She was on a business trip in Orlando, when her phone rang at about 3 p.m. “The words of the neurologist ‘Your husband has had a massive stroke, and we need your permission to administer tPA’ still resonate with me,” she said. “He kept trying to explain tPA to me, and I kept interrupting him to say ‘give it, give it now’ because I knew there was an ideal window for its administration.” Reed was 50 years old.
Flying home that night, Mary felt overwhelmed. “I did not know if Reed would live or die,” she said. Her mind was flooded with scenarios they might face and how they might handle them. “Naturally, my greatest concern was for Reed, the love of my life, my high school sweetheart, who was too young to have a stroke. By the time I landed, he was moving his right side and I was elated. When I arrived at the hospital, the full impact of his brain injury hit me. It was not clear that he knew me when I saw him. I held his hand, tried not to let the full brunt of my emotions come through as I assured him we would get through this together and that I loved him. I am certain he did not understand a word I said.”
Despite receiving tPA, Reed was left with deficits: An almost complete inability to communicate verbally or understand what others are saying; partial paralysis on his right side; profound apraxia, which is difficulty coordinating the motor functions required to speak; and anomia, the inability to recall or say the correct words for things he wants to talk about. Reed also had some auditory processing issues, causing difficulty with how his brain processes what he hears.
Aphasia spans a wide spectrum of possible impairments, from expressive aphasia (problems communicating) to receptive aphasia (difficulty understanding what is being communicated) to global aphasia (inability to process language at all, including reading and writing). It can result from the brain injury caused by a stroke. The severity varies depending on the degree of injury to the language centers, which are primarily in the left hemisphere of the brain.
Aphasia is not a problem with a one-size-fits-all solution. “It does typically improve over time,” Crawford said, “but that’s not to say that survivors with aphasia don’t continue to struggle with communication. Language is a complicated business requiring neurological capacity that may not ever be recovered.”
That has been the Harrises experience. Right after the stroke, Reed could follow one- to three-step directions, answer simple yes/no questions, read single common nouns and make his needs known through limited words such as “yes,” ”no,” “OK.” He could also use gestures such as pointing, as well as facial expressions and head movement.
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