Hello and welcome back for another episode of the Future Ear Radio podcast!
For this week’s episode, I had the pleasure of speaking with Liz Fuemmeler, Au.D., Audiologist & Clinical Product Manager – Balance at Interacoustics, and Daniel Romero, Ph.D., Audiologist & Assistant Professor at Vanderbilt University Medical Center’s Department of Hearing & Speech Sciences.
In this episode, Liz, Daniel and I discuss:
– How Daniel & Liz met and the backstory of starting their podcast, A Dose of Dizzy
– A Dose of Dizzy’s “accessible & digestible” podcast format, bridging the research & clinical gap, and catering to niche audiences (“100 true fans”)
– The surging interest in Vestibular Audiology amongst the next generation of hearing professionals & the long-term viability that vestibular services provide Audiology clinics
– Takeaways from the 2023 American Balance Society conference held in February & some of the most exciting innovations taking place within Vestibular Audiology
– Podcasting as a way to connect with like-minded individuals from all around your niche/industry
Oh, and if you’re going to be at the American Academy of Audiology this week in Seattle, come join the three of us for a drink at the Sheraton Grand Seattle on Wednesday night! We hope to see you there!
-Thanks for Reading-
Dave
EPISODE TRANSCRIPT
Dave Kemp
Okay, everybody and welcome to another episode of the future ear Radio Podcast. I’m pumped to be joined today by the dose of dizzy crew, Liz familar and Daniel Romero. Liz, welcome back to the podcast. Daniel. Thanks for joining us today. How are you doing?
Daniel Romero, Ph.D.
Great, great, ya know, thank you for having us. Liz and I are really excited to be here we going on more than I guess, yep. Two years of more than two years of being in the kind of the podcasts game. And yeah, we’re super excited to sort of spread the word and, and, obviously talk about everything, all things vestibular because that’s definitely the thing that we love to do. And we love to, to share, share that passion with others. So thank you. Awesome. So
Dave Kemp
real quick, let’s start with some backgrounds. Liz, like I said, You’ve been on before. But if you want to introduce yourself, as Liz, and then we can, you too can introduce dose of dizzy, because obviously, I wanted to have you two on together today so that we could talk all about your podcasts as types of stuff that you guys cover. And then you know, at a macro level, just like vestibular audiology and in the role that I think it’s kind of playing from from, you know, a high level. So let’s start with introduction. So let us go ahead.
Liz Fuemmeler, AuD
Perfect. Yeah, it’s always good to have us both on because you might get a different story if you’re talking about now and just checking. My name is Liz familair. I am an audiologist. And I’m a I still consider myself a new grad. I probably love for like 20 years. I graduated in 2019 from Purdue with my doctorate and I currently am serving as a clinical Product Manager for inter acoustics. And it’s a really, it definitely has opened up my eyes to the future of vestibular because I get to help build in some of those products and protocols. So that’s my background and where I currently am
Dave Kemp
awesome, Daniel. Well,
Daniel Romero, Ph.D.
I’m Daniel Romero. I am also an audiologist and I graduated with my AUD in 2018. And then my PhD in 2021. I’m currently an assistant professor at Vanderbilt University. And just full disclosure, I also serve on some committees for AAA and I’m the treasurer for American balanced society. So my but my as far as my actual position, I do some do some research, I do some clinical practice and some teaching in there.
Dave Kemp
Yeah, I was just saying, before we started recording, I just saw your name and the most recent audiology now, you had a study that was that was featured in there some research. So you’re everywhere I see I’m seeing Daniel Romero had PhD all over the place. And same with you as you’re popping up everywhere. You’re you’re now the president of the Missouri Academy of Audiology, which is great to follow Missouri, Missourians working together to to, you know, enhance our State Academy. But I, like I said, wanted to bring you to one. Because I just think that your podcast is really interesting for a number of different reasons. And we’ll talk about that. But let’s just start, I’ll get you to talk about like how this whole thing came to be how to dosa does he begin? And you two, how did you two meet and all that?
Liz Fuemmeler, AuD
I was gonna say maybe we should start with how we met and says, we’ve been in communication for a long time. So Danielle, and I both volunteer with the American Academy of Audiology, and we have been longtime volunteers, as students in our graduate program. I think our first and since we were on the planning committee for the SA conference. And so that was I’m a year younger. Yeah, you’re younger than Daniel as far as schooling. And so that’s how we met, we got put together on the same project are working on that. And just, you know, the people, when you find somebody you can work well with, you tend to stick by each other, as you’ve learned how they work. And we both ended up in the world of vestibular, which Daniel always knew he was going to be in, and I definitely did not. But that’s how we originally met and just kind of kept in touch. We both served on the SAE national board, and just did a number of projects throughout our graduate years together.
Daniel Romero, Ph.D.
No. And so yeah, over the years, we sort of just kept in touch and then you know, 2020 happened. And you know, I think around that time, a lot of people were sort of starting up new hobbies trying to, you know, new new things that they can sort of get into and I remember texting Liz and saying, Hey, what do you think of, you know, us having some type of, you know, vestibular education, podcast talking about research, things that are new at the field, and, you know, we sort of just bounced ideas off until we, I guess we didn’t even really know we had when we first started it and, and, but, you know, it was it sort of just started growing and I think as as, as we’ve been doing more One more episodes as we we’ve been, you know, receiving more feedback from our audience. I feel like a dose of dizzy, it’s, you know, the it’s, I guess purpose or its goal is starting to take clear form and I think it’s just kind of been this organic process over over, you know several months but it’s it’s certainly something that keeps us going and we obviously both enjoy doing it.
