Issuu

Official Publication of The American Sleep And Breathing Academy

FALL ISSUE 2021

Dr. Dave Singh & Kirk Huntsman have changed the landscape of dentistry INSIDE THIS ISSUE

Father and son team are an

unbeatable force.

Upper airway remodeling: fact or fiction.

Dr. Morris was

almost found guilty for something he didn’t do. sleepandwellness.net | Fall 2021 | 1

Paul Van Walleghem, DDS, has been with the American Sleep & Breathing Academy (ASBA) from the start. As credentialing director for the ASBA,Van Walleghem has shepherded numerous dentists to Diplomate status, a crucial step in starting or cementing key relationships with sleep physicians. “Physicians want to see that credential,” says Van Walleghem, owner of Pointe Dental Group, with Michigan locations in Gross Pointe Farms and Shelby Township. “That’s how you start relationships with physicians. If you just call them up and announce that you make oral appliances, it does not work well.” As president of the American Board of Sleep and Breathing (www.abosb.org),Van Walleghem’s Board of Directors are well qualified to bestow diplomate status on behalf of the ASBA. In practice for 32 years,Van Walleghem took his first sleep-related course in 1991 in Boston. Led by a physician who invented a tongue retaining device, the course detailed the ways in which oral appliances, very much in their infancy, could solve sleep apnea problems. “Today, people are still getting a lot of misinformation,” says Van Walleghem, who leads a multi-specialty practice where many opinions are readily available. “Dentists are being told they can make millions of dollars in dental sleep medicine, but that’s not why we should be doing it. It’s a lot of work, and if you do it properly, it involves a lot of follow-up and a lot of letters to physicians.You must charge a reasonable amount, but not an exorbitant amount.” Ultimately, breaking through economic and clinical misconceptions is crucial, and diplomates are well versed in ways to succeed in a challenging environment. “CPAP is the gold standard for treatment, because you can keep turning up the pressure,” says Van Walleghem. “CPAP compliance is still about 45%, but M.D.s like CPAP’s 95% efficacy.” When physicians are eventually on board with oral appliances, the prescriptions can and will begin to flow. “You get a prescription from a physician that says, ‘Please construct a mandibular advancement device for the treatment of OSA.’ Remember, we are not the treating physician,” Van Walleghem explains. “We are the DME provider, and that’s what we want to be. Getting started and/or improving relationships begins with that Diplomate status.” For more information on achieving ASBA diplomate status, go to ASBA.net/Diplomacy. To learn more about the ASBA, go to asba.net.

2 | Sleep & Wellness Magazine

From the

Editor

Sleep and Wellness welcomes James Sanders as the new managing editor. Sleep & Wellness magazine welcomes James Sanders, the newest member of the team. He is leading the effort to reestablish the Sleep & Wellness magazine and website (now sleepandwellness.net). He hopes everyone will have an opportunity to read the magazine and visit the website. He has worked for IBM for 26 years as an Integration Architect specializing in electronic data interchange (EDI). But even with his technical background, his entrepreneurial spirit finds time to break free and start new companies, with his most recent divestiture being a trucking company. James and his wife are raising their two grandchildren, who are 5 and 9 years old. Two young children keep them very busy, and James practices a biphasic sleep pattern. With all this activity, he has a great passion for all things sleep-related. James has been diagnosed with obstructive sleep apnea by Desert Center for Allergy. James is an avid teeth grinder when he sleeps, and Dave Gergen recommended a Herbst device to address his sleep apnea and nightly teeth grinding. Dave is sure a Herbst device manufactured at Gergen Orthodontics will drastically improve James’ sleep quality.

Tech Corner by James Sanders I have worked on cloud applications since 1995. The advantages were apparent from the start as we delivered apps at considerable cost savings. Before the cloud, an app required a building containing computer systems, software developers, system operators, and network access. Cloud providers now offer most app components at very competitive rates, and expert software developers are available through sites like upwork.com. Orderful.com is a perfect example of how a business process was reborn with a new interface at significant cost savings.Value-added networks, often called VAN, promised to deliver electronic business documents to any other trading partner with a single connection. However, these VANs failed to reduce their prices as their delivery costs dropped. The cloud has given captive VAN customers costeffective alternatives like Orderful.com. The sleep industry has an opportunity to evaluate current processes and leverage synergies to reduce operational costs, improve customer satisfaction, and even deliver educational information. An idea is all it takes to launch an app on the cloud. Just imagine a cloud-based app that would improve some aspect of your operation or even better help the sleep industry. If you already have an idea, you can click on the QR code to reach out to Alan Hickey to get it launched. PUBLISHING SLEEP & WELLNESS MAGAZINE IS PRODUCED, PUBLISHED AND DISTRIBUTED QUARTERLY BY SLEEP & WELLNESS, LLC, IN PARTNERSHIP WITH THE AMERICAN SLEEP & BREATHING ACADEMY, INC. ENTIRE CONTENTS COPYRIGHT 2021 SLEEP & WELLNESS, LLC. ALL RIGHTS RESERVED AND PROCEEDS ARE DONATED TO THE AMERICAN SLEEP & BREATHING ACADEMY, A NOT FOR PROFIT ORGANIZATION. REPRODUCTION IN WHOLE OR IN PART IS PROHIBITED. PRODUCED IN THE UNITED STATES OF AMERICA.

Table of

CONTENTS 5

ASBA Thanks Alan Hickey

Andre Collins

SleepCon 2021 Speaker List

Upper airway remodeling: Fact or fiction?

CPAP Recall

ASBA Welcomes Dave Singh to the Hall of Fame

The Story Behind Vivos

The Day Dr. Morris Almost Went to Prison

Addressing the Sleeping Elephant in the Room

42 The time has come to put the rumors of David Gergen’s demise to rest... 4 | Sleep & Wellness Magazine

ASBA THANKS ALAN HICKEY For the 2021 ASBA sleep and wellness conference, we need to give a big round of applause to Alan Hickey. Alan is a person I am proud to call my friend. Alan reached out to me in February after hearing I was making a slow recovery from Covid-19. He suggested that we do the ASBA annual meeting in July. Then he surprised the heck out of me and said in Phoenix, Arizona. I told him the temperature will most likely be 115°, or we’ll have monsoon storms blasting through. Either way, I told him it’s not going to be a very flattering event. Alan begged to differ. We’re going to hold this in a five-star resort. A five-star resort where the prices are usually $500-$900 a night. We can negotiate a great rate, and our members will absolutely love it. Alan again showed his genius when the price came in $129 a night, unheard of. Then Alan asked for my help to convince the board to approve it. He said we just need to pick the dates and times, prepare everything, and present it to the board. He said this will need your support because there will be push back from board members. They will say we shouldn’t plan the event until the pandemic is more under control. They will want another date that is further out. Alan insisted that we can’t look at other dates. The window will soon close, and we will miss this golden opportunity. If you say yes, the other board members will trust your judgment and get this done. And that is precisely how this conference was launched. Rani and I immediately supported the timing and were ready to rally the other board members to vote to get this moving. Alan presented a brilliant idea. Being a gunslinger my entire life, I related to Alan’s vision and knew this required fast action from the board. This was a risky decision as Phoenix had an ordinance against any groupings of 150 people or more. Once the conference was approved, attendance quickly exceeded 150. Alan jumped into action, preparing a floor plan that would meet the social distancing requirements at that time. He worked on the seating arrangements and extended the capacity up to 250. The meeting attendance is right at that number, and the conference is within Arizona law. This meeting is a direct result of Alan Hickey’s brilliant idea and ability to reach out to the necessary people to make things happen. I, David Gergen, thank Alan for all he has done for this industry and all he does for ASBA. He has become one of my best friends, and he’s an amazing human being. sleepandwellness.net | Fall 2021 | 5

