I have fatigue related to Ehlers-Danlos syndrome (hypermobility type) and Postural Orthostatic Tachycardia Syndrome (EDS and POTS)
When fatigued, my speech can be affected in the following ways:
1. Reduced ability to form coherent sentences
2, Reduced ability to use the correct word
3. Reduced ability to form/pronounce words
They are such common occurrences that I have various keyring cards to explain them - which is a great help in reducing the awkwardness!
But for those who haven't lived with these, here's a bit more detail:
1, Reduced ability to find the correct word.
"could you fetch my bath...bed....thing...[attempt to mime 'bag']..BAG...from the.....corridor.....space.....[point in right direction] there."
Incorrect words usually have the same starting letter as, or rhyme with the word I want, are something from an earlier conversation or have a linked meaning.
If the wrong word is stuck in my head, it is often quicker to reel off incorrect ones until I find the right one because if I stop myself, then all I can think is, for example "bed..no, not bed...BED...NO....b...b...no, it's still not bed!"
Moments of this are a daily normal, but frequency increases with fatigue. My undiagnosed, probably-bendy Dad was the same when tired. "Do you want a banana, because I'm putting the kettle on." was considered perfectly normal tired-Dad-speak. (banana = tea, in case you were wondering.)
2. Reduced ability to form sentences:
Instead I fire off key words in no particular order, in the hope that my meaning will become clear.
"Could you fetch my red bag from the hallway"
"Bag. Red. Hall. Bring?"
Attempts to turn it into a sentence results in silence - as if the concentration required to think of the proper phrase steals the concentration required to actually say the words.
At this point I will usually stop talking and use gestures, cards or written words. Interestingly I can sometimes still write sentences even though I can't speak them.
At this point I am what friends, family and work colleagues term 'Drunk'. (Due to fatigue, not alcohol or illegal drugs!). The finely tuned coordination that speech uses simply doesn't happen - my words can become indistinct, or certain letter combinations too tricky to manage.
When it is mild I might be able to concentrate hard, put more effort in and mask the difficulty - making me sound temporarily posh and slightly stilted - and when I stop concentrating it reverts to..well...drunk!
All of these worsen with fatigue - and are some of my warning signals that I need to pace: change activity or rest, depending on the situation.
I can't give you in-depth medical reasons for all of these, although I suspect that the laxity EDS causes, and the temporarily reduced blood flow to the brain due to POTS both play a part in the fatigue-related symptoms I experience.
If you experience the same, you are not alone!
And if you don't...please accept that sometimes speech isn't a practical option for me, so conversations may need to be delayed, or my part carried out via written words.
(Note: keyring cards available from stickmancommunications.co.uk )