2020 Ep. 13 Covid-19 Masks

Dale Johnson: Exercising proper social distancing, or as I prefer to call it physical distancing, because we all need a little bit of socialization. That’s why I have Dr. Sandra Miller on the phone with me today to do some socialization about Complete Hearing. complete-hearing.com is the place to go for a lot of information, much, much more than we will be able to talk with you about today, good listeners. Dr. Miller, thank you very much.

Dr. Sandra Miller Au.D.: Good morning. Still joining you from the phone with some good physical distancing still happening.

Dale Johnson: And thank you for doing that. I don’t know if listeners can can detect a difference in the way I sound over the radio, because what I’m wearing right now is what the mayor wants you to wear, and what the governor would like you to wear, if you do not have a mask. And I’m wearing a cloth, it’s just a handkerchief, over my mouth and I’ve doubled it up just a little bit to make sure it’s even more effective. This is what I would wear out in the public. The mayor says it’s okay to do. The governor says it’s okay to do, but this is an audiology show. This is a conversation about helping people hear better. And this sounds muffled to me, Dr. Miller, how does it sound to you on the phone?

Dr. Sandra Miller Au.D.: Well, I think what I definitely noticed is that I can still hear you, but I can’t hear you very clearly. It sounds kind of muted or muffled because you’re covering up your face. So I think it’s really important today, we do talk about that we have a great leadership happening in our city and in our state in terms of what’s happening to help us flatten the curve with COVID-19, but the use of masks brings a challenge, not only for those people who have hearing loss, but those people who don’t. So I thought it’d be really important today that we do talk about when we use masks, what are the things we need to consider? And so when you use a mask, it acts kind of like a low pass filter. And if you think of the word low pass, that means low frequencies are being able to be heard. That’s why I can still hear you.

Dr. Sandra Miller Au.D.: But the high frequencies are attenuated. That means they’re kind of muffled or turned down. So when somebody wears a mask, you’re hearing them but you’re not hearing them clearly. So what happens is the frequencies from about two to 7,000 hertz are just attenuated, and it can be anywhere from three decibels with more of a cloth mask, all the way up to 12 decibels with one of the more, the N95 masks that most of our healthcare providers are wearing that are on the front lines treating our patients with COVID, and those in the hospitals and the nurses and the doctors. So just to be aware of that, I think it’s important to me we talk about what does that mean.

Dale Johnson:
To what degree… I’ve taken the mask off. To what degree is there is some adjustability in hearing devices?

Dr. Sandra Miller Au.D.: So what I would say most importantly with this is, the number one factor I want you to take away is that we covered up our face, and we’ve talked so much about in the past that we get so much information from visual cues and reading people’s lips, so that we’ve taken that away. So not only is the sound decreased, the clarity is decreased, but now you don’t get any visual cues. And so there’s a double, triple whammy here where people are going to have a harder time. And so I think that’s important. Now if people were to turn their hearing AIDS up, it would be helpful. But we’re still taking away that visual cue as well.

Dale Johnson: So if someone does come to you, a patient with a hearing device, what is your first, either series of questions, or course of action? How do you help someone with a device make an adjustment to the times in which we live?

Dr. Sandra Miller Au.D.: I think the most important thing we’ve been telling our patients for sure is, if you’re, wear the mask as it is recommended. And so it’s important that we keep ourselves healthy, number one. Hearing can obviously be the secondary thing, but we want to make sure that people are staying healthy. So if the use of masks are happening, we want them to remember three things. The first thing is just to make sure that we try to get into a more of a quieter environment, because when we’re talking through a mask, the sound is compromised and our visual portion is compromised as well. So if you can get into a quieter space with whoever you’re communicating with, that would be best. If you want to turn your device up or ask the person to speak louder.

Dr. Sandra Miller Au.D.: I had a patient in yesterday for… We are seeing emergency appointments in the office, and I’m gloved up, masked up, patient had her mask on, and pretty soon we were looking at each other and having a hard time communicating. And it was just the two of us in the office. And so I found myself slowing down. I found myself speaking louder to compensate for what she was not hearing, and we just want to make sure that it was quiet, speaking slowly, speaking more loudly. So you have to start using some really good communications strategies. Not only if you can increase the volume, but think about how you can communicate more effectively.

Dale Johnson: Dr. Sandra Miller from Complete Hearing on The Conversation Starts Here. We’re here every Saturday morning on KFOR. How about the six foot distance that is recommended by health experts? Is that becoming a problem, a challenge for people with hearing devices?

Dr. Sandra Miller Au.D.: Well, I think we’ve always talked about, to have effective communication, you want to make sure you can see the person and that the volume is going to be adequate. And so it does put a little bit of hamperence on maybe what may be happening in terms of the conversation. My favorite thing now is that people are abiding by this social distancing and they’re getting in… I saw a group of four sitting in a Target parking lot yesterday and they were parked in a square, but they were in their cars and they must’ve been friends, but they were at least sitting there having a conversation. Now do you have to compensate for the distance?

