Greg Loyd is gregarious, always seems to smile and likes to talk.
Sitting with a group recently at the University of Arkansas Speech and Language Clinic for Medical Sciences in Little Rock, Loyd, a former Little Rock chef, entertained himself with a lively story about the culture vegetables in his backyard.
“I grow them from seed, the…” Loyd trailed off, closing his eyes momentarily, searching for that last word.
The word is there in his mind.
He knows the plant’s life cycle and even the complicated scientific words to describe its botany.
But the simple word “tomatoes” gets lost somewhere between his mind and his voice.
“Aphasia,” he said evenly.
In 2012, Loyd was undergoing kidney dialysis at his home. He stood up for a moment before falling and hitting his head. The next thing he remembers is waking up in a hospital.
Today, aphasia is the only sign of a stroke that left him hospitalized for months and in long-term rehabilitation for years.
Aphasia is a language disorder, affecting a person’s ability to communicate, either by speaking or the ability to read, write or understand spoken or written language.
It is always caused by a brain injury which can occur after a stroke, head trauma, brain tumor or a degenerative disease such as Alzheimer’s disease.
Aphasia was mostly unknown outside of the clinical world – even though more than 2 million Americans have it – until it was recently announced that Hollywood actor Bruce Willis had been diagnosed with the condition. .
Those who worked with Willis – who retired from his acting career after the diagnosis – had worried about his decline, according to Dispatches. The actor struggled to remember his dialogue and needed accommodations like an earphone to feed him his lines and shortened lines.
Like Willis, Loyd had to give up his career as a chef at upscale Little Rock restaurants.
LIVING WITH APHASIA
Loyd knows he’s lucky.
Not that the road hasn’t been difficult or that he hasn’t experienced the irritability and frustration that come with illness, but he is optimistic by nature. He sought out therapies, immersing himself in programs and seeking the company of others with aphasia.
It didn’t take him long to get in touch with the UAMS Speech Clinic. Center services are provided by graduate students under the direct supervision of licensed teachers who are also certified by the American Speech-Language-Hearing Association.
“Really, once I walked into that class, it felt like home. I felt so normal going into those classes,” Loyd said. “We’re going to work on reading lessons. We’re all good at reading, but when it comes to reading out loud, we’re a bit slower. And our sights are all different, so we all look differently. But we have always read as a team, one of us will read a section and someone else will read a section.
The clinic welcomes patients of all ages, from infants to adults. Services for aphasia begin with diagnostic services and continue with individual and group sessions in speech therapy, language and literacy.
“We have several different groups and what we offer each semester may be different,” said Dana Moser, associate professor and director of the UAMS speech-language pathology program.
The group includes adults who suffer from aphasia, motor speech disorders, or other speech and language problems caused by brain injury or neuromuscular diseases.
The group also teaches patients about other modes of communication.
In a group activity, patients were given a week to take random pictures of their lives and then talk in class about different aspects of living with aphasia.
“In all the years that I’ve worked with people with aphasia, I’ve seen so much resilience. When we did the photo-voice assignment, a lot of the things we talked about in that group were the challenges you face and what it’s like to live with aphasia,” Moser said. “The story they told was that there was a loss, then an adaptation, then a reinvention of themselves. It was as if they had found new ways to engage, to find meaning and purpose to the life of their old life.”
It was on this mission that Loyd introduced his friends and clinicians to his newfound love of gardening.
Importantly, Lloyd said, the group lesson shows people like him that they’re not alone.
Worry crosses his face as Loyd worries out loud for a friend who has stopped dating.
“I called and emailed,” Loyd said.
Portia Carr, assistant professor of speech-language pathology at UAMS, said the groups focus on speaking, listening comprehension, reading and writing.
“We try to make all tasks conversational and very comfortable to help improve their quality of life and their ability to participate in activities of daily living,” Carr said.
Loyd said the group gave him the confidence to keep talking.
“I’m empowered,” Loyd said. “I wish I could progress more in my recovery. I’m not where I want to be, but this clinic got me where I am.”
Aphasia can range from so severe that patients are unable to communicate at all to so mild that it is undetectable to others.
It’s different for every patient. Sufferers may lose the ability to retrieve object names or the ability to read, while others cannot assemble words into sentences. It is common for several aspects of communication to be impaired at the same time.
“Aphasia can affect your ability to simply use language in general. It might be speaking it or understanding what someone is saying to you. It might be understanding what you read and being able to also write something,” Moser said. said. “Depending on what part of the person’s brain is damaged, it looks different to different people.”
Loyd can fly under the radar most of the time, Moser said.
“It’s hard for me because I want to say a smart, sophisticated word, but I can’t do it,” Loyd said. “I have to say the shortest, simplest thing possible that relates to the conversation.”
Loyd said another band member couldn’t speak due to aphasia, but he could type whatever he wanted.
Symptoms of physical aphasia may also be present. People with aphasia may also have right-sided weakness or leg and arm paralysis because the left side of the brain is the side that is usually damaged.
There are several types of aphasia, including global, transcortical mixed, Broca’s, transcortical motor, Wernicke’s, transcortical sensory, conduction, and anomic.
A patient with aphasia does not usually correspond to only one type of condition and other types of aphasia exist beyond the predominant eight.
Moser said the lack of language expression skills often makes strangers believe that the aphasic patient has lost their cognitive abilities, but their intelligence remains the same. It is the ability to communicate that is lost. Similarly, an aphasic patient’s memories remain intact, but the ability to access ideas and thoughts via language is disrupted.
Although the onset of aphasia is sudden, the individual may gradually improve over time.
According to the National Aphasia Association, about half of those who initially show symptoms of aphasia make a full recovery within the first few hours or days. If symptoms of aphasia persist beyond the first few months after a stroke, complete recovery is unlikely, but improvements and coping skills can be achieved even over a period of years or decades.
CULTIVATE A FUTURE
On a recent hot day, Loyd was in his garden. Sweat ran down his face and visitors were greeted with a broad smile.
Raised beds bordered with wooden planks occupied the once large and open yard.
Arkansas Traveler tomato plants sprang from the ground, locked in wire cages.
Loyd spoke clearly, and the word “tomatoes” rolled easily and quickly from his tongue.
He gestured at the green strands of red potatoes that were rising in pots. He grows the reds, he says, but Kennebec potatoes make the best fries.
“They’re crispy on the outside and soft in the middle,” he said.
Loyd’s family and friends aren’t in tune, he said, when he can’t utter a word during a conversation. They laugh together and help him find the word.
He carries an aphasia ID card with him when out in public in case he has trouble communicating. The card explains aphasia and asks for patience.
“At first I was going crazy and frustrated,” he said. “But the clinic has made it normal for me now.”
He has a life with a purpose, he says. He wants to raise awareness of the disease by continuing to share his story and he wants others who are newly diagnosed to know they have a future.
“It can happen to anyone, but there is hope,” he said. “For me it was gardening, from seeds. As soon as I open the back door and see the gardens, I feel so good.”
He moved from one bed of plants to another.
The words flowed from his tongue.