Deaf Health Talks

A monthly livestream series in American Sign Language, for D/deaf communities

Deaf Health Talks: A Partners in Deaf Health, Michigan Medicine, and Michigan Deaf Health Collaboration

Deaf Health Talks are regular, virtual live stream health education monthly events for Deaf signers, with available closed captions for non-signers. These presentations, covering current health topics, are given mainly by different Deaf health experts' education forums in American Sign Language to generate an accessible health education platform for Deaf and hard of hearing community members. These presentations are free and open to the public and provide opportunities for community members to ask questions in an interactive question-and-answer forum. The Deaf Health Talks can include live demonstrations on cooking, exercise, and good health practices, that can help you take control of your health right from your home. Viewers also get access to opportunities to contribute to health research studies and connect to community health resources. The series is hosted by a partnership between the MDisability Program and Partners in Deaf Health.


Create an accessible online health education platform for Deaf community members.


The organizations involved in the planning of these talks are the University of Michigan Family Medicine Department and Partners in Deaf Health.


The Deaf Health Talks bring in health experts from all over the country to speak on pertinent Deaf health topics. We have doctors, nurses, dentists, medical students and residents, social workers, and more! If you are interested in signing up to be a potential presenter or would like to recommend someone who may be interested in presenting please contact Michael McKee, M.D.


Each talk has certified interpreters to accommodate non-signing members of the Deaf or hard of hearing community. Live captioning is provided through CART services. Captioning size can be adjusted on Zoom to accommodate Deaf-blind individuals. Any questions, suggestions, or comments to improve the accessibility of the Deaf Health Talks, please email Michael McKee, M.D.

To find out about the next Deaf Health Talk, follow us on the University of Michigan Department of Family Medicine Facebook page, on Instagram @deafhealthtalks and subscribe to email alerts through our listserv.

Frequently Asked Questions (FAQs)

How do I attend the Deaf Health Talks each month?

You can register to receive a Zoom link which is posted for each upcoming Deaf Health Talk each month on Instagram and Facebook, and sent to our email listserv.

Do I have to pay money or sign up to watch the talk?

No, the Deaf Health Talks are presented free of charge each month and can be accessed with a Zoom link. Visit us on our Instagram, and Facebook pages, and join our email list for up-to-date communications.

Are these talks only once a month?

Yes. Right now, the talks occur once a month, every month on the fourth Thursday at 8 pm ET. We have different topics and presenters throughout the year. Visit us on our Instagram, and Facebook pages, and join our email list for up-to-date communications.

How long have the Deaf Health Talks been going on?

Deaf family physician Michael McKee, MD, MPH, and colleagues start the Deaf Health talks in 2008 at the University of Rochester. Starting in 2018, Dr. McKee, Associate Professor of Family Medicine at the University of Michigan, resumed work on the Deaf Health Talks, hosting in-person events at the Deaf Health Clinic at the Dexter Health Center in Dexter, Michigan. After the start of the COVID-19 pandemic, Dr. McKee and other DHT contributors transitioned the in-person talk format to socially-distanced online, live events. 

How can I support this program?

Please visit our community fund page to help us keep this program as an accessible platform with health information for Deaf/Hard of Hearing individuals. 

How do I contact your team?

Please contact [email protected] for any suggestions, comments, questions, or other inquiries. 


Past Deaf Health Talks

Deaf family physician and Associate Professor of Family Medicine, Dr. Michael McKee and Nurse Stacy Woods led a discussion on how you can protect yourself from sunburn, sun stroke, and other health concerns during the warm summer months.

Deaf Health Talks, provided in ASL, with Q&A. Happening Tuesday, June 22, 8 to 9 PM EST, on Facebook Live and Zoom. Healthy Smiles: A Discussion on Oral Health, with Joe Samona, DDS from University of Texas Health Center at San Antonio, Christopher Lehfel

A free Facebook Live discussion and Q&A with Deaf dentists in American Sign Language, hosted by the MDisability Program, at the University of Michigan Department of Family Medicine, in partnership with Partners in Deaf Health and Michigan Deaf Health.
Invited Speakers: Joe Samona, DDS from University of Texas Health Center at San Antonio, Christopher Lehfeldt, DDS from Finger Lakes Community Health & Elmwood Dental Group in Rochester, and Michael Korleski from the University of Michigan School of Dentistry will join moderator Samantha Ratakonda.

Download the event's resource document

Download the audio transcript (PDF)

Read the Transcript

>> SAMANTHA RATAKONDA: Hi, everyone.

Welcome to the June Deaf Health Talk. My name is Samantha Ratakonda. I work as clinical research coordinator at MDisability and Family Medicine Department at the University of Michigan.

And I'll be beginning medical school in the fall. Our moderator, Sarah, could not join us today, so I will be filling in.

I identify as hard-of-hearing but will be speaking today. Before I introduce our guests, let me tell you a little bit about the Deaf health talks.

The talks are held virtually each month and are a source for community health education for the Deaf and hard-of-hearing members.

Deaf Health Talks is hosted on Facebook Live and Zoom with accommodations.

Each month, we cover many different health topics. So, if you are interested in knowing what is going on, please sign up for the mailing list.

Over the next hour, the team will be posting links in the comments, such as the resource guides, research study on pregnancy, and newsletter sign-up.

Please feel free to put your questions in the comments or chats at any time.

Now, thank you for joining us. I hope you are excited. And I want to introduce our presenters tonight and our experts on oral health.

Joe Samona from University of Texas Health Center, San Antonio. Chris Lehfeldt from Amwood Community Groups.

And Michael Korleski from University of Michigan School of Dentistry. We are so glad to have them join us today and share their knowledge and answer your questions.

I'm going to ask each of them now to briefly introduce themselves. And we will start with Joe.

>> JOE SAMONA: Hi, everybody. My name is Dr. Joe Samona. I just graduated from the University of Michigan Dental School last year.

I grew up in the Detroit area. And I'm about to finish my residency in San Antonio, Texas. So, next month, actually, I'm moving back to Michigan.

>> SAMANTHA RATAKONDA: How about Chris?

>> CHRISTOPHER LEHFELDT: Hi. My name is Chris Lehfeldt. I'm in Rochester New York. I work at Elmwood Group, a practice within the Deaf community, full-time.

And then I also work with the community center about an hour outside of Rochester, New York. I graduated dental school a LONG time ago, 1987, from the University of Maryland.

And I've had a lot of practice now, 34 years, as a dentist.


>> MICHAEL KORLESKI: Hi, everybody. My name is Michael Korleski. I grew up in Delaware. I graduated from Gallaudet University. And then I transferred to the University of Michigan.

And so Joe and I actually were together just three years apart during school for a little bit. I'm now in my third year of school. And I'm working with my practicum with patients.

And I'm really excited to really be hands-on in terms of interacting with the dentistry and Deaf culture, and making sure that ASL is present with our patients and that way there's more benefits,

to be able to see ASL and Deaf Culture in the dentistry world. I'm very, very excited about the possibilities and where I'm going to go from here.

>> SAMANTHA RATAKONDA: Okay. Thank you for introducing yourselves and joining us today. We are going to have each of them give a little bit of --

share about their experiences, their knowledge, and we will hopefully learn a thing or two. Why don't we start with Chris.

share about their experiences, their knowledge, and we will hopefully learn a thing or two. Why don't we start with Chris.

>> CHRISTOPHER LEHFELDT: Sure. Okay, so if a new patient calls or texts to make an appointment with my office,

which is the first time that I'm meeting this Deaf client, communication is vital. That we have this face-to-face interaction. And really develop a good rapport.

That way, the two of us get to know each other well. And then we will be able to, you know, be on task with our business.

You know, sometimes people don't know what's going on in terms of their oral health. So, we really start very basic. We do questions a bit, to ask about their knowledge.

A lot of patients are really unaware of their oral health history or any exams they may have had.

So, during that first sit-down time, I usually dig into kind of a little bit of their past. I'll do some measurements. And I might show them a little bit about what I'm going to do.

I'll show them some of my instruments as well. My instruments are my tools. One of them is called a periodontal trope. And it's a very thin device that measures in millimeters.

There are these black lines going down the probe (CC correction -- probe not trope). So, if this is the tube and where my shirt is is the gum, I probe around the gum where it connects to the tooth.

I measure that the first time I see those patients. I use that probe to measure and I give those numbers. And then we put them in their file, which at this point it's just in the computer.

And then a lot of patients are curious, what are those measurements? So then I'll go into detail to say that prob will help me determine if there's any bleeding or if there's any abnormal things

going on in terms of the gum line or any issues I can notice. If you guys look in the chat, there's a picture. Are we able to share that picture right now?

>> SAMANTHA RATAKONDA: It has been shared.

>> CHRISTOPHER LEHFELDT: Okay, great. So, that first picture in that link... is we use a special dye. They'll swish this pink liquid around.

And what that does is, it leaves areas of their teeth pink. Patients often get very concerned about this discoloration so I'll explain to them

that what that does is, the pink coloring sticks to the plaque on their teeth. And I'll just say this is a normal everyday occurrence. Plaque gets on your teeth because of what you eat.

And the best way to address this is by brushing. But where they don't get with brushing and where they miss sometimes if they don't floss, it's stuck on their teeth.

It's really important when we have patients, that they get to see the importance of flossing as well as brushing.

You'll rarely see someone's teeth without any pink at all. But for whatever reason, you might see, again, in the third picture from that link that you guys sent, which is an inflamed gum,

you'll see that the gums are red and there's plaque buildup around there. And what happens in that area is that bacteria starts to grow.

And the fourth picture in that link you sent, you see all those interesting shapes. That's under a magnifying glass, right? We've taken an image and blown it up.

And you can see the bacteria living inside the biofilm -- or inside the plaque.

So they get, well...

So when you just eat on a regular basis, at meals, that food sticks on the teeth. And the bacteria use that food in order to grow and multiply.

And if they're not dealt with, then it becomes a hard calculus. So, if we move on to the next one, the last picture, you can see that white buildup

has grown. And so that dye is showing us how thick it is. And that starts to irritate the gums.

Okay. So, I help them identify, and in my exam, figure out if there's any disease present, any decay, how the bone is doing...

We measure the gums. 2-3 millimeters and no bleeding I would consider a healthy gum. If the gum recession is deeper than that, 3, 4, 5 millimeter, we might start to get concerned.

Or if the gums are inflamed, that could mean presence of infection. There's bleeding or pain. If any of the teeth or loose.

We go ahead and address that and try to calm our patients' concerns. We walk them through every step of the process so they really understand what's going on.

And we're able to talk about the importance of brushing every day, going to the dentist sometimes not every six months but every four months if things are going on.

We really develop a catered treatment plan to address any peridontal or gum disease with our treatments.

We'll do x-rays. We'll use novocain for any areas we naed to get in there. We'll work on a quarter of the mouth at a time with any of the gum problems.

The second appointment we might work on sort of the other side of the top set of teeth. Because we've done a deep cleaning on the top left,

but we work quarter-by-quarter so we'll then move to the top-right. And it really doesn't take that long. It normally takes about an hour. But if you've not been to the dentist in three, four, five years...

that's when we really need to do the process in sections as opposed to cleaning the whole mouth at one time. And if you're really concerned about the pain, I make it my top priority to make sure my patients

are comfortable. And at any point during the treatment they can ask the hygienist to stop because they're having some pain and we might put some numbing medication on it.

Or as the dentist I might come in and again do a little bit of numbing injection.

And I'm not always seeing patients on a three-month basis. Sometimes it can be as long as six months in between. If there's no plaque or tarter buildup, the mouth looks healthy, that not in pain, none of the teeth are loose,

they're not really having any issues, it's not really that complicated. Or sometimes for their first appointment I want to make sure that our patients really understand what their treatment will be and really get them involved.

>> SAMANTHA RATAKONDA: Chris, you finished with your presentation?


>> SAMANTHA RATAKONDA: Chris, you finished with your presentation?


>> SAMANTHA RATAKONDA: Okay. We will move on to Michael. How about you share some information?

>> MICHAEL KORLESKI: Yeah, absolutely. Thanks, Chris, for your excellent explanation about pperiodontal disease.

Okay. So, I'm going to talk about cavities, dental decay, tooth decay. Some of you may or may not know what that is.

So, let's take a deep dive. Cavities come from bacteria. And how much of...

your pH, which is a measurement we take of your mouth, your pH level, to see whether your teeth are beginning to break down or not.

Bacteria will feed off of the food that you eat. But before I go into that, let me back up.

There are different types of categories and different types of treatment plans depending on what's going on.

Healthy teeth, what we call sound teeth -- right? Very much a hearing word -- what we'll do is we'll do an explore. This is something we'll do to really dig into a cavity.

And so what that does is that explorer will make a really strong sound for the dentist. And so that's why you have sound teeth if you pass that test.

The other thing is, we have -- where like if a hygienist will take x-rays of different portions of your mouth. Typically there are four, to look at each section.

And between where two teeth are, are called interproximal. And that's where we have a difficult time seeing what's going on between the teeth and so lots of stuff can hide in that interproximal area.

And that's where your teeth are often touching each other. So, we're able to not really see those as a dentist just with a visual look, so we have to look through an x-ray.

And then we'll also do a double check with our probes to be able to confirm what we see on the x-ray.

So, that aside...

During the exam, we'll use our variety of tools. Depending on what we see. Are your teeth softer? Are there any abnormalities?

We'll pick the right tool, based on what we see. When we find a cavity, there are lots of different approaches for treatment and care.

So, if it's just a tiny little spot, just the littlest point of decay, we might even -- we might just go ahead and drill around it and dig around it and get it out.

Especially if it's in the outside of the tooth. Because understand, the tooth has three different structures.

Especially if it's in the outside of the tooth. Because understand, the tooth has three different structures.

There's the e namal, the outermost coating and the strongest part of the tooth. And then the next inside layer is called the dentin layer. It's weaker than the enamel but still rather hardy.

And then we have the pulp, which is the innermost part. We have to determine how far the cavity has gone through those layers. If it's gone all the way through the pulp the tooth is going to need to be pulled.

It's quite serious at that point. But if the cavity is really just in the enamel portion on the outside, it's just going to be something that we watch. That's the most conservative approach.

We might just do fluoride treatment, wlich is something that we paint over that area. And then if it's a little bit bigger of a cavity, we might put a sealant on it.

And that stops the bacteria from continuing to feed and grow in that cavity. Because there's no hole left for them to be in. So, the bacteria that's in there dies, which halts the progression of the cavity.

And if it gets all the way through the dentin, that's when a dentist might say, okay, we need to go ahead and address it now.

Because once it's gone through the dentin, there's really no going back. That cavity is there. So, we're going to have to drill in and cap it off.

And now all dentists use a white filling. Maybe in a special situation, like a hospital or something, there might still be a silver filling.

But that's not very common anymore. Really, the white filling is what they use to cap and seal it. And that gets the cavity out.

However, if you decide -- or if it's not treated, and that cavity continues to decay and it gets all the way down to the pulp,

that's when the patient is going to start to really feel sensitive from that tooth and that's going to cause a lot of pain.

At that point, there are two options. There's a root canal, where there's a drilling all the way down to the pulp and they dig out all of the bacteria-ridden area and they try to save the tooth.

What that does is, it really prevents infection being caused by the bacteria just living in there. Or, they'll put on a crown.

There are lots of different approaches to dealing with cavities. It's important to know exactly what's going on with your teeth, keep them as healthy as possible.

Gum health as well is a really important thing to keep up on. So, your appointments should be about six months apart, for cleaning.

And then the dentist also comes and double checks what's the hygienist has done and just looks over your teeth and makes sure that the shape and everything looks good.

That way, nothing gets missed and stays undetected and your teeth are nice and clean and healthy. So, that's my portion. Thank you very much.

>> SAMANTHA RATAKONDA: Thank you! So far we have heard about gingival health from Chris, and Michael has explained the structure of the tooth and shared details on cavities.

So, thank you both for that helpful information. And let's move on to our third and final presenter, Joe.

>> JOE SAMONA: Hi. Thanks, Mike and Chris, very much for going into cavities and gum health. I wanted to talk about our body and how that's connected to our oral health.

Smoking, alcohol, diabetes, what you eat, all of these relate to our physical health as well as our oral health.

I mean, alcohol is something we drink to enjoy, but a lot of that can have continued influence, that's the impact on our body.

So, when we eat and drink, our mouth creates saliva. When it's dry. And that can really lead to oral decay. And that makes our gums --

hurts our gums as well. Other thing is, diet is a big risk factor. It's important to control how much sugar we eat. Because that can really

lead to accelerated gum decay and cavities as well. So, we want to control our sugars, and that leads to better gum health.

If you have diabetes and your diabetes is well controlled --

That plaque that Chris was talking about is where that bacteria can live and that sugar will feed that bacteria.

So, fun fact. About half the people with periondontists were smoking.

Four times as likely to get gum disease than non-smokers.

Where that plaque is, builds up even faster if you're a smoker. So, smoking changes our body's response to things. Our body becomes more active and it takes a longer time for our mouths to heal if something goes wrong.

And smokers also have a more difficult time responding to gum treatment. So, that's why it's important to really keep on oral health. Brush twice a day, morning and evening before bed.

And it's also important to brush with a fluoride toothpaste. Fluoride has minerals inside of it and that mineral helps to strengthen the tooth, which prevents against tooth decay.

Most people have a hard time brushing certain areas of their mouth. For example, like Michael was saying, in between teeth.

Or if you're right-handed, they'll sometimes have a difficult time getting to the back-right area of their mouth.

And people also think that you have to brush aggressively to make sure it's nice and clean. But brushing aggressively can actually damage your teeth and reduce your enamel layer.

So, it's better to brush with a little bit more sensitivity.

So, let me talk about the best way to brush and some of the technology. So, you want to brush at a 45-degree angle to the tooth. And you want to brush in circular motions.

You want to get all three sides of the tooth -- top, back, and front.

A lot of people tend to ask, what about an electric toothbrush verses manual? Really, they're about the same. People think an electric toothbrush is better, but really it's preference.

An electric brush is good for people who have limited motor control. That might be a good tool for them.

And, yeah, that's... that's what I planned to share.

>> CHRISTOPHER LEHFELDT: Can I add something?


>> CHRISTOPHER LEHFELDT: Okay, yeah. I just wanted to add, first, thanks Joe, and Michael, both of you, for your presentations.

As a patient, if you've newly been diagnosed with diabetes, a lot of people are concerned and confused why a doctor would say, how is your oral health, or how is your foot health?

From a dentist perspective, speaking of, like, gum bleeding...

What happens is as you start to bleed, things can get stuck in those capillaries. So, capillaries are the thinnest blood vessels, all over your body.

And you have them in your gums as well as in your feet. And so, as we're -- like a pod a trist, a foot doctor, will go through and feel all the areas of your feet to make sure there's no numbness, swelling, that you still have sensation and that there's no pain,

the same type of assessment is happening with your gums and that kind of pain. It's really important to come to the dentist regularly for screening. That way we can keep on any measurements and exams

that we need to do to see how your oral health is going. To control your sugar, make sure that your A1C stays a rund 11 and your sugar levels stay low.

Because once you start to get into those higher numbers and your diabetes is really out of control, it's really bad for your health in general.

As a dentist I know my focus is mostly oral health, but when it comes to diabetes, it's really important to make sure that's a strong component in your overall health.

Because bone loss is something that is very hard to detect. And so if your diabetes goes unchecked and leads to bone loss, gum loss, bleeding?

Eventually your teeth become loose because your gums will create this pocket. And you wouldn't be able to enjoy food the same way when your teeth start to fall out.

So, keeping your sugars under control is very important as somebody who is a Deaf diagnosed diabetic.

So, at beginning of that diagnosis, I really encourage people -- you know, doctors will say, lose weight, keep on your medication regimen, you know, see certain specialists.

But especially, come to the dentist. That way we keep on your oral health as well. That's similar to what Joseph was saying about diabetes.

>> JOE SAMONA: Thanks, Chris. The other thing that I wanted to mention about the best brushing is the fluoride. You want to make sure you spit it out. Don't swallow that toothpaste. That fluoride needs to come out of the mouth.

>> MICHAEL KORLESKI: Many people, I think, are just so used to spitting because what happens is when you brush, there's that foaming.

So it's really important for us to not swish afterwards, though. Spit the toothpaste out. But then don't rinse. Because you want to leave the fluoride from the toothpaste on the tooth.

Rinsing after brushing can be fine, as long as the rinse has fluoride in it. Because you don't want to wipe the fluoride off with the swishing after you've brushed.

>> SAMANTHA RATAKONDA: Okay, everyone, we are going to -- well, first off, thank you so much. That was helpful information. And such different topics from each of the three of you.

We're going to go ahead and allow the audience to ask their questions. So, for those of you who are watching, feel free to put your questions in the Facebook comments or in the Zoom chat.

And we will see if we can get to answer some of them for you.

And while we're waiting for your questions, why don't we go ahead and start off with a question for you, Joe? So, you had mentioned

some of the risk factors, and you talked about diabetes, which Chris had added on to as well. Can you maybe share some of the most helpful, preventive measures,

and diet suggestions that will reduce the risk for poor oral health?

>> JOE SAMONA: Yeah, I mean, I definitely could suggest, you know, reduce your number of sugary beverages. Don't have big meals. It's better to eat small meals as a diabetic.

Because that gives your saliva time to clean out the mouth after the meal. And if you are go to drink a sugary drink it, don't sip on it all day. If you sip it it's just going to sit in your mouth.

If you are going to have a sugary drink, drink it all in one sitting.

Reduce carbs. And if you find you're a big pop and coffee drinker, rather than saying just stop, maybe switch to diet pop or do a sweetener instead of sugar in your coffee.

Or if you can, if you do drink a full sugared pop, swish with some water afterwards to rinse it out. Chris, did you want to add something?

