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Public Awareness

Public Awareness

Public Relations Outreach Efforts: A Year in Review (October 2018- September 2019)

October is Audiology Awareness Month and we want to take this opportunity to showcase the media coverage to include audiology coverage, as well as that of our members over the past year.

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President’s Message: Get Involved

President’s Message: Get Involved

Message from the President: Lisa Christensen, AuD | September 2019

As summer winds down, people return to school, and we all resume our regular duties, what better time than to think about how you can be more involved in the Academy’s activities. I want to fill you in on a few ways that you can be involved.

Submit Nominations for the Board of Directors—Due September 20

I can tell you first-hand how rewarding it is to serve on the Academy board. We are seeking candidates to fill one president-elect position and three board member-at-large positions.

I am the chair of the Nominations Committee, and I ask you to send in a nomination for a colleague or yourself. It is simple—review the steps on our website here

Our volunteers are critical to advancing our initiatives, and we are delighted that many members will assume new volunteer positions on October 1, including leadership roles on the board, councils, and committees. The volunteer portal re-opens next spring, but at any time you can sign up for the volunteer reserve to fill spots as they become available. 

Support the Medicare Audiologist Access and Services Act of 2019

We urge you to send letters to your representatives and senators to encourage their support of the bill. Check out our legislative action center for sample letters, and sign up for the Grassroots Network to be more engaged.

Promote Balance Awareness Week…September 15-21

The Academy is pleased to have worked with VeDA (the Vestibular Disorders Association) to collaborate on a poster, infographics and Ask the Expert articles. Resources are available here on the Academy’s website for your use. Please spread the word!

Share Your Knowledge, Research, and Expertise at AAA 2020 + HearTECH Expo in New Orleans

Submit your abstract proposal by October 1. Visit www.AAAConference.org for more information.

Get Ready…It Is Coming Up Soon; National Audiology Awareness Month starts October 1

Download resources, fact sheets, posters, and other materials to help promote and celebrate this month. 

Join Me for the President’s Year in Review: Looking Back and Looking Forward for Audiology

As I wrap up my term as president at the end of this month, I will offer a retrospective in a eAudiology webinar on September 25 (.1 CEUs). 

Are you confused and worried about the state of our profession and our Academy? This presentation will help YOU identify key issues facing the field of audiology and then give YOU some tools to help YOU start to influence OUR profession.

Thank You 

And, lastly, a huge thank you to Jackie Clark as she moves out of the immediate past president position, but also to Tracy Murphy, Chris Zalewski, and Bopanna Ballachanda who move out of their member-at-large positions. I will truly miss working with all of you over the next year, and a big thank you to all Academy members who have made this a very enjoyable year for me. Thank you, and I look forward to seeing all of you on the September webinar.
 

Lisa Christensen, AuD
(Twitter handle: @AuDLeadership)

Audiology Today Sept/Oct 2019…What’s Inside This Issue?

Take a look at the table of contents and delve into these online articles, which you can now easily search by topic, title, or author. 

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Public Relations Main Image

PUBLIC RELATIONS | Getting Media Coverage Is Only Part of the Equation

In 1968, artist Andy Warhol coined the expression “15 minutes of fame,” when he said “In the future, everyone will be world-famous for 15 minutes.” Since that time, people who are lucky enough to be interviewed or have their story in the news often joke that they received their “15 minutes.”

Topic(s): Public Awareness

Author(s): 

Publication Issue: Audiology Today September/October 2019

Feature 2: Story image

Our Responsibility to Move Audiology Forward

A culture of quality is needed if we are to bring audiology into the spotlight and highlight our expertise in hearing and balance. Ritz-Carlton co-founder and former president Horst Schulze states that we can create transactions every day, but until we place the person next to us as the most important person in the world in that moment, we will never create an experience.

