The information provided in this podcast is not intended to be a substitution for professional medical advice. Always consult with a qualified health care professional with questions you may have regarding a medical condition. Piers Grove [00:00:17] Hello, my name is Piers Grove. Welcome to 404: Brain Not Found. In this episode, we examine language in a communication with Doctor Andy Kilov, my speech pathologist. I'll share my experience and get her insights on my progress and the road ahead. I think this brings us around to exploring some of the terminology that the terms that we used for me were apraxia and aphrasia. Two very, very similar, words. Two words I wasn't familiar with. Two words I had a very hard time differentiating. And to this day, I do not completely understand the difference between them. Doctor Andy Kilov [00:01:10] Is it a bit like operation, getting your head around the terminology, as well as the recovery and everything else in between? Piers Grove [00:01:18] Absolutely, absolutely. I had very, very limited reading ability quite recently. So anything I learned about strokes was from podcasts, and, that's the reason we're recording this. And we'll also provide a transcript of it on the website that it's meant to be as accessible, no matter what symptoms, you have experienced from a stroke. The first one is apraxia. Can you run me through exactly what that is? Doctor Andy Kilov [00:02:01] I will try to do this in a very sensible way. So. Dyspraxia relates to the coordination of movements, and when you have a stroke, you can have either an oral apraxia, which is when you can't coordinate movements in your mouth and speech muscles, swallow muscles and that may affect your swallowing. For example, you may not be able to coordinate how you hold food and drink, and that might impact on the coordination and safety of the swallow. And this might lead to coughing or choking or an inability to propel the food and drink back. So that's an example of oral dyspraxia. When we talk about speech dyspraxia, we talking about the coordination of sounds. So how sounds are formed and held together to form words, and then how we use those movements also to speak in sentences and beyond. And it's a really tricky, difficulty to navigate because you know exactly what you want to say, but the coordination falls apart when you form the word that you'd like to say at a planning level. You have a breakdown in the sequence as you start producing, verbally producing the word or the sound sequence. And so your speech might sound quite distorted, lacks vowel sounds, might be distorted so that you have accented speech. Sometimes the precision of your articulation, reduces. You can sometimes have difficulty forming longer words, because you can't get the coordination pattern around so many different moving pieces in a word, and that becomes really frustrating and difficult in the early days, where you're putting so much effort into communicating your needs. And once and then as you're able to communicate more, so you're experiencing these dyspraxic errors, which cause you to trip over your speech and impede on that comprehensibility of your message. So. That's the dyspraxia part of it in a nutshell, you can explore it a little bit so that as we go along. Piers Grove [00:04:20] It sounds more like, a trauma to the body that is expressed through inability to physically deliver on what the brain is, is sending out as the message. Does that sound a reasonable way of to differentiating it from the aphrasia? Doctor Andy Kilov [00:04:43] Yeah, that's one way you could look at it, for sure. You can look at it from that perspective in that you've got the message, but it's the out of the content that's impaired. It's not a weakness of the speech sounds, like a dysarthria where your speech sounds slurred, but the coordination is there. When you're dyspraxic you have a problem coordinating those sounds and getting to those accurate targets in a rhythmical and timed ordinated fashion. Piers Grove [00:05:13] Okay. And does dyspraxia heal like a, like a broken leg in that case? Or is it a is it a permanent state or is that variable from client decline. Doctor Andy Kilov [00:05:30] It is variable. I've seen a lot of stroke patients work well with very intensive speech pathology programs to resolve the dyspraxic errors and to improve the accuracy and consistency of speech patterns. And I've seen people, learn to readjust and work around the dyspraxia, which doesn't always lead the communication system. I think the main thing with working with dyspraxia and actually any of the. I guess people that, and symptoms that derive from having a stroke is that you have to be working on these skill sets all the time, even if you have the opportunity to reach a point of resolution with some of these, communication disorders. You have to keep maintaining and ensuring that the function is well supported, because the thing with your rehab is that there's a principle called "use it or lose it". You have to keep those networks firing and active and stable so that your function isn't variable. Piers Grove [00:06:47] Okay. Can we, give the audience the benefit of my, the sort of the impediments, in that people have now been listening to me rabbit on and no doubt have heard, the sort of the, the the breaks in speech, the mispronunciation, the