Aphasia: I just can’t find the words

Hello friends! I’ve been in hibernation for the past month thanks to the polar vortex, which seems to be affecting everyone outside of California (is Winter over yet?). Today was finally a gorgeous 60 degrees, so I ventured outside of my blanket burrito to write about something that has been a huge part of my semester so far: Aphasia.

Aphasia is a communication disorder that affects over 1 million people in the United States, with over 80,000 new cases every year. Aphasia is more common than ALS and Cerebral Palsy combined, and yet most people have never heard of it unless someone close to them has been affected by it. Aphasia can be caused by strokes, traumatic brain injuries, tumors, or brain infections that damage (usually) the left side of the brain. In most humans, language is predominantly localized in the left hemisphere of the brain (although some individuals, especially left handed people, may have right hemisphere localization). These language areas of the brain communicate with each other and other areas in the right hemisphere to help us comprehend language, produce speech, read, and write. Damage to any of these areas can lead to devastating losses in communication ability.

There are many different types of aphasia depending on the site of lesion in the brain, but I’ll name just a few.

  • Broca’s Aphasia primarily affects language production. Individuals may have some impairments in comprehending complex language, but they understand language fairly well. However, they have a lot of difficulty producing language. Speech is characterized by extreme effort, word finding difficulties, and short sentences or single word output only.
  • Wernicke’s Aphasia affects both comprehension and language output (although differently from Broca’s Aphasia). Individuals with Wernicke’s have severely reduced language comprehension, and although they produce fluent speech, their language output is usually nonsensical and may be characterized by jargon and made up words (to a foreign language speaker, the output may sound completely fluent, but to a native speaker, the output would have little or no meaning). These individuals are also usually unaware that they are not comprehending or producing intelligible language.
  • Global Aphasia – a very severe form of aphasia where comprehension and language output are very severely impacted and the individual may only produce grunts or be completely mute.
  • Other forms affect naming ability, occur in the absence of trauma as a progressive neurological disease, etc.

Importantly:

  • Aphasia affects ALL modalities of language, not just verbal output and auditory input. Individuals with aphasia also have deficits in reading, writing, and sometimes math.
  • Since every brain is a little different, symptoms and severity of aphasia in each person can vary greatly.
  • Aphasia does NOT affect intelligence. Many individuals with aphasia describe their language difficulties as having a disconnect between getting the words from their brain to their mouth. The information is all still there, just more difficult to access.
  • Aphasia can be devastating to an individual and loved ones – the loss of the ability to communicate can be extremely frustrating and may feel like a “loss of self”. Caregivers, friends, support groups, and medical professionals play a huge role in improving quality of life and working towards improvement.
  • Language abilities CAN improve over time through intensive therapy and commitment to practice. Language can continue to improve even years after the onset of aphasia.

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The reason I chose to write about aphasia is because this semester I’m taking a wonderful class on aphasia classification, diagnosis, and treatment, and one of my clinical placements is in Aphasia Group. Aphasia Group is run through the Pi Beta Phi Rehabilitation center at Vanderbilt and has been meeting for 10 years. All of its members have some form and severity of aphasia and some have been attending for 10 years while others are new this semester. Aphasia Group serves as a wonderful support group as well as an avenue for social interaction and language practice with some therapy thrown in. Every Thursday, I work with these individuals from 10-4:30 helping them navigate computers, participate in a book club, discuss current events, and work on their comprehension, speaking, reading, writing, and overall communication. The goal is to help them develop strategies to get around their language deficits. I was initially extremely nervous to work with adults since I’ve only had experience working with children, but the last two weeks have been incredible. It is a long, tiring day to constantly try to be an effective communication partner, but the members are so positive, upbeat, patient, and committed to improvement, which makes my job so rewarding and educational.

I think it’s so important that people learn more about aphasia, because there’s a very high chance that at some point you will encounter a grandparent, parent, sibling, or friend who acquires aphasia after a stroke or an accident. Individuals with aphasia still have a lot to say, but they need your support, patience, and understanding.

