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Episode 97 - Karen Wolk - Inspire Implant Update

1:06

Hey there, it's Emma Cooksey here and I'm your host.

So we're coming up on my 100th.

Episode of the podcast here has seen in a couple of weeks and I'm gonna have an Instagram live on June 2nd at 7 p.m.

1:22

Eastern and so if you're not already following me on Instagram at sleep, apnea is stories on Instagram and I'll be doing a live.

I'm hoping to kind of talk a bit about some of my Favorite episodes.

You might have missed and maybe I'll interview a few and special guests for updates and since they were on the podcast so those are my ideas.

1:46

But I really hope you guys will all join me.

Then I also wanted to do a quick correction for a previous episode where I it was the one with Teresa and Trent Ted ball and they were talking all about Trent's journey.

2:06

And I mentioned Graham Stony and how he had talked about in his interview that he had to test for sleep apnea before he saw a specific, chronic fatigue doctor, So he got in touch just to say that the way that I characterized, it wasn't quite right, so he I think didn't end up seeing that doctor, I think is what he said, but anyways, so apologies to Graham.

2:35

So today is conversation is with Karen Woolfolk, who is in Gilroy, California, she works as a regional brand activator in the Northwest you asked for Massimo consumer, she got At her Inspire and plant in July of 2018.

2:56

She's being a volunteer patient Ambassador for four and a half years for inspire and she's participated in hundreds of patient talks both in person and on zoom and talk with patients one-on-one as well as talking with doctors.

3:14

Being a volunteer patient.

Ambassador has given her life so much, meaning and purpose and she truly believes the Inspire therapy is changing lives for the better.

So, without further Ado, here is my conversation with Karen Wilk?

3:30

Welcome Karen.

Hey, thanks for having me on Emma.

Yeah, I'm so excited to reconnect with you after a while.

I feel like we've kind of been in touch since I interviewed you, but I can't wait to hear your update.

3:47

So you are actually the first person I interviewed for the podcast.

Oh, yeah, all that time ago, in the summer of 2020.

So I guess for people Whoo.

Whoo.

I will put the link to our original conversation in the show notes, but I think for people listening that didn't hear that maybe just recap kind of a little bit about your story and where we got two on the last podcast and then we'll pick up from there.

4:19

Yeah, since 2020, a lot of a lot has changed but a lot is also still the same.

I mean, things just keep getting better and better.

I remember when We interviewed I know that I was like your first guest other than you would a.

4:34

It was really exciting and I remember all of these ideas of what it was you wanted to accomplish and I'm so excited about all the things you have accomplished and all the connections that you've been able to make and all the people you've been able to help.

So a little bit about what's changed for me, is that things are getting much better than a lot.

4:56

Doing a lot better as far as being able to function in the world.

Old and and get out and do more things and take on new challenges.

For people who didn't listen to the first episode, you were talking about how it took a while to get.

5:14

The diagnosis was sleep.

Apnea.

Sure.

And you had a lot of cognitive impairment and the thing that always sticks out in my head is that you were doing your job and talking about Lens cap and you can't think of the word for lens cap and you were like, there's something really wrong.

5:36

And so you talked us through going to different doctors and eventually getting your diagnosis.

And and so at the end of the last episode, you talked about how you tried CPAP that didn't go well and then eventually you found that Inspire implant and yeah that was you know going well for you.

5:59

So Then pick up there and okay, what is no, then what happened?

Yeah, yeah.

So at the time when I found Inspire that was, you know, the same surgeon that did and nasal turbinates reduction, for me to be able to tolerate the mask and I did like, you know, I did try by CPAP for a year and BiPAP for a year and then I actually went quite a while untreated because during the time when I between By 2017.

6:30

When I got medically cleared for inspire, it took a year to get, you know, insurance to approve it.

And so that was a really sad year and I would say I declined quite a bit in that year and you were struggling with depression a lot, then depression anxiety symptoms, you know, panic attacks which, you know, I realized that I was probably choking all night and having them at night.

6:56

Right.

Just literally panicking because I'm not breathing.

And then, that's what I think I became really good at having panic.

Just not sure where it came from and never realized it was all happening.

While I was trying to sleep, and when you're nervous, I am is not getting that reset.