>> CHRISTOPHER LEHFELDT: Yeah. We were surprised at the research, like there's a creamer that goes in coffee that has a lot of sugar. And if you compare that to just like putting in --

Like if we compare milk, creamer, half and half, flavored cream, and all the different things you can put in your coffee, the sugars in those creamers is really high.

And if you're having three or four cups of coffee a day, every day of the week, that's going to be really detrimental.

So, our job is just education. Right? We look at the facts. The nutrition labels of the food, the first three of four items on the greed yents label, you might see high fructose corn syrup?

That's sugar. That's all it is. It doesn't say sugar, but it is sugar. That's what I'm telling you, it's a kind of sugar.

So, really try to keep that in mind. I don't know whether it's that it's more expensive or if there are other aspects of your life that you value more...

But like you said, diet. And if you use a straw, pop also touches fewer teeth. O.

and then also, drinking at the same time as a meal, as opposed to, like you said, continuing to sip on a drink all day.

For example, like... water really is the best drink. I mean, have coffee, I'm not trying to say don't. But just substitute. Even if you don't like the taste of sweeteners, try different brands.

There's Stevia, Sweet and Low, there's the blue packet. You might find one that you like. I mean, it's not healthy. There's still sugar in there. But even if you're to reduce how much

sugar you put in there, it's still sugar. And I drink it myself. So, if you can do, you know, put water with fruit in it, or iced tea, just try to expand your beverage choices to avoid as much sugar as possible.

Jeez, I can't think of anything else. Michael, is there something else you wanted to add?

>> MICHAEL KORLESKI: Yeah, thank you so much Chris for adding all of those points. I think one thing people struggle with in terms of quitting pop,

I was thinking of at least how to help reduce, and maybe it's like a slow transition. So, the first week, try to cut the number of pops you have by mixing it with water.

And then continue to adjust the ratio of mixing water and pop together in one glass where you eventually have more water in that glass and you're slowly taking the pop away.

So, we're avoiding quitting cold turkey and for your body to have that craving.

And also, another recommendation, it's important to --

Well, going back to what I was saying, pop is very acidic. And acidic environments are very bad for your teeth. So, if you're using a straw, that straw will help it go straight to the back of your tloet.

That way, the pop doesn't come in contact with the back of your teeth as much. So, that's something I share with my patients regularly.

>> SAMANTHA RATAKONDA: Thank you all for your input. Michael, you had mentioned earlier about dental checkups. Can you expand and explain how often

adults should get a dental checkup? And children as well?

>> MICHAEL KORLESKI: Yeah. I'm happy to answer that question. The answer is the same for both adults and children.

Children need to go as often as adults because cavities and tooth decay can show up in both adults and children. For children the risk of cavities is greater because their

motivation to clean their teeth is a little bit less. But you don't have to come more often, unless they have a bad diet, eat a lot of sugar, drink a lot of sugary drinks like we talked about.

That's going to lead to higher risk of tooth decay. But in terms of the number of times you should come to see the dentist, it's about the same for children and adults.

Unless you have any health concerns. What will happen is, as a child's baby teeth come in, they're going to be replaced by adult teeth. Those adult teeth are going to push those baby teeth out.

And the adult teeth are going to be stronger. And once those come in, you'll want to make an appointment every six months, to make sure you keep the cleaning regimen.

That way, you're able to catch any decay when it happens and add sdres it right away. Joe, did you want to add something?

>> JOE SAMONA: Yeah, I did. Most of the time, patients don't show up in the office until it's an emergency. Right?

So, they show up when they're having pain. What's important is to see the dentist regularly every six months so you don't ever get to a point where you have tooth pain. Right?

Don't ignore your teeth until there's an emergency. If you come every six months, you're actually going to save money in the long run by doing preventive care and maintenance.

We're going to fix something when we catch it when it's small, as opposed to leading to something big like a root canal, which is very expensive.

It's important to go to the doctor regularly, every six months, for that checkup to take care of your teeth.

>> CHRISTOPHER LEHFELDT: Joe, Michael, very good advice. Another thing people ask is when they should start bringing their kids in, and I would say, one year old.

Because if there's no fluoride in the water of your home -- you know, for example, people who have well water don't have fluoride. The risk of cavities goes up in those.

Brushing regularly with fluoride toothpaste is definitely supplemental. But we'll also use what's like a panlt, to actually paint fluoride on to the teeth,

to give kids better protection in between these appointments for those six months. Insurance is often happy to pay for those fluoride treatments.

Insurance companies recognize it's actually cheaper to pay for preventive care rather than surgery or extraction.

And we don't want kids to miss school because of tooth pain or have problems chewing or eating proper early. So, keep up those appointments for your kids. If we identify they're higher risk, we'll go ahead and do that fluoride treatment.

And it's a pediatrician -- some states allow your pediatrician to actually do fluoride treatments in their office. And it's the same kind of preventive measure as giving all a the vaccines that a child is scheduled to get.

>> CHRISTOPHER LEHFELDT: And another thought I had was, if you're not sure, in terms of flossing or brushing or if you have the right technology for you, when you go to your dentist for a cleaning,

right, or the hygienist who's cleaning your teeth, ask them about what you're using at home to clean your teeth and see if they have any recommendations to do something better. They will teach you. They might show you where you're doing something wrong. And they can give you a better technique as well. Anl they might talk about some tools you have.

There are floss holders. Like it's interesting, you would tie the floss around these two plastic picks and use that holder to go in between your teeth.

There are these green flexible sticks you can poke right through the gaps in your teeth.

There's lots of dental tools that your hygienist can recommend. So, don't be embarrassed. Speak up. It's your money. It's your oral health. Ask the hygienist how you can do a better job taking care of your teeth at home.

>> SAMANTHA RATAKONDA: Chris, we have a question related to what you just spoke about. So, someone from the audience is asking, how should we prevent and avoid plaque?

If you have gum disease, is it important to use the water tooth floss -- uh, Water Pik.

>> CHRISTOPHER LEHFELDT: (Laughing). Oh, you know what? The best is still -- for all of our Deaf community, we're very good with our hands, right? We know our signs.

You all should be phenomenal flossers. In terms of the Water-Pick, it's that high pressure water spray. It's like the same machine you use to spray your house down.

You get under the eaves with that water pressure system. But don't use that in place of flossing. Okay? It's just as successful as swishing water around in your mouth, to be honest.

Physically removing the bacteria and plaque every day, which develops within 24 hours, because every 24 hours that plaque creating bacteria grows again, so brushing twice a day is important.

Flossing is important. And getting in between those teeth. You want to be able to get both sides of the gaps in between your teeth.

And again, talk to your hygienist, have them teach you and show you the best way.

>> MICHAEL KORLESKI: Yes, excellent, Chris, good comments.

>> SAMANTHA RATAKONDA: Okay. So, earlier, Joe, you had mentioned and recommended not aggressively brushing. We have a question about any preference on a toothbrush, toothpaste,

and how often should we replace toothbrushes.

>> JOE SAMONA: It's important to have a soft bristle toothbrush. It's the easiest on your teeth. And it's not as aggressive when you go in there.

In terms of toothpaste, they're all the same. It's just important to make sure it has fluoride as an ingredient.

If you have sensitive teeth, you may want to go ahead and try Sensodyne. That helps reduce sensitivity. So, that's an option.

But as long as your teeth has fluoride, that's going to help make your teeth stronger.

>> CHRISTOPHER LEHFELDT: This is Chris. Can I add something? People think they need to clean their mouth, clean their teeth, like they clean the bathroom floor, and really get in there and stub.

-- stub.


Actually, you want to do it very gently, like a butterfly wing. You just want to brush against the surface. If you've got a toothbrush harder than soft, throw it out. Make sure it says soft on the package.

After three months, a soft bristled toothbrush is going to start to wear out and you're going to need to replace it.

When the bristles start to splay out, they don't get where they need to go. They can start irritating your gums. Or even worse, they can get down to the root between the gum and teeth and start to scratch.

So, once you start to see those toothbrush bristles splay, go ahead and replace them.

And think, scrub softly, not like you scrub the bathroom floor. Okay? Again, your hygienist can show you how to do it.

>> JOE SAMONA: Think of a massage. You wouldn't want an aggressive massage.

>> MICHAEL KORLESKI: Chris, Joe, your comments are great, but I did want to add one thing. The soft bristled toothbrush is important, but another thing I find very important is

how long you eat after you brush. Because food, as it stays there, really starts to eat away at your enamel.

So, to keep your teeth nice and strong, you need to be able to get in there and brush quickly. Food staying in your mouth also creates a more acidic environment in your mouth.

And what happens is by brushing, you're able to get your mouth back to that baseline, and your saliva can start to work on that enamel again.

So, when you eat, brush as soon as you can. And dig away some of that food that's going to get stuck underneath your gums or in between your teeth.

But you want to wait about half an hour after eating. That way your saliva is able to get in there and raise the pH level again of your mouth.

So, wait a little bit. Wait about a half hour. And then go ahead and brush after eating.

>> SAMANTHA RATAKONDA: Okay. So, we have a question. I'm going to address it to Michael. So, recently, the Dental Association took daily flossing out of their routine recommendations.

So, should we continue to floss or...? We don't need to floss as much?

>> MICHAEL KORLESKI: (Chuckling). Well, my answer is, you still have to floss every day. Flossing is so important. Brushing and swishing are powerful.

Whether you use an electric toothbrush or a manual doesn't matter. But flossing will catch about 30% of what you missed with your brushing. Because a toothbrush can't reach every area.

And even brushing twice a day, you will still want to floss after you brush. And just think of it as a nice ending to your brushing routine. So, floss twice day.


>> MICHAEL KORLESKI: Yep. Guys? You want to add anything else, Chris, Joe? No?

>> SAMANTHA RATAKONDA: Okay. So, the next question, from our audience, is -- and Chris maybe I'll address it to you.

Many young families struggle to find dental care for even their 2 to 3 year olds. Do you are anybody else have any thoughts about the fluoride varnish to bridge that until they're able to secure a dentist long-term.

>> CHRISTOPHER LEHFELDT: Well... (chuckling) every family situation is different. It really depends on what your family situation is.

I can only address what I see in the state of New York. I know that that's covered by insurance. Doesn't matter w what your income is. I think it's up to the age of 18.

And some insurance plans will cover it up to age 21. And if you're under your parents' insurance plan, even up to the age of 26.

So many pediatricians or family practice physicians have knowledge about where these resources are. So, if you don't have dental insurance or you can't cover that,

then I would suggest reaching out to maybe your government association to see if there's, you know, like a medical plan that you could probably get on.

Some insurances have like a coordinating -- like a specialist? You could reach out to a social worker. Or even your family doctor.

Just somebody who... and maybe it's under where you work. Maybe you're reaching out to HR. Just figuring out some way to get it under your medical plan.

You know? And I know that's not going to be the answer for every state.

Since Obama care was enacted, it's really been great for our state. You know? People who are covered, who've not been able to afford treatment and they're able to come in, and now they're able to

get preventive care, it really has reduced the number of cavities. It reduces the number of days kids miss school because of oral health issues.

So, you know, just reach out to your family doctor. You know? And if they can do a fluoride treatment in a regular appointment, go ahead and do that. And then just kind of investigate what your insurance

can do, if you have insurance through work, bringing it up to your HR department. Or the county health department. If you reach out to them and talk about ways to cover your child's oral health, they should

have resources for you. I hope that helps in answering that question.

>> SAMANTHA RATAKONDA: Okay. So, our next question, I'm going to address it to snow. Someone had asked that they noticed that people over the age of 40

tend to have brown or darker colored staining on the teeth. Could you maybe explain why that is the case? And because you talked about prevention, maybe any suggestions for that?

>> JOE SAMONA: Well, the brown coloring is years and years of staining, since they were a kid. Drinking coffee, drinking tea, drinking wine. All of that dark coloring stains the teeth and it will

eventually become darker. So, there are a few ways to address that. Again, regular cleaning, every six months. You could also do whitening strips. That can help address the staining.

I don't know, guys, anything else you want to add?

>> CHRISTOPHER LEHFELDT: Joe, I just want to add to what you said. The best way to get the whitest teeth really depends on your comfort level, so to speak.

How much you want to do. You know, if you really want your teeth sparkling white, sure. You know, you don't want cavities is more important. You don't want gum disease.

But ask your dental hygienist for recommendations. They might do a whitening strip. There's also a whitening rinse. I would say that they...

do 50-60% -- reduce fifty to six i percent of the staining. Because, again, it's red wine, coffee, a lot of those dark drinks.

If you continue to drink them, your teeth are just going to get stained again.

There's another thing they do, where you sit in an office chair, right, and they'll do a UV light treatment, for an hour. And your teeth can be sparkling white after that.

Or if that's too expensive and you don't have that time, there's at-home application whitening strips. The American Dental Health Association --

Or if that's too expensive and you don't have that time, there's at-home application whitening strips. The American Dental Health Association --

You know, please... don't order the ones online when you're just looking around at 3 or 4:00 in the morning. Find the respected trustworthy organization that has a strip with approval from the ADA.

And then you would use those every day. Some people think the longer you leave them on, the whiter you're going to get, but all that stuff dissolves after a certain amount of time.

There's also these trays that have things that you have the whitening stuff that you put in there and then put on your teeth.

I think you leave them on for... I think it's every day for about a week? Maybe it's about 45 minutes or so?

But... I think it's like a peroxide. You'll feel this bubbling when you put it in. So, that's also another tool for teeth whitening.

>> SAMANTHA RATAKONDA: Okay. So, we are nearing the end of the hour, so I don't think we can answer any more questions. Thank you so much to everyone for asking your questions.

And before we end, I want to quickly allow the presenters to just give some last words, last advice, anything that they want to share after they wrap up the talk.

Why don't we start with Michael? Do you have any last words to share with the audience?

>> MICHAEL KORLESKI: Well, yeah, I think just to repeat what we've said: Go to your dentist every six months, brush twice a day, floss regularly.

It's really important. That's what you do to keep your teeth healthy and strong.

>> SAMANTHA RATAKONDA: And, Joe, any last words?

>> JOE SAMONA: Yeah. Really I want to say the same thing as Michael. Brush twice a day, morning and evening. And then there are some other resources I have to share with you.

I made a YouTube video that you can find online about oral health and I've got lots of pictures in that video. It's all done in ASL. And that will really help you understand clearly what's going on to be able to take care of your teeth.

>> SAMANTHA RATAKONDA: And lastly, Chris?

>> CHRISTOPHER LEHFELDT: Okay. A good, well-respected website for oral health is They've got an abundance of resources and links, both in English and in Spanish, which is excellent.

But feel free to e-mail me with other questions. I mean, if you have specific things about your own health, I can't give you a recommendation because I'm not your dentist and I'm not seeing you.

You'll want to go to your dentist with all of your questions. Because it's your teeth, your life, your money. You know, your dentists are happy to share their experience with you and work with you to keep your teeth

healthy and strong for a lifetime.

>> SAMANTHA RATAKONDA: Okay! I want to give a few quick thank-yous before we wrap up. Thank you for your last words.

Huge, huge thank you to our presenters tonight, Joe, Chris, and Michael. Thank you for slarg so much of your own personal knowledge and answering everyone's questions.

Thank you to Kate Miller for the CART services.

And our interpreter, James.

And lastly, I want to thank everyone who was involved in helping put together this event, including our Deaf Health Talks team, Kaila Helm, Dr. Michael McKee, Noa Kim, Sarah Hein, Pava therefore i Chilukuri -- pavani.

And Sanjana Ratakonda. Thank you all for attending tonight. Next month there will be no Deaf Health Talk. The next talk will be on August 24th at 8 PM Eastern Daylight Time. Hope to see you then. And enjoy your night.

Are you someone who wants to learn about or have questions about different mental health topics including access and strategies to manage it?

We are joined by featured guests and medical experts: Donna Guardino, PhD, a licensed clinical psychologist at the University of Rochester’s Deaf Wellness Center in Rochester, NY, and LeeAnne Valentine, Marriage and Family Therapist at University of Rochester Medical Center. Moderated by Susan Demers-McLetchie.

Resources document

Download the closed caption transcript (PDF)

Read the transcript

>> Okay! I think we're going to go ahead and start. Hello, everyone. Welcome.

We are so glad that you're joining us here tonight for our Deaf health talk.

Two awesome speakers will be introduced soon.

Prior to that, I want to give you a description of my background. My name is Susan. I have a black shirt with some decorations down the side on the arms.

I have a gray background. Welcome to the Deaf Health Talks. We have these every month. We have a variety. Of topics that we do.

Tonight's topic is mental health in the community.

The Deaf Health Talks have been made possible by several people being involved, and several organizations being involved.

So, the Deaf Health Talks are the University of Michigan Family Medicine, Michigan Deaf Association, Partners in Deaf Health, PDH, of Rochester, New York, Michigan Deaf Health, and Michigan Medical Interpreting Services.

So, thank you to each of those for providing services and help for us today.

Mental health is such an important issue and it's a very tough conversation to have sometimes.

Sometimes it feels embarrassing, like something we need to hide. And some people are open about talking about it. We have a variety of ways we deal with it.

We have two experts with us tonight, LeeAnne Valentine is in Rochester at the DeafHealth center. She is a family therapist.

And then Donna Guardiino is a PhD. She graduated from Gallaudet in 2018 and she works one on one with adults at the Deaf Wellness Center.

I'll let them explain more about themselves if they'd like. But we can go ahead and start. If you'll just give us a little bit about your background?

>> DONNA GUARDINO: Sure, great. My name is Donna. I am Deaf. I work in Rochester, New York at the Deaf Wellness Center. I'm a clinical psychologist licensed in New York State.

I provide therapy to groups and one on one counseling.

Great, thank you, LeeAnne?

>> My name is LeeAnne Valentine, name sign in the corner. I also work at Deaf Wellness Center as a family therapist. I work one on one, with groups, variety of settings.

And I've been doing that for a while.

>> SUSAN DEMERS-MCLETCHIE: And I forgot to introduce myself! I'm the moderator for this evening. We will have captioning as well on the Facebook Live so you'll be able to use the captioning.

If you cannot see the captioning -- it should have been worked out and everything should be fine now.

Once a month we have Zoom meetings on Facebook Live.

If you are interested in sub vibing to our monthly meetings you can sign up via mail chimp and we'll make sure you have information for future meetings and events.

So, awesome! Donna, would you like to talk about your work within the mental health within the Deaf community?

Give us a little bit of information that you have? And then we'll move it over to LeeAnne for question and answer. Any questions we can type into the chat.

You can type them in right now even before the end and we'll be ready to bring those questions up later.

>> DONNA GUARDINO: So, I work with a lot of individuals who believe that there is a stigma in understanding mental illness and mental health.

>> DONNA GUARDINO: So, I work with a lot of individuals who believe that there is a stigma in understanding mental illness and mental health.

And they think, oh, I don't want to take medicine because that means there's something wrong with me.

Or they've been told there's something wrong with them, and that really impacts their therapeutic process.

With mental health, we know we need to break that stigma. We need to get rid of that.

So, a stigma, when I talk about that, specifically what I mean by that is...

it's a public stigma, meaning that people who are known to have a mental health or other diseases, they're looked down upon.

People are going to look at them and say, oh, they're crazy. Or they're mentally ill, they're going to lose all my time. Or they're a danger to society, they're going to hurt someone, they're very explosive.

All of those stigmas are things that people believe. You know, people talk about the weather in Rochester, that it goes up and down, oh, the weather is bipolar! And even though they're not talking about

by polar as a person, they're still talking about bipolar as a stigma. Saying that, oh, it's very up and down. It's a very negative attitude that is looked upon with mental health and mental illness.

So, those kind of stigmas are the public stigmas, but they're also self-stigmas, that I think something's wrong with me, I'm not normal, I'm crazy, I'm weird.

You know? And people feel a lot over shame from that or a lot of embarrassment. You know? And if I can get help? No no no I can't do that, I don't want to do that, I will be fine.

Other people go to counseling. I don't want to go to counseling.

So, understanding mental health, there's a lot of struggles to be able to accept and know that therapy will help, and therapy will make a difference.

But it's really a hard time getting in there and getting moving with therapy and getting it started.

So, when we're talking about stigma we try and think, okay, so, how does that happen? Where did all that start?

And there's not a lot of information about how the brain works. You know? There's a lot of information about how people think about stigmatizing people who have mental illness.

You know? And there are a lot of things that they've heard about on the radio, from family, friends, someone else.

You know, if you go to a food store and you stand in line and you're waiting and you're talking about, oh, I go to counseling or I do that,

someone might say, um... use know, when someone looks at that, they think, oh, is this person normal? What's wrong with them that they go to counseling? You know?

Or they look at them as... okay, but then they get access to those communications. They get access to those services.

And people are understanding. But with the Deaf community, we don't have those conversations. We don't understand that having counseling is something we can do.

We've all grown up with the dinner table syndrome, where there's so much going on around us, that we don't know what's happening within our family.

And being able to have access to the communication to talk about mental health, to talk about, um, disorders, to be able to talk about that information.

The Deaf individuals don't get access to that information. And a because of that, what we end up relying on is media. On TV, in newspapers, in magazines.

And the media, when you are talking about the media, 60-70% of the mental health information that's learned from the media is concerning.

Because it reflects what people believe mental illness is or mental health is, and it's not.

People who have mental illness may see a movie on, um... skits fren ya.

If someone has seen a movie that a person is schizophrenic and they're dangerous and you need to be careful with them.

Or that a person is violent or suicidal. Or all the things that these media information shows you.

Or even depression. When you talk about depression, people will see in media that, oh, someone's depressed. Means that they have suicidal thoughts.

It means that they're thinking they're going to kill themselves. And that's not what depression means. There are many, many other symptoms that depression has shown.

