Am i the only one with a hypernasality? Does anyone else have or had one after a rupture? Its when your soft palate doesnt function well enough to block air from escaping your nose when you speak causing your Bs and Ps to sound like Ms and Ds like Ns, anyone whos experienced it knows its extremely frustrating! Strangers never understand me and sometimes my mom doesnt! I couldnt wait til i could speak again and now i just end up having to type stuff on my ipad in public. Ive never heard of it resulting from brain injury or stroke other than me, just after cleft palate surgery sometimes, anyone else with me? If so, anyone had surgery to repair it? Does it get better on its own over time?
My son had hypernasality due to a brain stem hemorrhage from an AVM. He had no palatal lift, could not talk at all due to nerve damage on his tongue (it was at first quite immobile) , his swallowing muscles did not work at first so he did not eat for 2 months and one of his vocal cords is paralyzed. He also had a tracheotomy because of all of the above. When his trach was removed and it healed he began speech therapy. I also spent hours and hours ( we would work for short periods of time twice per day to start) with him. I got him to work his voice based on the vowels that sounded the least nasal (a, I,o) . He would vocalize those vowels so they had the least amount of nasality possible and then make words with the vowels, then sentences. I found it was very important for him to listen to someone else say the word or sentence to get correct sound and opening. He want to a few different speech language therapists to get different strategies to work on the nasality. It is an art and not a science to correct this as the soft palate is an involuntary muscle. Anyway, 11 months since his bleed and his is back in Teacher's College and just finished his high school English placement, with Excellent across the board, including his voice. He is lucky in that his vocal cord was paralyzed in a middle position, so the other is compensating well. His voice is not 100% as it was, but it is strong, clear and it gets better all the time. He may need to get injections on his vocal cord in the future to keep it plumped up but that is totally routine. There are some surgeries for correcting velopharyngeal dysfunction (soft palate doesn't lift). I don't know how long it has been since your bleed but they would probably tell you to get speech therapy first (did you get any?) and if that doesn't help then go to a doctor who can fix that. You want to avoid those surgeries as they can be tricky. Don't give up. Get someone to work with you and get the direction of how to do that professionally. If you have any other questions send me a message. Good luck I know that must be terribly frustrating, as it was for my son.
I don't know what the specifics of your hypernasality are, or your voice, but here are some strategies that you can try and see if they make a difference:
-talk slowly and think of the vowels when you speak or even exaggerate the vowels a little
-try opening your mouth a little more to create more space
You can find some exercises on the internet like blowing up balloons and drinking through a straw and try those. The key is really having someone listen to you and tell you when they hear improvements in your voice. My son's nasality decreased when he was told to put his hand on his chest, in order to "feel more vibration" which is chest resonance. When he did that it was like the air column was directed away from the soft palate. Anyway, those are just some ideas. Again, if you can get a professional to just start you on the right kind of things that would be helpful.
This is an amazing community. I hope Susan helped you, or at least got you pointed in the right direction. Thanks Susan!
I found this quite interesting. When Mark was born he was such a slower feeder and then when he was winded he would bring up his whole feed. The midwife finally diagnosed that he would swallow lots of air when feeding and suggested using teats with special valves to reduce the volume of air he swallowed, it helped a little. He always seemed to speak down his nose.
Although they made no connection with the AVM, we always thought it might be connected and now I'm thinking it was.
After his bleed in 2013 he became more choosey over his foods and I'm wondering if the above was the reason.
Its a pity my son was left in the care of an epilepsy nurse rather than someone who knew what an AVM could cause and we might have got the right answers to our questions and the right care for our son. Sorry bitter.
Hm did it get worse after his bleed? I never had an issue before mine, it also doesnt seem to affect my appetite, swallow or what i eat but i am 19 and hungry all the time haha, although i dont talk as much as i want becuz it just frustrates me and whoever im talking to, hows your sons speech tho? Have they diagnosed hypernasality or mentioned a surgery?
Wow thanks, sometimes im understood better if i really over anunciate but thats hard to do everytime you talk, takes a lot of energy and i have weak breath support. Im 2 and a half years out and realizing my quality of life would be vastly improved if i could carry a conversation without the person im talking to just smiling and nodding even tho dont even kno wat im saying, that pisses me off. Ive been doing a CPAP therapy program to strengthen my soft palate, it was helping alot last year but doesnt seem to be working as well now but i still do it just hoping those to stimulate those damaged neurons and keep em alive long enough to heal, it just sucks i really havent heard my “real” voice since i was sixteen, its a tricky surgery? I was just thinking about gettin a consultation for it in a few months for more info
Ill give it a shot but the thing is i have to plug my nose to even try blowing a balloon up and i always use a straw haha i do a CPAP therapy program but it doesnt seem to help as much as it used to
I have to say Matt that I'd never heard of an AVM rupture causing this issue. I find it fascinating although I'm sure not so much for you. Susasn seemed to have provided some good information. I hope it is of help to you. Good luck.
Matt, my son's speech is pretty good now. His hypernasality isn't nearly what it was. The damage to his tongue and general weakness in his speaking muscles made it very hard for him to speak at first also. I kept working with him and trying to get him to speak more.He will not need surgery at this time certainly as his speech is pretty good and his nasality is very little. If you have tried CPAP therapy (I tried to find that where I live but couldn't) but not finding it helpful maybe it is time to consult for surgery. When I said it is tricky I just meant that they prefer people to try to get their voice and speech muscles to work naturally before trying anything. It is worth getting a consultation. I know how frustrating it must be as I watched my 22 year old trying to speak at first. He did not speak at all for over 2 months after his hemorrhage. Because every situation is different you have to push for moving yourself forward. I really would get a consult on surgery. Best of luck.
A brain hemorrhage can affect the nerves that move the tongue, that control the soft palate moving up when you speak and eat and even the muscles that allow you to swallow. Also many people who have strokes end up having speech that seems almost slurred for a while but this seems to disappear for most.
Susan I did have problems swallowing for a few weeks after my bleed/surgery. I had to be on a liquid diet until I could pass the "swallow test". Not the best thing I've ever experienced. Thanks for the information. I learn something new here almost every day.
Mark suffered lots of issues eating, vomiting, migraines all his childhood and seizures from 15 but not diagnosed with AVM till he was 18.
He was never diagnosed with hypernasality but his medical team failed him miserably.
He avoided some foods including his favourite after his bleed in January 2013.
At times when speaking it was as if he had discomfort in the jaw and he would stretch his mouth open. He would yawn and suck in wind at the same time, when we mentioned this to his nurse she said it was a type of seizure.
I know no one will know everything about such a complex condition but sharing information is helpful.