My tbi occurred during a rear end collision 10 years ago. The  back of my brain and right side were injured. I am legally blind because of it. I have excessive sleepiness all the time-diagnosed as Hypersomnia a year ago. I also found out I was misdiagnosed with Major Depressive Disorder at the time of the accident until anout a year ago. The correct primary diagnosis is Psuedobulbar affect with a comorbity of depression. I have been taking cymbalta, abilify, trintellix for those 10 years. Nothing helps. I take modafinil for the Hypersomnia. It barely helps.  I take Neudexta for PBA. It helps.  I would like to hold down a job again someday. And build a life again but cannot stay awake physically or mentally very long. I shut down completely or I cry profusely  if I'm not taking meds As drs have attempted to wean me off throughout the years. Any advice for leveraging  neuroplasticity again?  Keeping awake, how to keep awake and what's causing the sleep to be in overdrive?  What recommendations for "wake up" therapies, physicians that specialize and cognitive therapies to get my brain back. Have an MBA from pre-accident that I cannot use bc of my recall and shut down. please help. 
 
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Excessive sleepiness

Thank you for the question. May I ask what type of injury? That would lead me in the right direction to answe. is there voicing? How is his comprehensio? respiratory status? Looking forward to your response.

speech language pathologist

First, like Mrs. Mayya, it would be helpful to know what type of injury he suffers from. Secondly, assuming his vocal chords are fully healthy, the only other possible physical disablement that may be causing him to not speak would be his breathing and lung capacity. However, if that's alsi fully functional and his lack of speech is purely voluntary, an unwillingness, then there's only two things I could suggest. (1) The first, less aggressive, approach would be to simply play some music he likes and sit in the room with him and start singing along. This would encourage him to start singing as well, and that would work as a way to get him to restart using his vocal chords, but without any obligation. That is,  just by singing along, his words don't have any "consequences", so he shouldn't be afraid to say them. (2) The alternative, less pleasant and more aggressive approach would be to give him two options, but he needs to speak to tell you which he chooses. Along the same lines as the music choice, that could be as simple as telling you which band/CD he would like for you to put on. And don't hold up the CDs, but just lost the options and ask him which he'd like best. Then, instead of just pointing at his choice, he would actually need to speak and tell you his choice! Worst case scenario he still refuses to talk, you might need to use some more aggressive mean. For example, the two music choices are one band he really likes, and one he really hates. If he refuses to talk, then put in the one he dislikes, and let him kno that he can simply tell you to switch, but only by using his voice. Of course, you should only use this option after trying the other ones, and even then, only once all physical inability reasons have been definitively ruled out.  Hope this helps, and best of luck Moniquebtown!

My 20y/o son is 22 months out from date of injury and is still nonverbal. His vocal cords have been scoped and show no sign of injury. He can communicate with his hands. How can I help him to regain speech???

How to help with return of speech

My partner is 9 years out. Has been seeing a speech therapist for most of that time. At about the 1 year mark an ent scoped the vocal cords to discover one was paralyzed. With the help of an outstanding speech therapist and hyperbaric oxygen it is now fully functional. (hbot regenerated the nerves).

My voice was only a raspy whisper for over a year. Vocal therapy is what helped me, not speech therapy. I still have to be careful to not talk for too long or my voice will get very gravelly. I randomly have trouble swallowing. The odd thing is that I mostly have trouble with liquids.Seeing an ENT before doing more therapy is probably to check if your vocal cords are closing/opening properly. If they aren't, then the therapy will be targeted to get your vocal cords working properly.

I am about 9 months into this journey. I was in speech therapy and switched drs. And they don't even want to start speech until I see an eye, ear, and throat specialist. I still get issues when drinking water and eatings things like watermelon, fruit..etc. my voice is deeper sounding and breathy. Will something need to be fixed surgically? Have any of you gone through this? Thank you in advance!

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