Andre Collins

6 | Sleep & Wellness Magazine

Andre Collins of the NFL Players Association delivered an inspirational keynote speech on their Sleep Health Program and the Health Initiative for former NFL Players at the Sleep & Wellness 2021 conference held this weekend in Scottsdale, AZ. Mother nature delivered an unprecedented rainstorm that couldn’t dampen his message. Andre explained that since he has implemented the VA sleep program into the NFLPA, there has been only one death of a former player in 13 years. Before the program, they had been losing several ballplayers each year. This result is because this program quickly addresses the sleep issue. Dave Gergen states this program puts partners back together in the bedroom, which saves lives and relationships; that is a good feeling. Dave has helped dentists get started working with the NFLPA in different regions of the United States. Andre and Dave are looking for more dentists to treat the former players suffering from sleep apnea. Andre took questions and posed for pictures on both days of the conference. He made an impression on everyone he shared his time with and repeatedly asked if he would come back next year. It has been said that Andre’s job is “saving peoples’ lives.” After spending some time with Andre, the twelfth child of nineteen, this isn’t a job, but his passion for life showing. He parted some wisdom with me, saying, “When you are on your death bed and flipping your last dime, did you wring it dry?” It sunk in immediately that he was not talking about a bucket list but to give every last drop during your life. Andre shared that he plays the trumpet and paints, and his philosophy is observable when he described his passion for jazz music and art. His “Smocks for Jocks” program is an annual jazz brunch and art auction that raises money for charities and the NFLPA programs. His personal touch is accented by this event as it is “wrung dry” because it highlights paintings created by former players while fundraising. We certainly hope to see Andre at the next event.

sleepandwellness.net | Fall 2021 | 7

8 | Sleep & Wellness Magazine

sleepandwellness.net | Fall 2021 | 9

SleepCon 2021

Speaker List DSCS Coordinator’s Bootcamp

Cardiac Function and Sleep

The NFLPA Sleep Health Program and the Health Initiative for former NFL Players

Successful Medical Billing for Dentists

Rebecca Layhe

Andre Collins

Integrated Whole Health Approach to Sleep and TMJ Jon Caulfield, DDS

The Sleep Supplement for Everyone Dar Radfar, DDS

When Patients Come Back— Educational Seminar Addresses Simple Steps to Address Pain Dan Tache, DMD & John Carollo, DMD

Gender Disparity in OSA

Anjoo Ely DDS & Mona Patel, DMD

Closing More cases for Maximum Practice Growth Mark T. Murphy, DDS

Growing Your Practice Jeff Rodgers, DMD

Medical Billing Panel

Jill Glen and Laura Couture 10 | Sleep & Wellness Magazine

Atul Malhotra, MD & Jennifer Cook, MD

Chris Farrugia, DDS

Cannabidiol (CDB) As a New Path for Treating Anxiety and Sleep Problems Kent Smith, DDS

Comparative Bite Position Analysis: Adding Vertical and Other Dimensions to Bite-Taking Methods Jerry Hu, DDS

Review of Current Evidence on Physiological Remodeling of the Upper Airway Dave Singh, DMD

Managing the SDB Patient Suzanne Mericle, DMD

How to be Clinically and Financially Successful with DSM Damian Blum, DMD and guest panel

CPAP Recall Marietta Bibbs

Great Time Was

Had By All

The legend Dr. Sugg was reported to have had his scooter on two wheels.

sleepandwellness.net | Fall 2021 | 11

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14 | Sleep & Wellness Magazine

Upper airway

remodeling:

FACT OR FICTION? By: Dr. G. Dave Singh DMD PhD DDSc

sleepandwellness.net | Fall 2021 | 15

In 1675, Newton wrote, “If I have seen a little further it is by standing on the shoulders of giants.” In a personal communication to me in 2018, the late Dr Christian Guilleminault of Stanford University Sleep Medicine confirmed my concept that since remodeling exists with many organs it will also occur in the upper airway. It is left to us to further this particular endeavor by providing supporting evidence, but several challenges exist. For example, how can we assess airway remodeling clinically? Typically, 3D CBCT scans are used for upper airway evaluations, but for this complex, dynamic system, at least 2 Cochrane reviews suggest that current imaging modalities attempting to quantify upper airway volume changes are deficient. One of the current concerns during airway imaging is the respiratory cycle. Using protocols largely adopted from 2D cephalometry, 3D CBCT imaging protocols are not standardized, no consensus exists, and the influence of the respiratory cycle can, therefore, thwart the findings. In an early study to capture structural upper airway differences during daytime breathing, I used a different imaging technique [1] to show that airway measurements need

David Gergen, Roy Green, Dr. Singh

16 | Sleep & Wellness Magazine

to be taken at known phases of the respiratory cycle to produce meaningful clinical results. Therefore, professional academies and associations interested in airway, breathing and sleep issues ought to lead the initiative in some form of standardization so that treatment outcomes become comparable. Second, there is the issue of positioning during upper airway imaging. In these instances, most 3D CBCT scans are taken with the patient either standing or sitting during wakefulness. In addition, various earplugs, chin rests, handles, etc. are used in an attempt to capture the natural head position and associated airway morphology - with various degrees of success. Some 3D scanners also come with mouthpieces, which can change the position of the mandible and/or tongue during imaging, thereby affecting the appearance of the upper airway on the final scan. Furthermore, there is some debate as to whether the patient should be imaged in the supine position to mimic sleep, even though it is known that upper airway behavior during wakefulness is distinctly differently when compared to sleeping, and some patients sleep on one side or the other, which varies during the night. To circumvent these concerns, some clinicians advocated drug-induced sleep endoscopy [2] to examine upper airway structure and function. Therefore, one of the current needs for upper airway imaging is a consensus on clinical protocol. Even though dental specialists use 3D CBCT scanning every day, another point of discussion is that there is no validated protocol to affirm the reproducibility of images taken at T0 and T1, say, during the course of treatment. There is some evidence of CBCT-measured morphologic airway changes with surgery and oral appliance treatment for OSA [3], but currently, no valid CBCT protocol has been recognized since changes in contrast, resolution, x-ray scatter, digitizing noise, etc., can become significant, and disparate machine settings can give different results [4]. Furthermore, there is a need to develop a protocol to ensure consistent placement of anatomic landmarks before and after treatment to measure airway volume and other parameters when using 3D CBCT imaging. This lack of consistency might help explain the variability of results when reviewing and comparing changes with different treatment procedures on upper airway volumes. For example, as the magnification of a scan increases, pixilation does not, and objects that were clearly visible at low magnifications can appear to disappear on very close inspection. One method to get past these types of issues is to use edge detection algorithms to define the boundaries of the upper airway and/or other craniofacial structures of interest. We were perhaps one of the first to develop algorithms to not only render the 3D upper airway but also to do 3D printing from CBCT data [5, 6]. Moreover,

