

Stroke Research and Treatment Center http://www.fhsu.edu/stroke/


Copyright © May 2002

The Stroke Network, Inc.

P.O. Box 492 Abingdon, Maryland 21009

All rights reserved.