Liz Fuemmeler, AuD
And I should say our tagline for our podcast if you ever listen is accessible but digestible. I can’t even say acceptable but digestible dose of the stimuli research because I was full time in the clinic. And Daniel was getting his PhD. And I would call Daniel being like, what’s new and vestibular because I don’t have time to read, like I’m seeing patients all day. But I’ve always liked research, I’m probably never gonna get my PhD. But I always like it. I like to participate in it. And Daniel was my dose of dizzy, like I was calling him asking for what the dose was. And we kind of built it on that for the busy clinician that wants to stay involved, but doesn’t have time to sit down to read journals. And we all know scientific journals are written in a very interesting way of writing that sometimes it’s really challenging to digest and apply to your clinic. So that’s how it was born. And yeah, it’s really been rolling somehow we keep it up most month, even though we work full time, but it’s just a little fun. COVID project.
Dave Kemp
Yeah, I mean, like the cool thing that I like you said accessible, but digestible is like, the thing that really stands out to me is you’re taking something that’s so niche, vestibular audiology. And so the target the total addressable market for that isn’t big, like, you’re never gonna get a million listeners on that. I would imagine, maybe you will, I don’t know. Maybe I’m totally discrediting your possibility. But for the 1000 people that might listen to that, or however many, there’s nothing else like that. And so I think that like it’s, it’s catering to, even though it’s niche, it’s small, it’s something that I think there’s a ton of demand for that small little subset. And so, you know, I was listening to your podcast and walking the dog, and again, accessible. And as a lay man, as somebody that doesn’t have an AED. I just live in this industry. So I just get everything through osmosis. It’s super interesting, this format of like, you basically, like you said, Liz, you know, everybody’s busy, it’s hard to stay abreast with what’s happening in your scope of field even. And so to be able to have something like what you’re doing, where you’re taking the latest research, boiling it down, talking through the key themes that who the researchers are connecting the dots for the listener, I mean, even myself, some of it was going over my head, not not gonna lie. But a lot of it like was really interesting, I found it to be like, this is a great way to share something that is almost, I think, a little bit like, unapproachable, because it’s like, you look at that, and you’re like, you can see the abstract and it’s long, and you’re like, Okay, I need to dedicate time to that. And it just is one of those things that I can imagine a lot of people just kind of set aside. And it’s a stack this big, you know, and so what better of a way to take that same information and distill it down, then through a podcast like this, where you have like these, like 20 3040 minute conversations about what you all are learning, I just, I find this to be a really interesting niche. And was that kind of like what you were initially planning when you guys started to do this? And how did this like when when you did your first episodes? Did you have them pre mapped out? And you said, like, we’re gonna do episodes on these five things? Or how did that kind of work?
Well, good question.
Daniel Romero, Ph.D.
No, we had the first two years planned out from day one totally. Yep. No, I want to say like it kind of morphed as we kept going along, as we started doing, doing each episode. And, you know, you spoke to sort of an interesting way of bringing research to individuals that may not necessarily have time, whether they’re busy grad students, whether they’re busy audiologists. I mean, if we think about even just the world that we live in, you know, everything is accessible, and everything is on demand. And unfortunately, you know, it’s taken academia a little bit, to catch up, but they’re still, you know, with, with research journals, it’s still very much a very traditional way of disseminating research. And so while that is, you know, often considered the gold standard, and of course, it’s peer reviewed, everything else is there, but if the research is published and out there, you know, we want it to be able to bring that to these individuals or these, you know, everyone that his, you know, may not necessarily have the time to go through 10 pages of search through PubMed or Google Scholar or whatever, you know, database you’re using. So Uh, you know, having it, having it be a short 30 minute episode talking about a handful of studies and kind of give you the little nuts and bolts of everything, I think is beneficial to anyone listening to it.
Liz Fuemmeler, AuD
I think too, I always remind you know, this to the podcast was 100% Daniels idea, I tried to tell everybody that so we get a credit for it. And when we were talking initially, I think our goal was, well, my goal and I always say this to you, I don’t know if this was even your goal, Daniel. But my goal was to have episodes where we like reviewed the newest, like, here’s the newest journal, article, and vestibular are the top three. And we like had a quick little digestion of the top news and vestibular world. But it really when we weren’t going to do that we were like, Wait, like, we should probably just review the basics, like a basic disorder a basic test. So we kind of now have started, which we don’t always follow. So nobody hold us to this. But you know, we do tend to follow like we do an episode on did test and what’s new in the test, what’s the history behind it, then maybe the next episode, we work on a disorder like veneers disease, and then sometimes we bring a guest on so we try to go through a cadence where we go through a disorder, a test, and maybe a guest or something, you know, what’s happening in the field of vestibular or just something out there. So that’s our recent cadence, who knows if it’ll continue or kind of add when it comes to planning, but it’s been working well, and I think people like it, because they can find the episode episode in which they’re deficient in or maybe they want a little bit more information on and really hone in on that.
Dave Kemp
And the other, the other thing that I really like about it, too, that I think is a underappreciated aspect of it on the surface. And then I think as you do it, it becomes really apparent, is, you’re really I think, like, as an academic, and Daniel, you can attest to this, it’s like you put in so much hard work, of conducting that research. And it’s probably kind of hard to, I know, it’s hard to go out and like constantly be your own biggest cheerleader. So when you have somebody that’s like taking your information, and they’re basically promoting it, they’re kind of like putting a spotlight on, that’s very appreciated by the researchers that are doing this. And so I think that’s an element of it, that’s really cool about this, too, is that you gives you an opportunity for all your colleagues out there that are doing a lot of hard work, that maybe don’t have the like, they’re not like, you know, somebody that’s really interested in doing all the self promotion that goes along with that. That’s really cool. In my opinion, too.