So, when you're talking about things, you can't think, oh, that's just -- the media showeds exactly what it is.

No. There are many, many other things.

There are movies that show people going into an asylum and they're all crazy and psychologists are very cold and very mean.

And not someone that is being helped. So, all of that representation from the media is making it so people are not understanding what happens.

Sometimes the media says, oh, you can go to cons ling two-three times, everything fine and great.

But that's not true either. Counseling takes a lot of time of working on your self, and working with yourself, to be able to have that access.

And the information that we're seeing on the news in media on movies and TV, it has developed us to a point where we think that we should be ashamed if someone has a mental illness or disorder.

Or we should think that the media is showing everything. So, really, we need to understand that we can't rely on the information that we get, especially now, talking about social media.

It doesn't reflect everyday life for people. It's not a reflection of who we are. It's not a reflection of the individual.

Sometimes people post things on Facebook, they show pictures and things are happy and things are going on and it looks great.

But what is happening in the other times? Facebook does not reflect their whole life or what they're like, what's happening in their life.

Maybe 10% of their life is being shown on Facebook, so there's a 90% that they're hiding that we're not seeing, they're not portraying.

Everything lookdz great, oh, my gosh, this person gets to travel and they get to go their own way, but it's an illusion.

Because when we think about this, we think, well, they have everything and I don't.

I have a fear that I can't do this. You know? If I share my stories and experiences, I can't tell people that. I really can't do that.

So what we need to do is figure out how we can talk to people and make sure that we are having doctors' appointments and we're having individuals that are able to

have access to those and to be able to know exactly what's going on. We need to educate the public so that they understand what it means

when you say mental illness or mental health.

It's the same as if I go to the doctor for just a wellness visit. Or I have a pain. Or I have something else that is a physical condition that I need to go to the doctor for.

Counseling is the same way. You need to -- you go to a provider. You work on what needs to be done. And then we take care of it.

And that is something that we need to understand with mental health.

You know, it could occur because someone's depressed. They've lost their job. They're upset. They're having, um... a bad life at this point.

So, going to see a counselor does not mean that, oh, you need to go forever and you're going to do that for the rest of your life, go to counseling.

No. Sometimes it is just a very short time. It's situational. To get you through what you're experiencing at that time.

So, there is the ability to go to a counselor, get back to your mental health, the same as going to the doctor to get back to your own physical health.

So, we need to remember that...

Yes, yes. So, the same way that you have to figure out how to make yourself better physically, you have to figure out how to make yourself better mentally.

By going to those providers, that's what you're doing. You know? And there are good and bad things that can be done to take care of things.

But your life is important. You know? The priority for you is to know...

Friends and relatives. Of course, you know, that way you'll feel some commonality with other people. That helps you know you're not alone when you're struggling with things.

So, being open is the first step to sharing those feelings. Okay? It's interesting that we can stigmatize people with mental health problems

but if we talk about it more honestly we realize lots of us are going through lots of things.

You know, it's funny, when you can't decide what to wear in the morning, whether it's going to rain or not, just because you're indecisive doesn't mean you're bipolar.

Sometimes conversations with loved ones can help you understand the difference between what is going on in your life that is actually something you need mental health counseling for

or just normal things that are humanized. You know, we're all normal. We're all going through different points in our lives. Everyone is going through different issues.

Especially now, everyone is going through different things. But if we pull it back, that helps us to believe that what we're going through is very unique and much more problematic.

And that begins a downward spiral to making things even harder, if you do get mental health support later, to climb out of that depression or whatever you're going through.

So the minute you see a decline in how you're feeling and experiencing the world, if you can grab it by talking to people in your life, seeking some mental health support,

you won't crash in the same way and you'll be able to (captioner having trouble hearing interpreter voicing, please move closer to mic).

>> I think it's a good reminder to the community, when we're talking about the Rochester weather is bipolar, that's something we need to think about.

Because there's a stigma behind that. I think that's a very good reminder to us. . The appropriate sign for bipolar now, what are we signing at this point?

>> Yeah, you'll see some people spell it or use the sign. I think both or appropriate now.

>> I see some questions in the chat. I think what we'll do is go over to LeeAnne. If you want to say a few words, go right ahead?

>> LEEANNE: Sure. I've been watching the news and current events and seeing what's going on. It's a lot of heavy information. Black Lives Matter is a very important thing in the forefront of the world right now.

And we're seeing a lot of death by police negligence. We're seeing George Floyd. We're seeing people being physically held to the ground, knees on necks.

We're seeing more and more increasing police violence against innocent people, and it does increase fear in the community.

Especially with people who consider themselves racial identity, they call themselves Black, Hispanic...

People of color or affected more by these current events because it hits home for us. And it's not just causing fear. It's causing anxiety,

depression, heightened levels of stress, concerns about the future. As a Black Deaf woman, in the past I didn't experience these kinds of

racial injustices from police. But now if I see a police officer drive by, perhaps it height ens my concern more than it was an issue before, because of something in the news.

And that's an experience that many People of Color or having. It's not just one person of color who's been wrongfully killed by the police. It's many of us.

And so we're seeing there's sometimes many reasons that our mental health is heightened or agitated.

There are things that in the past may not have threatened you that are now causing higher levels of stress.

>> A white person calling the police on a black person.

>> Yes. So, fear anxiety all these emotions that people of color have experienced are now even more heightened. It's unfortunate.

And it does in fact affect everyone's mental health. And the question is, what do we do about it?

You know, how do we support each other? What can we do to help the situation? How can we have these important conversations?

And not hold on to those feelings that we've held back for so long. How can we talk about it, have open dialogue?

Not just with your families. You know, Black American families have talked openly about this for a long time.

What I'm really talking about is...

talking to other people, other individuals. People believe that religion is a help, and if it is, praying, talking to God.

But your mental health problems may not go away just by praying to God. It's not easy to talk about. It's been taboo for so many years

in so many families. In Hispanic culture and other cultures. That this is not something you talk about. You don't air your dirty laundry. That's not something that you tell people.

So if there's a mental health issue, people are going to mock you, they're going to look down on you. But, no, that is not what we should be doing right now.

If something horrible has happened to a person and they've been traumatized by it, it will increase their experiences of conditions such as

PTSD, posttraumatic stress disorder.

They may turn to other vice, drugs, alcohol, and increased violence. Increased abuse. Physical, verbal, mental abuse.

Even sexual abuse.

So, when we're talking about a violence that is continuing and it's leading to death, leading to arrest...

what are we doing to help these individuals? It's very, very tough. It's very difficult. People are resistant.

Resistant to acknowledging mental illness and mental health.

Mental health counselors, for a very long time, within the system, have been white.

So, for an individual, a BIPOC person, to be able to think that, oh, I'm going to visit with this white individual who understands mep and my quality of life is going to improve?

That's not something that we would feel comfortable talking with someone about that. If a Black person decides that they need help,

and they sit down with a white counselor or therapist,

culturally is there an understanding? There's a very big difference in the cultures. It makes individuals even more nervous.

How am I going to be able to tell you something that I'm not sure you would understand? There's not a trust there that I can develop.

And the problem's not going to go away. And often what happens is

many individuals are poor. They think, oh, if I go to counseling, I can't afford that. That's way too expensive. I can't go to counseling.

You know, I can talk to my pastor at church, that's free. I don't have to pay a minister. So, I can go and talk to the church chaplin.

But a mental health counselor, no no no, way too expensive, I can not afford to do that.

And at the end, they're suffering even more. And maybe they're not even understanding their insurance. Or even if they have insurance, they don't know how to get it if they don't.

So, having access to the Internet is another thing that could be a barrier to them. So, again, not having insurance, all of those issues,

all of those are things that we need to understand that they're experiencing. Deaf or hearing, doesn't matter. Those individuals experience that.

If we're talking about individuals who have a 5th to 8th grade reading level, throughout the United States, it's very difficult for individuals to understand

how do I work my way through this system? How do I get insurance? How do I find someone?

There are so many different types of insurance in the United States. And then they have to pick one?

And mental health counseling is not cheap. It can be expensive, yes. But there are counselors that work on a sliding scale. Some offer

financial assistance for the counseling, which is very nice. But how do people know that? Where are we getting our information from? We don't have that information.

And so, again, people are thinking, oh, I can't go, it's way too expensive. A second issue, a second big problem, is transportation.

Those of us who have a car, we know cars are expensive. You know, it's a luxury to have a car, to be able to drive one and have one. You know?

But think about individuals who have to use public transportation. The bus. Even calling a taxi if they can afford it. Most of the time, these individuals are using public transportation.

And they don't want to stand out in the hot sun as it's beating down on them waiting for the bus to come. No one wants to stand in the cold with the wind blowing and the ice and everything, to be able to

get to their mental health appointment. That's not me. You know? I'm not going to stand in the sun. I'm not going to stand in the wund and the rain. You know? I have a car that I drive. I have air conditioning. I'm safe inside my car.

So, that's not fair. It's not an even playing field for everyone.

Sometimes we're talking about individuals who live very far out, not in the urban area. Very rural. How do they get from their rural home to the counselor?

There's going to be a lot of cost to that. If we're talking about how to pay a taxi, we're talking about having to pay for anything that's going on,

and then have to pay the counselor for the 45-minute session? The expense is there.

There are not a lot of Black/BIPOC counselors out there. The counselors that are out there, to be able to understand the cultures and experiences

of a BIPOC person are very few, and that means that the comfort level is not there. If we're talking about a Black woman looking for a Black counselor, that isn't listed anywhere.

Where are the resources? How can I find them? They aren't listed anywhere. So, if a person of color wants to speak to someone, one, they have to we looking for a hearing person, and they're going to

type it in and see all these names but we don't know if they're Deaf or hearing. We don't e know their racial identity.

Just the struggle in finding someone who understands my needs and my culture.

It's even harder for women. A lot of Black women go through anxiety, especially when it comes to raising children.

With family situations, they suffer from depression, they don't know how to do -- what's going to happen.

And now we're talking about Black Lives Matter. How do I prevent mi children from being the victim of something like that?

For Black well to be able to understand and just search through and be able to find that one mental health counselor who is qualified is a struggle that many women are going through.

>> So, really, us as Black women, in the POC/BIPOC community, to work together to find these resources, you know, we're open to supporting

>> So, really, us as Black women, in the POC/BIPOC community, to work together to find these resources, you know, we're open to supporting

each other. We understand, you know, what your needs are. And also, if we can't find what you need, we'll find something that suits to meet your needs.

If it's not your first choice. Because we have resources here. We have funding. We have support available.

But what is most important really is to think about your mental health rather than suffering. So, please, we're encouraging you to ask for help.

It's a humongous barrier right now in the BIPOC community of really people knowing there is not only a stigma in the BIPOC community,

but most especially in the Deaf Black community, or even the hearing Black community, there is a special stigma about mental health, and it's var strong.

It's ironic. But in this community, people say, oh, they believe in voodoo and black magic, but it's interesting that we have evidence what's happening in real life, you know?

Or that the BIPOC community feels that voodoo has evidence, that it shows that it comes through. But it's interesting that community is also very suspect of the mental health community.

Because, um... because they have not always been -- they've been wrong sometimes.

They haven't always had the resources they needed.

Within the BIPOC community there are so many challenges, there are so many things that have happened so far. And people are experiencing.

And when we're talking about a pandemic even making it worse. And when we're talking about mental health, it is very difficult.

So, thank you so much. We have questions. How do we deal with the stigma related to being hard-of-hearing?

We've notice there's a lot of negative impact on mental health because there's not a lot of people in the community that we can speak to about this.

So, that's a challenge. So, being hard-of-hearing is a stigma in and of itself.

Donna or LeeAnne, do you want to answer that?

>> DONNA GUARDINO: So, any identities that are not obvious from first sight, you know, for instance there's a question about being hard-of-hearing and

feeling like perhaps you have some residual hearing, you may be able to use your voice, you may choose to use your voice,

so you kind of fit in with the Deaf community, and you may also sign, but you may be perceived by the Deaf community as not signing in

the fluency that people see as part of Deaf culture. You're not feeling as accepted. So, this concept of feeling like you're working harder to be a part of both communities. You can be stigmatized as not Deaf enough.

Yeah, that's a hard thing that people experience. And I think that something that people can do very much is really find your sense of

where you feel most comfortable. Perhaps, you know, you need to work harder with hearing people and your sense of identity. Perhaps the Deaf community sees you as not Deaf enough, but maybe being okay with that.

Finding the right place for you. The important thing is to find a community. Ideally of hard-of-hearing people. Who have those same struggles. But to feel belonging somewhere.

So you may not feel equally accepted in the hearing or Deaf communities, but to have a sense of belonging.

>> Right, the feeling of not fitting into the hearing world or not fitting into the Deaf world, yes, that is something that I'm sure people have experienced.

We have another question. How do we find free counseling services? How do we find a BIPOC counselor?

So, either of you?

>> Yeah, honestly, I really don't know of any free counseling available. Free counseling services or organizations. Most counselors do require payment.

There's many reasons for this. I think in terms of specifically locating BIPOC counselors, it's not an easy question to answer.

To be honest, most counselors are participating with a variety of different groups, depending on their state, depending on their community.

It's difficult to find us. My suggestion would be just to use Google and hopefully you can find someone that matches your specific needs and preferences

that matches something that you're looking for, what you want. It's also okay to ask your doctor, your PCP, your primary care provider to lead you to a counselor.

Also, you can ask the welfare office. I know it sounds awful, but ironically enough, they do have lists of providers. They do have places that, you know, they may have BIPOC counselors available.

So, those are resource toss reach out to.

>> Right, the welfare office/Medicare may cover the services. So, there are other ongss.

>> DONNA GUARDINO: Some people who work in different companies, sometimes their companies have a benefit called EAP, employee assistance programs, and they offer

counseling through them. So, there are lots of other avenue Donna?

>> DONNA GUARDINO: Often when we're talking about free counseling it depends on the insurance provider and if you have one.

They may both cover mental health sessions. But it can be hard to find a counselor that will accept both.

We have the Deaf wellness centers. Those are great resources and we have free counseling available for the Deaf community.

Especially during the pandemic. You know, we're having now more cess to remote counseling, connecting each other through technology.

If you live in Rochester and you find a BIPOC counselor in New York City maybe you're more likelily to connect with them.

>> It's ironic that you're mentioning tele-health because that's the next question. It's become more popular and used because of the pandemic.

Do we expect that? Individuals who are fluent in ASL will be able to find and match up through telehealth with a counselor? Is that more of a possibility now?

>> I think there are several counseling centers (LeeAnne speaking) in the United States that do offer telehealth right now. Forgive me if I announce the wrong name.

I believe it's the Deaf Counseling Center in Washington DV. That's where they're based out of.

Another that comes to mind -- I can't remember the name. Can someone help me out? National Deaf Therapy. And that's also telehealth.

We also have the Deaf Wellness Center. They provide telehealth. We don't know how long it will continue in terms of as things change

with the pandemic. We can't say. But we hope these resources will be available for folks in situations even beyond the safety concerns of the pandemic.

Again, it depends on insurance a lot of times. Insurance may say, oh, we no longer support telehealth because it's not required now that the pandemic is over. We can't predict.

>> Yes, next question. You know, people are expecting that they're going to tell me what to do. My whole life, hearing people have told me what to do.

Um... so, sometimes it's a lack of education with a Deaf individual. And the counselor will ask a leading question. This is all very much in English

so I'm trying to figure out what the question means...

Can you see the questions, you guys? The expectation, tell me what to do in the Deaf community.

If you go up, it's Question 4. Virtual counseling.

Okay, Read Questions 4 and 6.

So, if somebody is doing virtual counseling because they find it difficult to travel to appointments.

Um... is it effective? Does it work just as well as it does having counseling in person one on one? Is it as successful?

>> Well, I would say it depends. I think it can be as effective (LeeAnne speaking) but I am noticing a real increase in people using telehealth services.

In some sense it's more convenient to do it from home. Some people have children and problems with childcare. Maybe you can't bring a child to your counseling session.

There could be others in the house who need care. Or maybe folks don't have reliable transportation. They may not have cars, like I mentioned earlier, or it might be a 2-3 hour commute.

So, that's one benefit. It's also comfortable for them. I think sometimes people feel more comfortable staying in their own environment

rather than going into an office that they've never been to. So, whither a therapist or (please speak louder or move closer to mic) staying at home can be nice because as a provider I'm seeing something a little bit different.

(Dog barking).

>> LEANNE: Sometimes I'll notice a strange behavior in someone because they're comfortable and they're at home but I may not see that in the office.

Sometimes I'm able to spot problems and unusual behaviors because people are comfortable at home.


>> DONNA GUARDINO: I agree with what you're saying. I think it depends. Some people need that face-to-face speaking with someone because that's where the bond happens.

That's where the relationship is developed. But there are some people that, um... would struggle with having to rely on virtual or telehealth.

>> I do imagine that video provision could save time. It could reduce missed time at work. It could reduce, you know, some financial concerns.

So it can be --

>> The travel and the time that needs to be taken.

>> Yeah, and maybe less... to other sz. I think that's great.

We have 15 minutes left so let's touch on the next question.

The question is how to boost your mental health without seeing a counselor.

Do you have other tips or suggestions for people to boost their mental health? Self-care, maybe? Perhaps managing thoughts. Can you talk about that?

>> DONNA GUARDINO: Definitely self-care is part of it. Developing mindfulness, more awareness of the way you think, the way you behave,

how things affect you. Maybe reading a book that helps you with your own issues.

A big part of what we're doing is, you know, people are trying to figure out what to do. You know? There are so many things. People are busy and they're trying to finish something.

You know, maybe what we need is to have, you know, a day to themselves. A day for self-care. A day to give themselves that time.

Um... for some people -- actually, many people -- self-care for mental health is very difficult.

You know, you can see it with another person. A counselor can see it in you. You can see it in someone else. But to know myself to do it, I'm just not aware on my own. Any thoughts, LeeAnne.

>> Yes. I think that point of self-care, also, we give it a negative stigma. I'm doing something bad. For instance, it's not just saying

self-care because you abuse substances, drink too much alcohol, or overuse medication (dogs barking) those things... self-care...

eating right... food, eating when you're hungry, eating for Health (sounds like), taking the time to meditate.

You know, just taking time to socialize with other people. That in itself is self-care. So the idea of using bad substances, that's not self-care. That needs to more disappoint and more suffering.

And, you know, that doesn't help the emotions that you're trying to actually soothe. It makes them worse in the long run. It's just temporary.

Self-care is actually something that makes you feel good in the moment but also in the long run.

>> And maybe individuals can get in touch with their primary care physician or medical provider and talk with them about that.

And maybe get some tips from them that will match their individual needs.

The next question... oh, we lost...

How can I get a friend or a family member who doesn't want to go to counseling or to get help? How can I help them to get that assistance?

>> DONNA GUARDINO: Yes, this is a very difficult situation. There are people often who need counseling the most and don't want it.

But you cannot force someone to receive mental health care. I think the best thing we can do is to be supportive.

And I think what is also important for us is to be aware of resources that are available so when the time becomes right, you can provide

that to the person without saying, oh, hold on, I do want to help you but I need some time. You want to give them solid attention when they turn to you so you can lead them in the right direction.

But really, the most important thing when you know someone who needs mental health care but will not accept it, is to take care of yourself.

To have healthy boundaries. Not providing so much care that it's helping them but not helping you. But just to have the resources ready.

>> The next question that we have is, how do I know when I should be asking for help? What are the symptoms that I should be recognizing that it's a time that I need to ask for help?

How do I know when I should be contacting a counselor? LeeAnne?

>> Yeah, sure, I'll take this one. I think if you notice your motivation, just the timing, you don't want to go out, you don't want to take a shower,

and you see that over time increasing to the point where you just don't want to get out of bed and just would rather stay under the covers fofr days or weeks...

When you're seeing that, that's a sure sign that you should be asking for help.

If you're noticing you're crying for no reason and that's happening consistently. If you're noticing that you're sad every day or easily angered on a regular basis,

and that's happening of a course of time, those are signs that you need help.

If you're having a hard time keeping your train of thought. That's another time to get help. When you start to see things things happening.

When you start to consider hurting yourself, self-harm, considering suicide, even just day-dreaming about it, those are definitely times to get help without a moment's hesitation.

So that you have someone there to listen, to provide resources, to help you during that time.

>> DONNA GUARDINO: I think also when you are feeling maybe anxious, you know, I think that I can just put it past me and go,

but it's not as easy. You know, maybe that's when you need help. If you're feeling that beginning of the anxiety, that beginning of not being able to manage.


(Captioner having trouble hearing interpreter voicing).

>> You have to understand a little bit of anxiety can be normal for some of us. But once you start to have symptoms increasing on a regular basis, that's when it's going to be harder to get yourself out of that

struggle. That's when you begin to see a pattern.

>> LEEANNE VALENTINE: And I also want to add, you have to understand, some people think they're going to a counselor so they can fix me.

They're not going to fix you. You are there to learn tools, it's helping you to use your assets, being able to improve your life, your quality of life.

So, it's not the counselor's job to fix you.

We can't fix you. We're not in your shoes. We're not experiencing your life. We are there to help you utilize the tools.

And we're not baby feeding or bottle feeding. We are allowing you toundz stand what you need.

>> SUSAN DEMERS-MCLETCHIE: Right... right sources of support that's a very good point they're not there to tell you answers to your questions.

Okay, next question. People are saying, really, if I need an interpreter, isn't it much more difficult for me to get that mental healthcare?

If someone needs a sign language interpreter do you perceive that being a barrier for them in getting hooked up with a provider? I mean, maybe it depends on location as well.

>> Yes, yes.


>> SUSAN DEMERS-MCLETCHIE: You know, some localities are more aware of the need to provide disability access and some don't even know how to look for one whether or not they know it's their responsibility to provide one.

