Sunday, July 1, 2007

'It's been like going back to school again'

Patients band together, tackle communication troubles brought by stroke, illness, injury

Stroke victim Pat White, 76, struggles with speaking and uses a voice-enhancement machine to help her to be understood.Bob Pennell
Sanne Specht

MEDFORD — Les Brewer woke up one morning with no memory and no ability to communicate.

The 75-year-old had suffered a life-threatening stroke shortly after Thanksgiving at his home in Prospect.

Communication tips

Stroke, brain injury or illness can cause aphasia, a communication disorder that can affect a person's ability to use and understand spoken or written words. Speech pathologist Julie Mondz-Kleinman suggests some tips to ease communication:

  • Look at the person while you're talking to him.
    • Ask if it's OK to help with sentence completion.
    • Try substituting a different but similar word or ask the person to describe the missing word, how you use the item, what it looks like, etc.
    • Remember, everyone experiences the occasional word retrieval problems, Mondz-Kleinman says. And things are worse when the person trying to communicate is tired, stressed or unfamiliar with the topic under discussion.

"They gave him a 50-50 chance of survival," says his wife, Pat Brewer. "It was terrifying."

But things have improved greatly for the self-described "trucker, mechanic and cowboy" in the past six months as he learns how to cope with life after his stroke.

"It's been like going back to school," Les Brewer says.

School includes participating in a monthly meeting of fellow survivors of stroke, head injury or other neurological disease or disorder who are struggling with communication issues. The meeting is facilitated by Julie Mondz-Kleinman, speech-language pathologist for Providence Medford Medical Center.

Pat Brewer tells Mondz-Kleinman how much the group has helped in her husband's recovery. "Without you and this group, I wouldn't know what to do to help him," she says.

Brain injury or illness can cause a condition called aphasia, which means a loss of language, says Mondz-Kleinman. Independent individuals can suddenly find themselves unable to make their needs known, interact with people in the community, or express their feelings to friends and family members, she says.

"It can be very frustrating," says Mondz-Kleinman. "The words are in the brain but they can't retrieve them. The ideas are there, but sometimes a different word comes out, or nonsense, or part of a word, or nothing."

Mondz-Kleinman carefully leads the conversation around the table. Topics range from hobbies, music, travel and progress. She makes sure everyone has a chance to be heard — and group members are encouraged to communicate by whatever means they can.

Communication is not necessarily about saying words, she says. Sometimes it's pointing to pictures, drawing images or utilizing speech-generating machines, Mondz-Kleinman says.

"Most people will use all the ways," she says. "Whatever works."

Pat White, 76, had a stroke a year and a half ago. White likes to speak for herself, but she sometimes uses a voice enhancement machine that allows for pre-recorded information to be played. She can play the information quickly over a speaker phone if she has an emergency and needs to call 9-1-1, says Mondz-Kleinman.

Brenda Miller, 51, suffered a series of strokes. The "big one" was last August, she says. Miller, who used to bake the famous pies at Becky's Cafe at Union Creek, is being cared for by her friend Cherie Cloud.

Miller shakes her head as the group calls out their guesses for the restaurant's favorite pie. With a smile of relief, she finally points to the word "huckleberry" on a sheet of paper Mondz-Kleinman shows her. Miller wants to get back into baking, but struggles to find the word for "oven" until prompted by Mondz-Kleinman. She also is still experiencing weakness on the right side of her body.

Joe Andrade, 46, is the youngest member of the group on this day. Andrade was living on the streets when he suffered his stroke last February. He happened to be on the phone when he was struck, and the person on the other end called the ambulance, he says. Andrade spent two months in the hospital before his social worker found him a spot in an adult foster care home.

Andrade struggles to communicate as talking is very difficult for him. But when Mondz-Kleinman gets the whole group to sing "Happy Birthday" to one of Miller's friends, he joins in with a shy smile.

"Has anyone noticed singing makes things easier to come out?" Mondz-Kleinman asks.

For most people, language is processed in the left side of the brain. But music is processed on the right side, she says.

Wendell and Katherine Ross were both speech therapists before Wendell suffered a stroke 13 years ago. Although they both had an understanding of speech therapy, neither was prepared for the struggle that lay ahead.

"You feel so frustrated when you can't talk," says Katherine Ross. "Here you have the moral support and some insight for the caregivers and the people with the communication issues."

Isolation is the enemy. People often stop coming to visit friends or relatives who have suffered brain injuries/illnesses that affect communication, says Mondz-Kleinman.

"People are afraid to talk to people with strokes," says Mondz-Kleinman. "But their personalities and ideas are all the same."

Reach reporter Sanne Specht at 776-4497 or e-mail