Daniel Romero, Ph.D.
No, I was gonna say, I think that’s a really, really good point. Because, you know, you have some amazing researchers in in similar science, and, you know, they’re they’re putting out all kinds of different studies. And, you know, but again, you have if you’re not looking for it, yeah, if you go do, you know, a Google Scholar search and may pop up right away. But as far as getting that information out there, you know, how does this How does this work clinically? What are the clinical implications? Or how does this fit into the broader scheme of the literature? You know, those types of things may not be disseminated as well, as you know, bringing it to, you know, having it be the subject of conversation between two peering. So yeah, I think that’s, that’s, that’s an excellent point.
Liz Fuemmeler, AuD
And I really think there’s, you know, there’s three target audiences that we think about with our podcast. And this has developed over time, because when we started, we had no clue. But students are one because you know, there’s some universities, this helps fill, not a large gap, but helps fill a little bit of the gap at the universities who may not have dedicated vestibular faculty or students who want more vestibular experience. So there’s that education aspect. There’s the clinicians who are busy, maybe they can’t attend the conference, so they can’t hear that talk on the newest research, and then they can’t ever access it because it wasn’t recorded. It’s not available on demand. So like being able to stay abreast with that without being in person at that conference session. And then yeah, lastly, is that the research or aspect because your research is only as strong as how you can communicate? It is my that’s always been my opinion, and I’m big in marketing, if you ever talk to me, but I really think we need to bridge the gap between research and clinic because your research needs to make it to clinical practice for it to be useful. And I know there’s always been this really big divide. So we look at those three angles, when we think about our episodes, because we’re helping those different segments of Audiology. Hopefully,
Dave Kemp
I yeah, like I like how you segmented it out like that. And the other thing with that, too, is that there’s continuity. So if you’re a listener, again, it’s kind of what I was saying about this whole idea of catering. There’s a famous essay written by Kevin Kelly, who is the guy who was the original editor for Wired, and it was called 1000 true fans, and now there’s like an iteration of it. That’s 100 true fans. And the whole idea is that, you know, in today’s age where there’s, you know, you can have a tick tock and you could have millions and millions of followers like how many of those are your actual true fans, and And so when you’re doing something where you have like a really niche podcast like you do, you might really have about 100 people or 1000 people that are hardcore fans. And I think that what’s really neat is like for something like this, you can create an ongoing dialogue that really caters to people that are tuning in every single week, because you’re basically, recalling back to previous episodes, we talked about this research in this particular researcher, and you’re connecting dots for people. And for me, that’s like how you’re taking it from just, we’re going to just repackage this information, which is valuable. But when you can start to repackage it, and then you can provide context to it to, you’re already kind of like there and you’re in, you’re doing that. And I think that that’s the kind of stuff where people look at it. And they say, this is so valuable for me, because not only is it helping to educate me and keep me abreast of what’s happening, but you’re providing all that contextual detail around, this is a really, this particular study here is related to this and helping you connect those dots so that you’re providing that kind of context. That to me is like, a totally different level of, of value that you’re you’re doing by having that like ongoing narrative, you guys are doing the kind of, you know, dialogue of, you know, we talked about this back in episode three, or whatever it might be, it just seems like that’s very conducive to the format that you guys had designed as well, which is really cool.
Daniel Romero, Ph.D.
Yeah, I feel like, you know, it’s very fitting even for, you know, in the world of, especially in the world of vestibular, because you’re working with a lot of gray, you know, you know, I, as a student learning these, these concepts, it wasn’t easy. And, you know, it’s very easy to get lost in all of the different concepts and things that working as a vestibular clinician, or a similar researcher will throw at you. And it’s, it almost takes a step back. And especially, you know, relating one thing to another thing, and how does that look, you know, as far as the outcome of the patient, or how’s that, look, when the patient presents to you, like taking a step back and sort of seeing the bigger picture. And all of it, I feel like is, that’s like my first that’s like the similar one on one. So it’s like, you know, it’s just because there’s so much that goes into it. And it’s very easy to, you know, especially in my experience learning it, it’s very easy to get confused. And, and, you know, have you know, it’s a it could be it could be a turn off, you know, at that point, if, if, you know, there’s their struggle behind, you know, learning some of these more abstract concepts.
Liz Fuemmeler, AuD
And I think, you know, what’s been interesting, our goal was to create conversational AI, just as we’re talking now. I mean, some of my best ideas happen over beer. Most people know that about me, but you know, kind of it similarly, we wanted it to be casual and to be, you know, I don’t want I wouldn’t talk to you like I wrote one of my papers, because that’s not normal. And that’s not how we understand. So one thing that we’ve realized as that unintended impact of, of the podcast is that we actually have people who contact us because they don’t know any other vestibular audiologist. And many times, you know, vestibular is such a small subset, subset still that places that are doing vestibular there may only be one audiologist that’s there, and so they don’t have anyone to ask or resources to go to. So I think I’ve been I have personally been surprised about who and how many people have contacted us for like, case specific questions, advice on how to get a vestibular job, like just trying to build up that community. I’ve been shocked about that, because I was not expecting it.