the field of mathematical modeling has grown immensely in the past decades, and geometric morphometrics, including automated landmark detection, is currently becoming available to assess clinical craniofacial changes, and might also be used to investigate upper airway morphology. Using these robust approaches, it is possible to localize and quantify allometric changes that can be verified in statistical shapespace. I believe these elegant techniques for 3D digital data will be able to address our current, legitimate concerns, and these novel concepts provide exciting avenues of further research on upper airway remodeling. Clinically, the saving grace for dentists interested in sleep and breathing is perhaps the adaptive capability of the upper airway. It is suspected that active exercises of upper airway muscles through oral myofunctional therapy induce remodeling of the upper airway and its supporting structures [7]. This concept is not surprising since it’s generally known that exercise/workout routines can affect muscle tone and muscle mass with allied skeletal changes. Despite this contention, nasomaxillary remodeling through

invasive and/or surgical approaches such as surgicallyassisted rapid maxillary expansion (SARME), mini-implant assisted rapid maxillary expansion (MARME), and distraction osteogenesis maxillary expansion (DOME) is currently in vogue. SARME involves a combination of mini-osteotomies, including pterygopalatine disjunction, prior to the use of a fixed expander to remodel the midfacial complex followed by orthodontic correction. On the other hand, MARME uses mini-screw implants that widen the hard palate and often induce pterygopalatine disjunction without surgical intervention, followed by a course of fixed orthodontics. Alternatively, DOME is somewhat similar, but it uses the phases of osteotomy, latency, distraction and consolidation to achieve skeletal correction. However, DOME is also associated with pterygopalatine disjunction (without additional surgical intervention), and relies on comprehensive orthodontic correction to close the midline diastema created using these types of protocols. Nevertheless, these three techniques are thought be at least as effective as non-surgical oral appliance therapy in the treatment of sleep disordered breathing, including obstructive sleep apnea, although significant side effects,

Dr. Singh, Steve Keim, David Gergen, Mark Brnovich

sleepandwellness.net | Fall 2021 | 17

such as midline diastema formation, need to be addressed through orthodontic finishing, and the consequences of iatrogenic pterygopalatine disjunction are still unknown. In any case, the Agency for Healthcare Research and Quality (AHRQ) has released its recent assessment [8], concluding that CPAP does not produce long-term, clinically significant outcomes in the treatment of OSA. Thus, the effectiveness of newer approaches requires further determination. However, the underlying patho-physiology cannot be ignored since post-surgical wound healing is dependent on stem cell differentiation [9]. Concurrently, craniofacial soft tissue moieties require simultaneous correction. Here, the concept of airway stem cells enters the discussion again. I reviewed upper airway remodeling [10] based on the premise that stems cells are distributed and localized in various regions of the upper airway, ranging from nasal epithelial stem cells [11] to basal alveolar and mesenchymal populations [12]. In fact, mesenchymal stem cell migration and adhesion, as well as endothelial repair, may be involved in the physiological responses to OSA-associated airway changes [13]. Furthermore, Machado-Júnior and Crespo [14] recently opined that maxillary expansion in adults requires further investigation in the treatment of OSA. Therefore, these mechanisms may play a role in physiologic airway remodeling, and provide fascinating avenues for further research as we emerge into a post-pandemic world. Disclosure Dr G. Dave Singh is Founder and Chief Medical Officer of Vivos Therapeutics, Inc. He is currently collaborating with Stanford University Sleep Medicine in the development of a craniofacial facility. References 1. S ingh GD, Olmos S. Use of a sibilant phoneme registration protocol to prevent upper airway collapse in patients with TMD. Sleep Breath. 2007;11(4): 209-216. 2. S uto Y, Matsuda E, Inoue Y. MRI of the pharynx in young patients with sleep disordered breathing. Br J Radiol. 1996;69(827):1000-1004. 3. Alsufyani NA, Al-Saleh MA, Major PW. CBCT assessment of upper airway changes and treatment outcomes of obstructive sleep apnoea: a systematic review. Sleep Breath. 2013;17(3):911-923. 4. S iewerdsen JH, Jaffray DA. Cone-beam computed tomography with a flat-panel imager: magnitude and effects of x-ray scatter. Med Phys. 2001;28(2):220-231. 5. C elenk M, Farrell ML, Eren H, Kumar K, Singh GD, Lozanoff S. Upper airway detection in cone beam images. J Xray Sci Technol. 2010;18(2):121-135. 6. S ingh GD,Wendling S, Chandrashekhar R. Midfacial development in adult obstructive sleep apnea. Dent.Today 2011;30(7), 124-127. 7. S teele CM. On the plausibility of upper airway remodeling as an outcome of orofacial exercise. Am J Respir Crit Care Med. 2009 15;179(10):858-859. 8. C all for Public Review. Content last reviewed April 2021. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/research/findings/ta/callfor-public-review.html 9. B ruder SP, Fink DJ, Caplan AI. Mesenchymal stem cells in bone development, bone repair, and skeletal regeneration therapy. J Cell Biochem. 1994;56(3):283-294. 10. S ingh GD. Physiologic remodeling of the upper airway: Pneumopedics. J Sleep Disord Treatment Care 7:3, 2018. 11. Wang DY, Li Y,Yan Y, Li C, Shi L. Upper airway stem cells: understanding the nose and role for future cell therapy. Curr Allergy Asthma Rep. 2015;15(1):490. 12. Almendros I, Carreras A, Montserrat JM, Gozal D, Navajas D, Farre R. Potential role of adult stem cells in obstructive sleep apnea. Front Neurol. 2012 11;3:112. 13. C arreras A, Rojas M,Tsapikouni T, Montserrat JM, Navajas D, Farré R. Obstructive apneas induce early activation of mesenchymal stem cells and enhancement of endothelial wound healing. Respir Res. 2010;11(1):91. 14. M achado-Júnior AJ, Crespo AN. Expansion of the maxilla in adults with OSAS: myth or reality? Sleep Med. 2020;65:170-171.