word finding that's gone on. How much of that is aphrasia? Is aphraxia? There we go. I told you I couldn't separate them. Doctor Andy Kilov [00:07:21] Yes. Thank you, thank you. I love that you're so comfortable with, with pointing it out. And I think that it's nice for our listeners to be able to get real time examples of what that dyspraxia may sound like in someone's speech. I think that's a very good question. One of the difficulties we have as speech pathologist is measuring when we're looking at error patterns, deciding sometimes the profiles of dyspraxia. And aphrasia can run quite close to each other and it can be difficult to delineate, you know, is that more an error because of dyspraxia or is that more an error because of the evasion? I think in a very basic sense, when there's a trip over the enunciation and there's an articulation error, and a lot of the time that might be due to a dyspraxia, whereas when you're talking about causing a needing to find a word or using an entire word in a sentence, that's more of an aphasia. But again, it's a really broad term because language is just such a huge area and it's such a complex area because it includes so many different functions like. Comprehension. Expression. Grammar. Vocab. Use on higher level cognitive processes in language like problem solving, inferencing, reading, writing, processing material and so the essays can look like different things at different points in your recovery process as well. And I'm not sure whether you firsthand agree with me or not, but. In the beginning, I feel like aphrasia often presents as difficulty understanding or difficulty. You know, reading information or finding the right word, or feeling like you want to say something and you just can't string a sentence together will get a story across. Whereas once you've built up some of your language function, the aphasia might look like, oh, I didn't really notice that I had that inaccuracy in that email or that piece of text or, I had difficulty following that in print because there was so much background noise and so many other conversations I was managing. So it can look like different things at different points in time. Piers Grove [00:09:48] Look, here's a curious question. I think I, like so many others stroke patients became exhausted by communicating, reading a text message on my phone or replying to it, would leave me exhausted. Talking over the phone, listening to instructions or directions. All these things became really exhausting. And I mean, I our sessions started off at 30 minutes, which I thought was comically short and were immediately followed by a two hour nap. Is that my brain dealing with the dyspraxia or the aphasia? Doctor Andy Kilov [00:10:46] Great question and I'd like to offer a little bit of a different insight. Your brain is exhausted after you have a stroke. And there's a very real symptom that a lot of stroke survivors experience and that is called cognitive fatigue. And from what I understand in all the years that I've worked in stroke rehab, is that this cognitive fatigue hits you like a blackout. It's a fatigue that you've never experienced before. And it's a fatigue that leaves you with no other choice than to literally close your eyes and sleep and reset. And it doesn't matter how much better you are to keep going with your activity or your routine, or if you do push out, or you won't be left with very little ability to function safely and at all. So it's not uncommon for people recovering from strokes to have at least one sleep. I wouldn't even call it a nap. Like a proper sleep setting the day. And that would look similar from day to day. But it can also look different. Exactly like you said. Sometimes it happens straight after a really intense therapy session. Or maybe it happens after even just getting ready for the day, having a shower and getting rest. Your brain is working so hard to recover and regain fitness that any additional activity on top of its recovery becomes an added pressure on the system. And so it's really important in the early days of stroke rehab to be sticking to a really achievable routine. And it's a routine that looks different from what you're used to. And often that might look like having a salad, getting dressed and having a sleep, and then having a 30 minute therapy session and a little snack. And again, another rest. And, you know, and you become used to going through those motions and recovery processes and the routines you do to regain a level of cognitive resilience and fitness. But it isn't uncommon, then, for things like them which processing to take further energy from your brain and wind you out as well. And I guess that's what I was saying before about the aphasia, that sometimes it's not that you can't process the language, it's sometimes that the speed at which it's happening just isn't matched with the processing speed that your brain has. And so your brain's saying it's best to manage all that information coming in, but it's just not functioning in the same way as before. And so part of our job as therapists, whether it's O.T. or speech or physio, it's increase, also helping you increase that fitness and resilience to work beyond just short moments in time. And a lot of us see ourselves similarly to a personal trainer where if you go to the gym and you had a, you