>> LEEANNE: I have hearing families with Deaf children and Deaf adults with hearing children. So, we at the Wellness Center are pretty good at bringing in interpreters when needed. We have no

problem doing that. Other locations...

>> DONNA GUARDINO: Yeah, that's very true. If you're in more of a rural area... now during the pandemic... telihealth...

It's hard to know... it may be easier for those localities that know they have the... but not a lot to choose from providing an interpreter over telehealth.

But it can be difficult. And I think some providers -- and even patients -- have a hard time with having a third person in the room.

So, that can feel like a barrier for people.

And during COVID, maybe people feel more --

>> SUSAN DEMERS-MCLETCHIE: During COVID we have the resources.

and really it's just also important to foound the right interpreter, or the client for the counselor as well.

>> DONNA GUARDINO: Not just that but an interpreter who is aware of mental health, has training in that field, that's a real concern.

>> SUSAN DEMERS-MCLETCHIE: Yes, definitely. LeeAnne, you mentioned about children. How can parents help their children or teens who may be having mental health problems? What is your advice?

>> LEEANNE VALENTINE: I think the most important thing is to communicate openly. Not to punish a child dealing with mental health issues.

Perhaps they're misbehaving but it's not their fault. Often if you... it could be an emotional response or a chemical response to something they're going to.

So the parents need to be open-minded enough to understand that there are a lot of things involved. It should be something that they feel comfortable talking to a doctor or counselor,

to obtain resources for the child. And to make sure that the child feels safe enough to go to paurnt, to go to the doctor, to speak with other people. Because children really learn to cope with things during child had

that will give them the skills they need when they get older.

>> SUSAN DEMERS-MCLETCHIE: Yes, definitely. Communication is key. We laugh five minutes left. And it says this is the last question...

So, the question is... we're assuming --

It's a yes or no question. There's an assumption that hearing people (captioner didn't hear).

>> SUSAN DEMERS-MCLETCHIE: Whereas Deaf people are just told what to doin stead of figuring out what they want do you believe this is true?

So, between hearing and Deaf individuals, do you believe that they receive the same mental healthcare?

Is it equivalent when they are giving the care? Kind of in summary, you know, we know that sometimes a Deaf individual has spent their life

just accepting a hearing person saying, do this do this do this. How do we make sure that the counseling sessions are being approached

in a way that they're equitable for both the Deaf and hearing consumer.

>> DONNA GUARDINO: It's hard to say. Really as a Deaf woman myself, I'm not sure how hearing therapists handle their clients. We're all different.

There are Deaf cultural issues. For sure in Deaf culture we value being very direct. And, you know, it depends on what we've been taught,

what modeling we see in terms of coping skills or other skills, what mode of teach, whether you had Deaf parents or hearing parents

and how they communicated with you. There's a lot of variety. It may be very different depending on how culturely sensitive a Deaf or a hearing counselor is.

>> LEEANNE: And as well, what I've noticed with a hearing family compared to a Deaf family, the hearing family kind of side steps and is kind of oblique about thing.

A Deaf family seems to be more direct. So, with the hearing families we talk about how to talk about those things that are being kind of passed over.

>> SUSAN DEMERS-MCLETCHIE: It looks like we only have 2 minutes left so we will wrap up this conversation. I hope we didn't miss any questions.

>> SUSAN DEMERS-MCLETCHIE: It looks like we only have 2 minutes left so we will wrap up this conversation. I hope we didn't miss any questions.

I just want to thank everyone. I want to thank our two presenters for their valuable information and share their time.

This is certainly a great benefit to the Deaf community. I want to sincerely thank both of you.

I want to thank the audience for participating with your questions and just viewing and signing in today.

We also have more information about future Deaf Health Talks. You can sign up here at these links in the chat. There's monthly information, newsletters, and other

opportunities to participate in the future. You can check the website. The address is right in the chat.

Folks are saying that they're -- someone just made a comment saying thank you, we're getting some good feedback.

There's another comment saying... thank you so much for your effort to support this.

If you're interested in making donations for the future, we are certainly open to accepting donations so we can continue to provide these kinds of

helpful informational talks regarding Deaf Health. So, there is a link to donate.

Also, if something strikes you as a hot topic, something you'd like to see a Deaf Health Talk about, please send us an e-mail, send suggestions

so we can specifically try to address those interests. And that e-mail would be deafhealthtalks at Gmail dot com with your ideas for future talks.

Thank you for your time, everyone. Thank you to the presenters. Thank you to the audience.

Deaf Health Talks, provided in ASL, with Q&A. Happening Tuesday, April 27, 8 to 9 PM EST, on Facebook Live and Zoom. Maternal and Pediatric Health during COVID-10, with Angela Earhart, MD from Perinatal Medical Group, Nigel Howard, CASLI and WASLI, DI, BA

Are you pregnant or have children and have questions about COVID-19, vaccinations, or how to navigate health during the pandemic? 

Panelists: Dr. Angela Earhart, MD, deaf family physician and specialist in maternal-fetal health; Dr. Michael McKee, MD, MPH, Deaf family physician; Deaf interpreter Nigel Howard. 

Download the event's resource sheet

Download the closed caption transcript (PDF)

Read the transcript

>> MIKE MCKEE:  Hello, everybody!  Welcome to tonight's talk.


We're going to talk about COVID as well as its impact on mothers, pregnant women, families, kids.


And so we're just going to talk about how that's going on today.


I'm going to be one of the co-presenters tonight. We have Dr. Angela Earhart joining. She's a Deaf OBGYN in Texas. We're so glad she's with us.


So if you have any questions about how pregnant women can be safe during COVID, making decisions, and planning to keep yourselves safe during pregnancy.


Nigel will be joining us later this evening. So, we're thrilled that he's going to be here as well.


He's a professional interpreter from Canada.  So, again, he's going to be joining us as soon as he can. But with his experience as a medical interpreter,


he's going to clarify some of those concepts so that they're very clear in ASL.


I'm a Deaf family medicine doctor here in Michigan.


So I work with all ages of the family.


And as we've all had our world up-ended by COVID, it's important to know how to be safe and make good decisions.


So we're going to review a few things tonight with our Deaf Health Talk.


So, thank you for your support. We're going to talk about some of our collaborators tonight as well.  We have some partners with Deaf Health, Michigan Deaf Health organization, University of Michigan


Department of Family Medicine.


MDisability which is an organization within Michigan Medicine.


We have an interpreter services department as well. So, we just want to thank everybody for their hard work in making tonight as a success.


We have CART.


We're on Facebook Live. I know sometimes the captions can get cut off if you're viewing this on your phone, so a laptop or computer is usually better.


We'll also have captioning through Zoom as well. Want to thank Kate Miller for being our captionist tonight.


The other thing I want to mention, related to pregnancy, is we do have a Deaf maternal health survey. We're trying to investigate the


experiences of Deaf and hard-of-hearing mothers.


So we'll be sharing a link to that survey in the chatbox. We really encourage you to take the time and fill that survey out for us.


We want to learn more about Deaf and hard-of-hearing moms and their experiences with health injustice,


and seeing what we can do to make services better for them.


If you can't fill it out yourself but you know a Deaf or hard-of-hearing mom, please share that. Because, again, we're looking into health disparities and


we're working to improve access and health for Deaf moms.


So, COVID really has up-ended the family.


About 10% of all COVID cases are children.


And while their symptoms seem pretty mild, they don't have anything real severe, when they do a nasal swab or a throat culture,


they are infected with COVID about 10% of the time.


So we really encourage you to kind of take stock of what's going on at home, who you're socializing with, making good decisions


about acceptable risks, or what environments are really bad risks for your family.


We're at about 35 million kids who have already contracted COVID-19.


Most of them have recovered just fine.


So the question remains, why is it that children seem to have more mild or light symptoms compared to adults?


Research has shown, or at least has led us in the direction...


Where there's the Ace 2 receptor. Because children don't have as many of those as adults do, it seems that for their lungs, heart, or brain development -- right, because of their anatomy, they don't


have as many of them. So, the way that COVID infiltrates the immune system doesn't cause that same kind of problem for kids.


Does that mean that kids will never get sick?.


No, in fact about 1% of children who contract the virus have to be hospitalized. So, it's still important that you're doing everything you can to protect your children and avoid unnecessary risk.


But luckily, most children, when they get sick, recover quickly.


Only about 200 kids so far have died. Obviously we want that number to be zero.


But compared to the number of adults, which is 560,000 people in the United States alone who have died from COVID-19, 200 is remarkably


small and so we're glad that number is so low.


The other theng is, mis-C, which is a strange term. So, within the immune system, for kids,


what happens is when they contract the virus and their immune system starts to break down as it's fighting it,


about 1 in 50,000 kids develops this MIS-C.


And for that, they definitely have to go to the hospital and be evaluated in order to recover.


So the way the world is now, parents can feel so overwhelmed with kids having to stay home because schools are closing,


working on childcare, not being able to go to work themselves, feeling overwhelmed and isolated because they're only at home,


that isolation is really a difficult thing for families to deal with.


It's nice to know that some school districts are starting to open, so there's more socialization for our kids again.


Once schools are open, though, it's important that they have to follow the six-feet distance.


So the regular classroom seating we're familiar with is not there anymore. They have to be further apart.


And different situations where they would socialize, like lunch in the cafeteria, that also looks different in terms of seating.


Masking, handwashing.


They have to increase ventilation within the school building as well. The AC units have to filter and the airflow has to be at a certain percentage.


Studies have shown, though, that there is a lower risk of contracting the virus within the educational setting than just in a typical social setting.


So it is a relief as our kids start going back to school.


As a parent taking the time to consider whether or not it's safe enough for your child to go back to school,


also look at who they're around outside of school,


whether their grandparents are in a position where they're safe enough. So, that if kids were to b get the virus and bring it home.


Children can be carriers and we want family members to be protected.


If you have anyone with cancer, going through chemotherapy, has a compromised immune system, has had an organ transplant,


these people are at higher risk, especially of contracting the disease, with the severity of death. It wouldn't be great if kids brought it home.


So take stock of who is in your family, who has health issues, and make sure that you're confident there before sending your kids back to school.


There are still the remote and distant learning options.


And considering kids themselves, when somebody is going through cancer treatment or has an organ transplant, say, something like


sickle cell disease, it's much easier to contract the virus. So, it's up to you to weigh the risks to send them back before the vaccine,


but to make sure the risk is as low as possible.


And some kids also have to find a balance. It can be really isolating.


There might be some emotional distress. And remote learning, looking at a computer screen all day through Zoom,


is not the same experience. And so a lot of  our kids are suffering without that face-to-face contact.


Which leads to getting behind in school work and academic success.


So, it's important to really work hard at identifying these issues with kids and helping them catch up.


So you have to really look at each child and figure out what's the best scenario.


There will always be some risks. So, you'll laugh to weigh the pros and cons with each decision.


And there's no wrong decision. It's important that every family feel confident that you are making the right decision for your life, your family, your children.


And for other members of your family and their health as well.


As we look to summer and even the coming fall, and we think about sports or family vacations, outdoor sports and vacations


you should feel very comfortable with. Sports that are high contact usually require masks. For example basketball is one that's high-risk/high-contact.


Track and field is much more safe.


If you're considering going on vacation, I suggest avoiding amusement parks, avoiding arena, whether you're watching an event, just


remember distance spacing to keep safe.


As we think of the fall coming up, there may still be the options of remote learning, or going back to in-person school.


Some schools also have this alternating schedule where you would go in person on Monday, stay home the next day, while another group of kids goes into school.


And so they've sort of split the classroom up like that and they've rotated.


So just consider that there might be some stipulations as kids go back to school in terms of scheduling.


But I think that we're going to see most schools still providing both options.


So we'll have to see what that looks like in the fall.


I know a lot of parents are looking forward to or seeing if a vaccine is going to we available for their children.


Pfizer and Moderna have already started clinical trials.


To see if there's comparable safety for children as there was for adults.


So we'll still look forward to the results of that.


But they're at the head of their study right now.


Where both adults and children are continuing to be part of this study.


So as the months go on, we'll have to see what the results will show.


And we're still looking for FDA approval. Now they're still under emergency authorization.


And not sure exactly when that will be fully approved by the FDA. Could be the fall, could be even next year.


But I know that once that full approval comes in, a lot more people are going to be confident about receiving the vaccination.




So I'm going to go ahead and pause and let Dr. Angela Earhart take over.


She's going to talk about maternal health in pregnancy and to keep safe.


>> ANGELA EARHART: Good evening. I'm Angela. My focus is high-risk pregnancy. I take care of women who have complicated pregnancies


and I've seen a lot. There's a lot of questions about COVID and pregnancy that I want to talk about.


There are three things. The first thing is the danger of COVID during pregnancy.


The second thing is how to protect yourself during pregnancy.


And the third thing is, I want to address the vaccine.


Things that have just come out about the safety of the vaccination during pregnancy.


So those are the three things I'll focus on. The first thing is why pregnancy and COVID are dangerous together.


We know that pregnant women are more likely to get sick.


There's more risk for a birth that has to be transferred to ICU.


There's more difficulty in breathing. A lot of people need to have ventilation support for breathing.


We know that pregnancy causes higher risk for dying.


Pregnancy itself compromises a woman's immune system. It makes it a little bit different.


So the baby, as you're pregnant, the way it affects the lungs is --


It's not the same as when you're not pregnant.


Women tend to get sick more often when they're pregnant, and certainly with COVID.


Thank fully, most women who are pregnant, if they contract COVID,


usually have mild symptoms and tend to recover just fine and go through the regular process of pregnancy.


But we do have some groups of people who are at higher risk.


Older moms, so 35 above into the 40s, they tend to be more likely to be sicker.


African-Americans or Latina. People who have diabetes, high blood pressure, heart conditions, asthma, or COPD.


So there's a lot of different health issues that can cause more serious symptoms during pregnancy.


So one thing I really want to point out that I think is really important that we've seen so far, we have not seen any birth defects once the baby is born.


There doesn't seem to be any relation to the mother having COVID, the virus, and that affecting the baby in any negative way.


We've also not seen any virus cross through the placenta to the baby.


So of course the baby and the mom are connected by the umbilical cord and the placenta, and that's connection between the mom and the baby


and that's how the baby gets nutrients. And as we've tested babies, we haven't seen any virus transfer to the baby. Which is interesting,


because you would think, through the placenta, it's a barrier that offers protection for the baby, so it seems to be effective.


Also, research has shown that it doesn't seem to affect the time of birth, that once the blood draw is done, it doesn't seem to have transferred the


virus to the baby. So, it seems to be a balance. There is some protection between the mom and the baby during pregnancy.


So, how to protect yourself during pregnancy, this is the second thing I want to talk about.


So, it's very, very important to keep up with handwashing. Do that very often. Everywhere you go.


Use a mask. And the third thing is, make sure that you keep your distance. Try to avoid crowds, big gatherings of people.


And once the baby is born, a lot of people want to come visit and see the baby, but don't let that happen yet.


It's really better to limit visitors to see the baby.


As far as protection goes while you're pregnant, there's some new information about vaccination.


One of the things that's very interesting, there was a study done last year that did not include pregnant women. They were left out of the study.


So they were al doing men and women with no pregnancy and they found that was kind of a problem. Well, what do I tell women who are becoming pregnant,


who want to have the vaccine?  They want to know, should I get it?


And recently there's no information. It's available since December 2020 and so we've had maybe three to four months of tracking.


And so women who've gotten vaccinated are usually health care providers.


So they've gathered information from groups of women who are pregnant or who became pregnant after getting the vaccination.


And what we're seeing so far is that it looks very promising. Looks like there's good results.


The vaccine provides good protection for both the women and the baby, it seems so far.


There was just a publication I think maybe just last week in the New England Journal of Medicine.


It published about 35 women looking at the comparison between those who are pregnant and those who are not.


And looking at the side effects to see if there was any difference between pregnant women regarding side effects.


They found that the side effects were similar for both pregnant and norn. Other than soresness at the site and fatigue, both women had the


same side effects. So, that was very encouraging, because they weren't sure if the pregnancy would cause more issues.


And one thing that I do want to make sure is understood is,


the vaccination itself is not a live virus. Sometimes people are worried about that, but it is not a live virus.


It's a new kind of technology called mRNA. The so it's not the virus itself.


Another study was how effective would that be during pregnancy.


So they studied a group of pregnant women who had been vaccinated.


And then they looked at something called antibodies.


And so, those are things that we look at to make sure that you have protection, immunity to a virus, almost like an army.


You can imagine like the soldiers in an army kind of taking on the virus.


And so your body, once you get the vaccination, starts to make these antibodies.


So we'll check for a blood draw to see if your body is making the antibodies.


And so what we saw is that women who are pregnant had a good response and made antibodies similar to women who were not.


So there was some question about effectiveness during pregnancy and we found out that it does work.


So there was some question about effectiveness during pregnancy and we found out that it does work.


Another thing that was interesting was the research showed, they wanted to check the baby, the umbilical cord, and see


if the antibodies actually went through the umbilical cord to provide protection for the baby, and they found out yes the antibodies did travel through and give immunity protection to the baby.


So the mother's antibodies are able to travel through the umbilical cord and so the baby is born with the antibodies.


If the mom wanted to breastfeed, research has shown that the mothers milk -- they wanted to check and see if there were antibodies that would be


transferred in the milk, and they found out that was true.


So if you think about it, mom can provide protection during pregnancy if she's vaccinated by sending antibodies to the baby.


And even after the baby is born, through breastfeeding, the baby is able to get antibodies in two different ways from the mother.


So that's very exciting. But this is still early in research. We need to have a lot more research done, larger groups of people that we can study.


Because we still have some questions about early exposure.


So, pregnancy has different sections, three different trimesters. So, the concern is what happens if an exposure occurs during the first trimester versus later in the pregnancy.


In the first trimester, that's where the baby is really starting to develop. All the things are forming, brain, heart, lungs, spine.


And so right now, we don't see any relationship with birth defects and vaccination, but it's still early in the research. So, we are collecting a lot more data and we need to have some more long-term studies to


collect the data that we need before we can make a really informed decision on the first-trimester exposure.


And there's many, many questions about fertility. Can you get pregnant after you get a vaccination?  Will the vaccination prevent me from getting pregnant?  Will it cause infertility?


No. So, far we've seen women are fine getting pregnant after getting vaccinated.


So, again, there's more research going on about that.


Another question that is asked all the time is, can the vaccination cause a miscarriage to happen?


And so far what we've seen is there seem to be a similar percent of miscarriages, which is about 12%. We haven't seen any increase in that with people who are vaccinated.


But again it's still early on and we need some more information from long-term studies.


So, to review, we know that pregnant women tend to have a higher risk of illness because of COVID.


So we really need to make sure that they are protected, both for themselves and their families.


So really consider vaccination.


CDC, there was a news conference I think on Friday, that said now they are recommending that pregnant women get the vaccine.


So start talking with your doctor and see. Because so far we haven't seen any bad or higher risks for women who get the vaccination.


And it seems to provide protection for both the mom and for the baby.


>> MIKE MCKEE:  Great. And I know that a lot of people are already concerned, right?  The vaccine is such a new technology. But it's been


very, very positive. Very effective at protecting everybody. There seem to be a lot of benefits. And now like you're saying, it's protecting


moms and they can pass that protection on to the baby as well.


So I do want to talk a little about where we are with the three vaccines. I'm sure some people have heard and it's caused some concern,


about the Johnson & Johnson vaccine, which is on hold.


It does have potential to increase a person's risk of getting blood clots. Tends to be in younger people, under the age of 50, in women.


But it's a very, rare, rare development. I wanted to stress that. Less than 50 women. So, it's like 1 in 80,000 people roughly is the risk.


So compared to getting the risk of COVID, the risk of getting a clot is so minimal, from the vaccine.


And only just a little bit less than 1% risk of contracting a problem from the vaccine. You know?


And if you think about getting in a car and driving, which is what we do every day, it's less of a risk than getting into a serious car accident.


Again, all of these things are factors that you have to consider, whether or not the vaccine right now is right for you.


But there are so many positives. I really encourage everybody to get the vaccine.


And if you have -- so if you're a mother or you're currently pregnant and determining whether or not Pfizer or Moderna is right for you,


considering Johnson is currently under more scrutiny,


when we look at platelets, which is part of your circulation. Like when you get a cut it's the first part of the body to respond to that cut to make a clot.


Both Pfizer and Moderna are low risk for having platelet issues which could lead to clotting problems.


Will we see the Johnson & Johnson vaccine come out again?  I believe it will. But Moderna and Pfizer are still available.


And now teenagers can get it. 16 and up for Pfizer. Moderna is 18 and up. But I suspect that fuser's actually going to have the youngest


age limit drop down to 12 years old soon. They're currently in clinical trials for young teens. So, that age group from 12-16.


Which is part of what I talked about at the beginning of the talk tonight. The clinical trials have six months of study between that 12 and 16 year old age group.


So we're not going to see the results of that for quite a while. That's something we'll have to look forward to.


But I suspect that it's going to be available for a wider age range so that we can start to have that protection for more people.


And the vaccine is not just about protecting yourself; it's also about limiting the spread, right?  It's a community responsibility to tame the virus.


So I want to give Nigel some time to go ahead and talk about his experience as an interpreter within the Deaf community


and maybe clarify some of the misconceptions that are out there. Nigel, take it away.


>> NIGEL HOWARD: Thanks. Yes, thanks, Mike. First of all, I want to apologize for arriving late.


I just -- with the time difference, I just couldn't get it quite set. And I had 7:00 in my mind, but realized that your 8:00 is my 5:00. So, I just had a moment of confusion.


Anyway... as Dr. McKee and Dr. Earhart said, there are a lot of women out there, pregnant women especially, who are on the fence


about whether to get vaccinated. Dr. Earhart mentioned the three stages of pregnancy, the trimesters. Our public health officer just


announced that it was perfectly safe.


