EPISODE 3 - TRANSCRIPT

Emma Cooksey:

The following podcast episode contains discussion of personal experiences of medical diagnoses and procedures. None of the people featured are medical professionals, and you should seek your own medical advice from your own doctor, if you suspect that you have sleep apnea.

Emma Cooksey:

You're listening to sleep apnea stories. I'm Emma Cooksey. And if, like me, you're living with a chronic sleep problem, you just found the place for inspiration, hope and encouragement. I'm not a doctor, but I have spent more than 10 years coping with sleep apnea. And I have a great deal to share about strategies I've used to live more fully every day. Find tools to live your best life while managing your symptoms, or hear inspiring stories from all sorts of people, making the best of life with sleep apnea. This is sleep apnea stories, and I'm glad you're here.


Emma Cooksey:

Welcome to episode three. I'm your host, Emma Cooksey. And I'm really excited for you to hear our guest today, Dr. Joi Freemont.  Not only is she a dentist who specializes in oral appliances for sleep apnea, but she also suffers from sleep apnea herself. Joi actually didn't realize she has sleep apnea until she went to train on how to fit oral appliances for other people. I think you'll really enjoy the conversation. Another thing that I wanted to share with you once I listened to this interview back, I realized that the last two interviews I did involved people who found the right treatment. And after they found the right treatment, they just slept great and their sleep apnea was gone and they got on with their lives, which is wonderful. And that is what happens with some people. 

Emma Cooksey: 

If you're more like me where you use the CPAP and it definitely improves the quality of your life, but all your symptoms are not immediately gone.  Don't give up hope because there's a lot of other things that you can do aside from whatever treatment you're using at night. This is kind of more like do as I say, not as I do because since COVID my normal routine of self-care and all the things I do to help with my sleep apnea has just gone out the window. Normally I do yoga, I would go to yoga classes about three times a week. I would have acupuncture at least once a month. I would exercise every day, avoid wheat and dairy. I'm not allergic to wheat and dairy, but I just, in my body it just feels like, it makes me phlegmy and just generally inflames my whole body. I try to avoid wheat and dairy. I try to really limit how much alcohol I drink. And this is the one that's really the kicker at the moment is I try to be the right weight.

Emma Cooksey:

None of those things are going that well for me right now. And I'm not sleeping all that well. And I'm having to nap quite a lot on days that I can nap, just to keep going. If you're a person out there who hasn't found your perfect magic treatment, you're not alone and there are other people just like you. For me, it's pretty much a daily slog, but I feel like things hopefully will go back to some sort of new normal before too long. And hopefully, I'll be able to get back to yoga classes and all the other things. I hope you enjoy this episode. And again, if you'd like to get in touch, I'm @sleepapneastories on Instagram and the new website just went up. That's sleepapneastories.com. And if you go there, you can register for emails.


Emma Cooksey:

You just scroll to the bottom of the page and pop in your email and I'll keep you up to date on everything that's happening. You have sleep apnea yourself, and you also helped people in your dental practice who are being fitted with oral appliances for sleep apnea. I wanted to start by just asking when your symptoms first appeared and how that came about and how you knew that you had sleep apnea, to begin with?


Dr. Joi Freemont:

Sure thing. I found out in 2013, after the loss of my father, I found out that he had sleep apnea. And as a practicing doctor, I was just blown away that he didn't know that he had sleep apnea. He was the chief of staff of the hospital when he passed away. I mean, how do you as a doctor not know? So, I started, I think as any family member would, delving into his medical history, trying to figure out what the problem was. And so, as I was looking up sleep apnea, I realized that I, as a dentist could treat it. And I was like, what do you mean I can treat sleep apnea? I started studying and studying and going to all these courses.


Dr. Joi Freemont:

My very first course was six months after my father passed away. And everyone in the course, all the doctors, had to take a sleep study that night. And it was all the questions that they asked. I thought the answers were no. Do you snore? No. Do you stop breathing at night? No. My husband was like, "Yes, yes, yes, yes, yes." And I was like, "What do you mean?" He said, "You snore like crazy." I said, "But you never told me." (laughter)


Emma Cooksey:

(laughter) He wants to stay married to you. That's probably what it is.


Dr. Joi Freemont:

Exactly. And I said, "What do you mean I stop breathing at night?" He said, "Yeah, you stop breathing at night." And all of these questions that I thought were no, were yes except the fact that I didn't sleep well at night. I knew I didn't sleep well at night, but I thought it was insomnia because as a practice owner, I was up for hours just because I run a business.  I'm always doing paperwork. But I realized it wasn't insomnia because it was sleep apnea. Out of all the doctors that were in the course, there were only two of us that had apnea. And I was one of the two.


