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Episode 98 - Laing Rikkers - "Morning Leaves" - Loss and Undiagnosed OSA

1:06

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

So, thank you so much to all of you who've been leaving reviews on Apple podcast and Spotify.

It really does help people to find the show.

And and so, I thought I would just read a little review.

1:25

I got that.

Just thought it was so lovely and it's from a Jal 99-88.

So and they left it really recently.

So it says amazing podcast.

This podcast has helped immensely as They navigate my own diagnosis.

1:43

These stories give me hope that other people have been in the same situation.

I was in and that there is hope for treatment.

Well, recorded engaging an amazing resource.

So, thank you so much for leaving that review, a Jal 99-88.

2:01

So if you want to leave a review, you just go wherever you listening.

So, most people seem to listen on Apple podcasts or Spotify, but the Is available on all sorts of platforms.

So, wherever you, listen, it really helps the show.

2:16

If you write a review and leave a rating, we're at five stars right now so I'm hoping to keep that going.

And the other thing was I got nominated for the Social Health Network Awards this year.

And you might remember if you've listened for a while, I got nominated as a patient leader, like for my social media last year.

2:41

And I got into the finals and it was really exciting.

So, if you want to vote for me or to endorse my nomination, as what they call it, and I put a link in the show notes and so you can go there and just click the link and click endorse and so I would really appreciate it but more than that, and it's really nice to see some sleep and Patient Advocates represented because I feel like other areas Your cancer and other, you know, chronic illnesses are really well represented and we're just starting to see more people in the sleeper.

3:21

Rihanna, get nominated.

So I think that's a really positive change.

So, on to today's guest, I'm joined today by Liang.

Ricker's Lang.

Grew up in New York City and attended Harvard College and Columbia University following years as an investor she co-founded and is Executive chair of pro somnus, a manufacturer of oral devices for the treatment of obstructive sleep.

3:47

Apnea lying, also, authored morning, leaves, a reflection of poems, written.

After her sister's untimely death, due to the repercussions of obstructive sleep, apnea, Lying speaks around the country, to educate others, on the dangers of Osa, and the need for treatment.

4:07

I've put all of Lange's links in the show notes, and but I also went ahead and added her book that we're going to be discussing morning leaves to my Amazon list.

So everybody, I've interviewed on the podcast, who has a book is all there all together on my Amazon ideas list, which is you can just go the easiest To find it is to go to sleep apnea, stories.com and my website.

4:36

And then you click shop at the top or on the drop down.

Like if you're on a phone, it's like that little three-lane thing and you click shop and then you scroll down to where it says Amazon store, click that.

And then you'll see one of the list is books.

4:54

And so, I put a link there and along with all the other books of all the people that I've interviewed, so, so so without further Ado, here's my conversation with Lang Wreckers So welcome and thanks so much for joining me.

5:15

So one of the things about me as I grew up in Scotland and I met my husband in Scotland and he's from Florida.

And so that's how we moved to Florida and I've lived here for 15 years.

But I'm always like really interesting when I come across people with Scottish names.

5:33

So do you want to tell us about your name?

Just very briefly before we get into all right.

So so I first name is Lange, which has your correct is a Scottish journey and it is, it goes back on my mother's side of the family.

5:49

So my great-grandmother was Laura Lang, that was her maiden name and then my grandmother was Laura Lang.

My mother is Laura Lang.

I just have the Lang, but my daughter is also Laura Lang.

So my husband likes to joke that he married into a matriarchy.

6:06

So before we get into your Your book, do you want to explain to people a little bit about how you got into this world of sleep apnea, like for your job, like a little bit about how your career progressed and yeah, absolutely.

6:23

So I spent about 20 years in private equity and a firm called Health Point capital, and we invested exclusively in Orthopaedics and dental device companies.

And so we're sort of deep in there when our space we were For interesting Technologies and interesting businesses that we could buy in to help develop and grow and then sell to larger strategics companies or take public and it was in that context where I am at the team that now are the leadership team at PreSonus, we were working together at a business called micro channel.

7:04

It's one of the largest Dental Laboratory networks and we were Looking at ways to optimize the digital manufacturing of Dental products.

And we had a really state-of-the-art facility and relationships with the manufacturers of both equipment and materials and it was our customers that said you know there's a real opportunity in sleep and there are dental appliances that are out there but they're all handmade.