Dave Kemp
Yeah, I mean, you’re touching on something that I think is like kind of at the root of both the opportunity, but also kind of like, why vestibular isn’t more prevalent and pervasive. You know, it’s interesting, like, for anybody that’s been listening to my podcast, I’ve obviously been a big, I’ve had a big mindset shift in terms of like, you know, a lot of what I’ve been seeking, throughout the old, you know, journey of doing my own podcast has been, what does the audiologist look like, five years from now? And how does that profession remain viable in this increasingly, what feels like a commoditization of hearing aids, by and large? And over the course of doing all these and having these conversations and in my job and all that I’ve come to the conclusion in my own mind that the way that this industry or the way that the profession remains viable and sustainable, and does really well into the future is by reclaiming the full scope of Audiology. And, obviously vestibular is a huge portion of that. And so, I look at this and I say like, there’s so much opportunity in the sort of this specialty areas because in my eyes what that really ultimately can do for any, particularly the audiology side of the market that has the doctoral level degree is, that is like how you can really leverage that the specialty that you went and you obtained. And so I think that my question then is, okay, if if one of the ways that you can be successful is to have a, at least some semblance of a vestibular offering in your clinic? How do you do that? You know, for the folks that don’t have that today? That’s kind of like the million dollar question, in my mind is, it seems very obvious to me and listening to your podcast and like, getting to know you, too, that this is at least one really viable way of doing it. But the big obstacle, it seems, is, you got to purchase equipment, you got to figure out how do you implement this into your integrated into your practice, there’s so many different things about bringing this in and integrating it and actually implementing it into a practice that I can imagine our detractors, for clinicians all across the country where they just say, there’s just too many different things in here that I’m going to just take the out and say, That’s not for me or for whatever. And so like, that’s kind of where my head’s at. And I’m curious to get your guys’s thoughts on how do you create almost a groundswell, a grassroots movement where more and more of the profession sees this as a necessity for the future of, if not me, myself as an audiologist? Like, at least someone in my clinic, having that background and that expertise or something like that? How do you foster all this? How does this actually like come to reality? Do you guys have thoughts on that in terms of like, where we can take this and make this more of a focus? I think, for the profession writ large, and do you feel the same, that it’s something that’s really important and critical for the current state of Audiology?
Daniel Romero, Ph.D.
I, I’m gonna let Liz answer vision, getting all that started. She has much more experience in that in that domain. But I’ll just say like, as far as, you know, 60,000 foot view, you know, falls are, you know, one of the leading cause of deaths for elderly individuals, and we have a whole generation of older adults that are experiencing vestibular symptoms. And so the public need is certainly there. There’s a lot of dizzy patients, and there’s most of the time, it’s not anything that is going to be surgically treated. So, you know, that’s certainly lays the groundwork for our services. And one of the things just about audiology. You know, there’s certainly a lot of talks about ot C’s and all of this. And I think one of the things that I tried to remind students and anyone that I talked to is, you know, our, we just have to remember that our, our field is not centered around the products. It’s certainly centered around our services. And that’s those services very far and wide across hearing, you know, dizziness, balance, diagnosis, treatment. So certainly, there’s, there’s a ton of room and opportunity to kind of spread into some of these other domains. But no, Liz, you want to touch a little bit on, you know, how, how does someone to spar started that vestibular practice? You know, especially on the front end?
Liz Fuemmeler, AuD
No, I think that’s super challenging. And I just hearing people who want to get into vestibular, but haven’t a lot of it, I think is just a willingness to learn and be uncomfortable, because actually was talking to a student yesterday that he’s like, When am I going to feel confident and as tubular and I was like, never and it’s okay, because you’re constantly going to be learning and I think those who are not in vestibular, or like, I will never feel as confident you won’t feel confident in it either. But I think the obstacles sure there’s some inherent obstacles with like equipment and you know, costs or stuff like that. But you there’s, I think, a low threshold for getting into this tubular because the need is there. So as long as you are willing to give it a shot, it’s within your scope. It’s you know, on you maybe to learn through different entities how to actually see a patient, but I guarantee that anybody within the vestibular community would be happy for you to come shadow or you know, this or that, like everyone’s once more people in vestibular so there’s not necessarily a perfect blueprint for getting started with the vestibular practice. You know, I think there’s a lot of resources out there, but nobody has a perfect blueprint for starting hearing aid practice either and yet, a lot of people are starting a hearing aid practice so I I really don’t think it needs to be any different than how we look at other things. I just think people are a little bit more hesitant, because it’s not as common. But there are probably just as many people who enter in to owning a private practice solely focused on hearing aids that we’re not prepared to do that didn’t have the resources, we a lot of times to our business courses. So I think the same challenges are in every scope, and people are more terrified of vestibular for some reason, which is part of the reason why we have podcast.
Dave Kemp
Yeah, I mean, again, like that’s, that’s part of what I was getting at is like, I think that you’re, you’re catering to an unmet need in the market, which is largely great, I get it, I need to be doing more I need to be differentiating in some capacity. And there’s like these options in front of them. And the vestibular option is like, that’s a really viable option. But it’s, it seems like it’s intimidating or daunting or something like that. And it could be generational. I don’t know. I mean, you know, I know we’ve talked before Liz, about how when we were at AAA here in St. Louis, last year, you were at the Grand Rounds, or I believe or some something of that nature. And you said that there is a lot of interest within the younger cohort, the upcoming cohort of audiologist around vestibular. So it’s almost as if the younger generations are seeing the writing on the wall, and they’re seeing what’s on the horizon. And they’re saying, I need to figure out how to specialize now. Can you talk about that, in terms of what you saw what you’re hearing post AAA, obviously, for the last year, from younger professionals about how they’re approaching vestibular, in specialties, and in general?
