- Lewis Bartelle
- Mar 22
Updated: Apr 2
Your Complete Guide to Dysarthria Communication
Hey friends, Lewis here.
I want to talk about something that sits at the very core of what makes us human — the simple, profound need to be understood.
When my stroke hit, my mind was initially locked on the big visible challenges. Learning to walk again. Figuring out how to get through a day. Nine months in inpatient rehab, working my way from a pink gait belt and a walker with arm stilts back to something resembling the life I knew. Those were the battles everyone could see.
But as I started to find my footing, something else became impossible to ignore. Something that did not show up on a scan or a progress chart but affected the very core of who I was.
The way I spoke had completely changed.
Words that once came effortlessly — rapid fire, full of jokes and stories — now came out slow, slurred, and sometimes strained. Simple sentences required effort I had never had to think about before. And this new reality had a name I had to learn to say out loud.
Dysarthria.
I know firsthand how isolating this feels. The frustration of having a completely clear thought in your mind and an unclear sound coming out of your mouth is a specific, relentless kind of hard. But I want you to hear this clearly: you are not alone in it. And communication with dysarthria is a two-way street — which means there are real, practical things both speakers and listeners can do to make it work better. That is what this article is about.
My Speech, My Story — Understanding the Challenge
When my doctors first explained dysarthria to me it felt like a heavy clinical term, but the reality underneath it is actually straightforward. Dysarthria is a motor speech disorder. The damage from my stroke affected the part of my nervous system that controls the muscles I use to speak — my tongue, lips, jaw, and breathing. The control panel for producing clear speech got damaged. That is it.
This does not mean I forgot my words or lost the ability to form sentences. The thoughts are there. The intelligence is there. The personality — trust me — is still very much there.
But here is something I want to add that the clinical definition leaves out, because it is important and it is real. For me personally, sometimes thoughts and words get mixed up on the way out. I will mumble out something and then realize it made no sense — and half the time it was hidden behind the slurring anyway so people probably did not even catch it. That disconnect between what I meant to say and what actually came out is its own layer of frustration on top of everything else.
The signs look different for everyone but for me the main ones were:
Slow, slurred words. I often felt like my mouth simply could not move fast enough to keep up with my thoughts. Like a car with a powerful engine and a transmission that would not cooperate.
Breathy, raspy voice and volume control issues. My voice would come out strained and hard to project. I have had more people than I can count assume I was yelling when I was genuinely just trying to speak loud enough to be heard across a table.
Here is something that helped me when I first got this diagnosis: between 30 and 40 percent of stroke survivors experience ranging dysarthria symptoms at some point. That is a significant number of people navigating this same daily challenge. Knowing that did not make it easier exactly — but it reminded me that what I was going through, while deeply personal, was not something I had to figure out alone.
If the emotional weight of living with an invisible symptom like this is something you are carrying right now, go read my article on The Iceberg of Recovery — The Unseen 80%. It covers everything that lives below the surface that the world does not see, including the daily invisible fights that dysarthria is a part of.
The Social Struggle — Assumptions and the Silent Nod
Here is the honest truth about the hardest part of living with dysarthria. It is called the "silent nod".
You know exactly what I am talking about. That moment when you are speaking and the person across from you smiles and nods along as if they understood every word, when it is completely clear they did not. They do not want to make you feel uncomfortable. They do not want to slow things down. So they nod. And the real meaning of what you were trying to say disappears entirely.
I have been through the drive-through more times than I can count and had them guess my order rather than ask me to repeat it — and gotten it completely wrong. That is a small thing in the grand scheme. But small things add up. And each one is a quiet reminder that the world tends to prioritize speed and comfort over genuine understanding.
Here is what I want the silent nodders of the world to know: asking me to repeat myself is not rude. It is respect. It tells me my words matter enough to actually hear. That is all I am asking for.
The Communication Toolkit — Both Sides of the Conversation
Communication with dysarthria works best when both the speaker and the listener show up with intention. Here is the practical toolkit for both sides:
For Me — The Speaker:
Pace myself deliberately.
This is the most important one. I consciously slow down and give my mouth time to catch up with my brain. A deliberate pause between phrases improves clarity more than almost anything else. It is tough when the conversation is moving fast or someone is waiting on me — but rushing always makes it worse. Slow is smooth and smooth is understood.
