Transcription:
Audiology & speech Telemedicine services during COVID-19

Melanie Cole (Host):  This is the Weill Cornell Podcast on COVID-19 dated April 17, 2020.

Welcome to Back to Health, your source for the latest in health, wellness, and medical care. Keeping you informed so you can make informed healthcare choices for yourself and your whole family. Back to Health features conversations about trending health topics and medical breakthroughs from our team of world-renowned physicians at Weill Cornell Medicine. I’m Melanie Cole and today, we’re addressing the issues relevant to living with hearing loss during COVID-19. Joining me is Dr. Joseph Montano. He’s a Professor of Audiology and the Chief of Audiology and Speech Language Pathology at Weill Cornell Medicine. Dr. Montano, it’s a pleasure to have you join us today. What have you heard from your patients about audiological and speech services they might require during quarantine?

Joseph Montano, Ed.D. (Guest):  Well it’s very interesting people with hearing loss live with this on a daily basis and it’s part of their lives. And even though they may be required to stay at home or practice social distancing; they still live with their hearing loss and their concerns are still the same. So, they want to make sure that they are hearing the best that they can in all situations. They want to be able to make sure that their hearing aids are functioning and know that there are services available for them should any problems arise.

Host:  Such an interesting topic that we’ve got today Dr. Montano. What are some of the challenges for people with hearing loss during something like this? What might they experience during this pandemic and during quarantine?

Dr. Montano:  Well everybody, I think is on edge. A person with hearing loss is experiencing the same kind of mental health issues that we all are. It’s here, New York, it’s allergy season and people are beginning to sneeze and every time they sneeze, they become stressed and anxious thinking oh my gosh, what is this? Am I getting sick? So, they have the same mental health kinds of problems that everyone else does.

What differs is if they do indeed get sick, they have to go into a healthcare system with a hearing loss and may have difficulty communicating with their healthcare providers. And that is a cause of additional anxiety for many people with hearing loss.

Host:  Well it certainly is, and I’ve seen some COVID-19 news reports that don’t seem to be deaf accessible. What should be the protocol Doctor? What would be ideal for those whom hearing loss is prevalent and affects their ability to ingest this breaking news that’s coming at us all the time?

Dr. Montano:  So, it’s kind of interesting when you look at that. So, here in New York, we’ve had Governor Cuomo who has done daily briefings and all of his briefings have had an American Sign Language interpreter which has been great for people who are deaf and people who use American Sign Language. And all of the health information should be available for people who use sign language. The greatest percentage of the people with hearing loss, however, do not sign and require the use of captioning so they can read what is being presented on the television. So, most of these shows do have captioning that is available for people and they have accessibility on their television sets when they watch those kinds of programs.

The problem of course is when they go into a medical type situation. Some difficulties that people could have are let’s just take a patient of mine who explained this situation to me recently. She said that she had been in New Orleans and she felt sick and she started developing COVID symptoms and she needed to go to the emergency room. She was terrified. She was terrified for a number of reasons. First, if she was going to go into an emergency room during this pandemic and all of the physicians and the nurses and everyone are wearing face masks. What that immediately does for somebody with hearing loss it removes the visual cues that are so important for them in communication. So, you take away those visual cues.

The next thing that happens is that there’s distancing. So, not only do we have patients speaking to healthcare providers but frequently they are at a further distance than what is normal because of social distancing. And that makes it even more difficult for them because they get neither the visual cues and they also have difficulty hearing the auditory cues because they are muffled by the mask or they are further away. So, those kinds of things are very stressful for people with hearing loss.

Host:  Well thank you for telling us some of the difficulties a person with hearing loss might experience when they go to see a healthcare provider if they do have to. Are there resources for people with hearing loss within the community where they can obtain information about coping and communication strategies as you just discussed during this difficult time?

Dr. Montano:  Yeah well actually there are. And there are some wonderful resources available. We, here at Weill Cornell just actually sponsored a Town Hall meeting with members of the Hearing Loss Association of America, HLAA. The Hearing Loss Association of America is a group of people all with hearing loss who provide resources online and frequently local chapters throughout the country for people with hearing loss. So, what we did was I go together a group of professionals. We had an audiologist, a mental health counselor, and a person who has lived with COVID as a hearing impaired individual and we had a Town Hall meeting. I moderated the session. We had a number of people who participated using Zoom and it was amazingly popular. It was great. We had a lot of fun and people got a lot of information and I think it just embraced us with the community to let them know that we were there for them and here’s some ideas that you can have should you face some of these issues at home.

So, having the individual with hearing loss who experienced going to the emergency room I think was really, really helpful and it really put a real life person involved in the whole situation. So, it was quite successful. We do a lot with the Hearing Loss Association of America. It’s a very good group and if people needed to resource that it’s www.hearingloss.org, they can go visit their website and here even at Cornell, we advocate for that group and we speak frequently at their meetings.

Host:  It is so interesting to me Dr. Montano how this pandemic is encouraging healthcare systems to be creative and innovative as you just said in their ability to deliver essential non-COVID care such as those experienced with people with hearing loss. Tell us a little bit about some of the things besides this Town Hall, because that’s fascinating and really innovative using Zoom. What else are you doing that you’re really having to think outside the box to do?