Liz Fuemmeler, AuD
Yeah, I mean, I think in general vestibular is growing significantly. And we’ve seen that with like abs, which the American balanced society, which you may touch on, but the attendance from students has been significantly growing over the last several years. And I think part of it is realizing the impact you can have on patients. Like I think the impact that you can have, of course, in any part of our field is large. But when you can stop someone from falling and hitting their head, or dying, or you know, not being able to go work, like there are large implications to vestibular because people can functionally live their life. So I think students are noticing that impact. And yeah, vestibular is growing, even amongst our generation. So I think that makes it more accessible because they see it being modeled above them and see it in a lot of different areas, like private practice, to hospital to industry, like being able to see all the ways you can go and vestibular I think is also helpful.
Daniel Romero, Ph.D.
Yeah, yeah, I would certainly second that. There’s also, you know, Liz brought up a good point of, you know, even seeing the changes happening in our generation, I know, the students that I work with, and you know, when I was a student, and when Liz was a student, you know, you maybe had one person that was interested in vestibular out of your class, but now I feel just anecdotally, I feel like I’m seeing two to three students at least. And so that’s very encouraging. COURAGING The second thing is that you know, what is happening as far as the shift? Well, I think just as a whole, you know, and this could be just the times that we live in, or this could be, you know, the access to the information, you know, access to have a similar education. But, you know, I think one of the main driving forces is just trying to like demystify, what vestibular assessment is, you know, the more you do that, I feel the more that students and people are gonna get comfortable stepping into that arena. And, you know, once, once they’re, they’re in it, they’re, you know, they may not, they may realize that it’s, it’s not that bad. But, you know, it’s Yeah, and, and, and I think that’s sort of a meta goal for what our broadcast brings, is. So just try to again, just demystify it and just simplify it or just trying to Yeah, try to put it together. And just, hopefully, that doesn’t scare people out of tuning it. But I think just given our responses from given the responses that we’ve received from students, it’s certainly gotten them more excited about jumping into this field.
Dave Kemp
Yeah, I mean, so you touched on the American balanced society, which I know you too, just attended the relatively new ish show. I believe. We’re group I don’t know the full backstory. So you can totally tell me I’m wrong and off base there that it’s been around for a while. But what what what stood out to you from this show? I’m personally very intrigued. So I’m going to just now scratch my curiosity itch and I want to learn all about this. Like, what went down? What’s it like, what things really stood out from this year show?
Liz Fuemmeler, AuD
I think that in Daniel, you can correct me but I think ABS started in 2008. And it was originally it the day or day and a half before the American auditory society in Scottsdale, so it’s always been like the Monday or Tuesday right before. And so actually next year will be the first year that they are going to be on a different weekend due to availability. So it will be like its own standalone conference. But it’s a really interesting organization. It’s my favorite conference. It is a it’s vestibular audiologist, this tubular physical therapist, and some MDS and T’s are in there. And it’s so interesting, because I feel like we get really high level and applicable vestibular information. And I always feel like I’m leaving with something that I can use both immediately. And something that changes my mindset for how I look at patients, which I feel like is the sign of a good conference, when you have something you can use right away and something that changes how you think.
Daniel Romero, Ph.D.
Yeah, absolutely. And, you know, one of the other things that makes ABS very unique is that well, one, nobody owns dizziness. And so there’s so many different, you know, professionals involved. optometrists, neurologists, EMTs audiologists, there’s so many different physical therapists, of course, there’s so many different professionals involved in this area. And most of the conferences that I’ve seen, it’s all been, you know, physical therapists have in their conference neurologists have in their conference, audiologists have in their conference, but I feel like American balanced society is one of the few conferences that actually brings all of these professionals together. And yes, and truly makes it like multidisciplinary, because, you know, we’re, we I know, the keynote address was given by Dr. Dan Gould, and talked about, he’s a neuro ophthalmologist at Johns Hopkins University. And so we, we talk, you know, we see nystagmus all the time. And so to hear it from his perspective, and to kind of it just the amount of really great information coming from every different angle is just invaluable. And so that’s what I feel makes ABS very unique.
Liz Fuemmeler, AuD
It’s, it’s kind of like the conference, like I feel like it’s a vestibular, if you’re all in one topic field, whether that’s like the student RCI, you go somewhere like AAA and there’s a ton of offerings, of course, but you like handpick your like CI or you handpick your vestibular courses, and you’re like, Okay, I’m going to all of those. This is the type of conference that you’re like, every single one applies to me, this is amazing. Like, it just, it takes that completely out of the picture. And like everything is applicable to you, which is so cool.