Use gestures — play a little charades.
I fully embrace body language. Hands, pointing, facial expressions — all of it adds context that my voice sometimes cannot carry alone. Do not be embarrassed by this. It works. Use it.
Manage breath and signal the pause.
Dysarthria affects breath control, and I constantly sound like I am running out of air mid-sentence. I have learned to make a clear physical signal — a hand gesture or a held finger — that says I am not finished, I am just catching my breath. That one habit alone has saved countless conversations from going sideways when someone jumped in thinking I was done.
Own the repeat.
I have learned to say clearly — let me say that again — when I can tell something did not land. No apology, no embarrassment. Just a calm reset. It is always better than letting an assumption take root and grow into a misunderstanding.
For You — The Listener
Patience is not optional — it is the whole game.
Create a calm environment for the conversation. Remove distractions where you can. Do not rush, do not interrupt, and please — do not finish our sentences for us. Even when you think you know where we are headed. Let us get there.
The 3 to 4 second rule.
This one is specific and it matters enormously. When a dysarthria speaker pauses to breathe, that pause looks like the end of a thought. It is not always. Give us a full three to four second count before you respond. That window — small as it sounds — is often the difference between a complete thought and a cut-off one. Rushing in breaks the focused speech pattern we are working incredibly hard to maintain.
Ask, do not pretend.
I promise — I would far rather you ask me to repeat something than nod along and miss the point entirely. A simple “can you say that again?” is one of the most respectful things you can offer someone with dysarthria. It says: what you are saying matters enough to actually hear.
Make eye contact and read the whole picture.
Eye contact lets you pick up on facial expressions and body language that carry meaning my voice sometimes cannot. I had a boss who used to quietly follow my lip movements during conversations — fully present, fully paying attention. That level of care made an enormous difference and I have never forgotten it. Be that person for someone.
Try other channels when needed.
If a conversation is genuinely not getting through, suggest a different mode without making it awkward. Notes app on the phone, pen and paper, a quick text follow-up — these are tools, not failures. They make it a practical challenge to solve together rather than an uncomfortable standoff.
Your Voice Is Still Yours
My journey with dysarthria has taught me something I want to leave you with today.
My voice is a gift. It sounds different than it used to. It requires more effort from me and more patience from the people around me. Some days it cooperates and some days it absolutely does not — and on those days I lean on every tool in this toolkit and remind myself that the thought behind the words is still completely intact.
What I went through with speech is one of the reasons I built "The Word" and the Army of Warriors program at BeyondtheShatter.com. Because dysarthria is one of the most isolating parts of stroke recovery, and survivors living with it deserve a dedicated space to be heard — literally and figuratively.
If you have a story worth telling, we will help you tell it. The program is completely free and your voice — however it sounds — belongs in it. Come find us.
And if you are carrying the full weight of stroke recovery and need the complete roadmap — from the emotional journey through the practical tools — Beyond Shattered is on Amazon and it was written for exactly where you are right now.
The silent nod stops here. You deserve to be understood.
— Lewis
- Lewis Bartelle
- Mar 21
Updated: May 2
Why Recovery Is an Inside Job
Hey friends, Lewis here.
When a stroke first hits, you rely completely on the outside world. Therapists, doctors, medication, equipment — all of it is vital, all of it matters, and none of it should ever be taken for granted. These people are the experts, the map-makers, and the safety net. For everything they gave me — including my life — I am grateful every single day.
But here is the hard-earned truth that took me time to fully accept, and that I now believe with everything I have:
The ultimate progress has to come from within.
Nobody can want your recovery more than you do. Nobody can do the internal work for you. The best therapist in the world cannot rewire your brain — only you can, through focused, deliberate, daily effort that you choose. Not because someone scheduled it. Because you decided.
Recovery is an inside job. And the mindset that drives it is what I call The Hustle.
What The Hustle Actually Means
The Hustle is not about grinding yourself into the ground or showing up to every session with something to prove to the room. It is about something deeper and more sustainable than that.
It is about total ownership.
Ownership means you are not a passenger in your own recovery. You are not simply showing up and waiting for progress to be delivered to you. You are the CEO of your care — the one person in the room with the most at stake, the most to gain, and the most responsibility for what happens next.