7:36

They're very inconsistent and there's a real Need for a very precise, very count honorable product.

And so, our first product was developed in House at that business.

We later sold all of the laboratory assets and and then founded Pro somnus in at the very end of 2016 and it's Off to the Races now.

8:03

So it was really, it was really a market demand, and we were in the position.

Myself and my other co-founders on the tech and Sung.

Kim had all spent much of our career in medical device businesses.

They spend a lot of time at 3 a.m. and Striker and I had been exclusively a medical device.

8:24

And so we really saw this as opposed to being another Dental Laboratory opportunity or in product that this we were going to build it from the ground up, as a medical device company.

And so, as just because I don't really know very much about how You would run a company but so your co-founder but you actually work with them as well.

8:44

Like I know sometimes co-founders are kind of hands off but I am I am not hands off I right your hands in hands all over and so it's so yeah.

So my current role is executive chairman and as of the beginning of the year, I officially joined the team full time.

9:05

And although I've been spending all of my Time for the past few years, really working with the business and you know, we bring different things.

You know, I've helped from the fundraising and investor perspective.

Largely Len is the CEO and he's really had a lot of the vision for the business and song is, you know, the engineering and Manufacturing expert on our team.

9:30

So we sort of bring, you know the three pieces together and you know, fortunately get along really well.

We On a actually.

But yeah.

So this is purely for my listeners because I feel like I've had lots of people on the podcast to talk about their experiences with using oral Appliance therapy to treat their sleep apnea but I feel like every time we do an episode, I have a handful of people will be like are you talking about?

10:04

And they'll say, all sorts of words that they've heard from their dentist, Like night guards and you know like I'm what we're talking about is oral Appliance therapy or mandibular advancement device so actually therapeutic for sleep apnea.

10:21

That's going to draw your jaw forward and take your tongue and soft tissue type your Airway.

And because I think there's just a lot of misinformation about like, all these dead.

There's just so many appliances that do completely different things.

So whether it's TMJ, A devices to help people with that, or, you know, just a really basic Night Guard, the you know, isn't really doing anything about sleep apnea.

10:48

So just to clarify for every listening that that's the kind of appliances.

You're talking about, I kind of wanted to to talk a little bit about your sister.

Do you want to to kind of just share a little bit about your sister?

And before we kind of get on to the rest of the story, just a bit about who she was and am her life and her Family.

11:08

And that kind of thing.

Sure.

So so I had one sibling my sister three years younger and she was very educated and billion to, you know, had you know, she kind of Harvard undergrad, she had an MBA, she had a PhD.

11:28

She had done a lot of really interesting neat things.

She was very interested in writing and history and and Her sort of last big thing was, she had moved down to Nashville and had married her husband and they had a child, and she had finished her PhD program and was working for.

11:53

I think it was this maybe work out here in the state of Tennessee, helping to really develop the sort of cultural knowledge of and you knows bring awareness to sort of all that exists in 10.

Say she loves fancy.

We grew up in New York city.

12:08

So Very different, very different.

Yeah, but she was super super happy there and loved the people in the culture and so it was great perm.

And so yeah, I mean, I'll just sort of jump into the story.

So he she had started snoring really loudly and I'd actually hear about it often from my niece who because she would need to sleep my meet, my sister would need to sleep in her own room and it was really loud.

12:37

And, you know, they're, you know, There would be some of the kinds of jokes that people with, you know, that, you know, windows are rattling or some of those kinds of things.

And but, you know, obviously, I became aware through my job increasingly of how serious this could be.

She was tired all the time.

12:54

She needed to take naps pretty much every day and and she had, you know, moodiness and, you know, sort of mental health things that were concerned.

14:37

So did you immediately like just because of your job?

You immediately kind of know all those things tend to run together with sleep apnea.

And so I think for so many people, it can be really hard to talk to family members.

14:53

So how did you Broach?

Like, did you kind of think to yourself?

I should really say something, but you weren't sure.

And, or high.

Did you actually brooch it with her?

Well, I think you're absolutely right that it's really difficult to talk to family members about it.

15:10

I did talk to her and I, you know, I explained it and I sent her the name of a specialist.