Dr. Montano:  It’s interesting that you can find a positive swing when you think of COVID. Hard to find positive things. But one of the things that has happened as a result is that we’ve gotten to use Telemedicine. And I’ve been an advocate for Telemedicine for a very long time. And we were forced into it because of COVID. And we’re finding great success. Out speech program has just taken off. So many of our patients require speech therapy, children with language issues, professional voice singers, and speakers and we’re able to provide those services using Telemedicine. And the reaction has been so positive.

First of all, the speech language pathologists are so excited about being able to provide these services. The families are so thankful and grateful. In fact, I think many of them are preferring the Telemedicine practice over coming in to the office and having to see somebody live. A lot of our kids who come for speech and language they have very busy schedules at home, and they come after school and there’s homework and there’s so many things to be able to not have to take their child out from their home, bring them in for therapy to meet with the speech pathologist has really been fantastic. So, the fact that we were forced into providing these services has really been a positive outcome of this crazy pandemic.

In audiology, where a lot of what we do is technological where we do hearing tests and we have people in booths, some of the things we are unable to do. But what we have found is managing people’s hearing aids has really been surprisingly positive when we looked at Telemedicine. So, we have had video visits with our patients when they have had problems with their hearing aids or problems with their apps that control their hearing aids. We’ve worked it through with them and probably one of the most innovative things that we’re about to do is we’re going to actually have a group therapy session for people with hearing loss. We’re going to have audiologists meet with people with hearing loss and their partners and talk about communication strategies and help them work out the issues that they’re having as a result of their hearing loss.

Host:  How cool is that? So, tell us more about the virtual hearing health communication group and how participation in this group provides an opportunity to obtain support from others with hearing loss, and their communication partners while working closely with Weill Cornell Medicine Clinical Audiologists.

Dr. Montano:  So, running a group like that, it’s referred to as oral rehabilitation. So, we’re trying to maximize what people can do with the hearing that they have and with their aided hearing. What happens with hearing loss, is it’s such a difficult kind of problem for people to have because obviously, people don’t even know that you have a hearing loss. And there are many, many things that need to be done in order for you to effectively communicate. For instance, just putting a hearing aid on, well it does help a lot, but unless you use lip reading cues, make sure that your communication partners speak properly, know what is a good communication environment, know what a poor communication environment is, things that you need to use when you are in a restaurant when there’s a lot of noise. There’s so many other aspects to hearing that we don’t even think about it.

Most of us think, oh you have a hearing loss, you wear a hearing aid, everything is fine. But the reality is, you have a hearing loss, and you get hearing aids, or you get cochlear implants or whatever kind of technology you need; then you have to learn how to use them effectively. And that’s part of the reason for a group like this. We’ve run oral rehab groups for years. And our patients love them because they gain such insight and we always invite family members to participate when we run these groups because it’s never just a hearing loss. What it is, it’s a communication loss. Hearing loss doesn’t just affect the person. It affects the people around them and the people in their lives. So, a group like this is really beneficial for everyone involved.

Host:  Well it certainly is. What an interesting thing. So, before we wrap up, please give us your best advice. Talk about some of those topics. Talk about – kind of give us a good summary of this segment and really what you want listeners to know about the services that you have at Weill Cornell Medicine and the innovative creative way that you are using Telemedicine and reaching out to those who have hearing loss.

Dr. Montano:  I will say that I am thrilled as a department that we have been able to maintain contact with our patients, that we’ve been able to maintain therapeutic interventions with our speech program, that we are continuing to communicate with our hearing aid patients and our cochlear implant patients. One of the other amazing things that has happened is that in the hospital, we have births every day and part of the program that we offer is we screen the hearing of every newborn baby. And before they’re discharged, they’ve had a hearing test. And sometimes, babies don’t pass that hearing test for many, many reasons and so we call that a referral. Well if a baby refers and a mom or a dad hears that their baby didn’t pass their hearing screening; that’s an immediate source of frustration and stress. So, we have started a video visit right away when the mom and dad go home with the baby, we schedule the video visit, we assure them that we’ll be able to evaluate the baby and make sure that everything is good and we’ve even had some people come in and we’ve done some rescreening’s and have begun programming for kids if a hearing loss does indeed exist. It doesn’t always exist.

Sometimes it’s just a false positive. But the idea that we’re reaching out to these babies, to our parents, to the kids who’ve got articulation errors, to our singers who’ve got voice problems. The fact that we can still do this even in these trying times is pretty phenomenal for me. I’m so proud of the staff that we have here at Cornell. I have really seen them rise to the occasion and provide the same quality services that we always have provided in the past, now just being a little bit more innovative and creative and still getting fantastic outcomes.

Host:  Wow. What a great topic. Dr. Montano, and you are such an excellent guest. Thank you so much for coming on and sharing your passion because I can hear the passion in your voice when you talk about your profession.

Dr. Montano:  Thanks Melanie. I do love it.

Host:  It’s obvious. You can tell and thank you so much for coming on and sharing your expertise with us today. For information about COVID-19 including symptoms, prevention and travel advise, please visit www.weillcornell.org/coronavirus. Or you can call our hotline at 646-697-4000. Thank you for joining us today. This concludes today’s episode of Back to Health. We’d like to thank our listeners and invite our audience to download, subscribe, rate and review Back to Health on Apple Podcasts, Spotify and Google Play Music. For more health tips go to www.weillnornell.org and search podcasts. And parents, don’t forget to check out Kids Health Cast. I’m Melanie Cole.