I did not always operate this way. In the early months — six weeks in a coma, nine months in inpatient rehab, learning to shuffle ten feet in a pink gait belt while my daughters waited at the end of the hall — I was focused on survival. And that was exactly right for that season.
But at some point the season changes. And when it does, you have a choice to make. Are you going to keep waiting for recovery to happen to you? Or are you going to go get it?
Here is what total ownership actually looks like in practice:
Be the CEO of your care. Know your goals. Track your own progress. Ask your therapy team the hard questions — not just how did I do, but what should I be doing between now and next session to make the most of this? You are not just a patient receiving treatment. You are an active participant directing your own recovery. Nobody has more skin in this game than you do.
Practice on the off days. This is critical. Real gains do not only happen in the therapy room — they happen in between, in the quiet unseen moments when nobody is watching and you choose to do the work anyway. If your goal is hand mobility, pick up the TV remote with your affected hand. Wipe the counter. Reach for the glass yourself. Neuroplasticity does not have office hours.
Consistency is the currency of recovery and you are the one who decides how much to spend. I write about the full self-care and exercise approach in Beyond Shattered — including the bodyweight routines I used to shed 70 pounds and rebuild my strength from scratch. It is all in there if you want the complete picture.
Find your Why. Not the surface answer — the real one underneath it.
Not I want to get better, but the specific, deeply personal reason that makes getting better matter. For me it was getting back behind the wheel. Visiting survivors in that hospital as someone who had walked the whole path. Building something that could help the next person who wakes up in that bed with no roadmap. Write your Why down. Put it somewhere you will see it on your worst days. That Why is the engine — the thing that keeps the motor running when willpower alone runs dry.
Embrace the Fall — The Power of Failure
Now I want to talk about something that sounds completely backwards. Something that took me a while to make peace with and that I now consider one of the most important mindset shifts in all of recovery.
We have to learn to fail.
I know. You are exhausted by failing. You are tired of the gap between what you are trying to do and what your body will cooperate with. The last thing you want is someone telling you to lean into it.
But hear me out — because this reframe changes everything.
Think about a toddler learning to walk. They fall constantly. They wobble, they crash, they sit there looking confused, and then they get right back up and try again. Nobody calls it failing. We understand instinctively that the falling is the learning. Every crash is the brain and body figuring out something they will use on the very next attempt.
That is exactly what is happening when you fail in recovery. Failure is not an endpoint. It is feedback. It is the signal that you found the edge of your current capacity — which is precisely where growth lives. You cannot build a new road without first finding out where the old one ends.
Honestly? I want to see you fail. Because failure means you are pushing past comfortable. And comfortable is not where the progress is.
Here is what the real progression looks like — and I have lived every single step of it:
Try — and fail completely. You found the limit. Good. Now you know where to work.
Try again — and fail a little less. You adjusted. The brain took notes.
Try again — and stumble. You are almost there. Keep going.
Try again — and own it. Progress unlocked.
That chain — that persistent, stubborn, refuse-to-quit drive to be even slightly better than you were yesterday — that is what progress is actually made of. Not the big dramatic breakthroughs that make for a good story. The quiet, daily, cumulative result of choosing to try one more time when everything in you wants to stop.
Warriors and Gladiators — What Are Your True Colors
Every single person navigating stroke recovery is a Warrior. Let me say that clearly and mean it — just showing up for this journey, just getting out of bed and facing another day of this, is warrior-level courage. Do not let anyone tell you otherwise, and do not tell yourself otherwise on the hard days.
But Warriors have levels.
Think of it on a scale of one to ten. Every survivor starts at baseline — a Warrior simply by virtue of still being in the fight. But some Warriors decide at some point that they want more than survival. They want mastery. They want to look back at what tried to take them out and say — not only did I survive that, I came back stronger because of it.
That is where Warriors become Gladiators.
A Gladiator does not just endure the arena. They own it. They are not defined by the circumstances that brought them there — the stroke, the diagnosis, the limitations, the loss. They are defined by the ferocity of their comeback. A Gladiator takes full ownership of their effort. They practice on the off days. They ask the hard questions. They see failure as feedback and use it to go further. They never quit.