Now, in consideration of getting the vaccine or not, getting the vaccine is much safer than taking the risk. Because what that's doing,


as Dr. Earhart mentioned, it's the mRNA. It sparks the body. It says, hey, I need you to get ready. Right?  It's a training regimen for your body,


in case any disease were to come in. So, in the case of COVID, right, it's ready to fight COVID and to recognize if it's trying to infiltrate your


body. So, what the vaccine does, it teaches your body how to recognize it.


And she also mentioned the antibodies that it creates in your system. That's an army, ready to go, that front line of defense.


So when COVID is there, they're ready to get into high gear to address that virus in your system.


And a lot of research has gone into, is that you can still get sick, but it will prevent your symptoms from being so much worse.


She also mentioned the umbilical cord. When the baby is born, the breast milk as well is a good source of antibodies for the baby.


So what that does is, the umbilical cord gives the child all the nutrients that they need while in the womb as they grow --


Blood, antibodies, plasma, all of that stuff comes through the umbilical cord as the baby's growing.


And then in side of the breast milk as well.


So any disease, all of this can help to protect. So, when you get the vaccine, all of those antibodies then transfer to the baby these ways.


So because of these excellent pathways that the body uses to protect both mom and baby, it's much safer to get the vaccine, right?


This is a support system for your body as it fends off COVID or any other virus. Like the flu. That's what the flu shot does. The flu shot


alerts your body to be aware of this virus and when it recognizes it, it fights it for you.


If you don't get the vaccine, then so much more the virus can get inside, your immune system has to work harder, and that leads to


more complications.


Research has shown that all the vaccines available right now are good. Yes, Johnson & Johnson is on hold currently. But typically research for


vaccines takes decades to reach fruition. But because of the speed of this, there's also much more stringent regulations to ensure the safety


before we disseminate the vaccine.


The Internet's going to go off on its tangents.  The so don't look for that information. Look for the medical professionals.


Look, we've got two Deaf medical professionals here, experts in their field. Those are the people you're wanting to get information from,


not just people posting on the Internet. Where are they getting their information from?  The research may not be there to support it.


If people want to share their views online, there's nothing against that, but in talking about where the quality information is coming from,


check your sources.


And for pregnant women, the vaccine, again, is just going to boost your immune system to be able to work against COVID.


And the other thing to consider is variance.


Because what happens is, COVID will change a little bit. And those variants, your body is still protected from those with these current vaccines.


So when COVID's at your door or in the community, it's not able to effectively get into people who have the vaccine.


And if enough people have the vaccine, that virus can't get in, can't replicate, and eventually it dissipates. Right?


And so what we do, as we have more and more people who can get the vaccine, is we continue to expand our pool.


There are researchers all over the globe digging into this and sharing their k findings.


As we find more information and it becomes safer for more and more people, we're going to expand that pool of people who can get the vaccine.


And of course there are allergic reactions to consider. Right now it seems the vaccines cause, with the first shot, some site pain in the arm.


But people aren't dying from this. It's very, very rare that complications develop in somebody who gets the vaccine.


And so as they're finding more and more people are receiving the vaccine and it's working well for them, they're going to continue


to expand the pool of people that can get the vaccine.


So, 18 years old for Moderna -- or 16 years old for Moderna, 18 years old for Pfizer.


In Canada, where I am, it's 40 years old and older able to get the Afrazeneca vaccine.


What's different about that is that it's a single-dose vaccine, just one shot. And again there shouldn't be this extra resistance to it.


It's just something to help your body.


>> MIKE MCKEE:  Great, great talk. Thanks, Nigel.


So, when we're talking about the two vaccines that are two doses, with Pfizer you get a second dose three weeks later, but


you have to wait two weeks before you're fully immune. With Moderna, you get your second dose four weeks after the first and then again


it's a two-week window. With the Johnson & Johnson single dose it's still two weeks after for your body to develop full immunity.


Sometimes people think after they get their first shot, hey, I'm great, I'm vaccinated. Please pay attention. And follow the vaccination schedule


so that you are fully vaccinated and your body has all the protection it needs. We're going to go ahead and turn it over to the audience.


There have been some questions, the first relating to family and kids.


Is it all right to travel once parents have been vaccinated even though unfortunately there are no vaccinations for kids?  What should you do?


I support you traveling. But when you're going somewhere, where there's a lot of people, that's a higher risk.


So think about camping, where your family unit can be together and enjoy this. Or in a cabin. Air BnB. Single-family occupancy.


If you want to go visit family, as long as the other family members have been vaccinated -- can you trust them?  Are they following guidelines and taking cautions?  If so, that's great.


But having all these different households getting together and socializing, it's going to be much higher risk.


This is a great time to think about getting outdoors, getting back to nature. You know, outdoors is much safer.


So if you try to go to other countries, they actually require proof of the vaccination. Not so much here in America, but like Europe or other countries you might want to visit.


Pay attention to those travel restrictions. Because if your kids haven't been vaccinated even if you have, I'm still pretty sure that's still the requirement.


So you have to look at where you're traveling to.


And also look at the number of cases and whether or not they're on the rise. Unfortunately here in Michigan cases are really rising.


And once you get there, will you have to isolate?  There may be places you want to visit that have travel restrictions. You might fly somewhere and be stuck and not realize it.


So just think about all these things and where you might have increased risk.


Dr. Earhart?


>> The second question is, is it safe for pregnant women or women who want to become pregnant to get the vaccination for the flu or for COVID.


And the answer is yes. Both of them, the flu vaccination is fine during pregnancy. Please go ahead and get it. It provides a


lot of protection against the flu. And now, as I just shared, it seems loot thae far the research has shown that it's safe to get vaccinated


for COVID. So, again, please go ahead and sign up for the vaccine. It will offer protection for you and your baby and for the whole family.


>> MIKE MCKEE:  Nigel, did you want to add anything?


>> NIGEL HOWARD: Yeah. So, if anyone in our audience here gets the vaccine, whether or not it's Pfizer or Moderna, right, just pick one,


that two-week window that we're talking about, your body is still in training, so to speak. It's like building a house, right?


You lay a foundation, you have to pour the foundation first. You don't just move in, right?  You pour the foundation for sure.


But once the foundation is set, then you add the walls, start to frame the roof.


It's the same idea with the vaccination, right?  Once that first vaccination goes in, that's building the foundation.


Then you have that two-week window, once you get to several weeks after, up to four months depending on your state guidelines.


Whenever it is that your time schedule is to get the k second dose, that's framing the walls, building the roof, and building on that nol solid foundation of the first vaccine,


the first dose. So, that's completing your house. Once your house is complete then you get to move in. Same idea with the vaccination.


Once your body is completely trained, has done all the framing that it needs to do, it's ready.


So when your body is fighting the virus, it's nothing. It's just a little event.


So thinking about just -- it's important to still stay as contained as possible with your family unit.


If you want to expand your pod by including a couple of other people,


make sure, again, that you continue to see the same group of people. As opposed to everybody sees different people.


Because what you're doing is, you're seeing all the people that they've seen when you get together. So, stay with the same pod,


until your state public health officer gives the all-clear or changes the regulations.


As long as the public health officer is saying that there is still some concern, follow that concern. Don't socialize in large groups.


Right?  It's um important to, as your unit goes places, maybe you go traveling, like Dr. McKee was saying, but you go somewhere


and there's no hospital?  Be careful. Pack all the food that you need from home and bring that with you to your campsite or cabin.


That way you don't have to go grocery shopping in an unfamiliar environment where COVID might be around. Right?


And then of course clean everything up, don't leave anything on your campsite, be respectful.


Where I am in, in British Columbia, we're still on a travel ban. The local authority -- we have five different provinces.


And so you have to stay within your local province. So, Vancouver Island and the City of Vancouver, you can't go across the channel to vuz it.


-- visit. And for good reason. Even if it's by boat or by plane, you want to keep all these different provinces separate.


So the important thing is common sense. Right?


Once you get vaccinated, it's not gone. You are more protected but you have to think of the people around you,


whether or not they're at risk of giving it to you or getting it from you.


So, wait for your public health officer to give the all-clear.


>> ANGELA EARHART: I also wanted to expand. Once you get your vaccination, you still need to wear your mask, protect yourself, social distance.


>> ANGELA EARHART: I also wanted to expand. Once you get your vaccination, you still need to wear your mask, protect yourself, social distance.


>> NIGEL HOWARD: Absolutely.


>> ANGELA EARHART: And that's because you still might be able to spread it. We're still not sure. Even if you've been vaccinated,


please keep wearing your mask, keep social distancing.


>> MIKE MCKEE:  The vaccination is very effective. It's almost 100%. It's the best tool that we have right now in fighting this.


But it is important for everyone to remember it is not 100% effective. Both Pfizer and Moderna, 1 in 20 still get stick.


So it's important to be as safe as possible, follow the masking and distancing precautions.


The next question is traveling by plane.


What's interesting about a plane is that they filter their air. It's like what happens in an operating room. So, masking, distancing,


while sitting on the plane, handwashing, you should be okay to travel on the plane.


They are not distancing in their seating as much as they were before; I notice they're sitting people closer together again. So, that's interesting...


But within the cabin, the airflow is really well filtered so there's a lower risk of infection from that.


Whether or not you want to travel by plane or whatever, consider what you're traveling for. Family emergency?  Obviously.


But if it's just that you want to go out and do something, vacation, this may not be the best time to do that.


Again, consider your level of acceptable risk. Anyone else want to say anything on that?


No, okay.


Another question is will there be a fourth, fifth, sixth wave?


Well... just looking at Michigan, unfortunately we are in a fourth wave. We are really struggling as a hospital with the number of people that we are admitting.


So, things are not going well here. Across the US, it seems that actually some places are still experiencing COVID spread.


But as the warm weather comes around and lots of people are getting out more, the numbers aren't as bad in other areas.


So, again, the warmer weather will cause the COVID cases to fall.


Looking into fall and winter of this year, it will really depend how many people got the vaccine. Have we reached what we've known as


herd immunity?  Which is enough people in the community vaccinated. And like Nigel was saying, the virus is going to try to look for


an easy tar get, someone who hasn't gotten the vaccine. Because if the virus can't infect people, it will eventually die.


With herd immunity we need a minimum of 75%, give or take. But that's our target in terms of vaccination for immunity.


So even though we think it's enough, the virus can still spread.


Because COVID is changing. There are different variants. So, if there is a variant that we haven't seen before, that could be a risk.


But, again, these vaccines are providing some relief for us in terms of protection. So, follow the recommendations.


Once we have enough people who are vaccinated.


We'll see how it goes, though. Yeah, Nigel?


>> NIGEL HOWARD: Let's take a look at the big picture. Let's compare it to sheep. Okay?  You have a pasture of sheep.


All the sheep are white. White, fluffy, wooly flock of sheep. And then we've got one black. That one doesn't have the vaccine, right?


Everybody else in this flock has been vaccinated. The virus is going to look for the black sheep. As it tries to get way out there, it's


going to fail, it's going to die. That's that protection for the flock. Because enough of the flock...


And then I see this confusion sometimes about masks. You know?


I mean, if you look at hospital situations, they're the worst. You have to think about the health of yourself, but also the health of those around you.


Just wearing a mask. We're not twisting your arm. We're not asking you to permanently secure it to your face. You can take it on and off as you need to.


There's another thing I wanted to mention, though, in terms of the waves.


We're still kind of anticipating there's a little bit of a rise, we're looking to maybe our third wave.


What's interesting is that older people are dying less, are being admitted to the hospital less, because vaccine distribution,


here where we are, started with the eldest. And as enough of those people were vaccinated, we could continue to lower the age.


There have been a number of medical emergency personnel who have been able to bump the line as well.


We aren't down to zero, but much less than last year.


It goes back to my analogy about the flock of sheep. If we have enough people that, for whatever health reasons or whatever, are still


susceptible, it's still going to spread. So, we have somewhere between... 50s and 60s -- or 40s, people in their 40s.


I'm not sure what it looks like in the states for you guys, but still going to the hospital, because those are the ones that have not been vaccinated where we are.


Still important to follow common sense. Even after vaccination, distancing, mask wearing, hand sanitizing. These are all the precautions we need.


Follow the health department. They are making decisions that are the best for our communities. They're the ones that know. They're doing all the research. I don't have that knowledge.


I don't have access to that information. They're the experts and they're the ones we want to follow.


>> MIKE MCKEE:  Yeah, that's really great advice. In Michigan we have about 29% of the people vaccinated, right?  We have immunity for those 29%.


But in terms of protection for the others, you know, COVID is still able to find pockets of communities and people where COVID can spread.


Next question a person asked -- sorry, interpreter correction --


If there's a serious reaction, will you know if it's safe or not?


I just want to be clear, are you talking abouts once you get the vaccine?  Or if you get sick?


In terms of the spleen, so with antibodies I would recommend that if, in that situation, you have no spleen, it's really important to sit down with


your family doctor and look at the options. Could you get sicker from the vaccine?  Could use get sicker without the vaccine?  You know,


the flu shot and COVID vaccine are very different. You can't really compare. Do what's safest. Look at your health options, your health


sister, come up with a plan, and see -- health history. Come up with a plan and see if your doctor can give you better tips on that.


Okay, next one says COVID spreads as a respiratory virus, not through signing. So, does COVID spread less in signing communities


Okay, next one says COVID spreads as a respiratory virus, not through signing. So, does COVID spread less in signing communities


because they're not talking as much?  Does that mean it's a lower risk?


Well, no, because people are still breathing, right?  Breathing is enough to spread the virus.


Talking, singing, yelling, of course obviously the virus is going to spread a little further a little faster. But you're still breathing, so, no,


there's not like less risk. In fact, there are lots of Deaf people who have gotten sick and unfortunately in our Deaf community have died thinking this.


I know we have just a few minutes left. So, let's see if there's any other questions.


Oh, looks like there's one more. Question about mask requirement.


What's your best recommendations?  So the CDC just announced that once you've been vaccinated, you've had both doses, or


with Johnson & Johnson the full dose, right?  When you're fully immune based on your vaccination, you can take your mask off when it's safe


not when you're in a crowded environment. Like within a star -- I know some states are starting to get a little bit lax and leaving it up to


the individual to decide. I'm not sure about that. In my opinion that's still not safe -- in the store.


It's important to respect other people in the community. You don't know who has an immune deficiency, who is more susceptible.


Other people's health is our responsibility. Wearing mask is such a simple act. It's not a big deal at all. I know we're all getting fed


up with all the restriction, but it's so important to protect each other and it's such an easy thing to do. So, I recommend still wearing a mask.




>> NIGEL HOWARD: Again, I just want to reinforce, like, okay,  let's say you have a politician and you have a medical professional.


Who has the experience?  Who has all the knowledge?  The medical professional. They're the ones who have done all the research,


they have the years of experience, they have the university credentials. A politician doesn't know anything about that. They know how to


flush the toilet, I'll give them that much. The point is, listen to the experts, listen to who has the information, the doctors, the nurses


that professional community. A carpenter is the expert in building a house. They're experts in their fields for a reason.


Politicians have lots of things to say, but they don't know. They just want your vote. Right?  And I'm neutral. I'm from Canada so I don't


even have an influence in your American political system.


States all over are concerned, but one of the things that we can do is wear mace.


-- mask.


This lessens the variance. Because a lot of these variants spread so much more quickly.


Going back to the house analogy, right?  If you're in a house with a lot of people, right, it starts to get humid.


You've seen the windows fog up because of that. Don't do that all that breathing inside. Outside, social distance, wear a mask.


If you are together inside make sure there's ventilation, that the AC works well, that there's good exterior exhaust.


Health professionals know what to do. They will deliver the guidelines at the appropriate time. Politicians are great, they do what they do.


But no thank you, they're not the health experts.


>> MIKE MCKEE:  All right, it's time to close. We're getting to the end of our time. But I want to thank everyone for joining tonight.


Thanks to both of our other panelists for your expertise and for sharing.


Next month is going to be mental health because it's mental health awareness month.


So we're going to talk about mental health strategies for managing mental health during the pandemic.


I also want to thank all of our partners for supporting our Deaf Health Talks and making them a reality.


We're also looking for more moms to take our survey.


So if you know somebody who's a Deaf mom, hard-of-hearing mom, please encourage them to fill out the survey.


Thanks to our interpreters and to Kate for captioning, and thank everybody for coming tonight. Thank you, thank you!


Good luck, everybody, take care.


>> Yes, please, stay safe.


March 2021: When to go to the Emergency Department

When should you go to the ER? What do emergency doctors do? Two signing ER doctors Dr. Jason Rotoli, MD and Dr. IV Mirus, MD discuss examples of the most common reasons people go to the emergency room, discuss examples of emergency medical problems located in different areas of the body, and discuss the differences between the Emergency Department and Urgent Care. With moderator Sarah J. Hein, MSN, FNP-BC, Michigan Deaf Health. Download this event's resource guide.

Read the closed caption transcript 

>> SARAH HEIN: Hi, my name is Sarah. I'm a hard-of-hearing NP here at Michigan.

Welcome to the Deaf Health Talk.

This month we're going to talk about the emergency room, why you would go to the emergency room, why the emergency room is important

what you would see at the emergency room. So, we have two fantastic doctors here tonight. We have Dr. Jason Rotoli and we have Dr. IVMuris.

They're both from the University of Rochester and they're both really awesome.

So, um... before we get started I wanted to let you know that

if you're on the Facebook Live page, you can post your comments and questions.

We will have a Q&A at the end of this talk where you can ask questions and you can have a doctor answer your questions.

They might be able to answer questions during the presentation as well.

We also will have comments and resources during the presentation that you can click on to go to more resources during the talk.

I wanted to thank you all for coming tonight.

And thank our tech team, our captionist, and our interpreters.

So right now I'm going to hand this over to Dr. Jason Rotoli.

>> JASON ROTOLI: Thank you for introducing my. Dr. IV Muris was supposed to be here but we've had some tech problems and not been able to connect with him.

For whatever reason he is now blocked from getting in. So, I apologize that he is not here to present with me.

But anyway, I'm from Rochester, New York. I work at the University of Rochester emergency department, emergency room.

Some health talks we've done before.

We talked about the emergency room before but I wanted to make sure that we could do this again.

I want to be able to explain what the word emergency actually means when we're talking about the emergency room.

And the difference between the emergency room or department and urgent care.

So, we'll discuss those differences.

And we'll go through a few examples and scenarios having to do with the emergency room and what it looks like.


First, let's talk about why people are showing up at the emergency room.

They go there for whatever reason. There are some common reasons. Throughout the world show up for chest pain.

Or abdominal pain.

Sometimes it's because of dizziness, they've passed out.

Another common reason is at the time having a fever.

And the last most common reason is having a headache or migraine or pain.

But there are several reasons people show up in the emergency room.

Maybe you've experienced the emergency room yourself, had those experiences, had back pain or had a headache.

Or you've had some sort of pain that you needed to have addressed.

So whatever your emergency room visit was, what it looked like, you can let me know within the chat if you want to discuss that and let us know.

So go ahead and let us know if you have those experiences yourself.

So, what we want to talk about right now, though, is specifically the word emergency and what that really does mean.

It means any situation, a health situation, that causes your health to decline, to be impaired, to cause death, or

it can be a serious problem with your physical body.

It's anything that if you -- it's something that happens quickly.

And if you are not able to get treatment for it but you cannot wait for treatment let's say for tomorrow or the next day or next week,

that's an emergency. Something that you cannot put off treating or having taken care of.

And the problem is something that you should talk to your PCP about.

Maybe your PCP will direct you to the emergency room.

Or the PCP will ask you to wait and come into the office.

So, urgent care. Why do people go to urgent care? And really, that is the place that is --

It's for things that cannot or should not be treated at the emergency room. You can go to urgent care without an appointment. You can use your insurance to be able to pay.

You can pay in cash while you're there. And it also saves time.

So, urgent care, that deals with all kinds of health problems.

For example, a cold.

Or a mild flu.

Or maybe sinus infection.

Anything that is putting pressure or pain on your sinuses or drainage or a a fever or something like that within your sinuses, that would be a sinus infection.

Bronchitis or pneumonia. Both of those are infections within your lungs.

A mild asthma.

And understand, mild not severe asthma.

Gastro interitis, a bug in your stomach.

It's a virus that causes stomachache, throwing up, diarrhea. You're having gas tral issues.

It's either a virus or bug you've gotten in your stomach.

Also of course they can do minor surgeries. Minor lacerations. Minor if there's a broken bone there's a minor setting that can be done taking

care of the bones. Those are the types of things. So, again the laceration is something that can be taken care of unless it's on your face

or within your eyes. With that you need to go to the emergency room. But other minor lacerations or cuts can be handled at urgent care.

So understand the difference between the two of those and when you need to go to the emergency room for those specific lacerations or cuts.

If you go to urgent care, people are always trying to think, okay, so what happens there?

I know what happens in the emergency room. Who takes care of me at the urgent care center?

Most of the time the urgent care center has a PA, which is a physician's assistant, or an NP, which is a nurse practitioner.

Sometimes they have a physician as well.

But understand that the physician may not have finished their residency at that point. Or maybe they haven't been certified at that point.

So the...

So they might not have had the experience with primary care issues.

It could be a doctor who's retired and practiced a long time ago and decided that he or she wanted to go back to work and urgent care was where they ended up going back to.

If they have knowledge of primary care, it's questionable. You need to know that is a possibility with the individuals you face at urgent care.

In the emergency room, emergency department, they have the attending.

Most of the time they are board certified.

They have a level of knowledge and standard practices that they're aware of and they're able to do the job that they're trained for.

They have the accreditation and certification they need.

They may work with a hospital connected to a University. So, they may have residence there.