Emma Cooksey:

So, all that time, when you had undiagnosed sleep apnea, you were running your business. How were you doing that? Were you not so tired all the time?


Dr. Joi Freemont:

Do you know what? And as I realized, as I've gone through treating people, your body becomes used to whatever you give it. And that's not always a good thing.  I adapted to working and functioning off of three, four hours of sleep at night. It was normal to me and I was not sleepy. I just didn't sleep. I realized that I had anxiety and I realize now that’s linked to sleep apnea. I thought I was depressed because my father passed away. But it got better once I got it treated. There are so many things now that I look back on saying, “wow, that was sleep apnea the whole time”.


Emma Cooksey:

And honestly, that's one of the main reasons I started my podcast because there are so many people in that situation. For most of my 20s, I just thought I was depressed and anxious and a pretty miserable person. But until you actually have a diagnosis, you don't know the underlying reason why.


Dr. Joi Freemont:

Exactly. And that's why I tell all my patients, when you have these symptoms that may seem small or slight. Unfortunately a lot of my colleagues, we just give them medication and figured that's just the issue. The majority of people that I treat now have symptoms that are even small, with the small talk about sleep apnea and they're just amazed it could affect them. And the question always is, well, why didn't my doctor tell me that? And that's where I am now, I'm trying to educate most of my medical colleagues. Mail them a sleep study. What do you have to lose?


Emma Cooksey:

Right. And when you had, so you were on your course and you found out you had sleep apnea at the course. Then what was your next step? Did you go to your own doctor? Did you know a sleep specialist?  I mean, I'm thinking because you're a dentist, you're probably really well connected. I don't know.


Dr. Joi Freemont:

Well, the weird thing is once I found out I had it, I had the rest of my family tested. My mom got tested. I tested my brothers and we all had apnea. And the scariest part about it, and a lot of people think that when you have sleep apnea, you're overweight and you're an old man, they think that. My mother is nice and trim and she ended up having out of all of us severe apnea. My brother is a physical, personal trainer, fit. He has apnea. The doctor who my mother was going to was actually upset with me because I sent the report to him. He's like, why does she have this? And I said, well, didn't you test her? His words were, "Why should I have tested her, look at your mom. She's the picture of health." Exactly, but she's on medication for blood pressure. My mom has high blood pressure. As a cardiologist, you never thought to test your patients. I'm seeing that so many times now.


Emma Cooksey:

I found this article that was on oprah.com. I don't know if you read this, but it's called the article that could help save black women's lives. And it's all to do with the American healthcare system and how there are huge discrepancies in the treatment of black women. They're talking about going to doctors and feeling unheard and ignored. And just basically having racist treatment. Did you experience any of that when you actually went to get treated?


Dr. Joi Freemont:

Well, the weird thing is speaking of African-American women, my father was actually an OB-GYN. He treated, of course, all African-American women. And I learned after watching him for 40 years, that the way that we as African-American women communicate is different. And a lot of times we are known as the backbone, we're the strong woman. Our symptoms may not be believed if you understand what I'm saying.


Emma Cooksey:

Because you seem like you're coping so well.


Dr. Joi Freemont:

Like what I did, I thought, hey, I can't sleep. What's the big deal. I'm a strong black woman. I'm fine. But when I look back on my own health history, I definitely see that I was having, I never suffered with headaches, but I started having headaches. This was prior to my being diagnosed. And I actually went to two neurologists who both said, "Oh, no, nothing is wrong with you." I'm like, "I have headaches now. I don't have headaches normally."


Emma Cooksey:

Like, this is not normal for you because you know your own history.


Dr. Joi Freemont:

This is not normal for me. And they literally said, "Well, you're probably stressed out because of your practice, you're running the business and just take these antidepressants." And as a daughter of a doctor, I follow instructions very well. That's actually what I did. And looking back now, it's definitely true that we, as African-American women are overlooked because we have to have the most severe symptoms to be believed. It's unfortunate, but it's true.


Emma Cooksey:

Yeah. That's definitely something that needs to change.


Dr. Joi Freemont:

It needs to change. And it's more than just talking about it. I just think that the medical community has to, first of all, has to make themselves more accessible. And also the demeanor and bedside manner needs to improve. Let's just put it that way. Because if someone's not comfortable coming to you, they're not going to go and they're going to suffer at home.


Emma Cooksey:

Yeah, exactly. Well, that's definitely true. Well, thanks so much for that insight. When you did get diagnosed, did you start with a CPAP? Did they give you a CPAP to treat it? Or did you just know all about the oral appliances and just go straight to it?