18 | Sleep & Wellness Magazine

Dr. Martha Cortes, Dr. Willis Pumphries,

R. Kirk Huntsman, Dr. Michael Bennett, Dr. Dave Singh, Dr. Tara Griffin

sleepandwellness.net | Fall 2021 | 19

CPAP In June, Philips Respironics voluntarily recalled millions of ventilators, BiPAP, and CPAP machines because the sound reduction foam breaks down and can be inhaled or swallowed by the device user. It is unclear exactly how many systems were recalled, but the estimates range in the millions. In July, the FDA announced the Philips Respironics recall a class I, meaning it may cause serious injury or death. There is general concern about the safety of these systems along with the recall process. The Attorney General for Connecticut, William Tong released his letter to the FDA dated October 5, 2021. The letter starts with “I am writing to request that the FDA take more aggressive regulatory action pertaining to the voluntary recall by Philips Respironics of certain Continuous Positive Airway Pressure (“CPAP”), Bilevel Positive Airway Pressure (“BiPAP”) and ventilator devices, which contain a degrading foam that has been determined by the FDA to be potentially life threatening.” According to the FDA website, users of these systems have several options, including “Using alternative treatments for sleep apnea, such as positional therapy or oral appliances, which fit like a sports mouth guard or an orthodontic retainer.” Properly treating sleep apnea is critical for maintaining and improving patient health. The FDA urges anyone using one of these recalled devices to work with their medical provider for a suitable solution. Positional therapy would include products like slumberBUMP™ Positional Sleep Belt. According to snoringHQ.com, the slumberBUMP is a lightweight sleep belt that trains individuals to sleep in a non-supine position and consists of an inflated air pouch around the chest. They further indicate that positional therapy can supplement CPAP or BiPAP. The pandemic and this recall have stressed the supply chain for the types of devices recalled. The FDA fully supports oral appliances for the treatment of sleep apnea, and dentists teamed with medical doctors successfully treat patients with oral appliances every day. ASBA’s mission is to educate health professionals on all treatment strategies for sleep apnea. Consider joining ASBA today.

20 | Sleep & Wellness Magazine

ASBA welcomes

Dr. Dave Singh

to the Hall of Fame.

Harry Sugg

Elliott Alpher

Edward Spiegel

Todd Swick

Kent Smith

Dan Tache

Neal Seltzer

Bradley Eli

Robert Ricketts

William Dement

Wayne Halstrom

John Remmers

Rudi Ferrate

David Gergen

Harold Gelb

RENEW

your ASBA membership today to continue taking advantage of your benefits. sleepandwellness.net | Fall 2021 | 21

The ASBA provides networking opportunities with other members and organizations, lobbying for improved reimbursements while seeking to lower ever escalating health care provider costs, and discounts on educational events, products and accreditations for its members. This organization will help members more affordably lead the way to a new frontier in sleep medicine with the end goal to improve patient care through education for sleep professionals, sleep centers, patients and the community at large.

1745 West Deer Valley Road, Suite 11, Phoenix AZ 85027 22 | Sleep & Wellness Magazine

say goodnight to snoring...

Kirk Huntsman

The Story Behind Vivos Therapeutics The origin story for Vivos Therapeutics, Inc. is a tale fueled by opportunity, expertise, and a patientcentered approach. Now a publicly traded medical technology company,Vivos is focused on developing and commercializing innovative diagnostic and treatment modalities for patients suffering from sleep-disordered breathing, including mild-to-moderate OSA. According to Kirk Huntsman, co-founder and chairman, the foundational technology for the Highlands Ranch, Colo.-based company took shape a few years ago when G. Dave Singh, DMD, Ph.D., DDSc. was a professor and researcher at the University of Puerto Rico. Singh used oral appliances to treat children with cleft palates, and made several discoveries while helping his patients. Sleep & Wellness magazine (S&W) sat down with Huntsman to get a better understanding of Vivos and the current technology that is benefiting patients and piquing the interest of investors. 24 | Sleep & Wellness Magazine

with Kirk Huntsman

What did Dr. Singh discover during his work at the University of Puerto Rico treating children with cleft palates? In the process of doing that work, he discovered that these oral appliances could actually restore, almost to near normal size and shape, the overarching morphology of the facial features of the child. In looking at the radiographs and other images, Dr. Singh noted that the airway had also changed, as did the size and shape of the oral cavity. In many of the children, their airways opened up and Dr. Singh postulated that perhaps something similar could be done in patients with OSA. From there, he thought about developing an oral appliance technology or treatment that would reshape the oral cavity and reshape the airway That sort of began the journey. In 2004, he published what he called the Spatial Matrix Hypothesis. That is the scientific underpinning of the whole technology; and he published that with Dr. James McNamara from the University of Michigan. By 2007-2008, Dr. Singh had settled in on some designs that he began to commercialize. That was in the early 2010-2011 time frame and Dr. Singh began lecturing and teaching doctors how to use this. What was the situation when you met Dr. Singh? When I met him in 2015, he had already trained a fairly large number of doctors and certified them to use his technology. I was down a parallel track as a nonclinician. I had started a

number of companies, but the main company that I had for most of my career was a company called Dental One partners and that was a dental services organization that I owned and operated. In the process, I had taken a lot of continuing education courses. It led me to understanding the technology as a businessman and through the clinical eyes when I met Dr. Singh and I heard his first presentation. Sounds like you were well prepared to fully know the potential. I had the business acumen to really see what he had, and to see what he was bringing to market was a potentially gamechanging technology. By 2016, we had formed our company Vivos. We had agreed to purchase all the intellectual property rights, patents, and trademarks from Dr. Singh and his company, Bio Modeling Solutions.

Todd Huntsman, Dr. Harry Sugg, Kirk Huntsman

What was your level of optimism at that point? From the very beginning, Dr. Singh and I believed it was going to be a game-changing company. We formed it so that we could eventually take it public and gain the resources that would be necessary to create an organization on that scale. What is your business model? We go to independent practitioners and we teach and train them on the unique sleepandwellness.net | Fall 2021 | 25

aspects of what we do and why our technologies are different and how they work. We put that model together and launched it in 2018. By 2019, we came out with our full-fledged institute where our training takes place. We have Vivos Integrated Practices or VIPs. These offices have gone through the training, for both doctors and staff, and they basically have a very solid foundation and working knowledge of what sleep apnea is and how it comes into the population. We give them a comprehensive training program that is unlike anything else in the industry. This is not about hawking a dental appliance. It’s about way more than just the unique and proprietary designs that we have on our appliances. It’s about all the calls, all the training, all of the back-end support, the practice management, the medical billing. We call our medical billing service the Billing Intelligence Service because there’s a lot of confusion out there in the marketplace around medical billing for dental offices and frankly, most medical billing agencies and companies don’t understand. We really wanted to create a safety net or a backstop behind the doctors so that so that they would have mentors, practice advisors, and doctors who they could call. What types of results are you getting with patients? They’re being restored to a state of normal health and wellness. When they lay down at night, their airway doesn’t collapse and they can breathe normally without any appliance in the mouth. This is a technology that goes beyond mandibular advancement. This technology actually rebuilds the airway, just like Dr. Singh did with those cleft palate children. We actually do that for normally developed adults when a dentist works with our tools, technology, protocols, materials, and all of the resources that we bring to bear. The dentist knows exactly how to take a patient from their initial state of sleep apnea and/or sleep disordered breathing toward a state of wellness and full recovery. We are the only people who even claim to be able to do that. If patients go into CPAP, they have to wear the CPAP every night for the rest of their lives. The same is really true with the mandibular advancement device. What makes your company different? Every product on the market today, apart from Vivos, is a mechanical repositioning of the lower jaw. What we’re doing is something that’s never 26 | Sleep & Wellness Magazine