I was like the specialist is five miles from your house and will, if she was a big investor in personas, actually she's a big supporter of the business, but I think that she sort of thought.

Well, you've got a hammer, I'm not going to be your nail and I in some ways my involvement in it, maybe was too close to.

15:34

Where is she?

Just was like yeah this you know you think about sleep apnea all the time.

I'm you know, I'm not so sure.

So yeah I have the same thing just because I'm kind of like the sleep apnea lady.

So I feel as though, you know, especially people, you know, in my life, you know, they'll kind of say, well you think everybody has sleep apnea and I'm like, yeah, because it's a really commonly undiagnosed problem and it's a really serious problem.

16:03

But yeah.

I totally get that.

So yeah, no.

I mean, I absolutely talk to her and, you know, It's Tricky with patients, you know.

And who, you know, people like well, my sister, you know, who are ready, you know, I was always worried that she just shut me out if I if I push too hard.

16:20

So I didn't want to push too hard, which I think is somewhat common.

I think, you know, she didn't like the idea of any of this was pretty covid.

So home sleep test weren't as available as they.

Fortunately.

Our now, as she certainly had no interest in going and sleeping.

Asleep web and you know I think the there are also many barriers for people and particularly when it's somebody close to you and you know I'm in the same boat as you were people go.

16:46

Oh you know you think everybody else about me.

So that's that's a challenge.

But it was part of the reason that I really wanted to incorporate it into my book and wanted to get people both to raise awareness but also to be able to start Thinking about how do we get to people who are resistant to thinking about it?

17:09

So what were the main things?

You were hearing from your sister, but she just generally was resistant to the idea.

Or was there a specific issues?

She she didn't like the idea of, well, II a couple of and, at first, it was, yeah, yeah, like right.

17:24

And then she claims that she spoke with her primary care doctor who said, oh no, you don't sound like, you have sleep apnea, which of course.

Sort of breaks my heart?

I don't, I don't know if that's the case.

You know, it's not I did.

I was able to get her medical records and there's no, you know, documented conversation about it.

17:44

So I don't know if she was just trying to make me be quiet.

Okay.

Or if, in fact now, I think that there are a lot of general practitioners who are and particularly, you know, this was in 2019, you know, there were a lot of people who were less aware than they are today.

18:03

Fortunately, and I mean, I think hopefully it's changing but that is an all too, common Story.

I mean, like, I went for 10 years without a diagnosis and I had, I think I know a language and I are to speak about symptoms better than I would have been because I had no understanding of sleep apnea or Sleep Disorders at all.

18:26

So when I was going to my doctor usually in tears, I was saying I'm so exhausted.

I'm so tired.

I'm I'm so overwhelmed.

I am so sleepy.

You know, I'm taking naps all the time.

I have morning headaches, I basically had every single symptom, you know, but I think that sometimes if you're not using words, like daytime sleepiness, doctors are not, you know, there's so many things that can cause us to be tired during the day.

18:57

And unfortunately, especially women are kind of overlooked when it comes to sleep apnea.

Just because There's been this kind of stereotype of the only people that have sleep apnea or older overweight men, and of course, we know that's not true.

19:13

So, yeah, I think you're spot on.

I think that, you know, she had, I can, you know, put a put all of this in terms in a basket and go, you know, this is makes sense to me.

And but, you know, if she was at her, doc I don't know if she would bother to tell her doctor that she was snoring or that she, you know, I could see, you know, if she was You know, feeling depressed at some point in time, not connecting that to snoring or, you know, things like that.

19:41

And so you know these I think, you know, one of my real goals is to try to just get the word out and I'm so happy that you are too.

I mean, just as much as we can to educate people that this is some, you know, the statistic we use internally is even one in five adults.

19:59

I mean, I say to everybody, like you, of course, you know somebody for sure, you know.

You know, if you're sitting in the theater, you can reach out and touch a person or two detectives statistically.

And so, you know, we need to be talking about it and thinking about, you know, the other statistics I like to top it with like these are more patience than who have cancer.

20:18

Like this is It's So ubiquitous and so one of the things I think that is really misunderstood about sleep apnea and one of the reasons I'm so glad for you sharing.

Your story is that people don't Why's that there are serious health consequences that go along with untreated sleep apnea and so maybe you can share a little bit more about your sister and what happened.