7:17

Yeah, but I hear that some other people's nervous systems get during sleep and, and so you're really starting each day from this height and fight-or-flight, kind of a play.

Yeah, so a heightened state of awareness.

Out, you know, during the time when I was doing CPAP and BiPAP with CPAP first, the nasal turbinates reduction to help, you know, tolerate The Mask but then I found that like, you know, that happy face on the machine was always there to greet me in the morning and it did not match, you know, the face on my face, right?

7:48

And, and my everywhere sleepiness scales were, you know, pretty high.

And the only thing that keeping them without being at the top was that I would never allow someone to drive me in a car.

So I would never fall asleep, isn't.

Passenger to car so that, you know, they're right there.

There's there's some extra things that I could do it just simply because I was refusing to be a passenger and I would say I have like limited driving because and even like the area that my doctor would allow me to drive in.

8:17

He said, I had to keep like, a 50-mile radius to, you know, just make sure that I was always able to get home during that gear.

I also like, Like to keep my insurance.

I had to work full-time, my employer at the time.

8:35

Luckily, I had left my Cobra from my last employer where I had left on disability leave and my mic over had just run out and immediately moved over to new company insurance.

Got in enough hours just to be able to be covered.

They were so amazing.

8:51

They got me an advocate and then during the process of getting inspire I had to do an independent medical review and the the results were like one doctor said yes to said no, but the one that said, yes, contradicted.

9:10

The one that said no.

So then they immediate the state.

Immediately said we need to do another one and and of course I felt all the Peels and Inspire help me and then the state got me a free attorney.

Was what was their argument that you shouldn't get the therapy?

9:27

Someone didn't read.

Read.

And and so the doctor that said yes that you know, that read through all the documents that and all medical records realize that I had done all the things that writing an article for people listening.

9:45

So there's a process to go through, I think I think quite often with Inspire and we'll talk, we'll get to what exactly is in a second.

But I talk to people all the time who are doing really well.

With CPAP in terms of is lowering their age.

10:02

I and they're feeling better.

And and so those people are kind of like no man.

Bit annoyed with my CPAP.

Maybe I'll get Inspire instead but there is actually a process to go through.

Yeah, which usually involves people trying CPAP and not doing well with it and like yes there's a bunch of different things that the doctor will take you through to test for certain things.

10:25

Yeah, sure.

And and and those those things have kind of changed.

Changed over time initially, the reason why all these hoops were because it wasn't initially in 2017.

And, you know, 2018 it was still coming on board with being covered by insurance right now that these things don't happen.

10:44

The the time from, when you get medically approved to Insurance, approved is very much quicker if you're a candidate.

And so the process is, you know, you go, you need to have like a recent sleep study, you Need to have moderate to severe.

11:01

Sleep apnea.

There are some criteria.

You know, they have a minimum and maximum age.

I all of that stuff and your doctor will like, usually you Doctor that's actually doing the Inspire surgery will do a dice procedure to check exactly what's happening.

11:18

We're so that we need Yeah.

On they would do it the the dice they would go.

And you know, they just really need to know that you were either.

You do not tolerate CPAP not benefiting from CPAP.

Yeah, you know, there's a lot of a lot of things that determine what that means and a lot of the things that I felt were subjective and so if you looked at me on paper, if you just looked at my age, I on CPAP in the fact that I was desperate to be successful and I was doing cognitive behavior therapy for insomnia and Nightmares From The Mask, then learning sleep, hygiene and working my best, and being a mother.

11:59

Being all the things comfortable, patient, getting lost in the hallway.

Yeah.

I was lost in their hallways all the time after that, you know, getting inspired was a, it was a much longer process.

Like I said a year, but then everything shifted and it really was like, you know, like I said before, like in 2020.

12:19

It was really like, almost immediately.

Italy after activation, where I started to feel something.

Yeah, and for me, that was highly reinforcing and but when I did go, you do get wheeled in for my procedure, I promised myself.

And I remember saying to the doctor and that, you know, this thing work, this I'm going to tell everyone about it.

12:40

And and luckily, for me, it did and but then I was on the hook.

So yeah, I quickly tried to find out how I could, you know, help other patients.

So that's how How I became a patient investor, but and his volunteer, but and so, really.

Yeah.

12:55

Can you just explain Karen and for people listening who have never heard of this and don't know what it, can you explain a little bit about?