Topic(s): Professional, Patient care, Public Awareness, Centers for Medicare and Medicaid Services (CMS), Coding, Reimbursement, Practice Management, Hearing Assistive Technologies (HAT), Balance/Vestibular, Hearing Aids, Hearing Health Care

Author(s): 

Publication Issue: Audiology Today September/October 2019

Ask the Expert: Vestibular Migraine

Ask the Expert: Vestibular Migraine

Vestibular Migraine: Kristen Steenerson, MD

1. What are the diagnostic criteria for vestibular migraine?

The criteria for vestibular migraine were developed jointly by the Barany Society and the International Headache Society in 2012. As vestibular migraine was still a newly accepted diagnosis at that time, strict diagnostic criteria were developed to establish universal research standards. As a result, many patients who have vestibular migraine may not fit into the classic criteria established over seven years ago. As the current criteria stand, patients are required to have at least five moderate to severe attacks of vertigo (defined as any hallucination of movement, not just spinning) lasting 5 minutes up to 72 hours at a time. With these attacks, migrainous features such as headache, photophobia, phonophobia or visual aura must be present half of the time. Finally, a previous or current history of more classically understood migraine helps to clinch the diagnosis.

2. What are common clinical signs and symptoms for patients with suspected vestibular migraine?

​Patients with vestibular migraine typically have attacks of spinning, tilting, rocking, sway and imbalance. These are usually spontaneous, but can be linked to stress, poor sleep, dehydration, skipping exercise and meals. In between attacks, it is very typical for patients to have hypersensitivity to motion, sound, light, smells and medications. When evaluated by physicians, many of these patients are considered normal. However, with a keen eye, physicians will notice vestibular migraine patients have increased head motion sensitivity, visual motion sensitivity, and postural imbalance with exaggerated sway on occasion compared to patients without VM.

3. Are there specific vestibular tests that you find helpful for diagnosing vestibular migraine?

Unfortunately, there are still no gold standard diagnostic tests for vestibular migraine. Some interesting studies have been published highlighting some patterns in vestibular testing that may be helpful, but these are still in nascent stages and of uncertain generalizability. I find it still very useful to order the full battery of audiovestibular tests to make sure other vestibular disorders have been considered, especially Meniere's Disease, due to the considerable overlap in symptoms. 

4. What management strategies are most helpful?

​There are two main approaches to management: prevention and rescue.

  1. Prevention focuses on reducing the total number of attacks and frequency of attacks that occur. A good prevention plan will reduce severity and frequency by 50%; it is rare that patients will see complete resolution of attacks. Prevention plans include lifestyle changes, medications and physical therapy. Lifestyle changes can be very effective in most patients and may be all that is needed. For lifestyle, we use the mnemonic SEEDS: Sleep, Exercise, Eating, Dehydration and Stress management. Regular sleep, exercise, drinking water (avoiding dehydrating drinks like caffeine/alcohol) and eating schedules can be helpful in reducing triggers for migraine attacks. Stress management is also a key lifestyle modification that comes in different forms for different people: meditation, mindfulness, talk therapy, exercise, work modifications and sometimes medications. Medications used for prevention are borrowed from the migraine headache literature. These can range from over the counter nutraceuticals such as magnesium and riboflavin to prescription medications such as antihypertensives, antidepressants, and anti-epileptic medications. Vestibular physical therapy can help desensitize the brain to head/body motion and visual motion to help reduce triggering of attacks.
  2. Rescue focuses on reducing the duration and severity of an attack when it occurs. Medications typically used include anti-nausea, anti-inflammatory, anti-migraine, anti-histamine and anxiolytic properties that have dual purpose as vestibular suppressants. These medications must be used with caution as they are not intended to be used long term and can have longterm side effects. They are very safe if used a few times a month. 

5. Are medications available for vestibular migraine?

In the United States, we commonly use already-established medications used in migraine headaches. These can range from over the counter nutraceuticals such as magnesium and riboflavin to prescription medications such as antihypertensives, antidepressants, and anti-epileptic medications. These are generally effective, but can sometimes require trialling a few different ones before a patient finds relief. There are no randomized controlled trials that support one medication over another in vestibular migraine in the United States. Europe and other countries have trials supporting the medications flunarizine and cinnarizine, but these are not available in the US. 