20:44

She unfortunately died, very suddenly in atrial fibrillation and the EMTs weren't able to get her out of that and she was only 46.

And so, actually the state of Tennessee required an autopsy, because it's unusual and What they found was that she had an enlarged heart as well.

21:07

Which, you know, I think is very consistent as well.

You know, I'm not getting enough oxygen, your heart has to work that much harder to try to get the oxygen that it does have throughout the body.

And so, yeah, it's just so tragic.

21:25

And obviously, when I was talking to her, Yeah, I knew that it could you know decrease her quality of life.

I thought it could shorten her life.

It it honestly never occurred to me that it would be something you know as dramatic and sort of imminent as it turned out to be and it may well have been something else going on.

21:47

That was undiagnosed that you know started the Cascade or we don't know but you know she wasn't being treated for anything else and so you know she certainly reported being tired and Not feeling well.

And and in retrospect, you know, she looked fairly sort of gray, you know, she just didn't, you know, she wasn't healthy, she wasn't in good shape, but we didn't, we just didn't know enough to take action or necessary at the time.

22:14

So, so this happens.

Did you say before the pandemic or or it happened in December of 2019?

And so the great thing about that was that My family was able to gather and we all were in Nashville together.

22:32

And, you know, had a huge service.

And lots of people came in and that was really special and really nice.

But, you know, then just a couple months later, we all went in there.

Logging me walking down.

Yeah.

And so, it was made it really, it really exacerbated it because, you know, everything, everything we were all feeling.

22:56

I think got heightened because sitting staring at the walls of my phone are wondering what's going to happen next.

And so it was very frightening and and really difficult to not, you know, not be with my parents not be with my niece and my brother-in-law.

23:12

It was there were a lot of things about the timing that that really heightened it.

And so tell me about your process of coming to terms with grieving for your sister and what happened with that.

Hello is so um, well, you know, concurrently with all of this, you know, we had everything going on with the business, right?

23:37

So, you know, yeah, dentists offices were closing and are, you know, so there were a lot of things that I needed to be very on the top of my game to make sure that we were well funded.

And that we were able to manage the business through, you know, at the time you never you just didn't know what.

23:57

Lately, complete uncertainty.

I mean, really not knowing, I think that I mean, my husband's a small business owner and I know that with him, you know, it's not like any normal circumstance where you can plan for a short-term, you know, blip or you kind of know.

24:15

After six months things will be different.

He we just had no idea how long this was going to last, right?

So, yeah, that absolutely.

And so spent a lot of time with team You know, planning managing, you know, working on PPP loans.

24:31

And and we just yeah, for that we could, you know, get through that period and and, and be available to treat patients because covid patients in particular who had sleep apnea, we really needed treatment.

So, yeah.

We the business to the incredible leadership of Lenin song in the team.

24:52

They never close the single day, they manufactured every single day.

McCann.

And so, you know, we were, we were doing that.

So, you know, I have to sort of compartmentalize because that was a very important and sort of serious thing that was going on and, and I cared a lot about that, but I was really grieving.

25:12

I was, I was suffering personally.

And so I, you know, I spend a lot of time, Outdoors, walking and my husband, and I would get get out everyday.

And, and that was very important to me.

25:27

And I In Southern California.

So it was really beautiful and you probably remember without, you know, the traffic and the airplane.

Yeah, are quiet here.

And quiet is beautiful.

So that was that was really wonderful.

25:43

And I think a lot of people, you sort of reflect on how nature can be helpful.

And I certainly found that I was very fortunate.

I had before the pandemic started found a grief counselor and I was able to speak with her eye.

I found it to be invaluable.

25:59

I mean, it was she really, you know, allowed me to just process everything that I was I was facing.

And it was too much to sort of dumped on my family.

They were dealing with their own things.

And so I, it, I found that very helpful.

26:15

So, I mean, you know, I was fortunate to sometimes somebody like, I just know from my own Journey with therapy, sometimes somebody who's not involved.

All like he's not in your family at like that can be really powerful because, you know, you can just go and dump all your stuff on them and like they're not involved so you know and you're paying them so much cleaner perspective.

26:45

The last thing that I did that was really helpful was had this real desire to do something creative and I was I wasn't traveling is obviously because yeah.