know, done pilates or yoga or, you know, weights training before you have to start off with really light weights or really short sets to build that, that muscle memory and that muscle resilience. And the brain is similarly a muscle that needs to be very carefully managed and work so that it can take up that learning and that information and will develop the fitness as you recover. Piers Grove [00:14:09] We're putting a lot of emphasis on the aspraxia. And I'd love to now give aphasia its turn. So can you run us through essentially how aphasia presents to you? Doctor Andy Kilov [00:14:28] When we first visit someone who's had a stroke, we often do a screening and a quick check in to see what language functions are intact and which functions appear to be affected by the stroke. So we try to look at the communication system holistically. But the tricky thing about looking at aphasia in the early days after a stroke is that everything's changing so much. So what you're doing in that initial 24 to 48 hours after your stroke. If you're awake enough to communicate looks very different from what you might be doing on the third day or the fifth day or the seventh day post recovery. And so our role in the beginning is really just to monitor what recovery we're seeing and what access to your language you have and trying to support you in making your needs and wants understood and processing the information around you, educating your family about what to expect and how to support you. Whereas later on in the process we are looking at building up those skills, like finding ways to access your vocabulary and increase the amount of words that you have available in your vocabulary, and using those words to build sentences and story, and looking at grammatical accuracy and complexity in your language and know just different people speaking versus writing it. So. It's a really broad area and it fascinates me, the extent at which we operate on a daily basis when we're not thinking about our language skills, you know, and then you meet someone who has an aphasia after a stroke. You're reminded about this conflict skill set that we have access to. And, you know, you start to slowly rebel. It's a curse. And then it can be frustrating, but it can also be a wonderful, enlightening experience to rebuild those skills and reach those milestones and open up those pathways and work towards amazing things like being able to call your fiance by her name. Or ask your kids how their day was at school, or tell them about your amazing, or terrible day at rehab. Yeah, the journey has its ups and downs, but it is a really. I don't know if you can tell it to me, but I feel like a lot of people say it's a really cathartic experience. Piers Grove [00:16:52] It is. It's also a very self-analysis experience in that, there's the, learning how to do things methodically that you have otherwise been able to automatically, acquire as skills from a child. So you become much more mindful of, how you communicate, how you write, how you view things. And the complexity between, thought communication response, empathy calculations and things like that. So I think a great way to show aphasia is through some of the, the tests that you put me through. Would you be open to running a drill, a word finding drill or something difficult? With me that, will highlight, I guess, where where I come up short and will allow people at listening to to, sort of follow along and try to complete them alongside me, to see, you know, a bit of a comparison. Some of this stuff is not easy to do. And I have done it with the children and my fiancee and they've struggled with it. So I was one it'd be open to running a small experiment for our audience. Doctor Andy Kilov [00:18:29] Absolutely. You know, I'm always up for a challenge like that. Piers Grove [00:18:33] Yeah. Doctor Andy Kilov [00:18:34] I think yeah, I think I've put you on the spot over here. One of the words you mentioned before made me think that, at least my, my one little favourite area out of the mix and one of the areas that aphasia can actually have huge impact on is on another language. Because even though numerical sequences and digits are thought of as numbers, mathematics is actually a language and has a lot of language supports around it. So here's one for you. I would love you to come up in fives to begin with, from 330 all the way up to 370. Piers Grove [00:19:15] Okay. 330 335, 340, 400- 345, 450, 355, 360, 365, 370. Doctor Andy Kilov [00:19:34] Let's turn it up there. I'm going to ask you to come over into a larger sequence. So I want you to count now from 1370 in twos, and I'll change my pattern when I feel like you've got some fluidity in your sequencing. Piers Grove [00:19:52] Okay. 1370 1372. 1374. 1378. 1380. Doctor Andy Kilov [00:20:11] Keep going. Piers Grove [00:20:11] 1382. Doctor Andy Kilov [00:20:13] I might change it now to come up into 2000 into, let's start at 2300. And what I want you to do this time is I want you to take up- I want you to count in sequences of ten, but each time you move up ten places, I also want you to increase the units by two. So you're going ten and 12, then 40. And I also want you to increase the hundreds by one. So I want you to start off at 2300. I want you to divide by ten first and then make the extra manipulations for me. Piers Grove [00:20:54] 300 and. Ten. Three... Doctor Andy Kilov [00:21:02] Hang on. Go back for me. 2300. Piers Grove [00:21:06] 122. 