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Fear of the Phone: Speech Related Issues And MS

By Devin Garlit

The many, varied symptoms of MS can make a lot of normal, often trivial, activities into massive hurdles for us.   I’ve discussed some of these before, like showering, shoveling snow, walking, and even sleeping. Today I was reminded of one I deal with often, but had gotten so used to that I had forgotten that it wasn’t normal until recently.  I’m referring to being able to talk on the phone.  This is such a basic thing that so many people do every day, but I avoid it like the plague because of a combination of MS-related speech and cognitive issues.  This all seems like a great reason to talk about some of the speech issues that those with MS might encounter.

Like many folks with MS, I suffer from some speech and swallowing issues.  I’m going to throw out some terms and examples here in case you here your doctor or speech language therapist mention them; these are common issues that aren’t always discussed a lot.

Dysarthria is a speech problem that involves the weakness, slowness, and lack of coordination in the muscles used for speech (like your mouth, tongue, lips, throat, diaphragm, etc).  Just like many people have problems with their using muscles in their legs, the same can happen with our speech muscles.  There are different types of dysarthria you may hear your doctor/speech therapist discuss: flaccid, spastic, ataxic, hypokinetic, hyperkinetic, and unilateral upper motor neuron.  I won’t get into each of those, just understand that they are all related to different speech producing muscles.  The signals our brain is sending to those muscles isn’t fully making it there because the myelin around the nerves needed for that communication have been damaged.  One of the big issues this manifests itself as is slurred speech (ataxic dysarthria).  I’m sure many of you have heard the phrase “I’m not drunk, I have MS”, well add a little dysarthria to your foot drop and you can indeed appear drunk!  This is a pretty common problem for me and a big reason I hate using the phone.

Dysphonia is very similar to dysarthria, except that it affects the muscles that control voice.  The end result is that we may end up speaking in different pitches, or we may sound out of breath, or even only be able to speak quietly at times.

Basically, aphasia is the loss of words resulting in communication issues.  It is the inability to comprehend or formulate language because particular areas of our brains have been damaged by MS.  Trying to remember the name of people, places, and things is a common example (that “word on the tip of your tongue but you just can’t get it” phenomenon is known as anomic aphasia, as with all of these, there are different types depending on where your lesions are).  Aphasia can also include difficulty understanding what others are saying and even how to use words in a sentence.  Though we are discussing speech here, note that this issue can extend to written communication as well.  This is an issue I experience, and I can tell you, it’s both frustrating and terrifying.  I know it’s not my actual intelligence that is wrecked, but it sure feels that way.  I know the information is in my head somewhere, I just can’t access it.  It’s a maddening symptom and if you talk with me long enough, you’ll witness it.

Ok, this doesn’t necessarily hamper my ability on the phone, but since we are talking about speech issues in MS, it must be talked about.  Dysphagia is difficulty swallowing.  The ability to properly control the muscles needed for swallowing is damaged.  This causes coughing, the feeling of liquids “going down the wrong pipe”, and even aspiration of liquid and food into the lungs (which can lead to pneumonia).  This is also one that I have some experience with: I choke on liquids often.  I have also gotten pneumonia many times because of it.  This is a serious issue.  I’m often asked if I think MS can kill people.  I say, not directly, but I believe some of the symptoms caused by it can.  Dysphagia is one example of that: it can easily cause pneumonia, which can eventually lead to death.

Story Source: The above story is based on materials provided by MULTIPLESCLEROSIS.NET
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