And if I had more time Than I was used to.

And so, I had been given a book called the artists way, which is, you know, it's around for a long time if Julia Cameron and so I started going through that.

27:09

And, you know, it really is about sort of exploring your creativity.

And I thought I wanted to like Ceramics for me to really go ahead, but didn't have any skills.

I don't know any tools like that you knew of yet.

And so, so one of the things that she did suggest was Eating every morning.

27:28

So she has something called morning pages.

And so just to write out your feelings.

Uh, yeah.

And you can write anything.

You want you before you speak, before you do anything else, you just three pages, anything you want.

And so, I started doing that.

27:43

And, and a whole lot of some of it, just mumbo-jumbo came out and then if she does, she also suggests that you don't go back and reread it for quite a while.

And Good little roller follower.

I didn't.

27:59

So I waited for a few months and then I went back and and what I found was that I had been writing.

All of these sort of analogies with trees were bit outside than these beautiful walks and I was sort of expressing a lot of what I was, what was on my mind through these, what my editor called poems.

28:21

I don't think of them as poems per se, as I, as I was writing them.

But, and so, I first thought gosh, I should really take these up for my children.

I was very aware of my sister leaving early.

28:37

And what if something happened to me that my children, they need from me and do they know me well enough.

And so that was the original thing where I was like, I'll types often organized for them, then I will organize them for them and and once I did, I thought, you know, there's actually something more Universal here there.

28:57

It seemed to potentially connect with more broadly.

And so, I started showing them more, you know, with friends and things like that, and, and that really became the core of the book.

And so it was it was not a, it's not the kind of book where I sat down like, okay, I have a book on the right now, this is my outline.

29:15

I'm gonna blame you at all.

It really involved and was very organic and tell me all about the illustrations, because the illustrations are beautiful, aren't they?

Incredible.

See, that's the thing.

I got very, very lucky with illustrator.

29:30

So, yeah, there's you know, close to 40 poems.

They're all Botanical in nature and sitting really begged for some art.

Alongside them.

And this was new to me.

I've had done anything like this before.

I didn't know anything about putting you never liked written a book or publish things.

29:50

Okay.

So I so I was like, well, where would you find a Botanical artist.

So so I Google it, there is an American Academy of Botanical artist who knew hey, and so they all of their members have little thumbnails of their art and so I just went through them and I found I found a couple that I thought looks like a good fit but Kelly was really my first choice because I wanted someone who could not only paint, you know, beautiful flowers and things like that but I needed because of Text.

30:28

I needed someone who could do the roots and the Thorns as some of the sort of less pretty things and yeah, and I thought she did that, particularly, well, I did a wonderful job.

So, what my favorite, I spent the other day reading your book in a coffee shop and my favorite one is called roots.

30:52

And, and it's also my favorite of the illustrations.

Would you be willing to To read that or to read maybe a few for people who are sure, I'd be happy to.

So I'll start with roots.

So I'm obsessed with trees.

31:09

So my when we first moved here to Florida from Scotland and we bought this house new and in the backyard, they had a sapling little oak tree and it's now bigger than the house.

So we've been here 15 years and Children, you know, like have always been climbing that tree and we have swings hanging off it and so I literally like we already talked about downsizing when our kids leave and I'm just like, I don't know if I can leave the tree.

31:40

I love the tree.

So yeah, I think that's partly why that poems talk to me particularly, yeah, I we have since moved from a house where I wrote the book and I was comfortable leaving the house.

It was the trees as you say, I was there, I went around and hurts.

31:57

You know, I had a special violin a handful of the trees, that really my husband doesn't get it at all but it really I think that, you know, are high like, I love our eyes, but I think when we leave, it'll be the tree fell.

Yeah.

32:14

Well, and, and to your point, this poem came from, I read some articles about, you know, sort of, you know, the whole sort of underground connections between trees and I, So, fascinated by that whole notion that they're connected and communicating in ways that we don't understand.

32:37

And so I'll read it, and then we can talk about film called Roots trees.

Talk underground, route, to Route connection, communication warnings knowledge.

What do they share?

What do they know?

32:54

What would we learn if we could hear?

And that is its I love that I don't think.

Before I read that poem, I never even thought of, you know, of course, Roots must be connected under underneath.