2310. 2422. 3536. Ahh this is hurting. Doctor Andy Kilov [00:21:29] Yes. Piers Grove [00:21:31] 5650. Doctor Andy Kilov [00:21:35] Okay. You've done a really good job there. Except you've made your work too difficult because you've also taken your number sequence up by a thousand. So you've done one extra manipulation. Look, that's a really complex- Piers Grove [00:21:48] Oh, God. Doctor Andy Kilov [00:21:50] Manipulation that I've had you do there. But I think that what I wanted to demonstrate over there is that. You are having to hold onto digital manipulation, not only at a, not only at a cognitive level, that you're also having to think about the the language behind the place value of numbers. And so with aphasia, you know, one of the, one of the restrictions that are imposed for people who had a stroke is that you can't drive for a certain time after you've had your stroke. And, and that it's. Piers Grove [00:22:26] That's just to get you fit. Yeah. Doctor Andy Kilov [00:22:29] Well, yes. But then, you know, there is certainly a language processing pack to which we have to. Be mindful of. So even though in your mind you know exactly what the information means when you are having to multitask and hold onto lots of information, little glitches can happen in your system. And, you know, thinking about speed limits and school zones. And when we transition and stroke survivors to being safe on the roads, it's not about necessarily the physical safety. It's about looking at how is your brain going with manipulating so many different pieces of information and making appropriate decisions and responses to that information in the world around you? Piers Grove [00:23:16] I can see why you are, put in, you know, in a walker in terms of making decisions and engaging with the world. You are best off, having preparation and being able to check in with people like ordering an Uber, not reading a speed sign at, 11km when it's meant to be on a freeway at 110. Doctor Andy Kilov [00:23:43] Exactly. And I wonder if maybe you can answer this question for me. Because I think you would have experienced a lot of those early bird substitutions and errors that we'd see in someone with aphasia. You know, leaving that dyspraxia aside for a moment. Would you enjoy those moments where you made those word errors? You know, was it confronting or was it amusing, or was it both? Piers Grove [00:24:12] It was embarrassing, for a, for a victim who has no external signals. You know, it was a very, very silent symptom. And I couldn't hear it in the first instance. But once you can start hearing them, and you can start seeing how the brain is making the mistakes, they are, somewhat frivolous, and you start hearing them in other people after a big night on the terms, who have got a similar brain injury to myself. And yeah, they become, they become amusing in those, in those situations, and a huge pressure to correct. Doctor Andy Kilov [00:25:03] Yeah. I think, as I'm listening to you talk about that, I'm also thinking about a commentary that's shared with me a lot of the time with, with stroke patients who I work with, where we talk about the fact that people with horses, and dyspraxia and communication difficulties can become hypercritical of their performance and unnecessarily so. And I think, exactly like you said, I think that, there's a point in, in stroke recovery where you become less hyper critical and more aware of those variations in everyday communication. People, you know, myself included, often say, I feel like I'm having, you know, difficulty getting my tongue around these words or finding the right words to say or the grammar structure a little bit. I think that. It can be a long process, but I think when you've recovered enough function and you've achieved your goal sets, and you looked around and thought about how other people in your sphere communicate. I think it can be really interesting to recognise that no one has perfect communication and. I take a lot of great comfort in that because. None of us are totally fluent, perfect communicators 100% of the time. I think that being critical has its place, but I don't think that it is the only way of ensuring that you progress and make gains in your communication recovery. Piers Grove [00:26:47] Yeah. Yes, I think that's true. Could we do another exercise? But perhaps a word finding? Doctor Andy Kilov [00:26:55] Yes, I felt one. That's a word finding. Okay. Piers Grove [00:26:59] I've got so much better- I've got so much better at these, haven't I? Doctor Andy Kilov [00:27:02] No worries. I had to think about one to trip you up. Okay. Well, I'm gonna start with maybe something quite concrete first. How about we name? Let's, let's do something interesting here. I'm going to say to you, I'm putting up one minute on my clock, and I want you to name as many animals as you can think of. Piers Grove [00:27:21] Okay, we know how to do this. We go through a walk through Taronga Zoo. Okay. We have an elephant. We've got a seal, we've got an emu, cassowary, echidna, br-brown belly snake, zebra, giraffe, chimpanzee, ape, lemurs. Eagles, cockatoos, dogs and cats and pigs and, we're off the farm now. We've got a, cockatoo, we've got a peacock. We've got