6. Is vestibular migraine treated differently than other migraines?

​Yes and no. In many ways the treatments are similar. Due to vestibular migraine's unique motion sensitivity and balance difficulties, there is a singular role for vestibular therapy that is not commonly seen in more typical migraine. As more studies are completed, there may be evidence of unique pathophysiologic processes for vestibular migraine compared to migraine headaches, which may implicate emphasis on different types of medications, but this is yet to be definitively established. 

7. Do you recommend vestibular rehabilitation?

​Yes. In the hands of an experienced vestibular therapist, I find that many vestibular migraineurs improve in terms of balance and motion sensitivities. There are severe cases where even the most gentle of ocular motor or balance exercises exceed the threshold of what a patient can tolerate. For those individuals, we will usually attempt lifestyle and medication interventions first before trying vestibular therapy. 

8. What would you want the general public to know about vestibular migraine?

  1. Vestibular migraine is incredibly common. Up to 3% of the general public has vestibular migraine.
  2. It is important to recognize that headaches do not need to be a prominent feature in order to be diagnosed with vestibular migraine.
  3. It is likely an inherited disorder that can become active with certain environmental factors such as stress, hormone fluctuations (e.g. menopause/perimenopause) and irregular sleep/eating/exercise/drinking schedules.

9. What is your overall key take home message for providers working with patients with suspected vestibular migraine?

Vestibular migraine, like other forms of migraine, is an episodic, neurologic, hypersensitivity disorder. Central nervous system and peripheral nervous system pathways are preferentially affected, resulting in vestibular attacks of variegating types of motion and motion sensitivity. As these pathways can sometimes activate independent from pain pathways, vestibular migraineurs can have isolated vestibular events without headache, thus absence of headache should not dissuade the diagnosis. Lifestyle changes are paramount, medications can be helpful, and physical therapy can be useful for treatment in many of afflicted patients.

10. Are there any other specialties you’ve found helpful to include in a vestibular migraine patient’s plan of care?

Due to known connections between the vestibular circuits and the emotional circuits of the central nervous system, most patients experience an increase in anxiety and/or depression related to their vestibular migraine. Attacks are unpredictable and frightening and if suboptimally controlled can trigger maladaptive coping such as panic attacks, hypervigilance and catastrophization. Due to the connection to mood changes, psychological support such as talk therapy and meditation can be beneficial for coping with this distressing disorder. 

 

Kristen Steenerson is a board-certified neurologist with fellowship training in otoneurology. After graduating cum laude from Claremont McKenna College where she was honored as an All-American lacrosse defensive player, she continued on to medical school at the University of Utah in Salt Lake City, Utah. She then proceeded to Mayo Clinic in Arizona for neurology residency and a fellowship in otoneurology at Barrow Neurological Institute. Dr. Steenerson joined Stanford with positions in both Otolaryngology-Head and Neck Surgery and Neurology with the goal of jointly addressing the junction of inner ear and brain disorders.

 

Ask the Expert: Vestibular Disorders

Ask the Expert: Vestibular Disorders

Vestibular Disorders: Habib Rizk, MD

1. Dizziness is a common symptom reported by many patients. As an otologist, what about patient-reported dizziness is most concerning to you? What disorders do you most commonly see in the clinic?

Any patient presenting with new neurologic symptoms associated with their dizziness requires a thorough evaluation to look out for central causes. These symptoms could be new onset headaches, slurred speech, paresthesia, weakness in lower or upper limbs. Also, patients with loss of consciousness need to be evaluated to rule out a hemodynamic cause or an arrhythmia. Finally, patients with dizziness associated with audiologic symptoms orients more toward a peripheral inner ear disorder.

In our multidisciplinary dizziness clinic, Meniere’s disease and vestibular migraine and BPPV account for about 50% of our new patients

2. Are there differences based on age? Do kids have the same trouble with dizziness as adults?

In children, migraine equivalents are the most frequent causes of dizziness, as well as post concussive dizziness. While vestibular migraine is prevalent in adults, benign paroxysmal positional vertigo is still the most frequent cause of vertigo in adults. Dizziness is a general term and can encompass vertigo, lightheadedness, imbalance.