Yeah.

What, the Inspire and front does?

What the procedure is to put it in there?

Yeah, yeah.

So and I've been on over 200 virtual patient talks.

13:15

So, I've heard descriptions of how this procedures, but I am not a doctor and I might not sleep.

I'm off.

I'm not a doctor.

I know some doctors but I'm not a doctor.

Yeah.

And and I've heard that description many times of you know what it is.

So yeah basically you know it is surgery so there is you know, there is pain, it isn't painless and it is not an external attachment is actually is, you know, working Integrity.

13:43

Yeah.

So there is an incision where I have like right here and that's where the generator is and Then there, there's a lead that runs up here your neck.

That's my episode under my chin here and this is a hypoglossal nerve cuff.

14:02

You know, basically what it does, what's magical is?

Also, there's a lead, I have a lead with another incision a third incision.

They don't do the third incision anymore.

Now, there's a lead to a sensing late for the respiration, so every time you inhale or Inspire, which is hence, the name conspire.

14:21

Yeah.

What it will do is gently move my tongue out of my Airway and, and then it'll sense my respiration.

So it'll do it every time and I like that, the way I describe it is it does for me when I cannot do for myself.

So it's a tiny, like so it's quite a small implant.

14:39

I all looks almost like a pacemaker but the other side of your chest.

Yeah.

And then that is sensing when you breathe in.

Yeah.

And that's sending a message to your Nerve that controls your tongue.

Yes.

14:54

A motor nuts?

Yes.

Moving your tongue out of your Airway and it very, very gently though.

So there's there's, you know, the I have my remote control.

I can grab it, but I'm like, I'm traveling.

So I'm like in a hotel which is also amazing travel with this thing is fantastic and and I can go through.

15:14

I can go through travel.

Go anywhere, don't need, I don't need distilled water, I don't need to go figure out.

I'm gonna plug it in, right?

I don't think it'll clean anything and I feel like power outages not a problem for me.

Yeah.

15:30

All of this things that can be quite traumatic and, you know, and frightening wasn't, you know, when you're trying to find supplies and stuff.

All I got to find is now a double a batteries and, you know, I'm yeah.

But yeah, but just the procedure itself is now.

15:47

It's an outpatient procedure, and I ended up taking a narcotic pain medication for a couple days and then switch to Advil Tylenol and was back at work.

I was working from home after the two days on my computer and then back at work in one week and there is a lifting restriction with your right arm for a while, like 10 pounds, whatever the doctor recommends, and just so that you can take time to heal.

16:16

But yeah, there, you know, there is a little bit down time and I think that it's really great to Take a week off and just recover and then slowly get back to your, living your life.

And with the end goal of that, in one month, you're going to get this device activated.

16:33

Also, they do check your incisions like around a week from the procedure.

Make sure everything's healing nicely and but really, the fun starts and the one mark one month, Mark, and before that, it isn't really fun.

It's more this anticipation of What is it going to be like and yes, a lot of people ask me what it feels like.

16:54

That's like the question that's my question and and so ideally it almost feels like almost not noticeable because of course, I'm asleep.

Right?

So think about when you're breathing at night, and if your tongue wasn't blocking your Airway and how that would feel, and that's kind of what it is.

17:19

It's moving my tongue out of my ear.

So I can breathe without it.

My tongue is blocking my Airway and I'm having apnea so you know, people ask me, does it wake me up?

No but acne it wakes me up right.

That that some if I don't have if I don't turn the device on and I go to sleep, I go right back to the way I was.

17:38

Yeah, and so this just does the things that I can't do for myself and it is extremely comfortable and there's Comfort settings.

So, you know, you go home with With instructions and everything and there's an app and now we have the Sweepstake remote, which I saw that.

17:58

So, tell us a little bit about that.

So that's a bring that out work for a technology company.

So yeah, it ends up being that the most important piece of equipment and also the most important remote control I've ever had.

So my bad.

18:15

Okay, so I put the put the batteries in in the back.

Then on the back there this because this is Bluetooth, you can see on the back there's like a little button and you can sync it with your phone and and of course, the phone that I'm using for this right now with you is the phone where I have that, right?

18:35

So explain because before, like so, I just recently saw what the app looks like.

And it almost looks the same as like the way CPAP days her.

