Aphasia can mean the loss of the ability to speak or understand spoken language. For the sake of this blog entry, however, we’re going to use it in the first definition—the ability to speak.

Migraines and aphasia for me are a triple threat. Take the migraines alone, and they seem to have some affect on the speech centers of my brain. Either that or the incredible pounding pain makes it difficult to select the right words and have conversations. I’ve never actually taken notes during one of these episodes.

Second, one of my preventatives, Topamax, has documented side effects around cognitive abilities. Even their web site specifically mentions the phrase “difficulty finding the right word.” Yup, that describes me alright!

Finally, one of my abortives, Maxalt, also causes drowsiness, which can lead to the inability to select the right words (imagine trying to talk when woken from a sound sleep at three o’clock in the morning). All of this adds up to effective partial aphasia.

Now, aside from being a dream come true for my wife, coworkers and employees, partial aphasia is one of the most annoying things that has happened to me as part of migraine and migraine management, because, darn it, I’m eloquent! Or at least I used to be.

I am (or at least, was) eloquent, and I used to use this eloquence to my advantage. I could construct beautiful verbal arguments and deliver them with all “les mots justes” in all the right places as the French might say. When I was in college, I was the resident exam lawyer, arguing against ambiguous questions and usually getting favorable results for the class.

But I can only just barely up with the best of them now. I can still keep up with most, mind you, but I come up against some world class arguers in my life, and my arguing skills sometimes are found wanting—mostly because instead of having the right word right there I have to hunt for it and search for it. And I say “uhhhh” a lot. And I sometimes have to go for a much simpler word or a more lengthy set of words to describe my point. All of which can reduce the force of my side of the argument.

So, what do I do? First of all, I lose more. That’s a fact of life. I used to have an almost unbeaten record. Now, it’s not so good. Second, if it’s something I feel I can’t lose, I change the rules a bit. Here’s the trick about aphasia: it strikes the “speech” centers of the brain. This means that your written word can still be eloquent and forceful, while your spoken self sits there doe-eyed looking for the right word. I change the rules and move the argument to a written form. I write a paper, or move it to e-mail (if appropriate). If I can, I write my argument down (or key points, or at least key words) beforehand on note cards.

I may lose a little dynamism from these approaches, but it has saved me from both embarrassment and a couple losses. As always, your mileage may vary, but it works for me.