But again the resident also is working with an attending. So, there is always someone over watching and talking care of the patient care and what they are being given.

So you should know the difference between the two of them when you're talking about who works at urgent care and who works in the emergency department.

So now that we've clarified that...

What I'd like to do now is compare primary care, urgent care, and the emergency department.

Those three locations, when we're talking about them. When you go to primary care physician of course you need an appointment. With urgent care you don't need an appointment. With the emergency department you don't need an appointment.

Which is nice. With your primary care physician, they know you.

They're aware of you, they have knowledge of your past medical history, of who you are.

Urgent care probably doesn't know you. You don't have a relationship with them. And the emergency department you don't know when you get there who

will be your physician. If someone has gone to the emergency room often they may know that person, but most the time they're not known by the doctor themselves.

And your pramary care doctor's office, you may have a little bit of a wait when you go to an appointment.

With urgent care it will be a little bit longer wait.

In the emergency room you have the possibility of a very long wait to receive care.

So let's talk about what kind of tests each of those locations do.

Your primary care doctor can ask for blood work but there is a limitation to that.

The same as urgent care.

It's a set amount of o what they can request.

But remember that in the emergency room they can have a full blood screening, blood panel done if it needs to be done.

In your doctor's office it's very limited maybe that you could have an IV or whatever you need. At urgent care, yes, you could get it there.

And in the emergency room, yes, IV care, fluids, anything else, definitely available in the emergency department.

When you're talking about x-rays or CTs or MRIs, you know, where they do an x-ray and you go in the machine and back out,

obviously your doctor's office does not have one right there.

The urgent care probably does not have an x-ray machine or those mechanisms that they can use.

Realm remember, at the emergency department that's where they have all the mechanics they need.

They have the MRI, which again is the big machine your body goes into very slowly and you come out. They have x-ray machines and they have CT scan ability.

It really depends on what type of care you need when you decide to go, where you're going.

Again, your doctor's office is for more of your healthcare and keeping in contact with them. And the other two are urgent or emergent care that needs to be done at that moment.

Let's check and see if anyone has any questions right now.

So let's talk about some common examples of emergencies.

Remember before I gave a list of the most common reasons a person shows up is for chest pain.

Okay so let's explain that. What happens within your body? What does that mean?

You have two lungs, obviously.

And when you draw in air, the air comes in...

through your throat down to your lungs. And it goes through your trachea. That's what that tube is called. Or another word is your wind pipe.

When that goes in, then that splits off to each lung.

So as you breathe, your lungs fill up and go back down.

Your heart is located kind of in the middle of your two lungs.

You have three...

You have three ventricles there.

Your trachea goes in and you also have your aorta. You have the things that your body connects from your throat going down into your heart.

And your esophagus also controls going down.

So all of those are part of your chest.

So when you're talking about the possibility of having chest pain, it's important to know how your body is structured, how your body functions,

what's connected to what, so that, for example, if you have a heart attack, well, what does that mean? Well, that means that something within your heart, there's a problem within your heart itself.

For example, your heart beats. And remember I just explained about the three channels that are part of your heart, the vessels that are in there.

Most of the time normal blood flow goes through, in and out, and it's very normal.

But if you have a heart attack, it means that one of those vessels has flattened out.

Or its not letting the blood flow go through anymore.

And your heart is not able to get the blood it needs to be able to keep pumping.

So a heart attack feels like --

Or what it looks like is narrowing of the arteries in there. You feel a chest pain. You feel a tightness in your chest.

You feel very heavy. And sometimes people say that they feel like an elephant sat on their chest. That's what it feels like at this point.

The person starts sweating, can't breathe, may not be able to walk very far. And there is a possibility of feeling nauseous as well.

Some of the symptoms with older people can be a little different than with a younger person.

Maybe they will feel dizzy or weak or the pain is not in the middle of their chest. It could be farther down in their stomach.

Or maybe they're confused and having a hard time what is going on. So, people may not have an easy time figuring out what is happening to them, what is causing this pain.

But there are some common symptoms we need to know about. And again, a heart attack means the vessels are not working.

When we talk about heart attack let's discuss who is at risk of that.

Generally people age 30 and above.

Individuals who smoke.

Individuals who have diabetes.

If they have high cholesterol.

If they're a drug user. Cocaine is something that can cause a heart attack very easily. Those are the risks that are involved with the possibility of a heart attack.

when we're talking about a heart attack, the only symptom is not just chest pain.

There are many different areas of pain that you may experience.

This is the reason why you'll have pain in your chest, because sometimes there are blood clots occurring

which means that the normal flow of your blood through the vessels or through your veins, there is something that is stuck. It makes it so the blood cannot flow normally through the veins.

There could be the infection of pneumonia causing issues. That could cause pain in your chest. As wrel well as blood clots.

Reflux. It's called heartburn at times. That feeling could also be a symptom.

Issues with your gallbladder. Which is a very small organ in your body located right on the right-top side, kind of right below your liver.

So if you do have issues with your gallbladder, there will be times that it feels like you're having chest pain but it's actually caused by your gallbladder.

Shingles is an infection that people have had that is just like chicken pox. If you've had that in the past, as an adult it's called shingles.

It can be very painful and come all the way across your chest causing that type of chest pain.

You just may also have a muscle cramp and that could cause chest pain, which could give you the alarm thinking you might be having a heart attack.

Again, those are just things that could cause the chest pain.

Ah... looks like my co-speaker has made it in! Hello, nice to see you, comrade. I'm so glad my friend has made it back!


>> IV MIRUS: I am so happy to be in here.

>> JASON ROTOLI: You can start with symptoms of strokes if you're ready.

>> IV: Sure, catch me up. Did you talk about heart attack and chest pain, those types of things?

>> Yep, we did thal at rd.

>> All right. So, let's talk about stroke.

And let's talk about how chest pain and stroke, if they are related and how they are such important warnings.

Because these issues with heart attack and strokes are very time sensitive, in order to receive treatment.

Time is of the essence. It is krit tal that you get treatment immediately for either heart attacks or strokes -- critical.

So that you have less permanent effects from those.

Strokes can be caused because there's not enough blood flows happening to the heart or into the brain.

Also, Dr. Rotoli just signed about heart attacks.

There are many arteries in the brain. I have an example for you to kind of show.

So here this little simple toilet paper tube.

This is the same concept as your blood vessel.

So when you're young, your blood vessels are beautiful, open, the blood easily flows through, no problems.

Now as you get older, if a person has diabetes, high blood pressure, and any other -- some other health problems that could cause damage to your

blood vessels, this means they begin to narrow. And your blood flow is constricted.

It could be from high cholesterol, high blood pressure, or anything else that could damage those blood vessels and make them become narrow.

Which causes blood to have problems flowing through freely. If you do not have blood flow to the heart you can have pain.

If you do not have enough blood flow into your brain, that can cause a stroke.

And, again, time is of the essence. We want to immediately get that blood flow back to normal so that your body can respond in a mror appropriate and healthy way.

If there is a stroke, we have two different types of strokes that could be occurring.

One type is what we call a bleeding stroke, that's a hemorrhage ic stroke.

For example, again, with the blood vessel, let's say that there is something that has caused a leak.

And the blood, as it starts to flow through the vessel, is not actually getting all the way through to your brain because of that leak.

When that leak is occurring and is causing bleeding in the brain, this will then cause the hemorrhage stroke.

Another type of stroke is caused by blood clots.

And again, that doesn't mean there's no leak now in your blood vessel. What happens is, it's blocked. The blood cannot get through.

For example something like this. There may be a narrowing and the blood is just blocked from flowing through and that causes what's called an eschemic stroke, meaning there's not enough blood flow to your brain.

Now, both of these types of strokes can look exactly the same.

So when you see certain symptoms, you will know that there's a stroke. There's a really cool acronym. It's FAST.

And F means look at someone's face. Is one side of their face drooping? That's the sign of a stroke.

If you see that, ask the person to smile. If they're unable to smile with both sides, that means they may be having a stroke.

One side of their face could be paralyzed, unable to move. It could be the left or the right side of the face. Usually it only affects one side, though.

So it's called facial droop, F.

A is aphasia, meaning the person is unable to speak.

What they've looked for actually is people who use American Sign Language do have some of the same symptoms. They have a hard time producing sign!

They just can't find the right sign, the right concept that they're trying to come up with. It's the same thing that happens to people who use their voice to speak.

It just seems that there's a confusion in the way that people are able to communicate once they've had a stroke.

So that's the A part, aphasia.

S -- I'm sorry, actually, let me back up. I gave you the wrong thing for the acronym.

So S actually stands for the speech, whether it be speech or sign. So, F again is for facial droop.

A actually stands for arm. Whether one of the arms is hanging down and unable to be utilized.

If someone has a severe stroke they're unable to move one side of their body.

So it may be for example the right side has all range of motion whereas the left side would be very weak you'd be unable to lift it all the way

above your head or maybe you wouldn't be able to sign with one of the hands as normal.

And again this usually affects one side of the body.

If both sides are weak that's a different concern.

That actually has to do with a spinal cord issue, not having to do with the brain or a stroke.

Now, that being said, if you have facial droop as well as weakness of one of your arms, that could be enough of the symptoms to show

that you are having a stroke. If you have that as well as speech or sign change, that is cause for a severe stroke.

So 2 of the 4 symptoms means it could be a mild stroke. I'm sorry, 3 of the 4. Oorngs sorry, let the intsz ter back up.

2 of the 3, either face or armor speech are affected, that means you're having a serious stroke -- arm or speech.

If you're having all four, the T stands for time, meaning that the time is so important to get you there.

Three symptoms are face, arm, speech or sign, and then the T stands for time.

At that point you may need surgical intervention.

There may be certain medical procedures that cause your blood vessels to widen so that the blood can flow through.

If there's a bleed, a leak that's happening, they may be able to remove whatever the issue is.

There are many approaches how to solve the issues of a stroke in the treatment.

But the point is, if you notice two of the three symptoms, face, arm, speech or sign, get yourself immediately to the emergency room.

If you notice a change in somebody, if you again notice that drooping, ask them to smile.

If you notice they're not signing appropriately as well, get them to the emergency room. 2 of the 3, immediately to the emergency room.

Not urgent care, not primary care physician. This is a matter for the emergency room.

Just a second. Looks like Dr. Rotoli would like to add?

>> JASON ROTOLI: Hi again this is Dr. Rotoli. I would just like to add about heart attack or chest pain,

there may be other symptoms that you may notice related to a stroke. If you are having chest pains or symptoms of a stroke,

it's imperative that you go to the emergency room. It's okay to call your primary care physician to let them know.

They will most likely refer you to the emergency room immediately.

Please, do not go to urgent care with symptoms of a heart attack or stroke. They are unable to help you.

Again, chest pain means go directly to the emergency room as opposed to urgent care or primary care physician.

>> IV Mirus: We have a very good question, how do we know if we're having a stroke or a heart attack. You talked about the pain, but how do we know? Jason, would you like to expand on that?

>> JASON ROTOLI: Oh, I'm sorry, I was reading the other questions and I missed what you said Dr. IV there, sorry.

>> IV Mirus: One of the audience members asked how do you know if you're having a heart attack.

If your heart is not getting enough blood flow that causes your chest pain, that ache that we talked about that Dr. Rotoli said before.

Some of the symptoms are, again, as Jason explained before, pain in your chest, sweating, pain that's radiating or flowing down your arm.

Maybe someone has passed out. Those are the kind of symptoms that you see in men.

Now, understand -- it's an important thing to understand that women are very different.

Women have different symptoms when having a heart attack.

Sometimes a woman feels a little bit of pain and then it goes away in her chest area.

She's feeling kind of lousy.

The pain going down her arm, sometimes but not always.

Those are the things to watch for. But if you are talking about a heart attack and you're not getting enough blood flow, it will hurt. It will definitely hurt. Your heart needs to have that flow at all times.

Because understand that your heart is a muscle. And that muscle needs to have oxygen. All the time. You can't stop that oxygen in your heart.

You need to have it. If you have enough oxygen in your heart, you're fine.

But if you don't have enough, that causes that pain. And that's when you need to talk to the doctor and go there.

If you really are having a heart attack or the possibility, it could be not so serious and you can talk to your physician. But if you are having those symptoms you need to get checked out.

If your brain doesn't have enough blood flow that doesn't have pain associated with it normally.

Remember the FAST, facial droop, arm, weakness, and speech interruption or change in sign pattern.

Those are the things that someone would know if you're having a stroke. Those are the things they look for in the indications.

>> JASON ROTOLI: Another question that I saw in the chat. Somebody has asked if it's a good idea to call my physician?

Is it a good idea to call the physician to ask whether to go to urgent care or the emergency room?

>> JASON ROTOLI: Most of the time when we call the doctor or primary care physician the nurse will interact with you and then talk to your doctor about what may be the best option for you.

It's okay to speak to them because the nurse obviously has medical knowledge as well.

That was a very good question, thank you.

I am seeing that there are a few other questions.

>> IV: I think there's another good question here. What is the difference between a heart attack and heartburn? Okay, a heart attack is very serious. We understand that.

That is considered a serious problem.

Heartburn? That word is a misnomer. It's misnamed.

Your heart is not on fire. There's no burning in your heart. And it doesn't have anything to do with the pain.

The pain doesn't have anything to do with your heart.

It's the acid from your stomach that is working its way back up the tube that goes down your throat.

So for example if you drink too much coffee or eat something citrus or something that just has that acidic feel to it,

your insides start to feel warm and there's like this burn going up that tube again.

They call it heartburn but it is not related to your heart at all.

But surprisingly enough many people go into the emergency department and they're getting checked out and they say, ah,

I've just been having this strange pain, this burn up and down my chest, and I don't know why.

We have to check to make sure that your heart is working appropriately and if that is what's being affected.

Because we don't want to assume that, ah, no, that's just heartburn, not something we need to worry about.

Because remember, people with heart problems or problems that occur with your heart...

You know, again, heartburn is acid and we know that. You might have experienced it before and you know.

But let's suppose you haven't experienced it and you're having other symptoms, sweating, pain, other things.

So when you go to the emergency department they will be the ones to help you determine that.

If you haven't experienced that before.

>> JASON ROTOLI: I would just like to add to that. I do remember, must have been a few years ago now, one of my patients was about 60 years old.

And this is just like the perfect story about reflux. That's what it sounded like when we were talking.

And then of course I kept, in my mind, that women have different symptoms of heart attacks. And sure enough, after this woman, this patient's test, she was having a heart attack. It was not

acid reflux. The reflux was a sign and a symptom that she was having a heart attack.

And it almost fooled me which is why it's very important for all of us to keep in mind that women present much differently when having heart attack symptoms.

>> Right. You don't want to play around with chest pain at any time. We want to help fix it. Better not to take any chances.

>> JASON ROTOLI: Absolutely. There was another question in the chatbox. It was asking about how COVID-19 had been impacting either the emergency room or urgent care protocols.

As far as urgent care, we have taken over so many of the tests for COVID-19.

If you are in need of surgery or... if you are in need to go to the hospital for something, if you need to go to the hospital or something minor, minor is for urgent care.

Testing is for urgent care. Something major would be more for the emergency room, when you're having a major ailment.

Both the emergency room and the urgent care do need to figure out how to keep people social distanced six feet when we're in the waiting room.

They have set up little special areas for people that have blocked areas off so that people can have social distancing.

Everybody is following protocols with masks.

Yes, there have been a lot of changes that have happened.

But as far as changing protocol, I would say that a lot of the elective surgeries are something that have been cancelled and postponed

until we get to a different place.

We are starting to reschedule some of those non-emergency procedures.

Anything else you wanted to add to that?

>> IV Muris: We expected a lot of people would come in with COVID but we still had to take care of individuals who had chest pains, heart problems, stroke symptoms.

We still need to take care of them. We didn't stop because COVID-19 showed up.

So that was one of the bigger obstacles that we had within the emergency department.

Sarah, I think you had some questions that you were going to ask us that the Facebook audience had posed.

>> SARAH HEIN: Okay, Dr. Row toer and Dr. Muris, we have a couple questions from the audience.

One question that we haven't answered yet, they're asking about like skin color or nail color or lips.

Like if it's a different color does that mean that the blood flow is not normal?

>> JASON ROTOLI: That is an excellent question.

And the answer is yes, a resounding yes.

If you are noticing that the pinks of the eyelid are becoming white or the skin is becoming white and clammy,

it means that's the blood levels are dropping possibly.

If you notice fingernails are blue, lips are blue, getting a blue hue to them, it means the oxygen level is plummet. It's abnormal for that to be happening.

Please pay attention to the skin color absolutely. That was a great question.

>> IV Muris: And sometimes when it's cold outside you know you come in from the code and look down and you can see your skin is a little bit off color.

Of course that's normal. Your body is reacting to the cold and your blood vessels are shrinking. But when we're talking about blue on the lips or fingertips,

yes, that is very much a concern. It's not just because of serious cold. Other reasons could cause that.

>> SARAH HEIN: The next question is more of a comment. They said they thought they were having a heart attack because they were having a lot of chest pain

so they went to the emergency room and their doctor finally diagnosed it as the gallbladder.

She said that she felt bad for going to the emergency room but the doctor and the nurse told her that it was better to be safe than sorry.

And her doctor said always to check it out because it could be a problem with your heart. Do you have any comments?

>> JASON ROTOLI: Yes. Remember I had mentioned that at times the glal bladder can fool you and have that chest pain. They fool us sometimes with that.

It's on the right lower portion just hiding underneath the liver which is just underneath the chest.

And when that pain happens it can radiate up through the chest area, which mimics a heart attack symptom.

So, don't feel bad. It's our job to actually find out whether it's heart attack, gallbladder, pneumonia, or whatever else the ailment might be.

It's important that you went right away to the emergency room. I feel bad that it was a gallbladder issue, but glad it wasn't a heart attack.

>> IV Muris: Personally one reason I like being in emergency medical care is you never know what's going to happen.

And from the patient's perspective you don't know what's going on. You have to get checked out. And for us to be able to find that.

The people that come into the emergency room with no pawn and they look like they're fine, we think, okay... why are you here, what's going on?

And they say, oh, I just have a little bit of chest pain, it's no big deal. And it's like okay why did you come then?

Well, my chest just feels a little bit different. So, we send them to tests and guess what? They're having a heart attack.

And all they're saying is, oh, just a little bit of pain.

We see everything on the continuum that shows up. And most of the time, yes, people who have serious heart attacks, we can tell that.

We know that. You can immediately get them.

But every now and then there are people that show up and they're having a heart attack and they're just, eh, uncomfortable.

Eh, it's just a little bit of a hurt.

But it needs medical attention and it needs to be addressed immediately.

Because when somebody says, oh, I'm sorry, I came to the emergency room, don't be sorry. That's our job, we want to do that for you.

We want to make sure you're being taken care of. That's the reason we're doctors working in the emergency room.

>> JASON ROTOLI: I wholeheartedly agree.

>> SARAH HEIN: Regarding the last question, this person had a triple bypass several years ago and from time to time felt

like an elephant was sitting on their chest. And they went to the ER and it turned out to be a false alarm.

So they're asking if they have that feeling or another feeling how do they know when to go to the ER or not.

>> IV Muris: Wow, a triple bypass. Let's explain what that means first.

You know the human body has veins that go from your legs up to your heart up from your extremities to your heart and those are, again, more blood vessels in there.

They go into -- the arteries go into your heart and if those shrink, then that means that you're not getting the blood flow.

So when you have a triple bypass it means that you have to have a surgical procedure for that.

But it's really --

That kind of heart pain is serious, but is it urgent? It is. If you've had a bypass you need to go and get checked. You can't take risks with your heart and just pass it off.

If you've had problems with your heart, if you have a history of heart ailments and you have a chest pain, go and get it checked out.

Don't think, oh, last time they said this. What if it's serious this time? It could be. Or maybe it was something that was negligible before

but now it is serious. So, yes, go and get those checked out.

>> JASON ROTOLI: Absolutely. Remember we talked about those three main blood vessels on the heart.

When you are having a bypass surgery it means that another vessel is replacing one of those three that are attached to your heart.

It has to be moved up into another area.

And so you can go around life after that fairly normally. But please remember, that new blood vessel can also constrict, can also cause the issues.

So if any of those have small leaks -- because remember there's many vessels that branch off

from the three main vessels of your heart, those can cause pain as well and it is imperative that you get to the emergency room immediately to have your heart checked.

>> SARAH HEIN: I wanted to change directions because we've been talking a lot about the heart and heart attacks.

I have a good question here -- what happens if I go to the emergency room and the doctor says that they want me to stay overnight

or be admitted to the hospital or I have to have surgery? So, what would the next steps be?

>> IV Muris: So if you've gone into the emergency department, it is our job to try and figure out what is wrong.

And a big part of our job is trying to decide, are you safe? Are you safe enough to be going home? Or maybe is it safer for you to stay with us as an inpatient?

It may be something that you have to stay overnight. It may be something that requires a surgery.

There could bhe some other conclusion that could come from showing up in the emergency room.

But if something has occurred that requires surgery, then yes, you would stay within the hospital.

You know, it could be 1-3 days. We don't know for sure because it depends on what you need the surgery for, the reason for the surgery.

What you can expect is that when you're in the emergency room, they will put an IV in your arm.

They will admit you into the hospital to stay, for whatever reason it is, and they will give you medication and fluids through that IV.

It's a very quick process that they do to try and make sure that everything is taken care of.

If we do require surgery what then happens is that you cannot eat past midnight the night before.

If you're going to have surgery the next day, you cannot eat, you cannot drink.

Dr. Rotoli, are there other things they should expect when they're coming in and asked to stay?

>> JASON ROTOLI: Yes. When folks are admitted into the hospital the emergency team does an excellent transition of care and a warm handoff.

