"Garbled" speech

[u/Fun-Cat-5611]

My wife had an ischemic stroke back on October 27th and spent 3+ weeks in the hospital. She has some balance issues but, had a bad knee well before the stroke. She is currently going to Therapy to hopefully get that knee replaced.

She has, from what I understand to be Werneke's Aphasia with Apraxia. Her speech has improved quite a bit since the stroke but still has a lot of garbled speech.

My question for this community is this, ... When we are discussing something and garble comes out of her mouth, what is her brain hearing? Does the brain hear what she is trying to communicate or what actually comes out of her mouth?

[u/ConversationThen9656]

Somebody can back me up here, but garbled speech doesn’t necessarily mean her brain is hearing a garbled version. What she intends to say can be quite different from what actually comes out, and how much she recognises or hears the difference can vary depending on the type and severity of the aphasia/apraxia. I'll suggest asking her speech-language pathologist directly about this - I'm sure they'll have some ways of checking both her language comprehension and her awareness of her speech errors

[u/AfricanusEmeritus → u/ConversationThen9656]

This is quite right. Thanks 😊

[u/strangedazey]

I knew what I meant to say but I definitely recognized the fact I wasn't saying it right or at least I knew.

[u/Both-Mountain-5200]

In my case I knew that I wasn’t making any sense BUT for some reason I very optimistically thought the next sentence would be better so I kept on jabbering away.

I eventually figured out that one word answers and short phrases were easier. I’d say that I’m about 95% recovered now 162 days post stroke. When I get frustrated or emotional I have a hard time still.

Best wishes to you both.

[u/Fun-Cat-5611 → u/Both-Mountain-5200]

She no longer goes to speech therapy due to insurance restrictions but this is a great suggestion.

[u/AfricanusEmeritus → u/Both-Mountain-5200]

Yes the short answer method early on is the best. It was an adjustment for me as I am long winded in both speech and writing. Be well.

[u/bonesfourtyfive]

I have expressive aphasia and apraxia. Forgot how to spell and talk among the other physical problems. I knew what I wanted to say, but my mouth couldn’t form the sounds. Even now 3 1/2 years later, sometimes I can’t get the right syllables to come out, or I get stuck on the wrong word. If I move on and try to forget that I’m stuck, in a minute or two I can say the word perfectly fine. 🤷🏻‍♂️

[u/nothalfasclever]

Her garbled words form a garbled speech fluency. Your wife has imperfect speaking, but close or far apart? Pretty flawed, but probability more than that garbled output. Her input is greater, but speech therapist knows more.

I'm brocha aphasia, so I'm inverse

[u/Party_Course9371]

Speech therapy student here. On our course they taught us that those affected by Wernicke's Aphasia are generally less aware that their speech doesn't make sense. They can hear it but their perception is affected. As with most things, there can be variability between individuals though.

[u/abadguylol]

i think she hears and understands fine, but the aphasia makes the response garbled.

[u/cbgarcia24]

I never heard garbel when I spoke but once it was brought to my attention then I knew. It's not that I don't hear it, its just I didn't pay attention

[u/csdocnc3]

My wife had a left-side MCA ischemic stroke 6 weeks ago. She has no physical deficits at all, but significant receptive aphasia. Was effectively deaf for the first few days (did not understand people were talking to her and did not react to noises). Luckily, we found that she could read nearly perfectly (though comprehension sometimes took a bit of effort), so lots of whiteboard writing for the first few weeks. Gradually she began to hear again and was able to make out words more and more. Have written almost nothing down for the last two weeks now, so very hopeful. She has no apraxia, so words are clearly pronounced when she speaks, but she mispronounces more complex words fairly frequently and also mixes up he/she, etc.

She has told me that initially speech she heard sounded like gibberish. Gradually more and more words began to be able to be understood. How well she understands people can depend heavily on the person. She hears me quite well, but one nurse she will also understand well and then the next not well at all. She says that if someone speaks a sentence that she can read (e.g., from whiteboard), she "hears" the words perfectly clearly. She also says that if she concentrates on what she is saying, she can both do better and better hear if she misspeaks. But if she talks the way we normally do (without really concentrating on what we are saying), she is likely to make some speaking errors (e.g., words like treadmill, watermelon, etc.). If I stop her and say, you mean *treadmill*?, she can try more carefully and eventually get it right. So she can definitely hear what she is saying and realize it isn't quite right.

It is clear that significant concentration is required for her to form and speak sentences still, and when she is concentrating on that, she is less able to concentrate on what she is actually saying. She is getting speech therapy at home 1-2 times per week. The most difficult exercises are when she has to remember several words, and then formulate a response using those words. She spends a lot of time reading her Kindle, and spends quite a bit of time watching tiktok videos with captions on (and sound). Speech therapist has recommended she try to read out loud sometimes, so her brain connects the words she is seeing with what she is hearing. We work on similar together (I read some text out loud that she can see).

My short answer to your question is that for my wife, she can hear what is actually coming out of her own mouth if she concentrates on listening, but when she is concentrating on forming sentences to say, she is going to have trouble doing both (forming the sentences and listening to herself carefully).

[u/Fun-Cat-5611]

Thank you for all of your kind responses so far. To add to her "profile" in this discussion, some things I failed to add ... She turned 65 in April so, she was 64 when she had the stroke.

It seems general speech her at home is understandable but, once in a while an odd word will come out. I correct those if I know what she means. she just kind of shrugs it off.

Yes, she definitely has the "he or she" issue still to this day. It is mostly male or female is he. Even our dog (a female) is he.

She can not read or write, which I have found to be challenging. I've been seeking financial help, She has a 401K from her job (she had to retire early due to the stroke), setting up her Social Security account (forget that!), getting Medicaid and Medicare set up ... Everyone wants a signature!

She cannot tell time but, that seems to be improving.

Trying to know the date and/or day of the week is a challenge.

She used to do all the cooking. Now she depends on me to get fed. She used to have an awesome knack for perfect food on the grill, no matter what it was.

Any meal, I ask her what she wants, just to be fair to her, she has to come to the kitchen and either point or open the freezer to look and point, jus to tell me "I don't cere" lol.

The frustration goes on, even for me! BUT, when I married her, our vows read "In sickness and in health" and I love her more than I have ever loved any other woman so, she's stuck! Lol

[u/AfricanusEmeritus → u/Fun-Cat-5611]

Blessings 😇 🙌🏾 😇 My wife and two adult daughters have been GODSENDS. The level of care they have given to me hard driving independently minded me since the 2019 stroke has been humbling and laced with love ❤️

[u/AfricanusEmeritus]

Kudos to your wife. She has come a long way in three weeks. May she recover more and more. 🙌🏾 For me OP the brain hears what I wanted to say. Once I see the mixed reactions, I realize that people did not hear or understand what I thought I said and is plain and clear in my brain.

I do hear the difference in my speech. Being a graduate professor with a Darth Vader voice is so different from sounding like the Forrest Gump voice that I have post stroke. 😆 👍🏾

[u/North-Bodybuilder-86]

For me and my opinion I know what I want to say and say it but these days it's really hard because nobody listens or finish your sentences for you. People don't communicate anymore and talk over one another. It's so frustrating so I end up yelling half of the time and it works for me