Dr. Joi Freemont:

No, I went right to the appliance because I knew I was not going to wear that mask. And granted, I know that the CPAP is the gold standard. I have no problem with that at all. I tell all my patients, "I don't care how you treat this, just get it treated. I don't care if you have a CPAP. I don't care if you have an oral appliance. I don't care if we have surgery. We have to do something." And so my practice is mainly focused on now, those patients that are either not compliant with their CPAP, they don't want to wear it, or they can't tolerate it. And I want them to know, hey, the CPAP is the way to go first, but if you can't use it...


Emma Cooksey:

There are other options.


Dr. Joi Freemont:

There are other options. And so many doctors now don't give them the options. And that's where I am. 70% of people who have sleep apnea are not being treated.


Emma Cooksey:

Isn't that shocking?


Dr. Joi Freemont:

Most of them don't even know it, because they all think that it's a CPAP only, there are no options that are ever given. I know you've heard about the football player, Reggie White, who died of sleep apnea because he did not have other alternatives. He didn't know about them. His wife and I had spoken many times and she said, "If only he knew about the appliance."


Emma Cooksey:

Right. Because I think from what I've read, and of course you're an expert on this, but from what I've read, I don't know if you want to call it compliance, but the rate that people actually use the oral appliance seems to be higher than the rate of the people will use a CPAP, just because it less invasive.


Dr. Joi Freemont:

That's true. Exactly.


Emma Cooksey:

Can you just explain to me and remember that I'm not a dentist, I just want you to explain to me in really basic straightforward terms, how the oral appliance works to prevent sleep apnea?


Dr. Joi Freemont:

Okay. Let's talk about what apnea is in basic terms. Basically your airways or your throat is closing. That's just in basic terms. Your throat is closing up and you're not getting air in or out. The treatment is to open the throat. With the CPAP of course it blows air in your nose and your mouth and it forces it, like a big machine which it is, it forces your airways or the throat to open. But when you have apnea, the reason why your throat is closing is that your jaw falls back. Your tongue falls back and it blocks your throat. Your soft palate falls back and blocks your throat. What the appliance does, it actually moves your jaw forward to prevent it from falling back in the first place. It keeps your tongue from falling back and it keeps your soft palate from falling back. It does what the CPAP does without the hoses, without the air. The whole mechanism of any type of treatment is to keep your throat from closing.


Emma Cooksey:

Got it. This is a thing that people need to go to a dentist who actually offers this and be fitted for it. It's not like a thing that you can just buy. You have to go and actually have it fitted. Is that correct?


Dr. Joi Freemont:

Exactly. We call it a custom oral appliance or mouthpiece. And when we do fit you for it, we actually have a machine in our office that you breathe or blow into, so I can see exactly where your jaw needs to be so it won't fall back. It's definitely, it's custom. And I'm a little fearful of the commercial that people see on TV, where you can just buy one or mail-order one. Because how do you know where your jaw is supposed to be?


Emma Cooksey:

Right. You don't.


Dr. Joi Freemont:

You don't.


Emma Cooksey:

We talked a little bit about how a lot of people with sleep apnea are going undiagnosed. And even people who know they have a problem. What do you think the barriers are to people seeking treatment for sleep apnea?


Dr. Joi Freemont:

I think one of the barriers is just that some of the symptoms are things that people think, oh, what's the big deal about it? People think that the only symptom is snoring. And just because you don’t snore doesn't mean you don’t have sleep apnea. Then they think the only treatment is a CPAP. I hear so many of my regular dental patients say, "Yeah, okay. I may have it, but I'm not wearing that machine." And then they shut down immediately because that's what they hear the most. And I have to educate them on, first of all, I don't know you even have it. You may just snore. We could just fix that. You may have narcolepsy. I don't know, but we have to get you tested. And I think one of the biggest barriers is the lack of knowledge. Just the lack of knowledge about getting tested, first of all. And then the different options of treatment.


Emma Cooksey:

Well, hopefully, a lot of people listening to this will go for a sleep study because they think, well, that doesn't sound so scary. That's kind of the idea.


Dr. Joi Freemont:

There are so many different symptoms that are out there that will put you at risk, for instance, people who grind their teeth a lot. Grinding your teeth when you're sleeping, it's not normal. Trust me, and it's not just because you're stressed out. Grinding your teeth could be a problem that happens because your body is trying to wake you up. It's trying to say, hey, wake up. And then people who have acid reflux a lot, it's not because you have dinner late last night.