3. Many patients have been diagnosed with Meniere’s disease. What is Meniere’s disease? What management is available Meniere’s disease?

Meniere’s disease is a pathology that affects the pressure control of the inner ear fluids resulting in fluctuating symptoms of ear pain, tinnitus and vertigo lasting between 20 minutes and 12 hours. There is a high association with migraines in a large subset of patients. Treatment ranges from low salt diet and diuretics to intratympanic steroids, intratympanic gentamicin injections and surgeries: to preserve hearing such as endolymphatic sac decompression or vestibular neurectomy or that are not hearing preserving such as labyrinthectomy.

4. If a patient experiences a sudden onset of spinning vertigo, should the patient immediately go to the emergency department or is there an alternative pathway to care that you would recommend?

A brief episode of vertigo (room moving or subject feeling that they are moving) lasting less than a minute and triggered by a change in head position, typically would not require a specialized evaluation and is usually a benign paroxysmal positional vertigo. However, as a precaution it is important to be evaluated to see if there is any reason to suspect a stroke. Rarely, posterior fossa strokes will manifest only as vertigo without associated symptoms

5. I’ve been diagnosed with positional vertigo. Is it possible for this to return? What can I do to reduce my risk?

Yes. BPPV is known to recur and that incidence is often quoted to be 10% per year meaning a subject with positional vertigo has a 10% chance of having another “attack” in the same year. Any disorder affecting the inner ear such as meniere’s disease as well as vestibular migraine seems to increase the chances of this happening. Also, low levels of vitamin D have been considered a risk factor in bppv and supplementing for vitamin D deficiency is a low cost low risk intervention that may help (jury is still out on this one)

6. Are there medications that can help with my dizziness?  Alternatively, are there any medications that could potentially worsen a patient’s symptoms or recovery?  What about other treatment options?

During an acute attack of vertigo, meclizine, valium, promethazine may be used. If patient is vomiting, suppositories may be necessary. However, taking them long term is going to affect the brain’s ability to compensate and thus it is not advisable to stay on those medications indefinitely. Depending on the cause of the dizziness, a short course of steroids may be indicated as well as preventive therapy for migraines or for meniere’s disease

7. Imbalance is a significant concern for adults as we age. Why is this the case? Do you have guidance on when to seek out balance therapy resources?

As our population is getting older (a child born today is expected to live to be 130 years old), our sensory systems are aging as well. The same way vision is affected and hearing is affected, balance is also affected. Loss of the function of balance of the ears (vestibular function), loss of proprioception (back pain, hip pain, joint pain , reduced muscle mass) and reduced visual acuity increase dramatically the risk of falls. This in itself cause significant injuries and increase mortality in the elderly. If there is any concern for falls, near falls, hesitant gait or dizziness, a patient needs to be evaluated by a vestibular specialist and started on a vestibular rehab program that will significantly reduce that risk

8. What other specialists might be involved in the diagnosis and management of a patient with a suspected vestibular disorder?

Audiologists to perform an array of vestibular testing that will give us an idea of how the vestibular system is functioning. Vestibular therapists that are primordial in setting up a physical therapy/rehabilitation plan

9. What would you want the general public to know about vestibular disorders?

It is an invisible problem. It can have a significant toll on people from the functional, emotional and even cognitive standpoint. If you have a relative or a friend with a diagnosis of vestibular dysfunction, accepting an injury you cannot see will go a long way helping those patients go on the path to recovery. It is not “in their head”.

10. What is your overall key take home message for providers working with patients with vestibular disorders?

Do not underestimate the pervasive impact of a vestibular dysfunction on your patient’s overall health and functioning. New data even shows potential links with progression to dementia. This goes to say how important is our vestibular function in many dimensions of our lives. A thorough assessment to rule out severe etiologies (tumors, strokes) and to make a good functional assessment, will allow you to establish a multidisciplinary plan of care that should impact their quality of life tremendously.