If you’re interested in learning more, these are some great websites:

http://www.asha.org/public/speech/disorders/Aphasia/

http://www.aphasia.ca/about-aphasia/

http://www.aphasia.org/home

Why I’m proud to be part of Generation Y this year

Hello everyone! I’ve been enjoying the last few weeks of winter break at home – I went to Hawaii with my family for a week and then I’ve been relaxing in the beautiful 75 degree San Diego “winter.” 2013 has been a fabulous year – since graduating from college, I’ve moved to Nashville and finished one semester of grad school, increased the number of tv shows I watch every week, and decreased the number of meals I make in a microwave.

For my last post in 2013, I’ve decided to write about the people who have inspired me this year. As a recent graduate, I’ve been following the plethora of articles this year that claim that Millennials, or members of Generation Y, are spoiled (Washington Post), entitled (USA Today), sad (Huffington Post), lacking independence (Slate), and of course, all about “Me Me Me” (the lovely Joel Stein of TIME magazine). We are also supposedly addicted to technology and too emotionally stunted to form meaningful relationships (the internet). There are hundreds of stories about how graduates are overburdened by loans, unable to find work, and stuck living at home. While many of these things are true, when I caught up with friends this break, I was struck by all the impressive things my peers are doing with their lives.

I have friends who are furthering their education by attending prestigious law schools, med schools, and grad schools. Many are working in amazing jobs in consulting, finance, marketing, government, animation, engineering, and more. A couple of friends are doing good in the world already working for Teach for America, CityYear, the Peace Corps, and various other service organizations. Others are travelling around the world, receiving a cultural education. Everyone I know has worked incredibly hard to get where they are.

Has it been a difficult transition from college into adult life? Absolutely, and yet the Millennials I know are hard-working, successful, driven, and committed to making a difference in the world. My peers inspire me everyday, and to stereotype my generation as immature complainers is to underestimate our ability to make an impact in our communities, and possibly the world. As this year comes to an end, I am proud to be a member of Generation Y and can’t wait to see what my peers accomplish in 2014.

Wishing all of you a very Happy New Year filled with happiness and love. Thank you to all of you who have read this blog this year and encouraged me with your kind words to keep writing. See you in the new year!

IMG_1203P.S. These are my resolutions: http://www.buzzfeed.com/ariellecalderon/new-years-resolutions-every-homebody-should-make

A Thanksgiving List

This year has been one with a lot of life changes and new beginnings. Through it all, I’ve found that once again this Thanksgiving, I have a whole lot to be thankful for. While it is true that we should always be thankful for what we have, I don’t think it’s such a bad thing to have a day that makes us reflect on all the good things in our life.

So, I am thankful for:

  1. My family’s love and health. This includes our family friends who have always been loving and supportive.
  2. Old friends who make the effort to stay in touch and always make me feel at home. Also friends who are now scattered around the country and give me an excuse to visit them in new cities.
  3. New friends who have made moving to a new city so much easier, and who alleviated my fears that I wouldn’t make any new friends so far away from home.
  4. Great roommates who have saved me from the many roommate horror stories I hear from other people. I have been so lucky to find fun, caring, and respectful roommates who have become some of my closest friends.
  5. An amazing education. I received 17+ years of a fantastic public education from caring and inspiring teachers and professors and now I am thankful to be continuing my education at another wonderful university. Most importantly, I am thankful to live in a country where I can pursue whatever level of education I want.
  6. Aforementioned teachers, who in great part have influenced my desire to work with children. My teachers and other adult mentors who have supported and encouraged me and served as the best role models.
  7. Having found multiple places to call home. I never thought I could think of anywhere but San Diego as home, but Berkeley felt like home not too long after moving there, and when I say I’m homesick, I refer to both places these days. I am also thankful to have made a home in Nashville when I had so many reservations about moving again.
  8. A field of study and a future career that makes me think and learn and makes me happy everyday. I am so thankful to work with professors and clinicians and peers who have devoted their lives to helping others.
  9. Families and parents who do whatever it takes to help their child. It makes me so thankful to see families who are so committed to getting their child the services he or she needs regardless of all the challenges they face.
  10. Books and movies that take me away for a few hours and make me think and feel long after they’re done. Also, having seen Catching Fire last night, I am thankful for Jennifer Lawrence and her superb acting skills for bringing one of my favorite literary heroines to life.