Moments of crisis reveal true colors — how people respond when things get genuinely hard, how much they actually have in them when the pressure is on. This journey has put real pressure on you. And the fact that you are still here, still trying, still reading this and looking for ways to move forward — that tells me something important about what you are made of.
The Gladiator is already in you. I know it because you are still in this fight.
So here is my invitation: step into the arena. Take total ownership of your recovery. Demand daily progress from yourself — not because anyone is watching, not because it is scheduled, but because you have decided that you are worth the fight.
And when you are ready to go beyond the articles and get the full roadmap — every strategy, every tool, every honest account of what this journey really requires — Beyond Shattered is waiting for you on Amazon. I wrote it for the person sitting exactly where you are right now.
Own the Hustle. The arena is yours.
If you want to stand alongside other survivors who are in it with you every day, come find us in the Beyond The Shatter community on Facebook. And if you have a story worth telling — which you absolutely do — the Army of Warriors program at BeyondtheShatter.com will give it a home. Free, always.
— Lewis
- Lewis Bartelle
- Mar 21
Updated: May 2
Shining a Light on the Unseen 80%
Hey everyone, Lewis here.
I want to talk about the part of stroke recovery that almost everyone misses — including, for a long time, me.
When I survived my stroke — the ruptured brain aneurysm that came out of nowhere on what was supposed to be a regular Sunday morning — I was grateful for every single person who showed up. The doctors, the nurses, the therapists who helped me learn to move again. They were heroes, every one of them.
The visible, outward reality of what a stroke does to a person got addressed immediately. People could see it. People could rally around it.
But here is the truth I learned quickly: the stroke event was only the beginning. And most people — even the ones who love you most — can only ever see a fraction of the battle you are fighting every single day.
That is why I want to share what became my defining metaphor for this entire journey. The one I built the foundation of Beyond Shattered around. The one that finally helped me explain to people what recovery actually looks like from the inside.
The iceberg.
The Tip Everyone Sees
Picture a massive iceberg floating in the ocean. The part everyone sees — the dramatic jagged peak above the waterline — that is the stroke event itself. The diagnosis. The emergency room. The coma. The paralysis. The wheelchair. The intensive early rehab where you are clearly, visibly working hard and people can clearly, visibly cheer you on.
That was the tip of my iceberg. I was in an induced coma for six weeks. I woke up not knowing where I was, what had happened, or what my body was anymore. My first physical therapy memory is a woman moving my legs up and down in what I later found out was basic range of motion work. I eventually graduated to a pink gait belt and a walker with arm stilts, shuffling ten agonizing feet at a time like a wobbly astronaut.
That part — the visible part — got all the support. Every card, every prayer, every “you’ve got this” meant the world to me. And I needed all of it.
But what nobody tells you is that roughly 80% of the iceberg — the part that actually shapes your daily life, year after year after year — is completely hidden beneath the surface.
It is the part you cannot see from shore. The part that does not come with a dramatic diagnosis or a visible reason to ask for help. The part that when you try to explain it, sometimes gets met with a look that says: but you seem fine.
That 80% is what I want to name today. Because here is what I have learned — you cannot own what you have not named.
What Lives Below the Surface
Let me walk you through what that underwater mass actually looks like for me personally. Some are the same but we each have our own list. If you are a survivor reading this, I want you to feel seen. If you are a caregiver or loved one, I want you to understand what your person is truly carrying every single day.
Post-Stroke Fatigue
This is not tired. This is a bone-deep, brain-exhausting drain that hits without warning and has no simple fix. I can have what looks like a normal conversation with you and simultaneously feel like I just ran a marathon. The cognitive effort required for things that used to be completely automatic — following a fast conversation, making a simple decision, reading a paragraph without losing my place — is enormous. And because survivors get good at masking it, people do not see it. But it is there. Every single day.
Double Vision, Depth Perception and Balance
I have gone through more than ten pairs of glasses over twelve-plus years. Double vision is not a minor inconvenience — it affects depth perception in ways that turn an ordinary sidewalk into a calculation, make every line of text want to drift off the page, and transform something as simple as stepping over a bag on the floor into a genuine physical challenge. Because my head moves when I walk, my vision moves with it. The world is never completely still. Most people around me will never know that — because I have gotten very good at managing it quietly.