Dave Kemp
Yeah, I mean, like, the thing that really catches my attention when you’re describing this, that is so exciting. And Liz, we’ve talked about this on past episodes is this whole, like, relationship building with other medical professionals, again, I think is another, like part of the blueprint of how audiology remains viable into the future, is building inroads with. We’ve talked about neurology, you know, with the ophthalmologists, physical therapists like that to me. And I think that’s so cool that they bring all of these different professionals together. So you can learn from one another because I think that that is, there’s so much upside there as a, I can put myself in the shoes of an audiologist. And as you learn more about what the, you know, when you hand them off to the physical therapist, or when you refer them over to the neurologist to get a really good sense of what’s going on in that setting and speak to them and get a sense of like, what can I be doing differently? What would you appreciate that audiologist, neurologists relationship or physical therapists relationship, and to have a setting where you all can talk together? In terms of like you said, Daniel, nobody actually owns dizziness, it’s it’s a total multidisciplinary approach that’s taken, which again, like I think, is another testament of why vestibular is such a vital part of the future is, it’s a great opportunity to build those bridges in a way that maybe isn’t as relevant with the just the auditory side of things that, you know, when you get into the actual middle ear, and the balance and all that is like you’re suddenly opening up all of these potential relationships with all these other medical professionals. And that should be that should resonate so much with the hearing aid side of the business, knowing how much of the business is dependent upon physician referrals, right? So it’s like, imagine if you had your physician referral business, but you had that for like, four or five other specialty types of doctors that are constantly, you’re referring them here. They’re your, you know, blah, blah, blah. It’s just that makes so much sense to me. And it seems like a great opportunity for Audiology. But again, it’s like, if you’re not involving yourself in any capacity with that, you’re sort of just omitting yourself. And you’re just saying that I don’t have a seat at that table. And you’re not as relevant in the eyes of some of these other medical professionals.
Liz Fuemmeler, AuD
Yeah, and I feel like you know, it’s interesting now to be at this point in audiology and to think about what have we been missing? You know, and I think when you see somebody for hearing assessment and address their auditory concerns huge that’s amazing. But if you’re not asking about dizziness, you’re ignoring a whole part of our field whether you are comfortable seeing that or not, it’s still something that everyone should be asking about because you can refer to another vestibular audiologist, or at least show that like audiologist care about more than just your cochlea, because we should and we do. And that’s really where the field is trending is you are more than just a cochlea. Like we have a lot more. So I think as we start to think differently and start, you know, if you have only seen hearing aids for 20 years, that’s okay. It’s never too late to change. And it doesn’t mean you have to see this tubular patients, it may be as simple as asking if they have dizziness and referring them to the appropriate provider because that is everyone’s duty and audiology. And it should be the same with all of our other subfields whether that’s like a PE C eyes like we need to be assessing the whole picture and referring appropriately within our field and outside of it. It’s pretty quiet.
Dave Kemp
Boom. Nuff said. So, you know, let’s talk a little bit about your guy’s passion. What you’re podcasting about all that like you just went to abs? What do you find most fascinating right now that’s happening in the world of vestibular feel free to nerd out what what’s the stuff that like, you’re genuinely like, this is super fascinating game changing whatever it might be? What are the parts of what you guys are covering and looking at that really engages? You know? Endless?
Liz Fuemmeler, AuD
Well, mine for sure that I’ve talked about on this podcast before is concussion, I really think and that kind of is hand in hand with balls, like as Dana was talking about, because concussions can come as a result of a fall. So I think a lot of times when people are looking at that population, they’re looking at both. So I think that’s huge. And like Daniel said, falls are the leading cause of death and elderly and most of that geriatric population is the one that we’re also seeing in the concussion clinic. So I think that is fascinating. I think it’s gonna grow. The other thing that we just recently, I think our last podcast episode on was infant vestibular screening, which I know we’ve all talked about that in different capacities, but I could really see that spreading, because there’s a whole age population that we haven’t really been assessing appropriately from the vestibular audiology side. And that’s that young, young child population. So I could see that growing in the US, and I’m sure there’s some big barriers, but in the next 10 years, I see I see that happening.
Daniel Romero, Ph.D.
Yeah, that those are great. One of the things that I think, interests me a lot, and I think this ties into the concussion part of it, but just like, the effects, or the impact of the vestibular system on cognition is what really fascinates me. And, you know, we’re often we’re often taught that the vestibular system is just a series of reflexes, so automatic, but as we know, and as any clinician working with a dizzy patient has seen, there’s certainly an impact on cognitive function. And you know, I think one of the, the more fascinating new frontiers of vestibular research is to sort of dig into that more, kind of go up higher in the brain and sort of look at how the brain functions with and without a normal vestibular system, and, you know, see what other you know, brain centers are involved in, in just overall balance, you know, beyond just these, this lower order, you know, vestibular reflexes, so that that’s certainly an area that fascinates me. And I know, we’ve talked about this before, but you know, I don’t know how long it’s going to be 510 years, who knows. But, you know, similar implants is a new kind of thing kind of getting word, you know, buzzword kind of being thrown around. And so, you know, there’s certainly a lot of pearls in this in this field. And I think it’s heading in the direction that it’s always intended, or always needed to head into. And we’re just all of us here, you know, student whether you’re a student, whether you’re, you know, a clinician who’s just started working with the stib, or if you’ve been doing this for 3040 years, it’s just, it’s, it’s, we’re at a time right now, where, where, whether we like it or not, this is this is this area of research is going and, of course, impacting clinical practice, this area is going to, you know, kind of propelled into the next into the next level.
Liz Fuemmeler, AuD
This is I have a very random aside based on what Daniel said, and that is related to cognition, and I may have told both of you this stuff Right, because I think it’s fascinating. But I was at a PT conference in October called ICD yards, the International Conference on vestibular rehabilitation, it was incredible. And they are really tapping into how the vestibular system affects cognition. And in particular, the hippocampus is an area of the brain that they’re focusing on that I know Daniel has a lot more knowledge on than Miyan. But the coolest study ever was about London taxi drivers versus bus drivers. And it was looking at their hippocampus volume. And the reason they looked at those two populations is that bus drivers have the exact same route. And taxi drivers have to have to have really good spatial orientation cues, because they have to know all around the city and how to get there in the shortest way. So the hippocampal volume was actually larger in taxi drivers than it was in bus drivers. So it’s kind of like a use it or lose it because as soon as they retired, their hippocampus volume went back to normal limits. And it was the same as the bus drivers. So I think things like that, like that study is really stuck with me, because I’m like, there’s definitely an influence of how our vestibular system works and what cues we are using. And we maybe are just not looking at the right aspects for how it’s impacting higher structures. So I could see that being huge, that type of research.