Like, they'll have apps where it tells you like this number of hours, you were asleep.

18:50

And Of all the different stuff so it's almost like that right.

It's track hanging.

How much you're using?

Hey, so it tracks different data than you know, CPAP because, right, it's not tracking pressure, right?

It's it's not it's not also.

19:07

One thing that's great is it doesn't tell me how I feel.

I remember snow in for smiley face.

There's no you need to be happy because you slept and you were breathing while you were sleeping.

So there On the app, basically, tracking amount of hours, it does list like how much of stimulation like what setting you're at.

19:33

It does say the the voltage, but that won't mean much to patient, but it does mean something to your doctor and, you know, and I've kind of I kind of work it with levels.

I know the back here has, you know that I'm at level 6?

If like, someone has Alcohol.

19:52

They can turn it up and if they gain weight, you know, like can turn it up lose weight.

Turn it down.

Yep.

And that's all the patients fingertips like yeah.

Plus the - were all on the remote and there's the play/pause button.

20:09

Stop button.

You can you literally can pause whenever you want like or like I only paused to like, drink or eat or talk sometimes.

I don't even positive.

I'll just talk on it and but it's set for default times, like there's a run time of 8 hours initially, right?

20:32

There's positive, 30 minutes or sorry, start time at 30 minutes.

There's a pause time of think.

I think 15 minutes but everything can be customized.

So I have all my settings changed to meet so I need start time like a delay.

Kind of like a rap.

Yep.

Like we're yeah there's a ram.

20:48

Yeah so it basically Ali I can show you because this is really exciting so I'm going to push the button and and with that I love I love that.

You know how nerdy I am about sleep apnea.

So I'm just like chili, this is exciting.

21:05

So everybody get ready.

So you push the button, you'll hear the two beeps which you here in the Inspire commercial and then this this light will turn the ring.

Around this green button will turn green from White and that'll let me know if it's on my nightstand and I move it.

21:20

You can see see whether it's on or off if it worked like if some like your significant other wants to check, they can check and see that your device is running based on the ring around this other green button.

So I'm going to push the button.

It'll move my tongue out of my Airway for a few seconds.

21:37

You'll know that it's running and then technically how it would work, because then 30 minutes later, if it was on, default settings, it would start running.

Okay, here we go.

That's it.

I know that was exciting.

So if I just went off on my way, it would start running their, I turned it back off again.

21:56

But on the back you can see the levels.

They'll and then you can see on the back.

Also if there's like any issues, there's like, there's like if there's a problem with your battery going you know your batteries in the in the remote going dead, it'll give you a warning.

22:14

I always like to travel with extra double AAA batteries before they were AAA batteries and the previous remote and then I can sink it in the morning.

I just basically connected push a button on my phone which I totally nerd out on that too.

22:31

And then it brings the data over to my phone and then I get to decide how my sleep was.

I get to there's a little owl.

No.

And I can't a square, you know, smiley face.

And in fact, when they were designing the app I got to be in a focus group and that Something I was, I know, I like that.

22:49

Yeah.

Don't don't tell me how I slept only.

I know how I slept, right?

So, when I talked to Pat McBride, thank you for and connecting us.

Yes.

He was talking a bit about like, with any therapy like people kind of take to it differently.

23:06

And yes, like is, is there any need for adjusting thing?

Yes.

Or talk to talk about that.

Like.

Yeah.

So I'm, you know, one of the The great things about the therapies is dynamic.

So when you know, when you get Anatomy altering surgery, your best day as I've heard by the doctors that perform.

23:27

It is the it's like the best days the day that you got it done.

And then from that after that, it's all, you know, depending on a lot of factors, right?

But with Inspire that is not the case so you could get, you know, I got my Inspire device and July of He 18, it was activated on August.

23:49

I went on for like three years without really changing, any settings and working within the word you going.

Are you regularly?

See you don't shower or that.

Yeah, I think six months, every six months is ideal, yeah, not everybody can do that, but some people, it's like maybe once a year.

24:10

But what's great is if there's an issue now, your doctor's going to know Because the remote is not only reporting it to you but it's going on Doctor somehow in the the magic of some and internet.

24:27

I do that can't report it to your doctor so they can see yes.

And they can also see like the stuff that you put some of it puts my my usage.