Which means that they then contact the team that will be working with you and taking over your care. So, it won't be the folks from the emergency room, but the team will also transition you over to the hospital

team and you'll be in good hands from there. All of your care goes along with you in that care plan.

It's up to the hospital then to of course decide also what medications you should be on, if there is a special bed you may need, if your legs need to be elevated.

Whatever the doctor's orders are from the emergency room, those will be honored when you're moved on to your next care team.

So sometimes when it is a very serious emergency and you must be rushed in to the emergency room there's not a lot of time to do those mrangz and transitions.

So if that were to happen of course there would be conversations with you afterwards to figure out the next steps after the emergent issue is taken care of.

Right now one of the biggest changes from pre-coSid is that the emergency room at this point -- COVID -- does not allow any visitors.

That means most of the time my pay shengts are sitting alone waiting for treatment. It is sad. It's quite lonely. We realize this.

If the patient is confused, is emergently ill or in the process of dying, then of course we bring the family in or whomever their support person would be who would be able to advocate for them.

That's a little bit of a different story. And also with children, with minors. We let the parents come.

>> SARAH HEIN: Okay, the next question from the audience is...

Do you want to address any inequality in medical care or attention when it comes to different races such as African-Americans and Hispanics?

And do you also treat patients that do not have health insurance?

>> JASON ROTOLI: Wow. We do not even have enough time to talk about that topic.

It is so important and so very complex.

I will say that my department and my residents study hard to try to learn about the different cultures that are in our area.

To try to understand the people that come into our emergency room.

How we can best work together to figure out a treatment plan and what is best for the patient.

We do acknowledge the health disparities for people of color.

People of color hafr less access to health information. They have less access to physicians, to medical services.

And the emergency department is quite aware of those disparities.

So for me, it doesn't matter the person's religion, gender identity, race, whether they have insurance or they do not have insurance.

For me, the immediate goal is to take care of you.

>> Dr. IV Muris: The emergency department is a safety net. That's to make sure that you are safe and that you're taken care of.

The people who fall through the cracks...

Sometimes they come into the emergency department just because that's the only medical care they have.

They don't have a primary care physician. They don't have someone they see regularly.

And we try our best to connect them up with a social worker, connect them up with a healthcare worker.

But sometimes it's very difficult for that person who is coming to the department.

They may not have transportation. They may not have the funding. They may have a drug abuse problem.

Whatever it is, they're showing up to us. And our door is open to anyone. We cannot deny care to anyone. And that is the law.

It doesn't matter insurance. It doesn't malt ter anything else.

If a person comes into the emergency room they have a right to be seen and they have a right to medical care. And that's what we do for you.

>> SARAH HEIN: Okay, I'm going to ask a two-part question. The first question is asking if you're both Deaf or hard-of-hearing or hearing and how you communicate with your staff?

And then the second question is asking more about like what do your Deaf and hard-of-hearing patients do if they need an interpreter or accommodations to communicate in the emergency department.


>> JASON ROTOLI: Both of us are hearing physicians.

We speak with our voice with our hearing staff.

We do have Deaf physicians, Deaf nurses, Deaf social workers and Deaf psychiatrist, and I use American Sign Language with them.

I have Deaf patients, therefore, I sign directly with them.

>> IV MURIS: And myself, I'm CODA, so as Jason said, I'm hearing. But sometimes it's really difficult to communicate because it's such a loud place.

Sometimes the noise level is so high you can't pay attention to anything. But when Jason and I are working together on the unit we can stand distance apart and we don't have to worry about trying to get

close enough to communicate. We can just stand and sign to each other from several feet away and explain about this patient and that.

And we understand totally what the other person is saying. So, that's a very cool thing about us working together.

>> JASON ROTOLI: Ha ha, yes, it sure is.

>> SARAH HEIN: And the second question was asking what do the patients that are Deaf or hard-of-hearing do about accommodations?

Like can they have interpreters? Do they have captions? Clear masks? What kind of things can they get in the emergency room?

>> JASON ROTOLI: Very good question.

At the hospital that I work at, we of course want to meet the Deaf patient wherever they are.

So we have 24/7 access to interpreting services. They're some of the best in the nation. They are always in the hospital. We have staff interpreters.

They're not standing around waiting for the Deaf to show up in the ER because they are very busy.

But if I am there or Dr. IV is working, the Deaf patients typically come to our care because we don't need an interpreter. We have direct communication with our Deaf patients. So, that's wonderful.

But of course the interpreter will come when they can and try to stay the entire appointment. Depending how long it is.

If the pay shept is there all day, you will have interpreters switch out to serve the patients as well as the doctors.

Some patients are oral and want to write, some want captioning, some want interpreters, and some like to utilize all serviceses. And they can.

I implore my med students to please make sure they always have a qualified medical interpreter.

>> IV MURIS: Exactly. The University of Rochester is unique due to the community we work with. Unfortunately throughout the rest of the United States,

they don't have the experience that University of Rochester does. The best you can do is advocate for your need for an interpreter when you go into the emergency department.

You know, everything happens very quickly and very fast there. And they want to make sure that you're okay.

Sometimes they will ask you to use VRI.

And if you have to stay in the hospital they will bring in a "live" ingts ter. But it really depends on the hospital and the region itself.

But, really, yes. You have the right to an interpreter. You should have one. There is no excuse or any reason at all why the hospital will not accommodate you by giving you an interpreter or making sure one is present.

>> JASON ROTOLI: Some hospitals and universities do also provide Deaf interpreters and certified Deaf interpreters which means they'll have a hearing interpreter and a Deaf interpreter

working to xwets to make sure access and communication is very clear, especially in an emergent situation.

At times also when we put in a certified Deaf interpreter it helps a lot to communicate during very severe illnesses or very severe

emergent issues. So, those are available as well.

>> SARAH HEIN: Okay, I think this is going to be our last question because we have to wrap up.

They are asking: How do you know when to call 911 and wait forethe EMT to come and when you should just drive yourself to the ER?

>> JASON ROTOLI: Ah. That's a tough question (chuckling).

>> IV MURIS: I think it depends on who is calling, who is ill, who is driving.

If the person is having chest pains and they're having a medical emergency, how are they going to drive themselves there?

If, um... they have a broken arm. Or they have something else. And someone else drives them to the emergency room, of course.

It's always a matter of making sure you get there safely. If you're not really sure should I drive myself or take an ambulance, just call 911.

The dispatcher will advise you what to do, what the next steps are if you're not sure.

If you're kind of vacillating and not sure should I drive myself or call 911, call 911.

The prn you speak with will help you decide what to do next.

>> SARAH HEIN: Dr. Rotoli, do you have anything to add to that?

>> JASON ROTOLI: Yes, I would like to add on that some people, when they call 911, if someone doesn't have access to a car or any sort of vehicle for transportation

and you call 911 because you need to get to the emergency room or if a person doesn't feel good enough to drive, please call 911.

That is considered an emergency.

At times if you decide to drive yourself maybe if you're like should I call myself should I drive myself or call 911 you can try to call your doctor and ask.

But once again please don't hesitate to call 911 if it's a medical emergency.

>> SARAH HEIN: Okay. So, this concludes our talk tonight. I want to thank Dr. Rotoli and Dr. Muris from the University of Rochester.

I also want to thank our captionist and our two interpreters.

And I want to thank the audience for coming.

We're going to have our next Deaf Health Talk April 27 at 8 PM. We're going to talk about maternal and pediatric health.

So, moms, babies, and kids. That will be really fun and interesting.

You can always look at your Facebook event page for more information and resources. And we also have an e-mail address that we will

February 2021: Physical Fitness for All

Physical fitness should be open to all! Join deaf personal trainer Janna Sirianni, NASM, CPT of ASL Fitness at YMCA; Dr. Feranmi Okanlami, director of U-M Adaptive Sports and Fitness; and Leslye Kang, BS, deaf athlete and coach at Gallaudet University, Model Secondary School for the Deaf, in a discussion in ASL, moderated by Dr. Michael McKee. Download our resource guide.

January 2021: COVID-19 Vaccine Q&A

What is the COVID-19 vaccine and what is it like to get vaccinated? Sarah Hein, MSN, FNP-BC, nurse practitioner with Michigan Deaf Health; Michael McKee, MD, MPH, family physician at Michigan Medicine; and interpreter Nigel Howard, ASL medical interpreter, led a presentation and open discussion with questions and answers about the COVID-19 vaccine. Recorded January 26, 2021.

Download the event's resource sheet:

Download the event's closed caption transcript (PDF)

Read the transcript

>> MIKE MCKEE: Hello, everyone! Thank you so much for joining us on Facebook Live tonight.

We're very excited for the team that we have presenting tonight. We're going to talk in depth to make sure that you guys have the right health information

that is completely accessible. So, you guys have equal access to good health information.

We will be setting up future talks on the fourth Tuesday at 8PM regularly.

So, please, put it in your calendar and save the date.

We'll have a variety of topics coming up. So, I want to go ahead and review who's going to be here tonight.

I really want to thank Noa Kim. She's our communications expert. She set up all of the technology and the Facebook Live, so we really appreciate everything she's done to make tonight happen.

There are some other people as well. We have Kaila Helm who has been instrumental in this process.

And Samantha R. They are both on the research staff here. I'm really really glad that they're on board with us.

Also want to thank James Chech, who is going to be our interpreter tonight. He's also an interpreter at Michigan Medicine. So, thank you to him.

And we also have a CART transcriptionist, Kate Miller.

And so really you can see we've got lots of things set up to make this truly accessible.

This will also be recorded if people want to watch it later.

We'll be sharing some resources with you throughout the evening, throughout our one-hour presentation.

So check the comments for that. Some that will be in ASL, some of that will be video, some of that will be... in condensed English.

The point is to get accessible, clear information out to our community.

It would also help us if you would fill out a survey. We're going to have two surveys that we share with you.

One of them is related to communication access for Deaf and hard-of-hearing mothers during pregnancy.

They don't have to be pregnant at this time. They could have been pregnant in the past.

And also with COVID and how it's impacted their life.

Second survey is for anyone. And it relates to accessing information during the COVID pandemic. So, please keep an eye out and fill out those surveys for us.

Very excited to talk about our presenters tonight.

We have Sarah Hein. She's a Deaf nurse practitioner in Michigan. So, really grateful that she's joined us because she has a lot of experience.

She's actually already been giving out the vaccine to different patients and she'll go into depth about the vaccine and what you can expect.

We're also really grateful to have Nigel Howard with us. He's a very, very well known certified Deaf interpreter from Canada. And he'll clarify, really go in depth to explain more about COVID,

the vaccine, and also what you can expect.

So let's go ahead and get started.

I do want to take a moment and just recognize the traumatic impact that COVID-19 has had on our lives.

It's really sad that over 400,000 people have passed away in America. And it's very important that we keep our dedication in working together

to strategize how we can reduce its effect and also overcome this experience.

There are some key things like washing your hands regularly, wearing a mask, and social distancing. These are measures we have to continue to have in place.

But we're going to talk about a fourth measure, which we're going to talk about tonight, which is the COVID-19 vaccine.

Just in December there was an emergency approval from the FDA for two vaccines.

Pfizer is the company that makes one. And the other one is made by the company Mederna. I'll refer to them as P and M from this point on.

They were both approved, but there will be more information on that later. The technology is very impressive behind these vaccines.

And really we don't have to be nervous or uncomfortable with what's inside them. They are going to be very useful with stemming the spread of the COVID-19 virus.

There are over 18 million people who have confirmed illness. And maybe others that we don't know about. So, you can just see how quickly this virus has spread.

So, I want to talk about both vaccines, from Pfizer and Mederma, how they work. And they do not function the way that vaccines have functioned in the past.

In the past there was pieces of the virus, or maybe a dead virus, that's in the vaccine. There are no viruses in this vaccine at all.

In the past it's been a concern that you would be able to get the virus if a weak virus was injected into you. But since there's no virus in here,

In the past it's been a concern that you would be able to get the virus if a weak virus was injected into you. But since there's no virus in here,

there's no way to contract or spread the virus from the vaccine. So, RMRNA, which is part of the genetic properties in the vaccine, will trigger the cells to make antibodies.

But it doesn't actually enter into your cell. It's completely safe. It doesn't become part of your body at all.

What mRNA does is that it's encoded genetic material with the virus genetic code.

And then that is what is mixed together as part of the solution injected into you. So, when the mRNA is introduced into your cell,

And then that is what is mixed together as part of the solution injected into you. So, when the mRNA is introduced into your cell,

your cell goes forward and makes protein based on mRNA. And what that does...

is it matches the shape of the virus.

And so what it is, it's able to attach itself to any virus that does enter into your body.

So if you get exposed to the virus your body will recognize the virus and mount a defense against it.

Those are called antibodies, that first line of defense from the virus.

So if I were exposed to a person and I'd already had the vaccine, my body is already to mount a defense against the virus as it introduces itself into my body,

So if I were exposed to a person and I'd already had the vaccine, my body is already to mount a defense against the virus as it introduces itself into my body,

because I've already prepped my body to recognize it. And those antibodies remain inside of you.

We suspect that it will last one to two years, but we're not sure how much further beyond that. It still needs more study.

It's not just the one time for the vaccine. When you get a Pfizer shot, you have to wait 21 days.

And the 21 days kind of helps your body to build the defense it needs to build. And then you have a second shot.

So there's 35 days from beginning to end for the vaccine to be able to build its immunity effectively.

The Moderna vaccine functions a little bit differently. You'll get your first shot, and then you'll get your second shot 28 days later, so, roughly a month after your first shot.

And then even after the second shot, you have to wait another 14 days for full immunity, for your body to build those antibodies.

So you can see there's quite a bit of time for those shots to work together and your body to build up that defense.

They're currently going through clinical trials to make sure that they are good-quality vaccines.

So scientists administer the vaccine to different control groups. There are 43,000 people who were part of the original clinical trial.

So, it wasn't just a few people. 43,000 people last year were given the COVID-19 vaccine.

Some people were given the real vaccine and other people were given an injection that was not the vaccine. They didn't know which one they received.

And so, they were able to follow those people and see whether or not the vaccine was successful or not.

Those who did not receive the vaccine, got sick if they were exposed to the virus. And of those who did get the vaccine, only nine people got sick.

So, about 60-70 -- so it wasn't 60-70% effective but 90% effective. Which was really encouraging.

Moderna, now, they'll be going through more trials, with 30,000 people. 15,000 people getting the actual vaccine and 15,000 people getting a shot but not the actual vaccine.

And again, not knowing which shot they're actually getting.

So of those people who got the vaccine from Moderna, 11 people got sick. I think those who didn't get it, it was 162 people in the control group who didn't get sick.

So it was 94% effective protecting against COVID-19, for the Moderna vaccine.

So, Pfizer can only be administered to those 16 years of age or older. And for the Moderna, it's 18 years or older.

They are currently going through trials with those that are younger than those ages, and hopefully will be able to administer them to kids in the future.

But at this time they're not approved for children.

There's not enough vaccine right now available for everyone, unfortunately.

And I know that it's a struggle to get them. But hopefully it will be much easier as we go along. At this point in time there's not enough for everybody.

Michigan Medicine is taking the approach of focusing on those who are age 65 and older because they fall into the high-risk category.

Once everyone in that category has been vaccinated...

they'll focus on those with other factors like diabetes, comorbidities, other illnesses that put them at high risk.

And then after that group, there will be more available for everybody.

So, it will take some time before most people will be vaccinated. Probably sometime during the summer everyone who wants the vaccine will be able to get it.

If you're curious about where you can get a vaccine, it's important to contact your health provider, whether it's a hospital system, your doctor, maybe your county health department.

And you could reach out to them and see where you can register to get the vaccine even though it will take some time.

Many vaccines right now are given on a random lottery basis. So, that's another thing to consider if you're not picked, even if you're in that category.

I want to be able to get through my information pretty quickly, that way we can get to the other presenters tonight.

So what about getting your vaccine if you've already had COVID?

I do recommend that you still get a vaccine. The reason is that, you could develop antibodies after having already been sick with COVID, but sometimes your body doesn't develop antibodies.

Really, the more serious illnesses that result from contracting this disease are so overwhelming to your immune system that they don't develop antibodies.

If you get a very light case of COVID-19 your body then is able to mount a defense. But that's not always how it happens. And if your body doesn't have enough antibodies, you could contract COVID-19 again.

It's important to remember, though, that this is a safe vaccine. It's sodium and sugar mixed with the chemical...

there's no mercury in it. It's a remarkably safe and healthy vaccine. It's just chemicals with the mRNA.

But if you're worried about having an allergic reaction, you know, like let's say you have a pollen allergy or you're allergic to different foods, you should be okay.

Just let your providers know if you've ever had a very serious reaction, like anaplactic shock. That would be an important thing to tell your healthcare provider before getting the vaccine.

Or when you go to get the vaccine, explain it to the person who's administering it to you.

There are other things that we'll go through tonight about how you can prepare to get the shot.

Just remember, you will need two shots to complete the dosage. For the Pfizer. And then you'll have to wait 14 days after getting the second shot for Pfizer, for full immunity to develop in your body.

Now, once you have your vaccine, you still need to continue to wear a mask, wash your hands, and socially distance.

Because there are other people who will still be at risk. And so until the pandemic is really under control, these are measures we need to keep in place.

You may have heard of a term called "herd immunity " and I like to describe it like this...

if you have a lineup of people and no one's had it before it's very fast for that virus to spread from person to person.

If everyone's received the vaccine they're already resistant to it. So, the virus will then try to find the next person who hasn't received the vaccine or hasn't been sick.

Then you reach a certain level, which for example would be 80% of the United States, having resistance to the virus. Then that means we've got herd immunity and we're resistant.

So, for example, if you have that lineup of people and eight of those ten people have already been sick or have had the vaccine, the virus won't be able to find a host and then therefore dies.

So, when you get the opportunity, please take it. And get the vaccine. Don't put it off. Get it as soon as possible. If you are able to get it and it's available, it will help us all in America get back to normal as soon as possible.

So right now I'm going to turn it over to Sarah Hein. And she's going to talk a little bit more about the vaccine, some of her recommendations, and what you can do to prepare.

So, Sarah, take it away!

>> SARAH HEIN: Hello. My name is Sarah Hein. I'm choosing to keep my camera off at this time because I want to focus on the interpreters so everybody can see sign language as well and everything is acceptable.

I will pop up at the end when we do the question and answer session.

Okay. So, I'm going to talk about the overview of the visit when you get the vaccine.

Before your visit you probably would like to talk to your PA or your nurse practitioner or your doctor and just assess your health history with them, make sure they're okay with you getting the vaccine.

Especially if you have chronic conditions like heart disease or diabetes or anything like that.

Also if you're pregnant or breastfeeding you'll probably want to talk to your OB and make sure your OB is okay with you getting the vaccine as well.

Other things that you want to think about before you get the vaccine are, as Dr. McKee mentioned, if you have had prior serious reactions to vaccines or other foods or anything like that.

That's important that you monitor that with your healthcare team when you get the vaccine.

Another thing to keep in mind when you go for your vis it is if you're taking a blood thinner or you have a blood disease, let them know. Because you might bleed a little bit from the shot.

When taking a blood thinner you might bleed a little bit more. So, it's important for them to know if you might bleed.

You want to check with your doctor if you're immune compromised as well. Let's say you have cancer. You'll probably want to talk to your oncologist before you go for your vis it.

One thing you can do for yourself is to read about the vaccine or attend presentations like this, so that you're well aware of what the vaccine is and what happens at the visit.

So, a lot of information on the CDC website, the State of Michigan website, and both of the vaccines have websites as well and you can check on those.

One other thing I want to mention before you do your visit, make sure you don't take ibuprofen or Tylenol before the vaccine. Because that's going to decrease the effectiveness of the vaccine.

If you had a serious reaction in the past to anything, any type of vaccine or a medication, you can bring your Epi pen with you and you can bring Benadryl as well.

I know that we're all Deaf and hard of hearing and we have questions about access.

So, when you sign up for your appointment, call the office or check on the website to see what kind of accommodations they offer.

Some of them have clear masks. Some of them write on whiteboards. Some of them have video relay.

So it's good to let them know what you need and ask what's available before you go to your visit. You can take a note pad just in case they don't have what you need.

When you go for the visit, they will check you in at the desk and you will go back with a nurse, a nurse practitioner, or a medical assistant.

They will ask you about your health history. They will ask you about your allergies. They are doing all this just to make sure that they know your history and what's going on with you.

They will al also ask which arm you want to use.

I don't believe it matters what arm you use. It's a personal preference.

When I give a vaccine I usually ask what hand do you write with? Or the other one that I ask is, what arm do you sleep on?

Because if you get the vaccine in the arm you sleep on and then your arm hurts then you're going to be waking up at night.

Another thing that they might do during the visit is schedule your next appointment. So, I recommend taking your planner or your phone

that has your schedule so you'll know when you can go to your next appointment. You can probably ask about accommodations for the next appointment, just so that it's planned ahead.

When you get the vaccine, it is going to go into your muscle. If you remember where you got your flu shot, it's going to be in the same spot.

After you get the vaccine, you will be monitored for 15-30 minutes. The timing depends on, for example, if you had anafalaxis in the past

due to some kind of medication then we're going to want to monitor you longer. If you're just a normal person with normal health history, then you'll probably just sit there for 15 minutes.

Why are you being monitored? If you're feeling sick at all. If you feel light headed. Or you feel like your heart's racing or anything like that while you are being monitored,

you need to raise your hand and wave down any of the staff and let them know that you need help.

And they will come and help you. Okay?

Next I want to talk about some of the side effects and reactions that you might have.

The most common side effects are: Pain at the site where you got the shot. Feeling very tired. And headache.

And the less common side effects are: Muscle pain. Chills. Joint pain. Fever. Nausea. And swollen lymph nodes.