Dave Kemp
I mean, that makes sense. To me. It’s like the neuroplasticity and that certain parts of your brain take over other parts if you’re like really relying on that, you know, and so that makes sense. And going back to the vestibular implants, how would this work? What would that even I don’t know a whole lot about that. So interesting. I’m curious,
Daniel Romero, Ph.D.
I want to say there’s three centers. I want to say one is international, but two are here, at least in the United States. And they’re currently going through, it’s essentially a cochlear implant for for your vestibular system. So you know, instead of the electrodes being attached to the Cochlear auditory nerve, they’re attached to some of these end organs and vestibular nerves. And mainly, as far as right now, it’s mainly used for individuals who experienced bilateral vestibular hypo function, so not necessarily unilateral. But as far as I know, all three centers are within clinical human clinical trials. And so they’re there, they’re going through the stages, they’re kind of finding bugs, they’re, they’re working all of those those things out before, before. You know, things get, you know, approved or all of that, or it kind of gets spread wider to the general population. But it’s certainly, yeah, it’s certainly things that are happening now. And a, an amazing technology that, you know, is only made possible in the last 1015 years. Yeah,
Dave Kemp
yeah. And then going back with the whole pediatric vestibular thing. I like screenings. I mean, I think that’s so interesting to think that in 10 years, like you said, Liz, like, maybe that will be common, where, you know, you have your newborn screenings. Every baby birthed in America, I think, in theory should be having their, their hearing tested, will we get to a point where they’re having like their vestibular system tested to it, it’s really interesting to think about these things. And they, a lot of what I find interesting about vestibular is it seems like it’s like, kind of, in a way, a little bit, like 10 years behind the auditory stuff. So you’re seeing like, not optimistic, 20 years behind, already 40 years behind. But you kind of see, like, what the, you know, the like, current state of the auditory side of things looks like, you know, it’ll be interesting to see how the vestibular side kind of gets built out. And, again, it’s like, I don’t know what the future holds or anything like that. But it just seems like it seems like so much of what’s happening right now is there’s like this, sort of massive, I don’t want to say it’s an identity crisis, but it’s almost like a renaissance of like, the audiologist is like, really, it’s like reinventing themselves basically, in a way, because they’re kind of forced to, you know, I think that there are, there’s definitely a portion of the professionals that are like cool with the status quo, and maybe they’re gonna ride it out until they retire, or they sell their practice or whatever. But for the people that know they’re going to be in this for at least a significant, like 510 1520 30 years. I think that there is this feeling of like, there’s gotta be changed. There’s got to be some new direction that we move into. And it’s been really interesting, like even over the course of doing this podcast, it’s blossomed so much like the, the, I can say with certainty that just the level of interest around this tubular audiology seems to have gone up an order of magnitude. And I think again, it’s all sort of rooted in this like notion of like, we gotta find ways to differentiate ourselves. And so now I think it’s more just a matter of like, you don’t even have to almost sell people on the idea of doing it. It’s how do you do it? And that’s where I think the focus kind of lies right now. And, again, kudos to you for for creating your podcast. What’s next for the podcast? Do you know I know that you just wrapped up? I think you wrapped up Season Two of of dose of dizzy, do you have any idea of what comes next?
Liz Fuemmeler, AuD
We do not. We are taking a break for a few months just to kind of regroup. This is a super busy time with conferences in the spring. But we do have some plans we plan to continue that is for sure. Good. Well, we are confident in announcing. But we may have some new things coming for season three as well.
Daniel Romero, Ph.D.
Yeah, I think another thing that we enjoy doing, because it took a lot of the work out of doing the podcasts off of us was interviewing, you know, right, right now, most of the first season is us, you know, talking about, you know, certain disorders, talking about certain tests. But we interviewed at least three people for season two, I believe. And that was just fascinating. It was it was just it was wonderful. Because I mean, we were both learning as we were going along. And you know, who better to explain some of these things than, you know, some of the experts in these particular areas that we touched on. But you know, so certainly more of that. Certainly some other things that we’ve been cooking. But, you know, we’re will worked that out before we
Liz Fuemmeler, AuD
one thing to know about us is we’re usually very last minute when we’re recording, which is why we haven’t had many guests, because I’ll like call Daniel and be like you want to record right now. And it’s like, perfect. So that’s why we are we don’t know all the plans, for sure. But we have a lot of exciting ideas that I’m sure a few of them will come to fruition. So we appreciate any feedback from anyone too, because I feel like a lot of people who have contacted us or said that they listen to podcast has been really helpful to guide us for what people’s continued needs are.
Dave Kemp
Did you meet any fans when you were at abs?
Liz? Liz said she met all the fans. I didn’t see anyone.
