Speech language pathologists: Be proactive to prevent stroke

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A stroke can be devastating to a person’s ability to communicate — depending on the part of the brain that has been impacted — causing a patient’s inability to find or form words.

In May, which is Speech Therapy Month, Rennes experts want to ensure people know the value of speech therapy in helping people recover following a stroke — and also to create awareness about some of the risks that can lead to strokes in the first place.

“When I see someone who had a stroke, we always talk about the factors that may have led to it, including the dangers of having a higher blood pressure,” said Marsha Ferguson, a speech language pathologist with Rennes Health and Rehab Center-De Pere. “Patients and families always have questions why — though sometimes there is no clear-cut answer.”

The American Stroke Association, a division of the American Heart Association, notes there are some risk factors for stroke outside of a person’s control, including age, family history and prior history of stroke, heart attack or TIA (transient ischemic attack, or mini-stroke).

Factors within a person’s control include smoking, diet, physical inactivity and blood pressure — one of the stronger risk factors for stroke.

Two of the common types of stroke are ischemic stroke, when the blood to the brain is blocked, and hemorrhagic stroke, or a ruptured blood vessel causing a bleed in the brain. The latter type is most commonly caused by uncontrolled blood pressure.

Staying in touch with physicians about blood pressure and other factors, as well as seeking medical attention if warning signs are present, can help prevent a major stroke, Marsha said.

Sometimes there are subtle signs that people often dismiss, Marsha said. “They’ll describe a little visual blackout or seeing black spots that go away, or they might have a little speech slurring that recovers,” she said. “Sometimes it’s a severe headache or some dizzy spells. Those are things we take for granted, but they can be a warning that something’s not quite right.”

How a stroke may impact language depends on the location in the brain where the lesion occurred, said Jane Zernicke, who also is a speech language pathologist with Rennes Health and Rehab Center- De Pere.

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Some speech issues that can result from stroke include aphasia — not being able to think of the right words, or dysarthria or apraxia — physical inabilities to speak, for different reasons.

“Language is in the left side of the brain, so if the lesion is in the left side, you’re more apt to have trouble with your speech, or word-finding, or language,” Jane said.

A stroke can and often does impact more than speech — it can also mean a patient has trouble with swallowing, memory, balance, problem-solving ability or hearing — so speech language pathologists are often working through multiple issues at once to help patients recover or improve, Jane said.

And there’s no way to predict how a stroke will impact a person.

“I’ve been working in this field for 28 years, so I can tell you that no stroke is the same,” Marsha said. “Even if the actual site of the lesion is the same, it’s never the same in an individual person.”

Speech language pathologists will assess new patients to see where the deficits are — but they will focus on the abilities that remain.

“We always play into the strengths instead of the weaknesses,” Marsha said. “While the damaged areas will not heal, we can help the patient create new neural pathways to use the strengths they have.”

That might include using writing, picture boards, iPad games or other tools to strengthen communication and build problem-solving skills. The idea is to create successes and compensatory strategies that help a patient heal. Therapists work with patients toward desired individual goals and improvements, such as being able to read again, balance a checkbook, return to driving, or even simply to transition to a home environment.

“It’s about working with patients on whatever they need — we dive in and work with patients where they are and figure out what areas we can help them improve,” Jane said.

But it is a process that requires patience, as a stroke can cause swelling in the brain that takes months to resolve.

The good news is the brain doesn’t stop creating new pathways no matter how old we get. “The brain has plasticity,” Jane said. “We can make new neural pathways throughout our whole lives — you don’t just reach age 62 and you’re done.”

Controlling the factors that can be controlled may help a person avoid a stroke in the first place.

“Obviously, you want to keep your stress to a minimum, to the extent that that’s possible,” Marsha said. “I think it’s often how you cope with it.”

That includes taking a step back and coping with stress, regulating high emotions before they get to the boiling point.

If you’re a smoker, then quitting is one of the best things you can do to protect your blood pressure, Marsha said.

Controlling diet: including watching sodium intake; eating more fruits, vegetables and healthy proteins; and drinking less caffeine and alcohol, also will help, Jane said. People may often overlook the importance of getting enough sleep, which is vital to helping reduce stress. Getting enough exercise and maintaining a healthy weight also will help.

“You don’t have to run ten miles or sign up for a marathon,” Jane said. “Just walk around the block a couple of times to get moving. Even if you use a walker, you can still get out and walk a little bit.”

At Rennes memory care and Community-based Resident Facilities (CBRFs), some residents participate in low-impact activities like chair yoga, which aids movement and stress reduction, she said.

Those who are managing high blood pressure should monitor it and ensure they visit their doctors to talk about strategies to reduce it going forward.

And the advice applies to everyone, not only seniors.

“What we’re seeing, unfortunately, because we live in such a stressful society, these strokes are occurring in younger and younger people,” Marsha said. “Years ago, you wouldn’t see a stroke until someone was a bit older.”

Warning signs of stroke are noted in the acronym “FAST” — Face drooping, Arm weakness, Speech difficulty = Time to call 911. Seeking immediate medical attention is key to saving lives and reducing the chance of disability. Other symptoms may include a sudden and severe headache, disorientation or confusion, trouble seeing in one or both eyes, numbness, fatigue or nausea.

For more information about stroke risk factors, visit https://www.stroke.org/en/about-stroke/stroke-risk-factors.

Visit our locations pages to learn more: AppletonDe Pere/Green BayPeshtigo East or WestWeston or Rhinelander.

Learn more about the importance of Speech Therapy Services at Rennes Group. Contact us today to schedule a tour or speak to a Rennes team member.

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