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Ask Dr. Gott 2/13
Stroke damage probably permanent after 30 years
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    DEAR DR. GOTT: About 30 years ago, my brother-in-law, while working in extreme heat and consuming alcohol, suffered heat stroke. He was left with a strong speech impairment. He cannot pronounce consonants, and his voice is quite rough. He took speech therapy for a while after the stroke, but it did not help. Otherwise, his health is good. He takes no medications and is 74 years old. He has a slight balance problem but can work in the yard, mow with a riding mower, etc. He hasn't seen a doctor in years. He is quite alert. His wife died two years ago and he is lonely, but he will not go out in public because of years of people making fun of his speech. It has greatly discouraged him. I believe people are more tolerant and understanding today, but he doesn't. He generally doesn't say anything unless asked a question, and he answers in as few words as possible. His grown children are sympathetic but not assertive toward the situation.
    Is there a medical procedure or therapy that could help him? Should he see an ear-nose-and-throat or stroke specialist? What about another speech therapist? I don't want to get anyone's hopes up and have there be no solution. What is your advice?
    DEAR READER: Your brother-in-law may have run out of options. If he hasn't improved in 30 years, the likelihood of improvement is very remote. However, with modern techniques, some of his difficulties may be lessened.
    If he were my brother-in-law, I would pull out all the stops and have him evaluated by a neurologist (stroke specialist), ear-nose-and-throat specialist and a speech therapist. This should cover all the bases.
    If, as I suspect, your brother-in-law's damage from the stroke is permanent, at least you can be certain he has been evaluated thoroughly and found to be in otherwise good health.
    As a further step, he may benefit from therapy. In this setting, he will be able to communicate with someone and not have to fear ridicule. It may give him the confidence to talk with family members in a more meaningful way. From there, a stroke support group, perhaps one geared toward speech-impaired patients, is an appropriate step. This should allow him to open up even more, because he will be surrounded by people who truly know what he is going through. In the best-case scenario, he will feel more comfortable in public settings. In the worst, he will have acquaintances (maybe even friends) with whom he can talk freely. Either way, his loneliness will ease and he will happier.
    Let me know how this turns out.
    To give you related information, I am sending you a copy of my Health Report "Stroke."
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