Slurry Speech and Multiple Sclerosis
by Lorna J. Moorhead
Speech is one of the first things that we recognize in children as a great step towards becoming an adult. It is also occasionally one of the first symptoms in MSers who are effected more cognitively than physically. At the times in our life when we most need to communicate about our feelings and needs, our brain cuts off its long term relationship with our mouth. I have tried repeatedly to get these two back together but have only succeeded in a rocky relationship that quits half the time. Yet it amazes me that when I feel I am speaking with the proficiency of a drooling two year old, no-one seems to notice. (Except the two year olds.)
I am beginning to believe that Multiple Sclerosis is not only a sneaky MonSter but that it has a very sick sense of humor. On days when I am proud of myself for appearing only half psychotic, my family tells me that my speech is slurred. I do not hear this; in fact I think my speech has been clearer than ever. Yet when I feel I am struggling to get words out and my mind feels is having some sort of syllable traffic jam, people tell me that they notice nothing. To make things worse, when I apologize for this jolted speech they reply, "Why your speech is much clearer than normal!" (These people should know that there are rules about teasing the crazy people.)
Now either my family is playing a nasty trick on me, and considering the fact that my family's jokes range from perverse to little rubber frogs wrapped as Christmas gifts , this IS possible. Or this feeling of an inability to speak is another one of those brilliantly mischievous and invisible symptoms of MS.
When researching this odd occurrence, I found that the slurring of speech is technically referred to as "dysarthria". Saying this word alone would make a person slur. "Doctor I have Dysssarthhria." Dysarthria is difficult, poorly articulated speech. Looking at this definition I resigned to diagnose all workers of a fast food drive-thru with dysarthria. (I always knew it wasn't MY hearing!) I also vowed to add "dysarthria" to my list of big words as it sounded much more educated than "slurred speech." I have wondered if my doctor even used this word.
On further examination I found that this horrible condition is caused by: Alcohol, badly fitted dentures, or (big surprise) a degenerative neurological disorder. Hmm. Now my family and friends would not believe the denture excuse for one minute. Blaming it on alcohol would not be prudent when at the grocery store at 10am. (Especially if my 5 year old son's kindergarten teacher was there.) I never imagined that alcohol, dentures, and neurological disorder could be put it in the same medical arena. This then led me to wonder about those of us with MS who drink and have dentures. How do they know if it is dysarthria or their teeth? How do the doctor's know that we have MS? Maybe we are all denture sufferers led to drink by our ill fitting teeth.
To make things more complicated as I read on another word flashed across the page. Another word that when pronounced, would cause a dialect teacher to slur. Aphasia. (How is that pronounced anyhow? Af-asia? That sounds like some old historical term for Asia. "Af-Asia", after Asia. But I digress.) Aphasia is impaired expression or comprehension of the spoken or written word, but it has the common courtesy to go away after a period. Hmmm, I wondered so when I have speech attacks, does this mean it's Dysarthria or Aphasia? I glanced over the causes for Aphasia and accidentally snorted my soda. Head trauma, stroke, and Alzheimer's. I'd rather be drunk with bad dentures. (Make that into a bumper sticker and put it on your car.)
This still did not explain the fact that when I slurred I did not notice it and when I felt I was stuttering no-one heard it. Nevertheless, after blowing my nose and cleaning up the soda, it dawned on me. Drunk people believe their speech is clear and I know my Grandpa never seemed to realize his dentures where sticking out of his mouth. (And boy did that lead to some horrible nightmares. Nothing worse than a bushy eye-browed old man with his teeth hanging out chasing you down a hall.)
Now I could begin to grasp the idea that although I did not hear it, it could still be going on. This left me to look for a cure. Surely there was a way to get my tongue back in order. For dysarthria, slurring, the suggested care was "speaking slowly and using hand gestures." I pictured myself giving orders to my pharmacist while slowly speaking and waving my hands. I was pretty sure it wouldn't go over well, although he might slip an extra bottle of pills into my order. Then this report stated that family and friends needed to give me, "the afflicted person" time enough to express themselves. (It was my understanding that even when we die; we feel that we never had enough time to express ourselves anyway.) Yeah right, my five year old was really going to stand around while mommy figured out how to say "clean your room" slowly and while pantomiming sweeping. He might giggle for a moment, but he wouldn't be around for me to finish.
To cure Aphasia the family is urged to give the person reminders when they slip up, such as why the house smells like smoke and they have a string on their finger. It follows by saying that for both afflictions a "calm environment where external stimuli is kept to a minimum is extremely important."
A calm environment. I was equally sure that my family was not going to appreciate my decision to move into the mountains and bury myself in a hole, because that is about where I'd need to go to get calmness in my life. Moreover, how can a person exist without external stimuli and in the case of a MSer external stimuli is everything! The air on our skin can be a disrupting stimuli. I resigned to write my own description of what this speech problem was and how to cure it.
Speech problems in MS are usually caused by brain "notwork-a" and tongue "displace-a". The only way to live with this affliction is to repeat yourself until you get it right, pretend you don't sound funny, or laugh. I suggest the last cure, as it always works for me.
© Lorna Moorhead
Lorna Moorhead was diagnosed with multiple sclerosis in 1999.