a sheep, a donkey, a goat. I've got, platypus, a kookaburra. I've got a wallaby. And, come on, the million- minutes got to be up by now. Doctor Andy Kilov [00:28:22] Nearly. Piers Grove [00:28:23] No? Nearly. Okay. We've got a camel- Doctor Andy Kilov [00:28:27] Okay. Time's up. Time's up over there. How did you feel? Piers Grove [00:28:34] I'd say I did really well. I feel like they worked. Doctor Andy Kilov [00:28:36] That's how you use your subcategories. That was a very organised way of accessing different word groups within that big category of animals. So let's, let's take this one a step further. I'm going to give you a narrower set. Now I'm interested to see whether you come up with a similar amount of, items or whether it is less. Okay. So now what I want you to do is I want you to give me the names of any creatures you might find in the sea. Piers Grove [00:29:07] Right? Okay. I would find an eel, a trout, a salmon. I'm going to go with the edible things. Controversially, a whale, a dolphin. A marlin. Tuna. Frog. A goldfish, a clownfish. Coral. Seaweed. Crabs. Lobsters. Balmain bugs. Sea snail. Starfish. oh. Jellyfish. A jellyfish would be there. Doctor Andy Kilov [00:30:12] Okay. Stop there. What's your sense, did you say more or less items? Piers Grove [00:30:17] I think I got less, I think I got less. Doctor Andy Kilov [00:30:20] A lot less or just a little bit less? What's your sense? Piers Grove [00:30:24] I'd say 20% less. I obviously stopped for 10s in the last one, so I didn't use all my time. But yeah, I still felt like I was there was bigger thought and less, stringing the ideas together. And how did they compare? Doctor Andy Kilov [00:30:42] So your first category, you've got about 24 items, in the second task, you got 18 items. So not, not too much of a reduction. On one hand, I expected that, you know, that narrow asset says me constrains your word planning. So you can't work across so many subcategories. But I love again having found a way to group those items together like things to eat or, you know, crustaceans versus, you know, larger mammals that you see I think that's the thing with, with verbal fluency and word finding is that sometimes your performance will be enhanced by, by structure. So giving you a really narrow set to focus on where there's a little bit more organisation. And sometimes your performance will be enhanced by having a much broader range of categories to explore and to use to fill that. Yeah. What we did there was we looked at what we call concrete categories. So, you know, these are names of animals and the things that you would find in particular places, if I like you to think of something more abstract now. So I might say to you, can you think of items that need to be or that can be mixed? So anything that can be mixed, I'm going to put another one minute up. Ready? Piers Grove [00:31:58] Okay. Mixed. Concrete, cocktails. Cordial. Children. To be mixed. Mixed. Vegetables, protein. Animals. Recipes, taste, mortar and pestle stuff. Looking around myself here. Tea, coffee. Hot chocolate. Juices. Fruit salad. Doctor Andy Kilov [00:33:03] Okay, you can stop there. Piers Grove [00:33:05] Oh, okay. That was hard. Doctor Andy Kilov [00:33:06] It was much harder. That category. So that's more of an abstract category where, it's more tricky to use those subcategories to formulate ideas and hook onto words. So you're having to think, you're having to really think about the action of mixing. And, and that word mix can mean different things, like you say, like mixing cordial, mixing cement. But then you can also have like mixed ideas or mixed words, or you can have something that isn't so concrete. And that taps into more of your, I guess, your cognitive processing and your higher level language. And that's a category that we probably wouldn't be using early on in stroke recovery, because it requires a lot more concept development and problem solving around what that category actually means. I want to just put up one other category and is. Piers Grove [00:34:06] The last one. Doctor Andy Kilov [00:34:07] This will be the last one I promise. Piers Grove [00:34:10] This is a, this is a full brain workout for me. Doctor Andy Kilov [00:34:13] It is a full brain workout I agree. I also leave you with the ability to string a sentence together after our little experiment. Yeah. Piers Grove [00:34:21] I would love people to comment on, on social media with us about how they performed on their own there, so that I can get a benchmark. Doctor Andy Kilov [00:34:32] What we're doing has verbal fluency. It's one kind of and you know, I've flashed up photographs for you to name places and people and parts of objects and things like that. But I really do love using the verbal fluency to give some objective benchmarks about, you know, how many items you're coming up with and what that speed of retrieval is. Because language is such a tricky thing to measure, and sometimes progress can be so subjective. This is one task where I think you can get really objective measures and really know exactly where you stand with respect to your own recovery. Okay, one more for now. Words beginning with the sound "R". Ready, set, go. Piers Grove [00:35:12] Read. Remove. Resell. Rewatch. Remove. Relate. Remnants. Responsibility. Responsiveness. Remedy. Ramesh Ramifications. Really? This