 

Habib Rizk, MD, MSc, grew up in Beirut, Lebanon, and is a graduate of the French Faculty of Medicine-Saint Joseph University in Beirut Lebanon. Dr. Rizk completed an Otolaryngology – Head and Neck Surgery (Ear, Nose and Throat, ENT) Residency at Hôtel-Dieu de France Hospital in Beirut with additional fellowship training in Otologic Medicine and Surgery Fellowship with Dr. Michael Teixido as well as in Neurotology at the Medical University of South Carolina (MUSC). He then joined the MUSC ENT Department as the director of the Vestibular Program, and established the only multidisciplinary program in the state of South Carolina to evaluate and manage patients with various causes of dizziness. He is on the board of directors of the American Balance Society, a member of the Equilibrium Committee of the American Academy of Otolaryngology – Head & Neck Surgery as well as a representative of the Academy in a joint task force with the American Academy of Neurology to investigate quality improvement measures in neurotology. 

Dr. Rizk is involved in hearing-related and dizziness-related research and has over 25 articles published.  He also authored several book chapters and published a book about anatomy of the ear geared toward teaching residents and medical students the complex anatomy of the ear and temporal bone. His interests pertain to all areas of otology and neurotology with a specific focus on medical and surgical management of vestibular disorders.

President's Message: Medicare Audiologist Access & Services Act of 2019

President's Message: Medicare Audiologist Access & Services Act of 2019

Message from the President: Lisa Christensen, AuD

Advocacy Updates

Our biggest news recently has been the introduction of the bipartisan legislation called the Medicare Audiologist Access & Services Act of 2019 (H.R.4056). This legislation was developed jointly by our Academy, the Academy of Doctors of Audiology (ADA), and the American Speech-Language-Hearing Association (ASHA), and introduced by Rep. Tom Rice (R-SC-7) and nine other representatives, and will enhance the Medicare benefit by providing beneficiaries with critical direct access to both diagnostic and therapeutic services of audiologists. In brief, this bill would remove the unnecessary physician referral to and streamline coverage of the full range of Medicare-covered services provided by audiologists that corresponds with their scope of practice. As well, the bill would reclassify the audiologist under Medicare as a practitioner to be consistent with other providers. The Academy leadership is very pleased to work closely with ADA and ASHA to advance this bill through introduction in the Senate and increased numbers of co-sponsors with the goal of passage in the 116th Congress. How quickly the three groups came together to draft this legislation and get it introduced demonstrates our shared commitment to advancing the profession on your behalf.

The Academy has also been working with ASHA, as well as the APTA and AOTA, to support the Allied Health Workforce Diversity Act of 2019. Introduced by Rep. Bobby Rush (D-IL) and Rep. Cathy McMorris Rodgers (R-WA), this legislation would make scholarships and stipends available to diverse and disadvantaged students underrepresented in the professions of audiology, speech-language pathology, occupational therapy and physical therapy. Accredited academic programs in these professions could apply for funding to support the scholarships and stipends; programs accredited by ACAE would qualify. The text of this bill was amended into HR 2781—The EMPOWER for Health Act of 2019. 

The Academy will also be supporting anticipated carryover legislative priorities from the last Congress, including The Telehealth Parity Act and the Access to Frontline Care Act. As well, we remain involved in several coalitions and collaboratives to promote the interests of audiologists. In late June, the Academy also submitted comments about the role of the audiologist in response to a Senate Special Committee on Aging request for stakeholder recommendations on prevention and management of falls and fall-related injuries.   

The Academy shared with members the recent release of the proposed rules for the 2020 Medicare Physician Fee Schedule. The rules generally show positive values for audiology costs. CMS also proposes new measures sets for the 2022 Merit-based Incentive Payment System, otherwise known as MIPS. Audiology will officially be included, and CMS has added three more measures in addition to the existing 6 for audiologists. The new measures are Elder Maltreatment Screen and Follow up Plan, Functional Outcome Assessment, and Screening for Future Fall Risk. General information is now available about the rules on the reimbursement section of the Academy web site, and more detailed analysis will soon be available.