Dr. Joi Freemont:

A lot of times it's a response that your body is trying to wake you up and all of your nerves are firing off and all that food is coming up through your stomach and through your esophagus, it's trying to wake you up. Those are some signs that people don't realize, hey, this is more of a problem. You shouldn't be popping antacids every day. That's not normal. I think we need to stop normalizing taking all these medications. I've seen so many of my patients who've been treated who are coming off the medications because their body is now functioning normally.


Emma Cooksey:

That's terrific. I think that's so true about what you said about the headaches because that's such a hallmark of having sleep apnea. I used to have awful headaches in the morning. And I think because just the way that everybody thinks about it, they'll just say, well, take a pill for that. But then I'm just thinking in the back of my mind, that's not normal to have a headache every morning.


Dr. Joi Freemont:

It's not. And we have to figure out the why. You're not taking in the oxygen and you're not breathing out the carbon dioxide. And that's why after you're awake for a couple of hours, magically the headache goes away, right?


Emma Cooksey:

Right. Exactly.


Dr. Joi Freemont:

Understand the why behind your condition. And just almost sometimes you have to beg for the sleep study. You'll be surprised just by getting treated with sleep apnea, the amount of life you have left. 


Emma Cooksey:

When you started using the oral appliance, did you just take to it straight away? Was there a learning curve for you? Did you immediately start sleeping better?


Dr. Joi Freemont:

I immediately the next day I felt like, oh my gosh.


Emma Cooksey:

Oh wow.


Dr. Joi Freemont:

What was I doing? But that's not for everybody. Trust me, if you get treated, whatever works for you is going to work. And your quality of life is going to improve because if you're not sleeping, you're not functioning properly. I thought I was, but my energy level just went through the roof. I was able to just function better. Of course, my husband was loving it because I didn't snore anymore.


Emma Cooksey:

Right. That is a real bonus of getting actually treated.


Dr. Joi Freemont:

My friends were like, "You're sending emails at two o'clock in the morning." I'm like, "Yeah, girl. I'm awake." But my sleep cycle has changed. My attitude got better. I wasn't as grumpy as I used to be. It was just wonderful. Sleep is so important. It's so important.


Emma Cooksey:

Yeah, so important. The other question that I'd like to finish up with is just to ask all of my guests if there are any silver linings to their diagnosis of sleep apnea or your journey with sleep apnea? Is there anything that you can point to that has been positive.


Dr. Joi Freemont:

Well, my silver lining is now that I know that I have it, I can identify more people who didn't know they have it and I can make them understand, hey, as your doctor, guess what? I have it too. And I'm going to help you get your life back together. It's not so much one for me, it's just the knowledge that I'm able to help other people. And I want any, as I say, any other daughter to have to go through what I had to go through.


Emma Cooksey:

With your dad.


Dr. Joi Freemont:

My father's death was traumatic. I had to do CPR on my father. I don't want anybody to have to do that. But his death allowed me to have an open mind about new ways of treating people and knowing that I'm able to save someone's life. That's my silver lining.


Emma Cooksey:

Yeah. That's a wonderful one. Thank you so much for speaking to me. And I just wanted you to quickly, if people want to follow you on Instagram or if they live in Georgia.  You're in Georgia, right?


Dr. Joi Freemont:

I'm in Georgia. 


Emma Cooksey:

If people need a dentist, go ahead and tell them where they can find you.


Dr. Joi Freemont:

I am in Hapeville, which is right next to the Atlanta Airport at 606 South Central Avenue. Our phone number is (404) 761-1659. And we actually do free sleep consultations. I can do them in the office and virtually. So, you can find me on Instagram and Facebook at Freemont Dental. That's F-R-E-E-M-O-N-T dental, D-E-N-T-A-L. And even if you're not in Atlanta, I did a consultation yesterday with someone in South Carolina and I found them a sleep doctor. I'm here to help you.


Emma Cooksey:

Great. I really appreciate that.


Dr. Joi Freemont:

And thank you for what you're doing. 


Emma Cooksey:

Well, I'm trying!


Dr. Joi Freemont:

I've listened to other podcasts and you're on the right track. So, don't give up, keep on going.


Emma Cooksey:

I think hopefully it's one of those things where if one or two people, they hear the message and they say, well, she's not so different from me. Maybe I could have that. And they actually go and have a sleep study and they improve their lives. Then I'll feel like I've done something good. 


Emma Cooksey:

Thanks so much for listening. If you're enjoying the podcast, please rate and review it. But more importantly, I'd love it if you would share the show with anyone you know in your life with sleep apnea. I love hearing from you, so if you want to share your story on an upcoming episode, you can reach out to me on Instagram, @SleepApneaStories, or by email, at sleepapneastories@gmail.com, or just reach out and say, hi. I love the community that we're building here. I'm Emma Cooksey and I'll see you next time.