This list could go on and on because there is no shortage of things to be thankful for this year. I hope all of you have a day filled with family, friends, and good food. Happy Hanukkah to all of my Jewish friends as well!

Happy Thanksgiving!

NO-vember

Recently I’ve been bogged down by a feeling of extreme apathy towards everything. That’s pretty much why I haven’t written in a month…or been much of a productive human being. Basically since the beginning of this month, this has been my thought process:

Do your homework. -No. Study for your test. -No. Write a post for your blog. -Nope. Cook yourself some dinner. -Lol nope, goldfish crackers are dinner. Get out of bed. -NO, YOU WANT TOO MUCH FROM ME.

Clearly this is not healthy behavior, but I think I’ve pinned down some reasons.

1. It’s cold. When I moved to Nashville, I thought I was moving to “the South,” which implied warmth in my mind. I did not expect this on my morning walk to school:

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Ummmm WHAT!?!?! It even snowed a teeny tiny bit the other day. My body is not equipped to handle this weather. I did however finally buy a pair of boots, so I do feel like I’ve come a long way from my freshman year at Berkeley when I wore flip flops all winter. Also, please notice that somehow we’ll be at 70 degrees by Sunday again.

Am I a drama queen when it comes to weather? Yes. Do I care that you’re judging me? Nope, because what did you expect from from a girl who grew up in San Diego’s 55 degree winters?

2. I’m tired. I rarely feel like I get enough sleep and for the first time in my life, I’ve started to resort to small amounts of caffeine to keep me awake in class. If someone asked me whether I’m in a relationship, I would probably say, “Yes, with my bed. We really can’t get enough of each other.”

3. I’m homesick. It’s not like I haven’t spent 3 months away from home before, but it’s been much harder this time for a few reasons. I’m missing two homes this time around –  I miss my family in San Diego, but I also miss the home I made in Berkeley for the past 4 years. When I left home for undergrad, I had the advantage of going to Berkeley with some of my best friends from home. I made new friends who are now some of my closest friends, but when I missed home, I had people to turn to who knew exactly where I was coming from. While I’ve made amazing friends here in Nashville as well, I miss the people I grew up with. You can’t replace the people who decided to be and stay friends with you even after seeing you in your middle school years (aka the worst years amirite?).

4. I need a hug. You would think that there would be non-stop hugging when you’re surrounded by women and children all day, but unfortunately this has not been the case. I need a good bear hug – gotta get that oxytocin and serotonin ya know?

Perhaps these are all excuses to not work on all the projects I have due in a few weeks, but the last couple of weeks have been emotionally rough at times. I know this post has consisted of a lot of whining when this month is all about giving thanks for what we have (while stuffing our faces). Despite all the things I complain about, I certainly have so many things in my life that I am thankful for (I’ll save that list for my Thanksgiving post).

I’m counting down the days till Thanksgiving break (8 days!!!) when I get to go home, eat my mother’s food, watch some football with my dad, and see my little brother for the first time since he went to college. Till then, dreaming of the beach, In n Out, and boba…

Lonely and alone are two very different things

I find myself these days (ok, for the past couple years) making a lot of “forever alone” jokes, perhaps indicative of this culture which insists that we all be perfectly partnered up once we enter our twenties. (To my friends with partners – I am very happy for you). While my thoughts on 20-something singlehood are a topic for another time, I want to dispel the notion that spending time alone means that you are lonely. This past weekend was fall break and my roommate and most of my classmates left Nashville for the 4-day weekend. I had my lovely townhouse all to myself and four days to do ANYTHING I wanted. Naturally, this meant I did all sorts of wild stuff (ate hummus with my fingers, started a new tv show, tried a couple new restaurants, and of course, did laundry for dayzzzz). Four days spent mostly alone may sound horrible to some of you, but it was extremely peaceful and rejuvenating for me. I love being around people and going out with friends and trying new things, but I also need time to recharge my batteries. Think about your daily activities – you probably plan parts of your day based on what others need from you, be it your boss, teacher, family, or friends. You may spend your day answering who, what, when, where, and why. When was the last time you spent an entire day doing only what YOU wanted, on your schedule, without needing to keep anyone updated about what you were up to?