The Academy continues to receive press inquiries in follow up to our inclusion on the Good Morning America piece about state insurance mandates for coverage of hearing aids for children. I had the opportunity to talk more directly about this, as well, on Sirius Doctor Radio this past week.

How Can You Get Involved?

  • Join the Grassroots Network and be on the alert to reach out to your legislators to support bills or to prepare comments on new rules that may impact audiologists. 
  • Contribute to the Academy PAC. Remember, dollars given to the PAC are used only as contributions to members of Congress. 
  • Share the word about legislation of interest to other audiologists and encourage them to get involved. 
  • If you teach policy in an academic program, connect with Academy staff to organize a DC student advocacy visit.      

To complement our advocacy efforts, the Academy also has outreach priorities to enhance public awareness about audiology at both the patient and provider levels. Our Health Care Relations Committee has been focusing on outreach to referring providers and recently launched the Outreach Grant Program. The inaugural grant submission deadline is August 30. 

Important Dates

In other work across the Academy, here are a few activities and dates of note:

Call for Abstracts
The AAA 2020 call for abstracts opens on August 20. Think now about your abstract submissions. You also might want to take minute to check out on the website the plans for our new expo experience for attendees and exhibitors called HearTECH Expo. Mark your calendar for April 1-4, 2020, to join us in New Orleans for what promises to be a fantastic conference.

Practice Management Specialty Meeting
Registration has been open for the Practice Management Specialty Meeting to be held on January 9-11, 2020. This is a must-attend event to keep you at the forefront of audiology practice management. What a great gift to yourself (or a colleague) to start the new year off with unparalleled learning experiences while enjoying the luxury of beautiful Hawaii. View the information on the phenomenal hotel discounts and details about the program.

Membership Renewals
Membership renewals will open soon. It is an exciting time for audiology, so stay involved in this dynamic organization to help shape the future. This is also a good time to obtain your ABA Certification if you have not yet applied under the new annual model.

Academy Board Nominations Due by Mid-September
It is also the time of the year to think about running for the Academy board. Nominations due by mid-September, and full applications will be due later in the fall. I strongly encourage actively engaged members to think about pursuing a leadership role on the board. I can attest to how personally fulfilling it is to serve on the Academy board and how important each board member is to advancing the profession.

Lisa Christensen, AuD
(Twitter handle: @AuDLeadership)

 

 

Balance Awareness Week

Balance Awareness Week

The Academy is proud to help support Balance Awareness Week—September 15–21, 2019.

Balance Awareness Week, an observance designated by the Vestibular Disorders Association (VeDA), aims to increase awareness about vestibular disorders and support patients in their journey back to balance. While many balance disorders are incurable, faster and more accurate diagnosis, along with effective coping strategies can greatly improve quality of life.

Audiologists play a key role in helping to diagnose and manage vestibular and balance disorders in adults and children.

The Academy has collaborated with VeDA to develop resources on hearing loss and balance and to help educate other health-care providers, the media, and consumers about the audiologist’s role in balance care.

We partnered with VeDA to create this unique poster for Balance Awareness Week, featuring an infographic for Dizziness and Psychiatric Conditions.

Download Your FREE Poster and Support Balance Awareness!

Connect with your local and state media, using this press release template.

Social Media Graphics and Ads

Download a skyscraper ad or graphics to share on Facebook, Instagram, and Twitter.  

Infographics

10 Questions for the Experts

Recent Topics in Balance Research

Show Your Support!

Show your support of National Balance Awareness Week with a cozy Hearing and Balance long sleeve t-shirt and matching drink tumbler, now on sale.

Visit the Academy Store today!

SAA Mural Donated to Ohio State University

The Student Academy of Audiology (SAA) teamed up with the Foundation for Hospital Art to create a custom audiology-themed mural that, when complete, was donated to the Ohio State University’s Department of Otolaryngology through the Ohio State University Foundation.

Hundreds of attendees at AAA 2019 took a short break in the exhibit hall and contributed to the painting for the “Paint for the Profession” event.

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