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 largely by different Deaf health experts education forum 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 the MDisability Program, with our partners Michigan Deaf Health and Partners in Deaf Health. Past co-hosts have also included the University of Michigan Adaptive Sports and Fitness Program.

OUR VISION

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

WHO IS INVOLVED?

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

WHO ARE THE EXPERTS?

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 fill out our speaker interest form.

ACCESSIBILITY

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. Those who prefer to view the Deaf Health Talks with captions are invited to join our Zoom channel, instead of the main Facebook Livestream. 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 deafhealthtalks@gmail.com.

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

Frequently Asked Questions (FAQs)

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

No, they are free to watch on Facebook. Also, you can share the event or video link your family, friends, and colleagues. If you want closed captioning, you have the option to sign up through a Zoom link which is shared with each upcoming talk.

Visit https://www.facebook.com/UMFamilyMed/ for more details.

 

Are these talks only once a month?

Yes. Right now, the talks occur once a month, every month on the fourth Tuesday at 8pm EST. We have different topics and presenters throughout the year. 

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 http://victors.us/deafhealthtalks to help us keep this program last as an accessible platform with health information for Deaf/Hard of Hearing individuals. 

Will you be able to see me or my name during Facebook Live?

No, we will not. If you do decide to like the post or comment, we will be able to see your name from that action.

 

How do I contact your team?

Please contact deafhealthtalks@gmail.com for any suggestions, comments, questions, or other inquiries. 

 

Past Deaf Health Talks

Click on the image or button to watch the recorded talk.

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.

 

Um...

 

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?

 

>> 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.

Okay?

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: https://tinyurl.com/FBlive-covid19-resources

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.

>> NIGEL HOWARD: Yeah.

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.