Meet Macy Plumer. She’s a speech and language pathologist at St. Tammany Health System’s Outpatient Rehab facility – and she’s also the latest guest on our weekly radio segment on The Lake 94.7-FM, in which we take a closer look at the day-to-day work of some of our many experts.
Click below or visit The Lake to hear her talk about her field of expertise. You can also find an edited transcript of her conversation with The Lake host Charles Dowdy below.
Charles Dowdy: All right, so tell me a little bit about who you are. Speech language pathologist: What does that mean?
Macy Plumer: I treat adults who have speech and hearing issues. So, from a variety of diagnoses I treat language, cognition, speech, voice, swallowing, among other things.
Charles: I have an aunt that I think does similar work to you, and if I remember correctly, she does a lot of work with stroke patients. Is that similar? I mean, do you do a lot of work like that?
Macy: Yes, so our main diagnoses right now, I am seeing a lot of strokes and traumatic brain injuries.
Charles: Ok, and so what is your job when that happens? Your job is to help them learn how to communicate again.
Macy: Yes, exactly, and that can present in a variety of different ways. … According to each patient, we will take them in and do an evaluation and see where their deficits lie and treat them accordingly.
Charles: So, how did you find this line of work? Did you know this was what you wanted to do? Were you always kind of scientifically inclined? Tell me about that.
Macy: Not necessarily. So, I went to LSU Baton Rouge. When I first got there to schedule classes I kind of had physical therapy in my head. I didn’t really know much about (speech therapy). I was thinking occupational therapy as well. Then I ended up speaking to one of the supervisors who helps us, and she told me about the speech therapy classes. So, I said, ‘OK, I will take the introductory course,’ and I just fell in love with it. So, it just went from there.
Charles: Do you really watch closely how people talk and communicate? You know what I mean – like, I think physiatrists, they study us.
Macy: Am I diagnosing you while I am talking.
Charles: Have I got issues or am I going to be OK?
Macy: You’re OK.
Charles: Let’s talk a little bit more, because I am in the speaking business. If there’s something majorly wrong maybe I need to know it.
Macy: I would call you a professional speaker. So, most likely with you I would see voice changes over time.
Charles: Is that good or bad? Like, I speak too much?
Macy: Yes, if you are not speaking correctly you can do some damage to your vocal cords.
Charles: Ok then. Let’s talk a little bit more about this. So, do you see people like me? In other words, people who have damaged vocal cords -- are people coming to see you for that?
Macy: Yes, I see a lot of teachers and singers. My case load isn’t full of those, but I have seen those and that is what speech therapists who specialize in voice would see a lot of. But you can also have voice issues from a variety of things. I see Parkinson’s patients who, you know their voice gets super low and their family can’t hear them anymore. And then I see someone who, after a stroke they have a paralyzed vocal cord, or after anything they have a paralyzed vocal cord -- changes in the voice in general. You can come and get an evaluation from me and then we will have you partner with an ENT as well so they can see what’s going on. Then we work together to see how we can treat that.
Charles: So, the singer, for example, that comes to you with a vocal cord issue. I would assume that treatment is different than a stroke patient.
Macy: Definitely, definitely. There are different techniques and exercises for each type of diagnosis. It is going to be personalize to each patient, because they are not all going to present the same. It’s not a one size fits all.
Charles: How do they get to you? Right, in other words, how is a patient ending up in front of you?
Macy: More than likely, we require a referral from a doctor. More than likely they are going to their primary care or one of their doctors and talking about this problem to them. Then it pops into the doctor’s head, let’s send you to speech therapy. Sometimes, since we are speech language pathologists, it can be a misleading title. We do more than just speech and language, so we can miss some of those people. The good thing about St. Tammany is I have doctors messaging me to see which patients are most appropriate to send to (me) and so that way we are getting more referrals and helping more patients.
Charles: Talk about some of the other patients you see and maybe some methods that are employed in your line of work to help them, because obviously at the end of the day, we want the ability to communicate and your job is to kind of rebuild that practice, right?
Macy: As far as communication techniques, it is really, really broad, and it is going to depend on the patient. So, another diagnosis I see often is traumatic brain injury. That is actually increasing a lot across all ages. A lot of times after that traumatic brain injury you are going to see changes in cognition. So that is going to be your memory, attention, executive functions. So, the ability to complete daily activities, sequencing, planning -- it goes a lot further than just being able to talk. It is being able to make those decisions. That is a really hard one to treat. A lot of times they don’t really fully understand what their deficits are. That is where we have to start: ‘We have a problem, now how are we going to fix it?’ Then I see a lot of other diagnoses as well. I mean you can see ALS, dementia, Parkinson’s, as well as people who are born with congenital things, like Multiple Sclerosis and things like that. It really depends on the patient and the severity (as far as) what kind of techniques we are going to use.
Charles: Macy, my wife teaches kindergarten. I am not going to name any names but occasionally a parent will have some concerns about their children’s ability to communicate. Some of them, I assume, are well founded. A lot of times it is just what parents do. We worry about and try to put our kids where everybody else is. So, talk about that for a second. DIs that something that you would see? If, for example, there is a child having a hard time, would someone in your line of work help in that situation?
Macy: Yes, exactly. They often have speech pathologists in the school. Early intervention is really important. As parents, and I am not a parent myself yet, but you tend to panic: ‘Oh, my kid is not looking like the other ones around them.’ So, really talk to your pediatrician and see what they are saying. It is never going to hurt to get in for an evaluation with a speech language pathologist. They can monitor the situation. You want to try to catch it early before it permeates into that higher school levels. It is going to get harder as they go along.
Charles: Now, when you talk about early intervention, is that everything when it comes to speech. Maybe, someone my age?
Macy: Yes, that may indicate that something else could be developing later in life: dementia, Parkinson’s, ALS. I don’t want to scare anybody, but if you are starting to see drastic changes in speech, language, cognition, swallowing, voice, you are going to want to get into your doctor and tell them about this and see what your options are. And then if these changes are warranted, they will get you a referral to a speech pathologist.
Charles: Alright, what have I missed? Anything else that we should have talked about that we haven’t.
Macy: We’ve covered it mostly. Overall, if you are seeing changes in any of these areas, please go talk to your doctor. Let’s see what we can do. If there is a problem. It’s never going to hurt to have an evaluation.
Charles: Alright, it was a pleasure meeting you and we appreciate you sharing this information with us.