been done, and that’s what’s so exciting about Vivos. We are actually facilitating a repositioning of the tissues in the oral cavity that make the airway more functional, more open, and less prone to collapse. That is the breakthrough that we have here. There is an end point to our treatment. How do you help doctors deal with the many variables? Every patient presents with a different profile, a different set of needs, and a different set of facial conditions. We have a lot of doctors who have been there, done that, and seen it all. We have created a network of resources for the doctors, so that when a doctor sits down with a patient he or she can feel very confident that they have the clinical ability to get from the beginning stage of this case all the way through to the end. To do that, doctors need more than just a weekendtype course. They need to have a company with sufficient personnel, capital, and sustainability to make the doctors feel comfortable. We are bringing something to market that literally no one has done. We’re building a full-on ecosystem that goes beyond the oral appliances that we have, and it goes beyond even some of the treatment protocols. What are some additional examples? We just introduced a diagnostic technology and we have an exclusive license for it. We call it Vivo Score powered by Sleep Image. We learned of this technology and immediately saw the application for use with our doctors, so we negotiated a licensing agreement. We are making this available to the dental profession and it’s got many advantages over other screen devices. It’s easy to use, consumer friendly, and the reports are quick and easy to understand. The data has been shown to be comparable to a full-on in-lab polysomnogram or PSG. We are very excited about the ability that we have to give dentists the chance to have a conversation.

Todd Huntsman

We now have in the hands of the dentist the ability to quickly, easily, and efficiently diagnose in close collaboration with medical colleagues. They can assist in establishing the presence of OSA in their patient population and then be able to work with medical colleagues to deliver a dental-centric solution. When we combine our appliance therapy, which we call biomimetic oral appliance therapy, and combine that with the myofunctional therapy, we get incredible results and we actually are able to help these patients.

Sleep Apnea Treatment with a Beginning and an End

The typical dental practice has an estimated 500 existing patients who suffer from obstructive sleep apnea (OSA). Dentists are in a unique position to identify the warning signs of OSA. As a result, the ADA has adopted policies affirming the essential role of dentistry in the treatment of sleep-related breathing disorders.

To learn more about the leading cause of obstructive sleep apnea and what you can do about it, use the QR code or visit vivoslife.com/better-sleep/what-is-vivos/. sleepandwellness.net | Fall 2021 | 27

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The Day Dr. Morris

Almost Went to Prison

(For Something He Didn’t Do) By: David Gergen It was an evening in November, and I received a call from Dr. Morris. This call wasn’t too surprising because we had been actively discussing the possibility of doing an NFL event in Las Vegas together to be followed by Salt Lake City, Utah, but what he had to say was absolutely unexpected!!! They had indicted him for falsifying Medicare records. Knowing Dr. Morris as well as I do, I knew he would never do something like that, especially knowing the consequences and its repercussions! I remembered and pointed out to him that at our last ASBA meeting, his staff member had boasted on what a great job she had done with billing that she had it down pat! This new information struck me as odd as I was under the impression his medical billing was impeccable. This situation didn’t make sense! I informed Dr. Morris that one of his staff members, who shall remain nameless, had called the lab shortly after the meeting, and I believed this was the same individual who had been boasting. Soon after the ASBA annual meeting, she had called my Dental Office and was inquiring about changing dates on sleep tests and that she called a second later asking if she were missing signatures if she could sign herself on the patients’ behalf. I responded with a resounding NO!! I said, “ You could be sending Dr. Morris to prison for that! She answered that she could lose her job if she didn’t do it, and I replied, next time, do it right!! sleepandwellness.net | Fall 2021 | 29

I offered my friend and colleague my full support. I assured him that I would do the right thing no matter what; I would tell the truth. I had been in this business since 1986 and knew of others who had been in similar situations, and not a single one went to prison!!! Dr. Morris was so convinced that he would be going to prison for 3 Years!! He was being coerced into admitting something that he did not do! I told him he was overreacting, and there was no way he would do time for mishaps on billing. Perhaps fines, but no jail time! He asked if we were still doing the NFL event, and he questioned whether he could do this if he became a felon. I replied that he was ridiculous! He stated he wanted to be the top Doc for me in Salt Lake City and St. George!! He also wants Las Vegas! LA is too large to give exclusivity to only one doctor. He then told me he was going to Hawaii for a family vacation, and I told him to enjoy his time and not worry. Time had passed, and I received a new call from Dr. Morris closer to our NFL PA event in Las Vegas. This was to be his coming-out party, welcoming him to helping with the NFL and that he would be on the cover of Sleep and Wellness Magazine. We did the conference with Dr. Morris, and he did a fantastic job! The first time we went digital with impressions, his work was terrific, still hailing his performance. We took pictures with Andre Collins with NFL PA. Dr. Morris’ Slumber Bump is outstanding for positional therapy and was a big hit! After his demonstration, Andre has implemented them into treatment ever since I have a Cabin in Minnesota and typically head there the first part of June for my usual summer escape. Shortly after arriving, while boating with my children, I received a call from Dr. Morris, which I expected to be friendly, but sadly it 30 | Sleep & Wellness Magazine

was not. To my surprise, he told me counsel advised him to take a plea deal of 24 months in Federal prison! He was so defeated, and I felt horrible! I had been teasing him and even nicknamed him the Hurricane after the legendary Bob Dylan song. This plea bargain was not what I expected for him. I was adamant about explaining his billing person’s part in this mistake. He explained the situation to them; however, they placed no weight or attention on this aspect as they were on an obvious witch hunt! I was 2,200 miles away from Arizona when it hit me like a ton of bricks, and I remembered logging this person’s billing issue into the Gergen Ortho complaint log. So I conferenced in Chris Morrison, the GM of Gergen Ortho, and he cross-referenced the complaint log and immediately found my entry. Dr. Morris was ecstatic! Chris immediately sent over a picture of the log entry. I told Dr. Morris to show his attorney and insist there would be no plea bargain as he was not guilty. Dr. Morris was very appreciative and grateful! Then I received a call from his attorney, and he questioned my log. I stated Dr. Morris might be the type of guy that doesn’t pay for extra dipping sauce for his chicken wings, but he would NEVER falsify documents, Ever!!!