If you happen to have a severe allergic reaction to the vaccine, you will have: Difficulty breathing. Swelling of the face and throat. Fast heartbeat. Bad rash all over the body. Dizziness. And weakness.

Usually that type of allergic reaction occurs right away. And during the monitoring period I talked about previously, that would be a good time to raise your hand and let people know that something is happening.

At my site we are very responsive to people that are not feeling well. Even if it's just anxiety. We will call the EMTs and we can take them to the hospital if they need to go.

In my experience, I have seen very few reactions. I have seen many people do just fine.

Also, I want to note that after the first vaccine, you usually don't have very many side effects.

After your second vaccine, you might experience more side effects.

But I can not predict what all of you might have, because all of our bodies are different. So, it depends on what your body does, to how you react to the vaccine.

If you go home and you're feeling really terrible, and you're having a really bad reaction, you will want to call 9-1-1 or go to the hospital.

If you go home and you're feeling really terrible, and you're having a really bad reaction, you will want to call 9-1-1 or go to the hospital.

If you're feeling unwell and you have more questions, you can always call the clinic where you got your vaccine. Or you can call your doctor.

Just make sure that you let someone know, so that they can help you.

So I've given you a brief overview of the vis it and kind of what to expect.

I'm going to pass the presentation on to Nigel Howard. He's an interpreter and a fabulous person from Canada. You'll really enjoy his presentation. Thank you.

>> NIGEL HOWARD: Alrighty then!

Hello, everybody. I tried to click my camera, and it was blocked! Ha ha. So, no matter what I did, I couldn't get it to turn on. Anyway...

Hello, everybody. So, with Dr. McKee's explanations and Sarah's explanations, it's really important to take their advice.

The vaccine is so important.

So, if you are on the fence right now, based on Dr. McKee's explanation of the vaccine, it's SO different compared to how vaccines have been made throughout history.

So whether or not you've gotten a vaccine before, for like the flu...

you know, like the vaccines have had dead viruses or parts of the virus inside. What's different about this one is that there's mRNA.

So, again, maybe you're confused about what mRNA is.

Protein. Think of like a protein shake, you know, that body builders take.

There's protein in the vaccine that carries the mRNA throughout your body.

And your body is ready to fight against anything that comes in, whether it's the common cold or some other disease.

Your body's always on the lookout for something that doesn't belong.

So when the COVID-19 virus enters your system, because it's looking for a susceptible person, and it grabs on to parts of your body in your cells,

that defense that your body wants to mount will have the vaccine to help protect it.

So there are two vaccines, the Pfizer vaccine and the Moderna vaccine.

So... if your body is unsuspecting and the COVID-19 virus gets in, it gets past your defense and your body is much weaker.

With the vaccine, it sort of wakes up your immune system and it says, hey! Do you see this shape of the virus? This is the kind of shape you need to be on the lookout for.

And it tells your body to be aware because it's going to be dangerous for you.

And so when the COVID-19 virus enters your body, your body is already prepared to fight against it.

Now, there are two shots you get as far as the vaccine goes.

And it's important to remember, the first shot kind of wakes your immune system up. And so it helps your body to recognize the COVID-19 virus.

But then after some time your body will kind of get a little lax again. It will get used to it.

So the second shot is like a wakeup call. And it reminds your body to really be on full alert, so that when the COVID-19 virus comes, your body is already set to mount a defense and get rid of that, out of your system.

It's important as many people as possible get the vaccine. Because if they don't, then COVID-19 has more and more people that it's able to get sick.

As Dr. McKee explained it, if there were ten people, and most of the people have the vaccine, let's say maybe only one or two people don't have the vaccine...

the virus doesn't have anywhere to go. There are no hosts. And so the virus itself withers.

COVID can't enter into those systems because COVID-19 is blocked. The virus is blocked. And so therefore the virus goes away.

So, keep in mind that the vaccine has a protein. That protein helps carry the mRNA. That wakes up your body's immune system to be able to accurately identify and defend itself against COVID-19.

It doesn't have any of the virus inside of it. It's completely safe.

Do you remember getting a vaccine when you were -- at any time when you were younger, right? And a nurse might give you a lollipop because they're trying to encourage you that this hurts but it's good?

Same thing. There's going to be a little bit of pain at the site. But then it's going to go away.

In some people -- but very, very rarely -- will there be a more serious reaction. You'll have a period of time where you'll be observed,

and then as your body has the vaccine in it, it's going to be able to bolster your immune system to be able to fight against the virus.

So right now, the virus kind of has more... power than what it should. Because there are so many people who can get sick.

So right now, the virus kind of has more... power than what it should. Because there are so many people who can get sick.

But as more people get vaccinated, then we will be able to overcome the virus. It will have fewer hosts to be able to come in. And we'll be able to deal with this pandemic.

In addition to washing your hands regularly, wearing a mask, and maintaining social distance.

Because if we do that, in addition to being vaccinated, then the pandemic will begin to slow.

And then we'll be able to slowly work our way back to normal life as we expected it. Okay? (Chuckle).

So, that's it for my part. Here he comes. There's Dr. McKee.

>> MIKE MCKEE: Hello!

Okay. So, now that we're all on screen here, we want to take a minute to answer some questions during a quick Q&A period.

I've been looking through the list of questions as they've been posted.

One question is: Why not do a mix of Pfizer and Moderna for the vaccine. For example, getting your first shot of the Pfizer vaccine and doing your follow-upshot as the Moderna vaccine?

That could be something that is appropriate at a future date. But at this point in time, whichever vaccine you get, you should get that same vaccine company for your second shot.

Whether or not they'll eventually be interchangeable, we'll see. Because essentially they're using the same pathway, with mRNA.

>> SARAH HEIN: I can take the second question. I mentioned this in my part of the talk, but I can go over it again.

So, some of the common side effects would be: Pain in this area where you get the injection (touching her shoulder). Headache. Feeling very tired.

Those are the top three, most common.

You can also have fever and chills. You can have body aches. You can have swollen lymph nodes as well (in the neck).

But those are less common.

I think I went over all of those.

>> MIKE MCKEE: So, Nigel, do you want to go ahead?

As I'm looking at the list, do you want to go ahead and talk about allergic reactions?

>> NIGEL HOWARD: Yes. When you think about the two shots for the vaccine, I mean, a logical question is saying, why not get both shots right away?

But remember that first shot is sort of alerting your body's immune system. It's the first time your body's being exposed to this mRNA.

So it's learning how to mount the defense against the virus. Because without the vaccine, your body has absolutely no idea how to recognize it. So, your body is very susceptible for the virus to enter.

So the first vaccine wakes up your body's immune system, and it teaches your body how to recognize it.

Think of going to school. Do you learn everything in one day? No! Of course it takes time for you to have a mastery of any subject.

And so there's 21-28 days from the first shot. Let's just come up with a fake timeline.

So, on February 1st you get called to get your first shot of the vaccine.

You go home. And after a period, 21-28 days, let's say four weeks later, you get called back in for the second shot.

And by that time your body's already more aware, prepared to recognize that virus, so with that second shot, you're even more immune.

So, it's very, very important to have those two shots at the appropriate time table as well, to really get your body to be as fully prepared as possible.

>> MIKE MCKEE: There's another question now about variance.

>> MIKE MCKEE: There's another question now about variance.

So, the COVID virus itself has mutated a little bit. So, the one that this question is particularly related to is B-117. That's a variation that first appeared in England and now is spreading.

So, many states in America are now seeing this virus, including our area.

And it seems as though, yes, it does come with a more -- it spreads faster.

And that six feet of distance isn't quite enough anymore. It's much more contagious.

But the vaccine will probably still be effective against it, which is a relief.

So, that variant -- there's other variants across the country. South Africa as well as Brazil, there are different variants of the virus there.

And they are unfortunately entering into the US. We're still studying these variants, about whether or not the vaccine will be effective against them.

Like for example the one in South Africa and Brazil. But we do know that the vaccine will be helpful.

Will it be that 95% effectiveness? Maybe not. Maybe a little bit less.

But still, the more diligent we are and the faster we're able to get the vaccine, the more we adhere to mask wearing, hand washing, and keeling our social distance...

then we'll be able to protect ourselves against any variations and mutations in the virus.

Sarah, do you want to take the next question?

>> SARAH HEIN: Sure. I'll take the next question. So, the next question is asking if this vaccine is like the flu vaccine? You know we take the flu vaccine every fall.

And we have to take it every year. So, what I've been told at my health system and from other people is... we're not quite sure yet.

Some people have said that this vaccine covers us for six months. Some people say that it covers us longer.

So what I'm going to say is, we're kind of finding out things as we go. So, we're learning new things every day about the vaccine.

So, just stay tuned to the websites that I mentioned. We're going to have some resources that are posted as well.

You can look at those. Just keep yourself updated. And you will know more information.

>> MIKE MCKEE: Nigel, to take the next one?

>> NIGEL HOWARD: Yeah. But before we do that I want to make sure the comments section are going to be where we're posting those resources? --

>> MIKE MCKEE: The comments section. If you were also interested in joining us for future Facebook Live e vens and some of the presentations we're going to have coming up, please register here.

Spread the word for those people who don't know about these presentations. Over to you, Nigel.


>> NIGEL HOWARD: The flu vaccine is an annual vaccine because it changes year to year. Every time we build a defense p against it, flu will be a little bit stronger against us next time.

So we have to be able to fight against the flu by vaccinating ourselves every single year.

But it seems as though COVID is different. And we mount our defense with the COVID-19, but we won't know how long it will be an effective vaccine.

Could be a couple of years, as Dr. McKee explained.

We're able to find out that the first shot, you know, whether or not they chose 100 people in each cohort, right? So those people who didn't actually get the vaccine,

what they got was a -- well, like a sugar water. Right? They didn't get the actual vaccine. And so with that, they were able to prove that, yes, the vaccine was far more

actually effective at protecting a person against COVID-19. So, with those trials we have two companies thatd were able to get approval for these emergency vaccines, Pfizer and Moderna.

So the flu virus is totally different than the COVID virus. The variation in South Africa and Brazil is a good example. Already the virus has mutated.

Seems as though the vaccines we have right now will still be effective. And we're not sure because this new vaccine spreads so much faster and us able to be much more contagious.

>> MIKE MCKEE: Okay, the next question would be...

Could getting the vaccine kill me? Or could I have a serious allergic reaction?

So, again, it's rare to have a significant complication like that. It's very, very safe. Right now it's 1 in 400,000 people have a severe allergic reaction to it.

Think about how many people have died from COVID. The possibility of you having a severe reaction compared to those who have died from actually getting sick...

obviously it shows that getting the vaccine is the much safer and smarter option.

It's also important to make sure you're on that time table of when the appropriate time between the first and second shot, and that you know your body needs the full time to be able to build its defense.

And during that time, even after you get the vaccine, if it's not that full 35 days for your body to build a defense, you could still contract the virus.

Many people have died because they've already contracted another virus or complications from different infections. The vaccine itself is safe.

And when I'm working with patients, now that I've had the vaccine, I'm much more comfortable. It's best to do what you need to do to protect yourself and your family. Which is the vaccine.

Sarah, want to take the next one?

>> SARAH HEIN: There was a question about when you get the vaccine if you want to take the next day off.

I tell my patients that come to the clinic to take the next day off. Because you don't know what kind of side effects you might have the next day.

You might have nothing. Or you might have all of them. So, it's better to just take the day off, rest, and just relax.

If you cannot take the day off, I recommend taking lots of water with you to work, and some Tylenol and ibuprofen, just in case you get a fever or a headache or body aches.

Just be prepared.

>> MIKE MCKEE: Nigel? Do you want to go ahead and take the next one.


Think of it like when you go to the gym. Right? After a gym day your body's a little sore because it's not used to working that hard.

Especially if you haven't been to the gym in 15 years, right?

If you decide that you have a good day and you want to go work out the best you can, the next day you're really going to feel it.

I mean, that's not the exact same severity, but what it's going to take is, your body is going to take a few days for it to get used to

this workout that it's going through. Just like your muscles would take a few days to get used to a physical workout.

So, again, thinking that you could have both shots and just be done with it won't be effective. That first shot wakes your body up.

Let's bring it back to the flu. What that flu vaccine does is, it alerts your body so that it's ready to recognize the flu virus when it comes in.

Without that, you might recall being sick. Or you were home feeling very bad. And your family may be taking care of you and giving you soup.

But then as your body begins to build its defense and you're going to start to feel better, maybe four days later...

you're going to feel so much better.

Now, if we take that to COVID, your body is not able to recognize the COVID-19 virus right now. So, what that first shot does is, it makes it so that your body is aware, and starts to mount the defense.

If you do both shots back to back without the appropriate time table, you're going to overwhelm your body.

Your body needs time to learn, to be able to take the dose in appropriate amounts to be able to build up your immunity.

And like Dr. McKee said, it might take up to 35 days, depending on whether or not you have the Moderna or the Pfizer vaccine. For your body to be fully prepared.

And after that second shot.

So whatever your healthcare provider tells you in terms of timing for the first and second shot of the vaccine? Follow it.

And don't put off the second shot. Make sure that you stay on that time table to really help your body be prepared.

Another example: If you have people in your family with health issues like diabetes, and you think you're fine, but you contract the virus.

You bring that home and spread it to your family. And maybe their bodies, because they're even weaker, would have a much more serious reaction to that.

Then they would have to go through the rigorous healthcare... they would have to go through all the health medical attention that they need. And hopefully, pull through!

Or if they're going through another infection or fighting another virus and then you compound that by bringing COVID-19 into the situation...

Don't spread it to your family and friends. Real, be vigilant with mask wearing. And social distancing. And cleaning your hands.

And do not go out and be in large crowds. Follow the advice of the public health officials. When they make adjustments to what's appropriate for the public,

follow those adjustments. Because, just like Dr. McKee, they have training and expertise in knowing what to do. And if you follow those directions,

you really, really will be saving lives. I mean, US is one of the worst rates of death in the world. 400,000? It is not something to take lightly.

So many times people didn't realize that they were sick, that they had the virus.

If you feel like you're sick, even if you think it's just a cold, stay home.

Protect yourself. Protect those around you. Wow. Really think of that statistic. Four hundred thousand deaths.

Follow the health experts, please. Do your part.

>> MIKE MCKEE: Thank you, Nigel.

The other question that we had was, um... well, we've answered those.

Will there be new vaccines coming?

So, I talked in my part about emergency approval for the two vaccines that we have now.

Johnson & Johnson is currently working -- another one of the large companies that is currently working on the vaccine.

Theirs is a one-dose, but we don't know how effective it is. We're still waiting on trial. But we should know more about their vaccine in a few months.

And the other vaccines will be coming out as well. There are many countries that are working on the vaccine.

The two that we're talking about are just approved in the US.

The other thing is, if you feel like you've got some pain at the site after your shot,

if you can handle it, don't take Tylenol or ibuprofen right away. If you're in a lot of pain, that might be fine. But really, you want your body to go through

what it needs to go through to build up its defense. So, if you can't tolerate whatever feelings you're going through, go ahead and take an ibuprofen. The.

That's not going to ruin anything. But it is going to mitigate it, it's going to make it so it's less effective.

And also, don't skip your second shot. Sarah, back to you?

>> SARAH HEIN: There is a question where someone asks: What if I have COVID-19 and I don't know? Should I go ahead and get the shot?

>> SARAH HEIN: So, my best advice in that situation is probably to go get a COVID test. To see if you have COVID-19 or not.

That way, you will know if you have it or if you don't.

We are recommending people that have COVID-19 and they've tested positive, not to come to the clinics.

Obviously because they don't want to expose the healthcare workers or other patients coming into the clinic.

So we would ask those people that test positive to wait until they're negative.

If you've had COVID-19 in the past, and you test negative, you can get the vaccine.

However, when we ask you those questions when taking your health history, there are two questions that they might ask you.

They might ask you if you have mono clonal antibodies or plasma against the COVID-19. If you've had those in the past 90 days then we will respect fully ask you to wait.

Um... I'm not going to get more into that, because that's a very... detailed thing to go over. We can probably talk about that in another talk.

>> MIKE MCKEE: We good? Yep.

So our next question is related to pregnancy. So, if you're pregnant, can you get the vaccine?

First, it's important to talk with your OBGYN. Or your primary care doctor. We are encouraging pregnant women to get the vaccine.

We don't have any data to show whether anything other than our knowledge that if you contract the virus it can be quite serious during pregnancy.

Do moms who get sick with COVID-19 die?

If you are serious enough to go to the ICU, you know, 80% of those people are on breathing machines. And the babies as well suffer.

So, again, it's a balancing act. If you're pregnant, and you're able to get the vaccine, I do recommend you get it. And we'll be following up on that as it goes along.

Sarah, Nigel, I don't know who wants to take the next question. Nigel?

>> NIGEL HOWARD: So, going back to it, if you feel... off... if you feel sick... get a test.

Make sure.

So, COVID has a 14-day period, right, where it could be in your system, and you're still spreading the virus! If you're yelling or singing. Right?

When you're opening your mouth and engaging with the air around you and the virus enters into your system.

For example, church has been a place where it's been able to spread. As people have been singing in church, the virus is in the air and then...

you're able to contract the virus. So, it's important to make sure that you're following strict rules about, you know, maximum capacity for people.

Or wearing your mask in a building. In Canada, religious services are not happening the same way they used to.

There might be 25 people in a building where there used to be 400. And then after a certain point they decided that they just weren't safe at all right now.

Because of the virus hanging around in the air.

But going back to like if you were to contract the virus, say Monday, it might take four or five days for your body to register.

And as soon as you feel something off, go get tested.

Or if you've been in a public place -- where you shouldn't have been, to be honest -- but let's say you were and you're concerned about whether or not you were exposed,

go get tested. That way you'll be able to see whether or not you've contracted the virus and you need to isolate yourself.

Or talk with your doctor and go through all of the health recommendations that you should be doing.

One of the biggest ways to really help against the COVID virus is to not be in large crowds.

What's great about sign language is you can be very distant. Right? You don't have to sit side by side. You can be further apart.

A lot of our senior citizens will go to a shopping mall and they'll sit in lawn chairs out in the parking lot and they'll sit very far apart.

It's important not to be close because that increases your odds of contracting the virus.

So, if you've been around somebody and you're concerned, get tested. Whether it's saliva test or the nasal swab.

Sometimes -- I don't know with the State of Michigan how it looks, but --...

>> MIKE MCKEE: Sarah, do you want to talk about getting tested?

>> SARAH HEIN: Oh, I can talk about getting tested. I've actually done swabs on people. It's not comfortable. I will warn you of that.

But I absolutely recommend that you get tested if you feel sick and you want to be safe and you have elderly family members or people that are immunocompromised.

Please go to the Health Department or any other testing site and go get tested as soon as possible.

It gives you a peace of mind to know if you have COVID or not.

I want to wrap up with the last question that we can answer because we're running out of time. And that is the big question that everybody's asking:

how do I sign up and get my vaccine?

My best answer for that question is to ask your doctor. Okay? Because usually your doctor is in something called a Health System.

So, Dr. McKee is in Michigan Medicine. I work for Henry Ford. So, your doctor may have more information on where you can sign up.

Sometimes it's through online portals, like my chart. Or sometimes you can make a phone call to the clinic where they would do the vaccine.

So the best place to start is, asking your doctor. Another way that you can sign up is to contact your local health department.

So if you live in Oakland County, you're part of the Oakland County Health Department and they can help you sign up for it.

And I am going to pass this back to Mike, and he'll close this talk tonight.

>> MIKE MCKEE: Thank you, Sarah.

Thank you to both of you. You did a great job. Really giving us all the details.

Thank you to our audience who joined us tonight.

Please, share our Deaf Health Talks. And let's work together to really overcome this pandemic.

Do what you can. Get vaccinated. And don't forget, wash your hands, mask-up, be socially distant. Okay? Thank you, everyone!

Thank you to my team, and good night! Good night, everybody!

>> KAILA HELM: We got so many people. 400 joined live. Yeah!

>> MIKE MCKEE: Congratulations, wow, that's great.

>> KAILA HELM: We got so many people. 400 joined live. Yeah!

>> MIKE MCKEE: Congratulations, wow, that's great.

>> KAILA HELM: Also, everybody loved you, Nigel. We got so many comments that you were amazing. That all of you rer amazing.

>> NIGEL HOWARD: Oh, that's so nice.

>> MIKE MCKEE: He's a star, he really is. Nigel's a star. So, glad we were able to ri kroout him for this presentation. Hopefully he'll come back.

>> NIGEL HOWARD: I am honored. Thank you so much. You guys have a great team. Really, it's the team.

2,400? Wow!

>> MIKE MCKEE: Whoo!

We need to be able to share, right? More people are going to watch it because they're going to watch it afterward. Begin thanks to all of you. We'll keep working on the schedule as we go along.

So let's do our best to work together, okay? S.

>> Okay, thank you!

>> MIKE MCKEE: Everyone's ready to go to bed, I'll bet.

>> NIGEL HOWARD: Not me. Not quite. For once, I'm not going to bed.

I am interpreting until 2, 3, sometimes 4 in the morning because I'm doing some jobs in Europe. And I'm on their schedule. So, for once I can be on British Columbia time and I don't have to stay up.

Ha ha. Thanks everybody. Thank you also to the interpreter.

November 2020: Mental Health During A Pandemic

In this time of social distancing and increased social isolation, it can be challenging to deal with mental health. Jahan Farzam, LLMSW, social worker, Michigan Deaf Health, discusses the impact of the COVID-19 pandemic on mental health. Held November 17, 2020.

July 2020: COVID-19, What is Known and What is Next

Deaf family physician and Associate Professor of Family Medicine, Dr. Michael McKee led a discussion on COVID-19, what is known, what is next, and how the Deaf community can stay healthy. Held July 2020.