So by the way, I've been using it for what.

Four and a half years every night except for two nights one night, I left it somewhere.

24:46

You know, I went on a trip and forgot it never do that again.

And then one time of sitting in a chair in an ER with someone and I fell asleep without it so those are the only two nights.

But other than that I have used it over eight hours a night for four and a half years.

But the settings have changed so I go in they interrogate the device they make sure in the do all the things that they need to do to make sure I'm good then because they have a programmer and then they, you know, Recheck, to make sure that my tongue moves away.

25:19

It should I get to tell them, hey, I'm not comfortable now before it was just mostly, you know, the data was all not on, you know, not immediately reported.

So I had to go in and then they would upload my data and then we would have that conversation now that be ready for me and they can call me in and say, Hey, you look like you're having problems.

25:39

And I can say, yeah, I'm going like this makes me think so much of a recent conversation.

I had about out remote patient monitoring and and for every type of therapy whether it's Inspire CPAP oral, Appliance therapy, Albany things like actually monitoring the patient.

25:58

Yes.

And then you can see, like, is there an issue?

Do we need to have them come in earlier and I really hope that's the way everything's going.

I hope so too in it, and I'm fascinated of course, with the technology, and how it all works, and how it works inside my body.

26:14

Yeah, I think it makes Me a very unique, you know, individual not just because, you know, this thing is, you know, helping me to breathe at night, but also it helps me to help other people, you know, who are struggling mostly in silence and and those who have maybe, you know, gone the other way where, you know, I'm going in every six months, right?

26:42

But think about the time, when I when I stopped using therap He and had given up, and I know a lot of people end up there and they may have been called not compliant and and such a bad word.

And, and I think that with Inspire what literally inspires me is that it's about in here instead, it's about letting the device do its job, it's about going in and, you know, getting I get my settings change.

27:08

So it about three and a half years.

I had him set disorder.

Wanted that look like like, did you notice more tiredness?

So you thought To get this changed.

So I, you know, I'm getting old.

I can't know.

You're not.

Come on, I'll so, I just turned like 52.

27:24

Yeah, I went in, and I was reporting that.

Hey, I'm not, I'm feeling like these cognitive issues are kind of creeping back in.

Yes, my I'm getting in the hours of sleep.

In fact, I'm over the hours of sleep.

27:39

I'm and I'm I'm having apnea through like the device is not controlling it.

It.

Because the settings need to be changed and there's tons and tons of settings.

So and there's one perfect for.

It's not just that there's a perfect setting for me, there's a perfect setting for me for every part of my life, you know, three and a half years before there was a different setting for me, and now than they reset.

28:04

And then I also recently had it done again and so you just go in and they took the programmer and through your just telling them how you've been feeling.

Yeah.

And then they're able to Look at the data they can will say, can look at my they can look at how my tongue moves when they turn when they interrogate the device so they can see that.

28:25

Oh, wow, it isn't, you know and then there are other things they can do.

They can do like maybe an awake and osca P.

That is something that they could do.

I haven't done that.

So, both those times did you find that they the programmers kind of adjusted what was happening and then that helped again and absolutely.

28:44

Oh but you're very like Like this and this last time it was fantastic.

Like it only took a matter of I mean I was feeling really bad and also you would the cognitive impairment and just feeling like yeah and also I have a whole nother diagnosis that I figured I disclose on here that apparently goes along and hold hands with you know, sleep apnea, Sometimes some people have other comorbidities right and So I was feeling bad because I was having more than one problem, and I realized that getting my device reset, might help some of it.

29:27

Right?

And without getting that completely under control, it's really hard to work on my other stuff.

So yeah, just went in and and they reset it.

So now my apnea is still, you know, between a 4 and a 5, h.

I so I'm still like normal and so I got really lucky because At Stanford I have you know amazing an amazing team and I was having you know issues that led me to a doctor at Stanford that specializes in chronic fatigue syndrome and also the packs Clinic there.

30:04

Yeah.

And so I met with him it was a very long visit and he asked a lot of questions and we went through my whole history and you know, he determined that I met the criteria for chronic fatigue syndrome and I do the rest of the words are hard for me, but encephalomyelitis, I believe is yes Emmy, which I find that people don't don't believe that chronic fatigue syndrome in Lay people, don't believe it is a thing.