Utah prosecutors proceeded to tell me that they needed to interview me and they wanted me to drive to Fargo at 8:00 AM. I asked if they could just come to me, and they declined, stating it needed to take place in a Federal court building. So I reluctantly complied, waking at 5:30 AM so as not to be late. Exercising my civil rights as an American and participator in a Federal court system, I was truthful. I told them my name and someone from Utah was to fly into Fargo and take my taped deposition. They inform me she isn’t here, so I called her, and she informed me she was in the next building and inquired if anyone had given me papers. No papers had been given to me. She asked me to stand in the middle of the room to be noticed and approached by someone who served me with papers. So I spoke with the clerk, and the David Gergen, Shad Morris clerk said nobody was in the next building and added that

this was unusual. I began to feel that I was being lied to and manipulated into being served when they could have just come to my cabin. So I called the prosecutor, and he stated she was not in Fargo. She was with him in Salt Lake City. I was agitated as I had left my young children in my cabin near a lake unattended; not acceptable! He asked me to appear in Salt Lake City, Utah, on a date that didn’t work for me as I had an NFL event already scheduled at that time. I am a cog in a machine, and I don’t make the rules. I told him they needed to change the date. They would hold me in contempt if I didn’t appear at the designated place and time, and I stated that this would not happen. I told them that I would put a call into my good friend Mark Brnovich. He was a prosecuting attorney who is now the Attorney General for the state of Arizona and is running for the US Senate. He would never do these immoral practices and is a man with honor and integrity. Then the prosecutor explained the difference between Federal and state levels. Well, Mark can attest to my integrity and morality as a perfect character witness. I was livid about the events of that day and disappointed with the prosecutor and this type of game.

that moment like so many do, what good am I? If I have a chance to help and yet refuse? If my hands are tied, must I not wonder who tied them and why and where must I have been? I laugh in the face of what sorrow brings. If I turn my back while Dr. Morris slowly and silently dies, what good am I? His reply? I’m telling you, Dave, it’s not your problem!! The US Government is too powerful, and you could be framed! I replied that as long as I tell the truth, all will be well. I have nothing to hide, and neither does Dr. Morris! I found myself in the Great Salt Lake valley preparing to testify for the Grand Jury but unable to locate the building. The prosecutor described the building as the Borge Ship from Star Trek, which this description further enforces my belief in his kindness as I am also a Star Trek fan. My testimony is about to happen, and I have no fear of ridicule for doing what I believe to be the right thing, total transparency! The prosecutor begins his questioning. I answered truthfully, but I felt he was slipping in trick questions as it progressed. I called him out on it, stating I cannot answer any questions regarding time and dates definitively. Let’s be honest! I said I could not be exact on times and dates without data in front of me, and he stated that’s ok, answer as truthfully as possible. I was becoming increasingly agitated, and I turned to the Grand Jury to explain. I told the story of what had happened in Fargo with the treatment I received being tricked into being served. Felt it was disingenuous

On the way back to the cabin, the prosecutor called and calmed me down by stating we are similar creatures and that the last thing he wants is to send an innocent man to prison. I figured at the end of the day, he was doing his job. I returned to Phoenix and found that special agents had gone to my lab to photograph the log for themselves and interview my technicians. My recollection of events was independently validated. Dr. Morris’s dental assistant didn’t call just once, but twice with the second call being much shorter. I was proud my memory served me well. My good friend Dr. Anthony Scienni strongly advised me not to get involved and that it was not my problem, and I replied that I couldn’t just standby while this happened and I cannot turn a blind eye or deaf ear. If I shut myself off so I cant hear Dr. Morris cries for help, what type of man am I? I cannot know something and not do something. If I hear Shad Morris, Andre Collins someone weep and freeze at

Many colleagues and friends warned me that this might happen. The manipulation of the truth! I told the Grand Jury I understand the US Government is a powerful entity that commands respect. So does God! I know he is on my side as I stand by and with Dr. Morris, the side of justice. At that time, the prosecutor called for a recess. We reconvened back into court and then questioning continued. The prosecutor asks about how we select our NFL doctors and if doctors find it successful. I sleepandwellness.net | Fall 2021 | 31

referenced several, including dental icon Harry Sugg. He asked about ROI. Dr. Sugg received 1.4 million over the years with an initial investment of $75,000. Also, Drs. Core and Dr. Bernstein (what are you saying about Dr. Core and Bernstein). If a doctor smudges the reputation of this institution, they are immediately dismissed. Then I am questioned about the number of Medicare patients with dates and signatures falsified or altered. I stated that’s an excellent example of why I know that Dr. Morris did not falsely bill medicare! This is Dental 101; never use white-out on dental records. I stated no dentist would ever do this! I challenged him to show me one case where this has been done!! This in itself should validate his innocence. When I returned to Phoenix, Dr. Morris’ attorneys thanked me for my time, courage, and honesty while on the stand. They wished more people were like me. I replied that it’s not hard when you are honest like me. I was wrong, thinking it was over and that Dr. Morris would emerge victoriously and the truth had prevailed. I received a call three months later from the prosecutor asking if he and a Federal agent could come to see me at my place of business to interview me again and go through company records. My good friend Mark Brnvich explained and questioned motives that this is just a follow-up, and he would provide a great attorney if necessary. They requested I bring my girlfriend Angela Rojas with me as she witnessed the events and expressed sympathy for Dr. Morris as she too knew his innocence. I was recorded and stated I had nothing to hide; please proceed. They started the questioning by telling me that the mother of 5, who I knew was guilty, would be going to jail for changing dates, and they tried to appeal to my sympathy; however, my truth was my truth, and Dr. Morris was not guilty. They gave me two ridiculous questions: one to my then assistant regarding soccer and Mormonism, which still to this day seems pointless. The other was for an explanation of why Mark Brnovich did not come forth as a character witness for Dr. Morris. I replied he could not as he doesn’t know Dr. Morris. He can only do that for me as he knows me personally. That should not even be a question. This is when I truly learned the game of justice! However, I still live in the Land of the free, Home of the brave, and home of my hero Bob Dylan. Dr. Morris was found innocent on all counts because he was! He thanked me for being such an incredible person, a true savant if you please. I was humbled by this experience and proud to have stood firm and immovable for someone and something I believe in!

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Mike Haynes, Shad Morris

say goodnight to snoring...

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Addressing

The Sleeping Elephant In The Room

entists planning to be in the business of treating sleep apnea have dealt with many hurdles in doing so. My name is Manuel Fuentes and I am the Director of Operations for Medical Concierge Services (MCS) a medical billing company designed to put Dentists in the business of treating sleep apnea. In all my years working in this field the most frequent questions I get are “So where do you start?” and “How do you start?” I will be sharing with you some of the main obstacles you may face and what happens after you overcome them.