Dysarthria and the Invisible Communication Load
My words are there. My thoughts are fully formed and completely clear. But the stroke damaged the part of my nervous system that controls the muscles I use to speak — and that means every single conversation requires an extraordinary amount of unseen effort. I need the environment calm. I need a listener who will not interrupt. Because when someone jumps in before I have finished, I do not just lose my place — I have to rebuild the entire thought from scratch. There is a whole hidden layer of brain activity behind every sentence I speak, and it costs far more than most people could imagine. I talk funny, as I like to say. But there is nothing funny about how hard the brain is working behind every word.
Inner Frustration That Gets Mistaken for Anger
When I snap, that frustration is aimed at me — at this situation, at the gap between who I was and what I can do right now. It is not aimed at you. But you hear it and take it personally, and suddenly I am managing your hurt feelings on top of my own. I want you to know: that outburst is not a character flaw. It is a human being processing a level of daily loss that most people are never asked to endure. Give us a moment. We always come back.
Identity Loss and the Grief of the New Normal
Before my stroke I was a gearhead. A builder. A store manager ranked in the top 100 audio installers in the nation. I had a career I was proud of and a life I built brick by agonizing brick. After the stroke, all of those identifiers got scrambled. The grief of that — the quiet, daily mourning of the person you used to be — is real and valid and heavy. Nobody hands you a pamphlet about this one. But it is one of the most significant things survivors carry, and learning to process it honestly is some of the most important work on this entire road.
This list is not complete — not by a long shot. Cognitive fog, sleep disruption, medication side effects, the social isolation of feeling like you cannot fully explain yourself — these all live below the surface too. The unseen 80% looks different for every survivor, but the experience of carrying it largely alone is something almost all of us share. You are not imagining it. And you are not alone in it.
Why Naming It Is the Most Powerful Thing You Can Do
Here is the thing about an iceberg: the part below the surface does not become less real just because people cannot see it. It is still massive. It is still powerful. And it is still shaping everything about how you move through the water.
For a long time I let that 80% be a source of shame. Something I worked to hide, to minimize, to apologize for. I performed “fine” so well that the people closest to me did not know how to help — because they had no idea what they were actually looking at.
The day I started naming it out loud — the fatigue, the vision, the dysarthria, the grief — was the day recovery stopped feeling like something happening to me and started feeling like something I was actively navigating.
Naming it is not complaining. It is not weakness. It is not asking for pity.
Naming it is the first act of ownership.
It tells your brain, your support system, and the world: I see this clearly. I understand what I am dealing with. And I am choosing to move through it anyway.
I go deep on all of this in Beyond Shattered — the full breakdown of what the recovery landscape actually looks like and how to start rebuilding it piece by piece. If you are early in this journey and need a complete roadmap, that book was built for exactly this moment. You can grab your copy on Amazon.
The Iceberg Is Not Your Ceiling — It Is Your Foundation
I want to close with this, and I mean it completely.
That 80% below the surface — the part nobody sees, the part that makes every single day a quiet act of endurance — it is not your limitation. It is your foundation.
Every survivor who is managing the unseen 80% while still getting out of bed, still showing up to therapy, still trying to speak clearly and walk straight and live a meaningful life — is operating at a level of resilience that most people will never be required to find. God put something in you that is tougher than what tried to take you out. I have seen it in myself over thirteen-plus years, and I see it in the survivors I sit with through the Army of Warriors program every single day.
You have been forged by something that would have broken a lot of people. The fatigue, the frustration, the invisible symptoms — they did not stop you. They shaped you into someone who knows exactly how strong they are because they had to find out the hard way. And that knowledge? Nobody can take it from you.
The goal was never to get back to who you were before the stroke.
The goal is to discover who you are capable of becoming because of everything that came after.
And I promise you — that person is worth knowing.
If you want to share your story and let other survivors see that it is possible — come join the Army of Warriors at BeyondtheShatter.com. It is completely free, and your story deserves to be heard. And if you just need a place where people truly get it, come find us in the Beyond The Shatter community on Facebook. You should not be carrying this alone.
Keep going. Name what is beneath the surface. Own your whole iceberg — all of it.
— Lewis
If this resonated with you, Beyond Shattered — available on Amazon — is the complete guide to rebuilding your life piece by piece. Every chapter was written for the survivor who had no roadmap. Come get yours.
