Interview with an Apnea Destroyer

Interview with an Apnea Destroyer
By Edward Thiele

I recently had the privilege to interview Dr. Jerry Hu on his incredible success using the PDAC Herbst appliance for his patients with obstructive sleep apnea. He wanted to share stories that will hopefully inspire other dentists to do the same, and notably, improve the world together. And to him, there’s no better Academy than ASBA to help him do that because it has the best platform and is the most recognized credentialing dental sleep organization by the government. With leading and forward-thinking dentists, ASBA will change the future!

Some of the cases he was able to share with me he couldn’t believe the results himself. He told me that when those patients came to him with their results and the reports of how their life had improved, he felt like he was dreaming because they were really that amazing and life-altering. From changes in memory to weight loss, increased energy levels to dramatic improvements with bed partners and family life, he credits all of that by using the Herbst appliance with his recipe of sleep hygiene, nutrition, exercise and patience. The most important and essential pearl he added is the work needed to do the proper follow-through.

But first, it begins with a thorough initial medical examination. This includes a review of patients’ medical history, medications, prior treatment and results. Also, current lifestyle, habits, sleep patterns, etc. all need to be assessed and documented. Getting a baseline of not just the sleep study results and diagnosis, but also the patient’s willingness to be compliant and to seriously focus on improving their quality of life altogether all matter equally. Ample time should be given to review and encourage each patient to follow protocol, and realistic expectations should be set. He reminds them that sleep should be one-third of our entire life, and quality sleep every night should be the goal.

From an AHI standpoint, Dr. Hu has never been able to get such consistent results under 5.0 until he started to focus on PDAC FDA-cleared Herbst-style appliances. Moreover, he wants to emphasize that not all labs are equal in their Herbst design, experience, and even the type they ordered. He’s found, for example, certain German-made arms do much better than Italian-made ones. Also, understanding how to cut, fabricate and finish the appliances matters significantly. Seeing him lowering so many patients’ AHI levels below 5.0, I want to give him a nickname of “the Apnea Destroyer.”

Patient Story Number One:
This patient came to see Dr. Hu as a “Cold War Patriot” who worked many years at the nuclear test site in Nevada. So much radiation and as one can imagine, so many systemic issues came upon these hero veterans from their place of employment.

When this patient arrived, he told Dr. Hu that most of his co-workers had already passed away, and he definitely wants to do all that he can to live longer and with better quality of life. His wife had been concerned for years on his sleep and breathing problems, and she also cannot rest or sleep well at night due to his condition.

His medical history revealed he had obstructive sleep apnea for years and was lied to about his treatment by his sleep physician at a sleep center in Nevada. He was told that CPAP is the only treatment for him and was also told by the sleep physician that his oxygen desaturation going down to 81 WHILE USING CPAP was “normal.” After researching online and finding answers out for himself, he had lost faith and trust in the sleep center he went to. Additionally, he has polycythemia, silicosis, and signs of congestive heart failure with Cheyne-Stokes. His pulmonologist did rhinomanometry and several airway diagnostic tests and told him so much of his health problems stem from his sleep apnea.

When the government referred him to Dr. Hu, as he was in-network, he felt it was a true blessing. Being told by his former sleep physician that there were no other alternatives, he felt passionate to prove him wrong. At one time, he had felt hopeless. But, he didn’t give up, and he can see that his other co-workers and friends who are still alive are needing the same treatment choices and the full truth on successful outcomes other than CPAP.

His initial subjective reports included worsening memory and brain fog. He was starting to get concerned about his daily functions, and his wife had seen a substantial decline month after month. Even with CPAP, his oxygen desaturation went down to 81, and Dr. Hu reviewed with him the studies from Stanford University on beta-amyloid proteins, meningeal wash, and the connection to Alzheimer’s and dementia. Dr. Hu also discussed with him central sleep apnea, loop gain and CHF, and he definitely learned all the connections to sleep apnea. Working with his pulmonologist and having supplemental oxygen with a customized Herbst appliance therapy, he was ready to commit to Dr. Hu’s plan.