30:33

So then there's the other were believe.

Yeah, yeah.

So I know, I know that there's a lot of controversy out in the world, Just about what's real and what's not, but what I found fascinating was after getting I got covid right after I saw him and then I ended up having long covid symptoms so and are quite similar for me.

30:55

And so it was kind of like having a diagnosis of something.

Ironically, he pinpointed like the late 2011, when I was having the word finding difficulties was around the time when the chronic fatigue syndrome.

31:10

I came into play so so I know that explains why even though I'm not sleepy I'm fatigued.

And and and those two things are different because I was going to have my next question.

How did you feel about that?

Like, how did you feel about that diagnosis?

31:27

Didn't it scared me?

Because, of course, you know, I like to research.

I like to ask a lot of questions when I'm at the doctor and I like to find out like, what are the possible outcomes and so what I found out was It could be like, you know, a permanently disabling condition or it won't be.

31:48

So, really depends on a lot on what works for me.

So I'm taking some medication currently taking low dose Naltrexone and I am trying some other medications shortly.

32:05

I have found the low dose Naltrexone to be hopeful and I am super I mean I feel like I'm really lucky to have seeking been able to seek out the help and and be able to get an answer when I originally made that appointment.

32:21

There was like a year waiting list to be seen and luckily there was like a cancellation, like seven months later.

So I'm glad I got that answer.

But yeah, I was very overwhelmed and for long hair again.

32:37

Yeah.

And then I know had to find out how that Going to impact me at work and I thought the doctor wanted to write in some accommodations for work.

So I have those and trying to figure out, you know, I have to do this thing called pacing where I'm supposed to be careful about how many activities I do in a day.

33:00

And try not to basically just try not to burn yourself out every day.

Try try and conserve your spoons.

I'm doing that.

And yeah.

And and but it is, it is interesting.

It is kind of come full circle.

33:18

I still think that I still see the same same psychiatrist that initially was the the guy that sent me to all your Apple actually sent you for a sleep study, right?

Well, he sent me to all of the different people but

35:03

Big obstacle that I see that at least for me and for people that I know that are afraid to go get tested, they see the treatment and then they don't want to know that they have it.

So Zoe 10, what they need to do is listen to my podcast.

35:20

That is definitely true and this, but I think I think that likes because now I can only get us far, you know, just me talking to people.

I can only get so far, but the people that I have talked to do about how important it is.

To get tested.

And then they find out they have it and then they end up getting treated.

35:38

I can only go so far.

I need a bigger platform.

I need to be able to like you need a podcast Karen.

I need a platform like YouTube channel or something.

Yeah, being I guess, I like the phrase comfortably uncomfortable, I like to be in that place because it's important to change the way people frame up their belief system.

36:01

And I think things are changing Doing honestly, I feel like people are starting to like, if you even just look at like the podcasting.

Yeah.

Landscape.

Like there's the park has to do really well or people just talking in a real way about, you know, their lives and what's happening.

36:18

So, I know one thing that I really want to ask you is I hadn't realized before, but you worked with dr.

Sarah Silverman on.

Yeah, on your CPAP like, Trying to kind of keep that my she was my person.

36:36

Yeah, yeah.

So, can you talk a little bit about that process?

I know that CPAP didn't end up being the answer for you, but just for people who might be struggling and looking for, how can you get them talk through?

What you did with her because that's super yeah.

So dr.

Silverman met her at Stanford when she was there and my sleep medicine doctors, you know, made an appointment for me to see her for Cognitive Behavior.

37:03

Therapy for insomnia.

Yeah.

And then I got into her office and then she kind of try to figure out what's going on.

And I told her, you know, one of the problems is the insomnia and one of the problems is I'm having nightmares from The Mask like all of, you know, for you guys kind of claustrophobia feelings, right?

37:20

I had and also I was choking that's why they moved through me from CPAP or BiPAP because I wasn't actually I was swallowing are not really breathing.

Yep and my apneas.

Without without CPAP my aah.

37:36

I was, you know, 20.6, but I'd stop breathing. 74 seconds at a time.

So it's like a moderate sleep apnea with a severe consequence.

Yes.

And so, you know, given that fact when I was when they knock down that aah.

37:52

I like, I'm that and have that.

Really.