Liz Fuemmeler, AuD
I did me a few and that yeah, it’s it’s just it’s, it’s very humbling. And it’s amazing to and I can’t even say fans, because they’re calling students are professionals. And it’s so cool that we can use social media and like our Instagram and our Twitter and our podcast to connect with people we wouldn’t have previously connected with, like, even this week, some someone contacted me like, can you call me on the phone, I just want to hear more about like how to get a vestibular job because a lot of them are posted. I’m not sure. Like half of our success is knowing who and how to rely on other people. And so I’m all about that. And I think it’s great. So yes, I got to meet some new people at ABS who like came up to my poster and like, I know you do the podcast. So like, that’s awesome. Like, I I love that. I think it’s so awesome.
Dave Kemp
That’s so cool. Yeah, I mean, I do, I think that this whole idea of like, you become, you become a huge resource for people. And so you obviously have the podcast, which is a resource in and of itself. But I think it’s a great way for you to position yourself to the broader community to say, feel free to contact me approached me about these kinds of things. Because like, that’s the beauty of podcasting, in my opinion, is it’s a tremendous way to basically be like the facilitator, like, I’ll introduce you to this person, and you introduce me to this person, and you’re kind of in the center of it all. And it’s such a great way to connect people and learn from the experts that are like, really deeply immersed in this. And again, it gets back to what I was saying at the beginning, which is like, I think that when you need like what you guys have built so far, like, I would definitely encourage you to definitely do more guests. Because I think that there are so many researchers that are doing a ton of hard work that really struggle with this whole idea of getting it out there and like promoting it and stuff like that. So having people on to talk about their work, and doing it in a way that’s fun and engaging. And you can highlight like how it’s related to some of the other things that you’re talking about. is valuable for the for the listeners for sure. But I think that it’s a tremendous service that you’re providing to the researchers in the field that don’t have a really good platform to share that kind of stuff. So kudos to you for building that. And I think that if you’re looking for ideas that my suggestion is more guests, I know that it might mean a little bit more prep, but I Got the plan? Exactly. I love that your episode with the crossover episode with the physical therapists, that one. I think that was the episode 11 In the most recent season. So check that out to get a sense of what we’re talking about here with the kinds of interviews that you’ve done. But I just I wanted to have you on today to talk through all this. I think it’s been fascinating. And I really think it’s cool with what you guys are doing. So big shout out to you. Closing thoughts. So anyway, oh, thank
you so much for Yeah, thank you so much for having us. And, you know, we’ll also both be at triple A’s. So you know, that’s upcoming, that’s going to be an exciting time in Seattle. So all three lesson Yeah, no. Yes. Stay
10
Cast meetup.
Dave Kemp
Should we should do a podcast meetup, stay tuned, more information to come?
Liz Fuemmeler, AuD
Yeah. Well, yeah, I really appreciate your podcast to because I definitely, I’m in my little vestibular rabbit hole. But I love how you’re keeping in touch with the different parts of audiology and really highlighting unique ideas that are occurring within the fields. Because I think a lot of times we can get complacent when you get into clinic and you’re just like doing your day to day. And sometimes you just need an idea or the thought that somebody else is doing it to feel confident to go out on a limb. And you know, everything from like, a different like mobile audiology service, like all of these super creative ideas to having an Instagram that all of these things are accessible to everybody posting a podcast easy you can everybody can do it. So whatever your talents within the field of audiology outside of that there is a place for you. And I think your your podcast is a really good job at highlighting that and serving as an encouragement and motivation for people to just do what they want to do and what they’re best at.
Dave Kemp
Thank you. I appreciate more the more collaboration, the better. I really think that like, that’s what’s most exciting, I think right now is that just sort of observing, like when I was in college, and I was working at Oak tree and the summers and stuff, Grenada, that was back in the like 2010. And, you know, that era, and so like social media was in its infancy, so but it just the sense of collaboration today feels like it’s at an all time high, which I think is one of the biggest positives about what’s happening right now is that it does sort of feel like there’s recognition across the board that we’re kind of all in this together, we gotta all figure this out. And there’s a lot of people that are willing to help one another in terms of like YouTube, like, if you want to get more involved in the vestibular world, come to us listen to our podcast, interact with the people that we’re highlighting the people that we’re having on as guests. I mean, I think that as soon as you start to realize that people are approachable, and they’re usually going to be pretty willing to hear you out. That’s a great way like a plug there for especially young professionals that are just getting started out, don’t be intimidated, to go in find somebody’s contact information and reach out and tell them, I’ve been listening to your podcast, I want to get more involved, whatever that might be. That’s how all of us kind of got started, was just putting yourselves out there and being like, I would love to learn from you. And it seems like there’s just more people than ever that are willing to share their experience and their wisdom and all that. Yeah.
Liz Fuemmeler, AuD
And I think it’s a I agree, I think it’s a really nice change for our field. Because a lot of people are focused on how our field has been really divided and a lot of different issues and even organizationally. And so I think it takes a little bit from everyone to have that collaborative spirit. But I definitely feel in vestibular and I think that’s very true at abs in some of these conferences is you really do feel that community over the competition coming through.
Dave Kemp
That’s awesome. Well, Liz, Daniel, thank you too, so much for coming on today. Everybody, be sure to go check out a dose of dizzy and where if people want to contact you directly, where should they contact you?
Daniel Romero, Ph.D.
I would say probably most we fish through our Instagram. So at at a dose of dizzy podcast. You know, we’re we’re both managing it. And Liz does all of the amazing graphics and social media post. So she certainly gets all the credit credit but we you know, we certainly tried to answer back messages that we get through there. So if you have a question or anything like that, just, you know, DM us and we’ll we’ll point you in the right direction, hopefully.
Dave Kemp
Awesome. Well, thank you so much. And thanks for everybody who tuned in here to the end jab with you next time. Cheers