Spending time alone allows you to take a step back from the daily grind to focus on yourself. It allows you to listen to all those thoughts and ideas that you file away for another time when all you want to do is fall asleep after a long day. Being alone is a state of being; being lonely is a mental state. Loneliness can be debilitating, aloneness can be energizing. We’ve all been alone and lonely, but I’ve also felt hopelessly lonely in a room filled with 100 people. Being alone is not a cry for help or a reason for pity and we need to stop treating it like it’s the worst thing that can happen to a person. Next time you’re feeling overwhelmed with your life, find some free time and go get a table for one at a restaurant, or go watch a movie where you’re the only one in the whole theater – see how much more you notice about the world around you when you don’t have to worry about making small talk or whether the person with you is enjoying themselves.

 

P.S. Chelsea Fagan, my favorite Thought Catalogue author, wrote a great piece on this: http://thoughtcatalog.com/chelsea-fagan/2012/12/the-difference-between-alone-and-lonely/

Scrubs: A sartorial sensation

Um…so I still have this blog and I haven’t written in a month, whoops. School and clinic have been super busy, but as much as I complain, I actually enjoy having a million things to do. However, I am on Fall Break (4-day weekend, holllaaa) and I figured this would be a good time to do all of the things I’ve been putting off (writing, cleaning my room, laundry, going to the gym…nope, that one’s probably still not going to happen). One of the more exciting developments this month was that I discovered that I could wear scrubs to clinic, and my life was forever changed.

I know that sounds a little melodramatic, but I kid you not, wearing scrubs is like getting to wear pajamas to work, but you know, actually acceptable professional attire. Elastic waistband? Check. Wide, flowy leg? Soft fabric? Large pockets? Check, check, check. I know I’m not a doctor or a nurse, but I do technically work in a hospital, and if I have to follow all other hospital protocol, then I will allow myself the liberty to wear scrubs. Also, I spend most of my time sitting on the floor (at child level), dealing with spit, tears, bubbles, juice, snot, and glue. I can’t let my formal pants take that kind of beating, so scrubs are ideal. Now, I love my skinny jeans, but if we’re all being honest, you know the first thing you do when you get home is undo that button, change into something less constricting, or just go pantless for awhile (usually acceptable if you live on your own, have your own room, or have an understanding with your roommate regarding permitted levels of nudity).

I rarely dole out fashion advice (why? Because jeans and a v-neck t-shirt is basically as fashionable as I get. For real fashion advice, check out my extremely stylish friend’s blog: http://girlabbreviated.com/), but if you can find any reasons to wear scrubs in your professional life, jump on that opportunity right away. You can find scrubs in just about any color, multiple styles, and you can even buy Grey’s Anatomy brand scrubs (unfortunately above my price range, but owning one of these designer babies is a future goal). Just look at how cute the detailing on these is!

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Take away message: Scrubs, good for wearing, not good for dating.

Here’s a quick recap of the last month of my life not in chronological order:

Went to the Tennessee County Fair (and watched pig races!), took three tests, led my first full therapy sessions (supervised, but I planned and led the whole thing!), celebrated my roommate’s birthday, went to the famous Bluebird Cafe, had my first visitor, did the Color Me Rad 5k, and witnessed the cutest proposal at a piano bar. Overall, I’m growing to love Nashville week by week.

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More posts to come this week to make up for my lack of writing this past month. Lots of exciting topics rattling around in my brain, just a matter of putting them into words!