I have a really small Airway.

They said it was like, breathing through a straw.

So imagine just forcing air through a straw and then I'm Just swallowing the are trying to breathe.

Hmm, and so she would talk to me about all of not only cognitive behavior therapy techniques, there was an app we would work on that app.

38:15

I would do my homework at home and then come and check in and we would go over whatever.

You know, had happened during that period of time.

And then also, we would work on sleep hygiene techniques and I found that it was very difficult to employ them at that time because I was Was struggling just, you know, just to be.

38:36

Yeah and I found but I did find her to be very positive.

Very, you know, she was inspirational to, you know, I was I knew I wanted to get better.

I just didn't know how I was going to get there and yeah, all the stuff she taught me.

I still use now and actually can use, you know, like, you know, getting the resource like that chicken or egg thing where when you're not sleeping at all, you Are just you feel so terrible that it's hard to make great choices.

39:08

Like, whether it's in, you know, just like food and nutrition and things like that.

But also, like all the things that you would need to do, like, around sleep hygiene to get a good night's sleep.

I feel like, yes, the more tired, you are the less likely to do those things, you are.

39:24

But then once you actually started getting some sleep because she had your Inspire, then like you actually can implement And those things which is great.

Yes, that does exactly it.

Like I couldn't do that stuff at the time and also because I couldn't remember anything.

39:42

Yeah.

And I couldn't stay awake for very long and then like, if you would ask me a question, they'll say you were dr.

Silverman you asked me a question if I tried to answer the question.

I'd be like, I would get a few words in and then I'll be like, what were you talking about?

No idea what you're talking about.

39:58

Yeah, and I knew that, you know, I knew we were having a conversation but I had no idea where it was going.

Or couldn't follow anything.

So now, you know, being able to retain information is super important when you're going to work on something like I was a favor important just for living life.

40:14

I mean I mean yeah having a cognitive impairment and doing cognitive behavior therapy is kind of interesting.

Yeah and yeah.

Oh my goodness.

I definitely enjoyed, you know the the sessions but I enjoy them even more now.

40:31

Yeah.

And and I I know that she's, you know, now helping a larger group.

Yeah, I'm actually getting ready to interview her, for the pot.

Yeah, so that's going to be really interesting and because I think a lot of times people don't think, especially people that are dealing with CPAP and having a tough time with CPAP.

40:50

I think that often times people are not thinking about sleep hygiene and all these kind of things that seem really basic.

But yeah, you know, I feel as though, you know, there Well, I can't sleep because the CPAP thing and that's true.

41:06

But then there's also a whole bunch of other things.

You can be doing to really set the scene for sleep and, and start from a place that's not high anxiety.

You know.

Yeah.

And now cover the Northwest United States.

Yeah.

What are you doing that?

41:22

I like everything from your social media.

Yeah, so I work for a company that recently got acquired.

Now that now, it's Massimo can Zoomer and there are a whole bunch of brands that that includes which would be Bowers and Wilkins Denon, Marantz Definitive Technology pulk and Class A and those are all audio Brands.

41:48

Mmm-hmm and we, we are like a team of regional brand activators.

We all just got together for a meeting in San Diego.

Yeah, traveling.

And probably.

Yeah.

And so I Go from store to store and my my customers Best Buy.

42:08

So I go to a lot of Best Buy stores and you know work with people that work there on how to sell and and you can never remember what a lens cap is called and the lens cap is also you know, that's nice.

I can remember the words and I do sometimes have, you know, brain fog tablets and I'm a lot better at dealing with it than I think most people.

42:33

And when I see somebody having a problem word, finding I know what that feels like.

So yes.

I try not to borrow Boy Nation more empathetic.

Yeah.

And I feel like I see I see the way other people treat people with cognitive issues and it teaches me a lot about what I need to not do.

42:53

Yeah not that.

I should judge others for how they treat others but more like I need to make step back and realize that I could be part of that problem and that I need to step back and Think of my, what are my intentions and, you know, coming, you know, coming into a situation.

43:10

I don't know how somebody ended up the way that they are, but we all are human.

And I also have found in my travels at stores and elsewhere, just how many people that have?

Number one have diagnose sleep apnea.

43:26

Then there's the ones that weren't diagnosed until we talked.

Yeah, and then and then I find out that they I had it too.