Dr. Sandra Miller Au.D.: Well, absolutely. You need to talk louder for sure. I think I can put it, you just have to keep those conversational, maybe, strategies in mind and so again, I would just say speaking more slowly, more articulate, louder, making sure that you’re patient. I would tell you this is a time when I think we are all very challenged. We’re out and about and it can be a very stressful time for a lot of people as well. So we ask for a lot of patience and a lot of grace when you’re working with… Whether you’re at the grocery store, you’re working with something where you’re having to work with one-on-one with someone, relationally, I think this can be straining, especially when people are frustrated by the fact that they can’t communicate effectively.

Dale Johnson: From someone who talks for a living, I’d like to make this suggestion, too, and that is to talk in shorter durations.

Dr. Sandra Miller Au.D.: Love that.

Dale Johnson: Does that make sense?

Dr. Sandra Miller Au.D.: Absolutely. We talk about making the information more succinct, and if people don’t hear you, rephrasing it and simplifying it. So we do that every day here in our office just because there are times when it is more of a hearing loss issue, which we now are creating a little bit of when we’re talking through these masks where the sound is not as loud, but I think that’s such a great recommendation.

Dale Johnson: Especially when I’m in the presence of older people, and it’s not an attention span thing.

Dr. Sandra Miller Au.D.: I think what’s very interesting, if you were to look at the trends in hearing loss, so if you look at a graph from young to old, and what the prevalence of hearing loss is, and then you would compare that to maybe a mortality rate of COVID-19. They look kind of similar because we know that the elderly population is more susceptible, and people with diseases are more susceptible to COVID-19. So I think it’s really important that we think about, when these people are going into the hospital, and they’re already compromised communication wise because they don’t hear as well potentially as they could, they maybe wear hearing AIDS and now you throw a mask on and you put a bunch of foreign sounds around them, beeps and people talking.

Dr. Sandra Miller Au.D.: And we know hospitals are not a quiet place, for sure, because there’s lots of commotion going on. That can be very challenging for them. So we have to keep in mind that that piece is so important. And I am even thinking about, to our patients who maybe be now in assisted living facilities, nursing homes, and they become very, very isolated because they’re not allowed to have people in now. So imagine how hard that is to not have communication and then to have limited communication.

Dale Johnson: More communication is taking place on Zoom, on the internet these days. Does that present a hearing challenge for people with devices?

Dr. Sandra Miller Au.D.: I love that question, because that’s all I feel like I do now is have meetings on Zoom, and I’m sure you’re feeling exactly the same way. I would tell you, and we are doing telehealth and we’ll talk about that maybe next week in terms of what that means and what telehealth looks like. I think it can be more challenging because it’s not that person in that room, but the nice thing about just even having hearing aids is it’s like watching television. We can turn the volume up. We can at least see that person’s face, and take advantage of, “I can now turn my hearing aids up and I can see the visual of that person talking, so I can see their lips moving,” things like that. So it keeps us safe, but it also allows us a way to still connect. So I’m so grateful we live in a age of technology where this is possible. Imagine if we hadn’t had this ability, we would really feel isolated.

Dale Johnson: Yeah, I’m grateful that we have the internet to be able to communicate this way in these times of self isolation. Few times that I have Zoomed, Dr. Miller, there was an electronic sound to it. It’s only as good as the speakers on your computer or the bandwidth strength of your internet. And I’m always curious about the adjustments that can be made by people who have hearing devices. Does an electronic sound cause any issues for people with devices?

Dr. Sandra Miller Au.D.: I think it’s a really good point. I guess I’m going to tell you, I take so much of this for granted because my husband is in IT. So I always have a great signal and a great stream, so I’m not the one to say. I really am grateful for that. What I would tell you is a lot of times, you’re absolutely right, is that if you don’t have a good signal coming through the speakers themselves, can the hearing aid compensate for that? Not necessarily, depending on what’s happening, so if there’s a lot of static or background noise that’s going to cause some interference.

Dr. Sandra Miller Au.D.: My goal for people who are doing any type of streaming in terms of Zoom or FaceTime is that we do have a good signal coming through the speakers. And so that’s a really good point that maybe people aren’t thinking of because not everybody has the ability to have some of the technology that some people do have in terms of how fast it processes the information or how clearly it comes out of the speaker, because you’re very in tune to what it sounds like as well as I am and sometimes people don’t know the possibilities or the availability that they would have to have a better solution for that.

Dale Johnson: People are different when they are at home, by themselves, or when they’re home for a long period of time. We dress differently, our behaviors are differently, and I’m wondering now that the emphasis has even been heightened more to stay home and stay healthy, if maybe people wouldn’t be wearing their devices as often. And what’s your recommendation about that?

Dr. Sandra Miller Au.D.: Absolutely. This is one thing that we do counsel our patients from the very beginning, is to make sure that you put these on every single day, regardless of what’s happening. There are sounds in your house every day that you need to hear, and if you take them off now and as soon as you put them back on to go out and do an errand, go to the grocery store, go see the doctor, you’re going to pick up a lot more noise than you’re used to because the brain has not been adapting daily. Your brain is what hears and it needs to be exercised every single day. So do not stop wearing your devices if you have them. It’s really important that you put them on every single day.

Dale Johnson: Dr. Sandra Miller is here every Saturday morning on KFOR for The Conversation Starts Here. I highly recommend that you go to complete-hearing.com, and Dr. Miller, thank you for continuing the conversation via physical distancing. Appreciate that.

Dr. Sandra Miller Au.D.: Thanks, Dale. We’ll talk to you next week.