should be easier. Rick. Richard. Rachel. Rebecca. Rake. Response. Doctor Andy Kilov [00:36:17] Okay. You can stop there. Piers Grove [00:36:18] Reheat. Okay. Doctor Andy Kilov [00:36:20] I think that that's a really good example of how sometimes fatigue can impact your system, because I think we tend to agree that you often give me, a significant higher number of items in those, that begin with this letter. But I think, again, that's a really good example of how the T can impact the organisation and access to words. And yeah, again, another good example of how they're different naming routes. So words beginning with an R. Again you can use subcategories and organise ways of finding those words. and then also you can have some, you know other pathways like when you buy, you know, response responsiveness, responsibility where you've got I guess it's like that predictive text function on your phone. You've got some letters at the beginning of the word and that helps you. Two words of similar phonetic structure, similar sound structure versus across different categories. Like you put people's names beginning with an R, which are, you know, if you were in a therapy session, I wouldn't be so generous with allowing you to remain in one category for so long that, sometimes that momentum of finding words is also really important because we don't want to block pathways, that we want to build and strengthen a lot of pathways and keep those juices flowing and that momentum flowing as well. So I'd be interested to know as well from other people as you go along, what are your most memorable verbal fluency categories, and how have you tracked in your therapy journey, and what other language tasks have you used? I mean, that's another whole episode in itself, what do speech therapy sessions look like and what kind of things do you do to target the dyspraxia or an aphasia, or a high level language difficulty or a dysarthria or a swallowing problem. And I'll leave that in your capable hands to guide us through those added topics as they come. Come our way. Piers Grove [00:38:18] We've given some really good examples of, the aphasia and, and treatments and diagnosis for that. Hopefully this has prompted, some of the listeners to either. Explore speech pathology, or recommend it for someone in their lives who they can hear. As, aphasia or asphraxia in their language. And we can include some links in the, podcast notes, so you can click through and there will be a shameless ad for Andy included in there. I guess the reason that you and I are talking is that the speech pathologist that I was introduced to was very much, a nurse, like you had taken some bonus workshops in speech pathology and occupational therapy. And that just wasn't good enough. I was surrounded by 70 year olds, and was progressing at the speed and being chased by their metrics. Of can I go to the shop and buy a loaf of bread? Can I attend a restaurant? Can I fill in a form for the government, for welfare. And that was the setting I was in originally. And I was recommended to you by a neurology doctor. In research, in fact, at, the Royal Alfred Hospital. And that was when things really changed and I got a proper diagnosis and introduced to some of the terminology that we've discussed today. And how do you tell? Whether you're on the right horse, whether your expectations are actually going to be built into the treatment.? Doctor Andy Kilov [00:40:38] You know, different impairments come in with different experience and approaches and knowledge of evidence based practice. And the one thing I always say is that I really like that we live in a place where we have so much choice, and what works really well for one person may not be ideal for another person, and I think. Being able to. Advertising yourself where you feel like you can be in control of your own journey. I think that there are some great watch services available in our communities, but they're not necessarily the most efficient or authentic way of getting us all to reach our goals and to your, you know, your endpoints and your outcomes. I think being able to say I want more or this doesn't feel right, at least allows the therapist you're working with to help you find ways to link in with other services or other people who may be able to give you a different treatment course, a different intensity of therapy. Piers Grove [00:41:43] Yeah. Look, I think the the takeaway for me is, ask around and you don't go straight to buying a house. You got to find one that you're comfortable in that, that meets your requirements, meets your budget and is available. Well, that's from my own perspective. And why seeing this conversation with Andy has been so, thorough is that it's just, we're a great team, and it's worked really well on that. I'm gonna let. Andy go to her next session. I'm going to go and have a nap. Thank you so much Andy for your time and tander. Doctor Andy Kilov [00:42:27] Likewise, yes. Piers Grove [00:42:33] Thanks to Doctor Andy Kilov for your insights. If someone you know has had a stroke, please let them know about this podcast. Stroke Foundation Australia is a proud friend of 404: Brain Not Found. For more resources and support on stroke, head to Strokefoundation.org.au or call Stroke Line on 1800 787 653. [00:43:03] This podcast was produced by General Experiments.