33:12

But for some reason, I always thought of them as like the individual tree and those roots and I didn't think about that, there's all this connection going on underneath.

Yeah, well and there's a lot of science.

Now that shows that They actually are sharing micronutrients that they're warning each other of, you know, pests that are coming and weather and different things.

33:36

So I'm not an expert in this by any stretch, but I find it fascinating.

Yeah.

It just the complexity of the natural world and the things that we don't understand and I think as humans we get a little bit arrogant sometimes and for sure did you want to pick out?

33:56

Your favorite and read that for us.

Oh wow, okay.

Um let's see.

Yes, let's see.

Which one am I going to do?

I think that I will do, I'll do - which sorry I'm going to do.

34:14

I'm going to do the giant kelp.

So It's called time kelp giant kelp in the South African.

Ocean tall, Mighty part of a fairy tale Forest under water, under the waves under the crashing.

34:32

Under the noise people, the trouble, the cares of the land down here, swaying shifting flickering in the light glimmering sunlight, slicing through bringing brightness and splendor Away from it.

34:47

All Dancing With Friends, enjoy being enjoying being alive and strong arms, up hip swing, feeling the group.

And look that that.

35:03

So, it's so it's about did you say it's South African?

Yes.

So, is that from a trip or what did that come from?

I had seen the documentary, The Octopus teacher or my oh, yeah, yeah.

And I just, I loved his connection with the octopus and I just love you.

35:24

There's a whole world of octopus lovers out there.

And one of my And said post something on Instagram.

There's there's an organization to do with octopuses and their videos are amazing.

Yeah, beautiful.

35:41

Yeah.

And you know there's a theme that I didn't realize until after I went back and really look at the book this, you know, this sort of getting away from.

You know that the sort of going underwater and then I there's other poems where I go up into the clouds and then there's a little bit of sort of escapism, or just sort of meeting a break, and different perspective.

36:05

Hmm.

And, and I think that that's important, I'll for all us, right?

I mean whet, whether it's during the pandemic or grief, or just day-to-day life to sort of recognize that sometimes we need to just step back and find a quiet place.

36:21

Even if it's just in our own had that we can, you know, recharge, you know, and and enjoy ourselves a bit more.

So, so tell us where we can get your book.

So it's it's available at Amazon Barnes & Noble Target.

36:38

Walmart Bookshop dot-org with through independent bookstores.

So it's fairly widely available.

Fortunately and there are links on my website if that's easiest, which is yes, language, curse.com and so Yeah, I hope people enjoy it.

36:58

It's really I really see it as both.

Hopefully a bit of an education tool and also a gift for people who are dealing with some sort of a loss.

It certainly could be other types of law.

So and I particularly loved you had a section where you listed resources so that people can learn more about like the signs and symptoms of sleep apnea.

37:23

And so that was really, really great that you did that.

That too.

So did we cover everything?

Is there anything else that you want to share that I missed?

How are you doing now?

And you're in your grief journey.

I know that for a lot of people they think that it's this kind of thing that you go through for a short time and then it's over and that's not my experience of grief.

37:46

But also how are you not post pandemic and and back to work and everything.

Yeah, you know, it's partly because I have done the book and I talked about it a lot, I feel Most days pretty good.

38:04

Although I have to say, I just this past Friday, went to the remit of the school that my sister and I went to New York When We Were Young, and I was sitting in the big assembly room and and I'm not usually in spaces where I used to be with her.

My parents aren't in the house.

38:20

We grew up in choose from.

Yes, you have a couple of it so I don't have a lot of physical spaces and I was in this room and I just started crying and I just felt so overwhelmed with sort of the presence of her and remembering the times that we would have been there.

38:37

And so as you say like it comes in different ways and fortunately somebody had said to me early on that, you know, it comes in waves and it feels in the beginning like it's just a constant crashing and then the waves get further and further apart.

38:53

And, and that's very much the experience that I've had this and I hadn't Add a wave in a while that had really sort of knocked me in that way, but it was a good reminder that it's still, it's still in there and still heart.

39:08

So, well, thank you so much for joining us and telling us your story and, and for writing the book what gift?

Well, thank you, and thank you for having me on and and thank you for all you're doing to spread the word on CPAP.

And I think it's so important that people get educated


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