Pageantry: the good, the bad, and the ugly

I hadn’t planned on writing another post so soon, but after watching the Miss America pageant last night, I felt like there was a lot I needed to say on the topic. Pageants have a pretty bad reputation – they are credited with being vain, shallow, anti-feminist, etc. Now for full disclosure, I am a former pageant queen. Many of you know this already, but it’s not something I tell friends right away just because of all the negative associations people have with pageants. I was Miss Rancho Bernardo 2009, a small, local pageant that focuses on scholarship and community involvement. Before you ask yourself how a 5’2″-not-a-size-0 girl competed in and won a pageant, let me tell you that this was not your average pageant. The scoring was based on an interview, business attire, impromptu question, and poise and personality. I didn’t have to wear a bikini or an evening gown or perform a talent. I competed during my senior year of high school after I realized that a few good friends of mine had quietly competed and won in prior years. These were all smart young women who I respected very much, so I figured it couldn’t be that bad. It also didn’t hurt that there was a scholarship associated with pageant, and since I was applying to college, money was definitely on my mind. I told very few people that I was competing, and I don’t think anyone, including my parents (it’s ok, I don’t blame you guys), thought I had any chance of winning. If you knew me back in high school, you know that fashion and hair/makeup weren’t (and still aren’t) very high on my priority list. Long story short, I competed with a group of fabulous, intelligent women who were all my classmates, and somehow managed to win. The year I served as Miss RB was one of the most educational and valuable experiences of my life. It helped that I competed in a pageant that valued intelligence and articulation over looks, but I learned so much about self-presentation. I learned appropriate hair, makeup, and dress for formal events, business mixers, and community events. I learned how to speak and to relate to strangers of all ages, how to represent my community in a positive manner, and how to present myself with self-confidence. I also came away with fabulous friends and mentors and I have continued to volunteer my time in the pageant whenever I am back in San Diego. Finally, I own a tiara and a sash and whenever I have an off day, I can wear that tiara and tell myself that I am a queen, and there is nothing better than that. If you have never worn a tiara, go out and buy yourself one because it will change your life. Being a pageant queen ended up being an extremely positive experience for me and really changed my opinion of pageants. Now, I know that there are plenty of pageants which focus only on big hair, big boobs, and high heels and plenty of girls whose lives revolve around what dress they’ll be buying next. But there are also plenty of girls who compete in very high level pageants who are smart, professional, and committed to public service. This brings me back to the Miss America pageant. EDIT: Due to popular demand, I must inform you that you can find pictures of this portion of my life if you google my name.

Last night, the pageant came down to an Asian American Miss California and an Indian American Miss New York (my roommate and I were super excited, CA&NY REPRESENT). Miss California is a Stanford grad and Miss New York studied Cognitive Science (holllaaa) at the University of Michigan. Both women performed well (ballet and bollywood fusion), answered their questions in a coherent, well thought out manner, and looked beautiful while doing it. They both championed great platforms as well (women in STEM and cultural competency/diversity). Unfortunately, you probably won’t hear about what they did well. Instead, you probably know about Miss South Carolina’s botched answer about geography or the various other “airhead” blunders we all commit yet we aren’t endlessly scrutinized for. This type of coverage just serves to generate the often inaccurate stereotypes that surround pageants. This writer wrote a great post that really resonated with me: http://www.buzzfeed.com/ashleym36/confessions-of-a-former-toddler-in-a-tiara-a-defense-of-the

And finally the last thing I wanted to bring up: the absurd amount of backlash and racism all over the internet because an Indian woman won the Miss America pageant for the first time. Here are some examples in case you were lucky enough to miss all the ridiculous comments people made: http://www.buzzfeed.com/ryanhatesthis/a-lot-of-people-are-very-upset-that-an-indian-american-woman. I never even imagined that this would be the response to her win. My reactions ranged from anger, disgust, disappointment, disbelief, and eventually…weariness. It blows my mind that even 12 years after 9/11, this level of misinformation, prejudice, ignorance, and blatant racism still exists. My only comfort is in knowing that these people make up an extremely small fraction of the population. There is a lot more I could say about this, but I will stick with saying: Nina Davuluri, I am proud to have you as a representative and role model for American and South Asian women – keep doing what you’re doing because haters gonna hate.