My speech expression is quite possibly my worst deficit right now (well, besides the easy overstimulation thing). I find myself using a lot of Ums and Uhs...I'm also speaking a lot slower and taking longer to respond/get my sentences together. Anyone else have this problem? It bothers me, but nobody except my close family and friends notice it. According to my doctors and therapists, they can't tell I have a brain injury at all.

"Can you hand me the...um...phone please?"

"If we don't hurry we'll miss the uhhhh...bus."

Nick

Hi Nick. This isn't surprising since your contusion and hematoma was on your left frontal lobe; this is where speech production is processed in your brain (Broca's area). The fact that it's not obvious except to those close to you suggests it's rather mild and/or improving. As I recall you are seeing a speech therapist, so my guess is this will continue to improve.

Yeah, I'm seeing a speech therapist. We don't spend that much time together, though. I had a couple individual sessions with her in the beginning...but now I only see her when she runs a class with multiple clients. The class usually consists of memory strategies and cognitive work-arounds.

My speech expression has actually declined over the months. I'm still not sure why...They are thinking about kicking me out of the NCEP program because I'm not improving. I was told that I'm showing backwards progress. My counselor told me that they get paid based upon client improvements. Its a program that is paid for by the government. Its a non-profit organization, too, and if they don't produce results with you...you get cut off.

I'm getting scared/frustrated because I keep having permanent declines with my speech and expression. It usually happens after a stressful event or overstimulation. I rest and I rest and it doesn't get better...just stays the same. Then, a couple months later, I have another decline.

In response to it being mild, I guess your right. However, it feels so much more severe to me. My brain really struggles to put together sentences and stuff...without it coming out wrong. I'm also very quiet when I have a really bad day. So, people don't notice me making any mistakes.

My search for answers continues...

Thanks for your response,

Nick

Hi Nick,

I have a lot of problems and issues with my speech, pronunciation, tone of voice and trouble trying to get the words that are in my head out of my mouth correctly. I will accidentally drop prepositions or say the wrong word completely, sometimes it's just a syllable that I mess up. When I'm tired, I will call myself "we" instead of "me". I sometimes reverse the order of the words I'm trying to say, so instead of asking someone if they will do something for me, I order them - "Will you get me a glass of water" in my head becomes, "You will get me a glass of water" out of my mouth. I can't even remember all the speech issues I've had in order to list them all here. I also forget words that I know well, like the word "phone". And I have trouble recalling words. I say "trash" when I meant to say "dishwasher". It's a totally absurd and surreal experience.

I know many technical words too - so sometimes I sound like an incompetent and complete idiot to people I speak to at work.

It's VERY frustrating. Sometimes the frustration comes out in my voice (accidentally) and whomever I'm speaking to thinks I'm frustrated with them and that only exacerbates my frustration!

I was very articulate and well spoken before the concussion I sustained - I was adept at communicating! I could easily help alleviate miscommunications among others - I could understand what each person was trying to say and be able to interpret it in a way in which the other person could understand too! I'm especially referring to communicating highly technical subjects to laymen (think about trying to explain routing audio paths to a manager who knows nothing about why we need to buy something expensive, or trying to teach a student about how a lightboard communicates with moving lights or something like that, because that's what I used to be able to do very well.)

And now just trying to say something simple, like "I need to rest" can cause a horrible miscommunication.

So, I totally understand what you're going through!!

I'm just very lucky that I've shown steady improvement over the last year. I'm hopeful that I continue to improve.

I'm also super lucky that the people I work with and live with, know me, they know who I was before the accident I was in and they know I'm struggling because they can see it and hear it when I speak. And they trust me. They know that when I say, oops, I made a mistake in saying that or that's not the tone of voice I intended to say that in, they know I'm telling the truth about it.

If I showed signs that I was declining I'd be even more miserable. I'm so sorry that's happening to you.

The author of the book I'm reading, Brainlash by Gail Denton PHD, thinks that there should be a very different approach to treating MTBI/STBI and mTBI. I agree with her. It looks like you're experience at the program you're currently enrolled in is evidence of that too.

You pretty much described me lol. And yes, its very frustrating as it is...but to notice a decline that's obvious to you but not apparent to others is even more frustrating!!!

Thanks for your response.

Nick

I get stuck like this quite frequently. Making a big deal of it only makes it worse in my experience.

This happens to me, too. I notice it more than others around me, except for my son. My son picks up on it VERY quickly and will zero in on the least little word I say wrong.

Part of mine might be due to the Topamax -- difficulty with word finding is a known side effect -- but I did notice trouble with it before I started taking that too. As an English teacher, I'm used to having a much better command of my vocabulary, so it's especially frustrating!

Neurolinguistically speaking, when you TRY to think of a word, there is something called "spreading inhibition" that often occurs that will prevent you from thinking of it at the moment, but it will come to you later when you aren't trying to think of it. This is a phenomenon that happens to everyone, and it's probably compounded by our extra neurological issues. So, probably the best thing to do, as Mark suggests, is not to make a big deal of it as much as possible and expect that it will come right sooner or later.

With friends and family, I have told them all that Topamax has this side effect, so they know to roll with the crazy.

My speech got slurred and hesitant 3 weeks after my tbi deteriorated for 2 weeks, improved very slightly and is stuck at the same um and er level described in here. Friends, family and my kids all notice the changes and my daughter updates me on how mad I am sounding from day to day. I was very articulate before and did public speaking daily before. The frustrating part is dealing with people who didn't know me before and don't appreciate how debilitated I am.

So the um er thing is normal? Thank God! I was starting to think my mind was in melt down.. my dad referred to me as having a catch phrase as apparently I frequently say 'Where is the thingy?' And then go 'um.. you know.. the thingy. the thing.. um.. oh.. what's it called? Um.. you know... that thing..'
Which normally, most people can get from our conversation, but if not, it's cripplingly embarrassing, and I don't have a hope at announcing the object I'm trying to mention.. More annoyingly.. I can picture in my head.. before I've ended up describing it.. Phone because 'um the thing with the buttons and numbers.. um.. er.. you talk to people.. on it.. you know um.. er.. the... um..' With people I don't know.. it's so horrible..

I do the same thing! I actually had the same experience as far as when I went to the doc they said my speech was fine. *Howeverrrr* my parents and my friends notice the speech decline, and the fact that it takes longer to have a sentence come out.

I can be in mid conversation and completely forget what I was talking about, even without distraction. It can be scary and frustrating too. (scary because I have to control the obsessive unfounded thoughts that it could turn into alzheimer's) I'm sure it wont!

I am just going to hold onto the fact that it will get better, but like you, I notice some decline in areas that were not a problem when I initially was injured.

I hope that the program doesn't kick you out. It's too bad that they are doing it based only on improvements, and not based on what you need help with!!! Maybe you can re-enroll if that happens? (I know, probably not, but worth a try)

Good luck...