It starts with you, the Doctor and it starts with your staff. Everyone must understand, like any service you provide, screening and treating sleep apnea adds a valuable service to your patient and will add to your bottom line revenue. An office must deem themselves a fully comprehensive medical center. There is an absolute cross over from dental to medical. The connections are found not only in sleep apnea but in poor oral hygiene, TMD, posture, periodontal disease, and even cancer among many more conditions. Our most successful practices understand that they are providing an overall health approach to their patients.

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Many dentists want to treat sleep apnea patients but are deterred by two things; the clinical process and medical insurance. Not having the medical knowledge on this sleep disorder can make it difficult to be clinically confident when speaking to patients about Sleep Apnea. Once that step is taken, dental offices are left to face the difficult billing process of medical insurance. Offices know that treating sleep apnea is a lucrative way to add revenue, but it is not an easy task. Knowing the steps of billing medical insurance is one step but going through it is a completely different process as opposed to dental plans. Let’s look at the reality of overcoming these obstacles. At the beginning our clients don’t fully understand how sleep apnea relates to dentistry and how to treat sleep apnea as a dentist. If you don’t feel comfortable communicating the process of a root canal, implant, Ortho etc how do you expect a patient to feel comfortable? How do you expect to approach the patient with such services? Getting yourself educated at a peer to peer level is the first step in overcoming this obstacle. Find yourself a qualified seminar with a dentist who has years of experience treating sleep apnea. You also want

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to get a hold of any associations/study groups, and sleep medicine forums that relate to you as a Dentist. Associations such as the American Sleep and Breathing Academy have educated thousands of dentist, medical doctors, staff, and financial coordinators. They also provide materials to educate the patient base. Aside from educating yourself, it is important to find ways to get your staff informed on sleep apnea to have them confidently speaking to patients. The office staff is vital to making your office a successful Sleep Apnea treatment center. They are part of the screening process and assist in answering patient questions. Overall your staff must be on board so your patients can benefit from the service you are providing and so your practice can reap the financial benefits. Being proactive in the sleep medicine community will strengthen your confidence along with give you significant credibility. Call the local dental society you are part of and ask for Sleep Apnea speakers. Get the education needed to have you confidently speaking to patients about this sleep disorder. Our firm uses a variety of educators. In California our favorite seminar speaker is Dr. Dar Radfar DDS, DASBA.

How to gain the most from this service you are now ready to provide? There are a few options you can look to in terms of billing the patient’s medical insurance. You can do the billing in house; however this will require the office to know how to bill medical insurance. If this step is taken, a dentist must ask if their staff understands the dynamic of billing and authorizing an appliance as an out of network provider. It may not be wise to invest in the training or hiring of someone in your office to fill this role. Initially you will only have a few cases and it will not be cost effective to pay for training or hiring of a competent employee. You could purchase medical billing software to aid your staff through this process. The issue with the software is most companies that sell the software are “turn and burn” companies. They sell you the software and provide very little support on actual billing and collections. They give you the tools to do something foreign to your practice. Lastly, you can outsource the billing to a third party biller. Make sure that you weigh all the options that

different companies offer. While third party companies will charge 8%-15%, will they charge a percentage of what is billed or paid by the insurance? Will they charge for each insurance verification, authorization, and appeals? Find a company that best suits you as you start your treatment center. A company with low signup fees, no monthly fee and no per patient charge is best when you are starting out. Though you are excited and confident about treating sleep apnea your second obstacle comes down to submitting claims effectively. Any of the solutions can work as long as they suit your needs and the staff’s needs. Now that you aware of the two main obstacles and what your options are there are typically 4 office visits to get through treatment.

Dr. Dar Radfar DDS, DASBA You can find his events at www.radfarseminars. com or at our client portal www.sleep-mgmt.com.

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Once you are comfortable with Sleep Apnea and your office is on board, you need to become familiar with the insurance process and how your office will bill for these cases.

Here they are: 1. Screening - Using medical history and an airway evaluation will make this process relatively seamless. If a patient is at risk you should discuss ruling out sleep apnea and refer a patient for a sleep study. Find a lab where your patient can get diagnosed by a Board Certified Sleep physician. Try to find a lab that can provide a home sleep test vs. an in lab test. Compliance is higher when the patient can test at home. 2. Review Sleep Test-After the sleep test is complete you must bring the patient back to go over the sleep report (must be diagnosed and signed by a Board Certified Sleep physician). At this time you and your patient should go over the treatment options which include a CPAP, Oral Appliance, and Surgical Modification. Identify what form of treatment the patient wishes to move forward with. 3. Delivering an FDA approved appliance-At this point you may take impressions and deliver the appliance. This is the time when you bill the oral appliance. At this point, ask your biller to submit your claim to the insurance.

4. Follow up-Bring the patient back after 30 days to gauge therapy and request a follow up sleep study with the oral appliance therapy. It is clinically correct to re-test the patient so he/she can see the efficacy of the appliance. With any new skill in the beginning, the learning process may seem complicated or tedious but after a few experiences it becomes simple. This is often the case when treating Sleep Apnea, especially for the practices that are completely unfamiliar with sleep disorders. The first step is to get educated on the topic. It can start with seeking information through dental associations to enrolling in courses. The other key step is getting the office staff educated and on board on the screening and treatment process. Once you are comfortable with Sleep Apnea and your office is on board, you need to become familiar with the insurance process and how your office will bill for these cases. After all these steps are taken you will find it easier to confidently speak with patients about this condition and explain to them the medical and insurance process.

About Medical Concierge Services LLC: We have been in the sleep industry for over 15 years and are very passionate about helping dentists grow their sleep apnea treatment center. We offer a streamlined solution that is easy to follow while also holding your staff’s hands through their first few patients. Our clients can utilize a portal that keeps track of their claims which allows their practice the flexibility it needs throughout the day. We are currently helping doctors in 19 states around the country and our oral appliance claims have an 86% success rate due to our easy to follow program. No software or equipment to buy, we only get paid when the doctor gets paid. Contact us today for more information Office 855-232-8560 / Fax 855-486-9390

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END THE APPLIANCE TITRATION GAME WITH ECCOVISION

START EXCELLING IN DSM

AT SLEEP GROUP SOLUTIONS WE ARE ON A MISSION TO HELP DENTISTS STOP GUESSING WITH APPLIANCE THERAPY AND IMPROVE PATIENT OUTCOMES WITH PRECISION AIRWAY MEASUREMENT TECHNOLOGY We are leading the DSM evolution and helping transform one practice at a time by offering the most comprehensive suite of education, coaching and technology solutions in the industry. Cutting-edge acoustic technology reveals patient airway collapse Identifies “sweet spot” for appliance therapy by measuring to determine the optimal vertical and protrusive bite position Precise positioning may eliminate additional appliance titrations and adjustments resulting in increased profitability, case acceptance, and decrease patient chair time

go.sleepgs.com/ASBAmag “SGS Seminars CE hours are ASBA Certified"

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Jon W. Caulfield, DDS American Dental Association American Sleep & Breathing Academy Diplomate Colorado Dental Association Metro Denver Dental Society Spear Faculty Club Member Vivos Senior Clinical Advisor, Trainer