So, after months of applying Dr. Hu’s recipe and using the Herbst appliance, he and his wife both came to report significant changes and amazing life improvements. His AHI at 19.0 went down to 0.0. His REM percentage went above 25% for the first time in years, and he now remembers having vivid dreams and wakes up with abundant energy. His minimum O2 was also at 91.4! He also had lost 20 pounds, exercises daily and tries to eat as healthy as possible. In an emotional testimony, he told Dr. Hu that his story needs to be shared with the world.

**Post dental sleep Herbst treatment sleep study**
Patient Story Number Two:
This patient came to see Dr. Hu in one of his sleep clinics in Alaska. She drove over 70 miles to see him. She too, failed CPAP and had an awful experience at a local sleep center. She had an inconclusive polysomnogram and was told she had to do her initial sleep study in a hospital setting. She reported to Dr. Hu that she couldn’t even fall asleep because they were doing remodeling and construction at the building she was in, and although she complained, they didn’t care to help her out afterwards.

She took it upon herself to look online and take matters into her own hands. That’s when she found Dr. Hu and was so glad she did. When she presented for her new patient exam, she was so exhausted. She had such intense daytime sleepiness, and she really wanted to know how bad her sleep was. Dr. Hu worked with another board-certified sleep physician to have her do a baseline home sleep study, and thank God she did one. She had severe OSA with an AHI of 71.6 and an ODI of 50.8 with oxygen desaturating to 80. Being of Medicare age, she was living a “tired and miserable” retirement life as she explained, and felt hopeless, too.

Dr. Hu took the time to explain his recipe and the importance of titration/calibration. With patience, commitment and dedication to adherence for protocol, she had an outcome that was nothing short of incredible. With enthusiasm and energy, she told Dr. Hu that she had also visited family in California during late winter and had a chance to see another physician to do a sleep study as well, and everyone involved were amazed at the outcome of her Herbst PDAC appliance. Her AHI went from 71.6 down to a 3.4 and her ODI went down to a 0.7. Her minimum oxygen stayed above 90 and she reports feeling like a new person altogether! At her last follow-up visit, she seemed to continually smile and was so joyful and energetic.

**Her sleep studies, before and after**
Patient Story Number Three:
This patient came to Dr. Hu as an active duty military personnel. Even though his sleep apnea was diagnosed as mild, he had serious daytime sleepiness and morning headaches affecting his day-to-day function. Dr. Hu understands that these soldiers who are serving our country need to be at their fullest potential, especially being deployed needing combat readiness at their ability to focus and be alert. This patient presented saying his wife also cannot stand his snoring, and he sometimes gasps for air at night. The noise wakes her up, and she gets profoundly worried.

With an initial AHI of 8.9, after one titration with his Herbst appliance, he was so pleased with his treatment results that show his AHI down to 1.0. His sleep efficiency also improved to 97.7 and he reported that his wife is thrilled at how quiet he sleeps at night. He said to Dr. Hu, my wife told me, “I sleep like a baby,” and I wake up feeling so refreshed and full of energy. He said he wanted to share his experience with other military members and hopefully, it will become routine for dental sleep medicine options for sleep apnea in the armed forces.

**After sleep result for patient number three**
As a veteran myself, I, too, am so grateful for Dr. Hu and Gergen’s Orthodontic Lab for my Herbst sleep appliance. I find that he truly is a compassionate and thorough dentist. He has real passion and takes the time to do things properly and he followed up with me for my own Herbst and I love it so much compared to CPAP, which I was intolerant of.

Although he has so many more Herbst stories to share with me, there is only so much room in a blog to write about. However, I am delighted to also announce that Dr. Hu has allotted time in his schedule to teach his “recipe” to the ASBA study club series. He will also teach medical billing and work with Nierman Medical Billing to help dentists and ASBA really change the world!

Edward Thiele