Yes.

And then they told me that.

Oh I'm getting treatment.

That seems like it wouldn't be passable.

But is hugely impactful.

43:42

That's I think like one of the biggest things that anybody with sleep apnea can do is just talk about their diagnosis.

You know, I'm a part of the volunteer patient Ambassador and that's what I do.

I talk to people about Inspire and I found that a lot of people are struggling to feel good.

44:02

So they're They're using their CPAP, they're using their BiPAP, they're doing the things they're they're putting in the hours they wake up and every day they don't feel better.

They, you know, maybe are having maybe they're having issues like that are leading to heart issues, maybe they're having issues where they're falling asleep at the wheel or feeling like they're going to and maybe they're having problems with memory.

44:34

Maybe, you know, maybe their whole experience.

They don't even know what's wrong with.

They know.

Something's wrong.

Yeah.

So they they're just not, they're not benefiting from the therapy but they are you know, showing up that's one patient.

44:50

Then there's the one that stopped showing up.

Yeah.

And and that is why perhaps in their drawer and you do no one, any good?

So both of those patients could be it, Inspire County.

But not, it isn't for everyone, right?

But the people that Inspire works for it, works really well.

45:09

Just generally and, and I've talked to Patient after patient after patient that, you know, have said that before Inspire they were, they were just existing and they were just doing the things to make them look good on paper.

45:26

Hmm.

And that was enough for their doctor because their doctors concern was The smiley face.

Well, not just the smiley face, but think about like they feel like they're doing their job.

If you don't, maybe you don't tell them or maybe they don't correlate your symptoms.

45:44

Oh, I'm not telling them, they just look at the data and they say, look at the data date is great.

Yeah, and I've got some good.

I've got one of one of my doctors that I go to is an inspired caring doctor and and I can't say enough about him.

46:05

He's just so exciting.

And and he talks about treating the Wastewater is it so I'm seeing a doctor in Fresno.

Dr. Nazir, you know, a but I love I love all the doctors.

I see.

So like it's like a Love Fest but I really, I love the fact that he treats patients like whole people and then he, you know, he listens and I try to come to the appointment with notes.

46:33

You know, to kind of Atari, I was important, but I think for inspire though, the patient is, is definitely, you know, to be a candidate.

There's all these, you know, all these criteria but the and the pathway is pretty quick to get approved.

46:51

Once your medically approved and I just feel like that there's so many people that if they're looking at CPAP as the reason they're not getting tested.

They should also think about that.

It isn't the only path, right?

47:06

And that.

And that I'm not saying and then for the people that I have talked to wear CPAP worked, and like, at first, when I talk to them, they had even been tested.

They were afraid of the the the mask, and they still went and got tested, because I nag them and then they, you know, and then they tried them the CPAP therapy and even the first night they were like this is amazing.

47:30

So for that, You know, that's amazing.

That's great because the gold standard.

Well, it says, the right therapy for the right patient, right?

And but then for the ones that is that it doesn't work for, that's not their fault.

And if going to the sleep doctor is frightening because they're going to possibly prescribe something that you don't that you're terrified of.

47:54

It's better to go and find out what the options are find out how like, number one, if you have sleep apnea, To find out how bad it is, and to find out what other health implications there are ya to get educated to immerse yourself, you know, if you find out yes later.

48:12

I what the options are for you and then and then find out, do you know, go and look at what's out there and inspires an option?

It's a, it's a second-line therapy, but it is a therapy, it is not a surgery, it's not a one and done, right?

48:28

You don't go in, get your ongoing every night, you can Can you Indigo and, and turn on that device?

Every night you're committing to beat.

You're basically in charge, just like with CPAP, you're in charge of turning it on and turn it off.

And I think that that's ultimately great.

48:46

It's great to be.

I'm accountable to the thing that's working for me, right?

Yeah.

And so we are you and I are have the same disease, right?

We treat it.

Two different ways.

What works for you?

Didn't work for me.

49:02

Me, does it mean that there's anything wrong or bad about either one of us know?

It actually means that we have learned to accept things that in the past.

We maybe would not have.

We are brave people who went and got sleep studies.

49:17

Yes we are.

Thank you so much for joining me again, and it was so great to catch up with you Karen, I really appreciate ya.

Thank you.


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