Dr. Jon W. Caulfield owns and operates Epic Dentistry in Littleton, Colorado, where he focuses on treating patients with airway, sleep and TMJ disorders. A selfproclaimed CE junkie, Dr. Caulfield has committed the practice to continuing education for himself, his team, and for other dentists around the country who share his passion for helping patients reclaim their health and live better lives. He has been fortunate to work alongside world leaders in neuromuscular occlusion, sleep, and airway improvement. He has been a certified DNA appliance provider since 2010 and is an integrated clinical advisor for Vivos. He also holds a diplomate status with the American Sleep and Breathing Academy. 40 | Sleep & Wellness Magazine

Caulfield is

ASBA’s new President. ASBA, at its 2021 Sleep & Wellness Conference, announced Jon Caulfield won the election and is now President. Special thanks to Kent Smith for his service. Jon is looking forward to expanding the membership of ASBA. Members are looking forward to seeing his high energy and business acumen in action Memberships in Professional Societies American Dental Association 2000-Present Colorado Dental Association 2000-Present Metropolitan Denver Dental Society 2000-Present Denver Implant Study Club 2002-Present World Clinical Laser Institute 2008-Present Spear Faculty Club 2011-Present Spear Study Club 2016-Present American Sleep and Breathing Academy- Diplomate 2016-Present

Volunteer Service: Denver Rescue Mission, Denver Colorado 2008-Present Mission Ministries: Juarez, Mexico July 2016

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The time has come to put the rumors of

David Gergen’s demise to rest... By: Zack Palmer

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This man holds almost every school record in the Peoria Unified School District for football and track and field. He even had perfect attendance throughout elementary school. David once scored 380 points in a football season. His record was eight touchdowns in a single game. A trick play with David passing to Willy Faulkner; interception return for a touchdown; punt return; rushing touchdown; pass reception; kick return; another interception; and finally a pitch to David! This record, as is the opinion of many, is untouchable!!! As I dive deeper into David’s athletic history, no one will beat his 380 point season record! David posted 330 and 320 points in the following two years, and these three-season total yard records are still the top three district records.

David also held a broad jump record of 9’ 10” that stood for over 28 years and earned him a plaque signed by President Jimmy Carter. David was only 13 years old, and his speed was outstanding and unprecedented! As a 5th grader at Pioneer Elementary, David ran a ridiculous 5.2 forty-yard dash, another

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school record. In 6th grade, he ran a 4.9 forty-yard dash. David was good for four first-place ribbons or medals at most track meets. Warren Faulkner said, “he witnessed the greatest comeback victory.” with David as one of the few 7th graders on the Kachina Elementary track team. John Jaqua, an 8th grader, was the fastest on the relay team, and David had a great deal of respect for him. John had started the 4 X 200 meter race. With the two middle runners falling behind, David was in 6th place when handed the baton, and the front runner was almost 11 yards ahead of him. David quickly cut the lead down to three yards and closed in on the front runner. In the last 10 meters, David passed everyone and took first place in a photo finish race against another runner who also passed the front runner. Coach Swinford jumped up and down when he turned to Warren Faulkner and stated, “Now you know why I put Gergen at anchor! He refuses to lose!” David’s split was 23/9, and remember this is for a 7th grader with incredible times. David was a member of the Jr. Olympic team and told me, “I am a five-time state champion, a two-time national champion, and sometimes I need to draw from those experiences.” So, here is part of the story that shows he will never quit.

David Gergen

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This now brings me to a point in his life where quitting wasn’t an option. Covid 19!!!! An outbreak entered our world, and as with so many others, David Gergen contracted the often lethal virus!!! He contracted the virus while visiting Texas. David began medication and self-care and was feeling stronger. Then he came back to Arizona, and once again, he contracted Covid 19! Unheard of!!! He was admitted into the hospital with double lung pneumonia and flat-lined 4 times!!! His son Jack was told there was little hope he would recover. He was placed in a medically induced coma.

promise to David’s Jewish tribe a long time ago. David still had work to do, but David, who had always been a non-believer, would require more than just a verbal message. Jesus raised David’s bed high above the room where David could not look upon his face. David heard his voice state, “No man may look upon the face of God and live. “David replied that he did not need to see his face to believe. David now believed, however, what Jesus told David next, he could not believe. Jesus told David he was not a gentile but of Jewish descent. David questioned Him. Jesus instructed David on what to do once he returned to his earthly state to find out for himself. Jesus told David to contact his oldest living relative, Lorren Crawford, and the truth would be revealed.* Then he said to him that David’s hero, the legendary Bob Dylan, kept his promise to God and fulfilled his end of the agreement. This mystified David as to why Jesus would say this about Bob Dylan. I believe that it is because Bob Dylan’s music speaks to David. Jesus then told David to convey all this to his

The following event is very personal and sacred to David. He humbly shared with me a most remarkable account of events that I find almost unbelievable!!! But... I do believe him. He is my dear friend and would never, and has never lied to me. He claims he met the almighty, the holy ghost, and Jesus Christ, the trinity. The Redeemers and Savior of all mankind. I believe David was dying, and God decided it wasn’t his time and delivered the message that God fulfilled his

* Scan to view Dave’s documentation

David Gergen

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mother, Diane. David loves his mother very much, and this would be his proof. Then, and only then, did David awaken from his induced coma. David had been in his unconscious state from November 24th to December 5th, 2020. The first thing he did was phone his mother to tell her about this incredible experience!!! He tells her he is Jewish. She denies this, and then David tells her to contact their oldest living relative that the truth would be revealed. It was!! David Gergen is a member of the first tribe of Israel!!! David decides to check himself out of the hospital against the doctor’s wishes, but David Gergen always does what David Gergen wants to do. David Gergen generally learns the hard way, and he could barely breathe with his ill lungs. He checked himself back into the hospital and still wished to leave, but he meets someone who changes his mind. He felt strangely close to the nurse he had just met. He decides to trust her care and stays. He is admitted, and she continues

her care for him. After looking through his medical records and assessments, she tells him that she is shocked that he is standing there living, all 5’8” of this man! He is now given an IV of heavy antibiotics. By the next day, his lungs are almost clear, and he’s feeling so much better!! David is released at 3 PM the following day from the hospital. He returns home pondering his life and counting his blessings. David thanked his heavenly father for giving him a second chance and the opportunity to care for himself, his household, children, business, and friends who all depend on him. He is a fighter! Quitting is not in his realm of thinking. He now believes, as Bob Dylan does, God lives. There are things in this life yet for David Gergen to do, and he is not done, not by a long shot. This is his second act, and I believe his finest!!! David asked me to ponder this quote by Bob Dylan, “Jesus is a King among nations, but a stranger at home.” For the life of me, I can’t figure out what it means.

Chris Morrison, Dave Gergen and Victor Garibaldi

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Thank You to our Sponsors

at the 2021 Conference

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