Workin' 9 to 5

Well, after all of the hullabaloo of graduation, it was time to start looking for work.  I knew being obviously pregnant, it would be pretty difficult to find anything, much less something ideal.  I emailed Ms. Bartlett at the school to see if there was any volunteer work I could do in the mean time to keep my skills up, and she told me she knew about a dentist who was swamped and could use some help...I might even get paid!  She called him and presented the idea to him and emailed me back.  Turned out it was Dr. Stuart she was talking about.  Since we had been in the same Great Expectations mentoring group for 2 years and I worked with him during Dentistry with a Heart, it was a no brainer for both of us.  It was an answer to prayer for both of us!  We both knew God had arranged this at just the right time.

He had to spend a lot of time out of town because he was president-elect of the TDA and it turned out that his dad's health was failing and he needed to be with him and his family.  I started filling in for him, seeing mostly filling and emergency patients, but that means root canals and extractions.  It was hard at first to get back in the swing of things and build up confidence, but the staff is great and willing to work with a fresh-from-dental-school dentist.  I also had some down time to prepare for baby, go to doctor appointments and rest before my due date.

After 6 weeks at home with Audrey, I went back to work for a full week and I've been going in a few days here and there as he needs and will do so for the rest of the year.  We ended up working out a plan for me to work on Thursdays and Fridays along with any other days he needs starting in January.  I'm really excited to continue working there and so glad I don't have to find another job to support my dental school loans ; )

So, I'm officially working as a general dentist in Sunnyvale, Texas and looking forward to taking some good continuing education courses.  The Southwest Dental Conference is in January, and I'm all signed up to learn some oral surgery, endo, and treatment for snoring and sleep apnea using an oral appliance.  I'm also super excited to see friends as it will be kind of a little reunion.  I also need to get trained for Invisalign.

So much to learn!

End of the Road

I didn't post at all between January and gradauation in May and for good reason:  I had no time.  It was a sprint to the finish that turned into pleading for permission to cross the finish line.  Getting cleared for graduation was like pulling teeth, but I made it and it's all over. 

I ended up doing 39 crowns, no bridges (I know, right?), 115+ fillings, and 8 units of removable with my one crazy 9th case getting passed off to a 3rd year because it didn't seat 3 times.  Perio was a nightmare where they let me SCRP all four quads in one appointment and the patient cancelled their reeval appointment.  I still got credit.  They made me come back to seat two crowns the week before graduation, one of which did not seat all the way (are you kidding me?), so she got finished up this summer.  It was pretty much a worse-case-scenario kind of finish.  But I finished.

WREB is a whole other story.  I record it here for posterity, but I really don't think I'll ever forget it.  My operative patient had an MO on #31 and a DO on #29.  Perfect, right?  Same quad, could do both at the same time.  Only problem was that Megan had done a DO on #31 so I wouldn't have to worry about it a few months earlier for her progress exam. So all I had to do was take an x-ray before I sent him for approval so they could see the tooth as it existed.  So I had a folder of the images for #31 and another folder for #29.  Keep in mind that you can see both teeth in all the images, and I only updated the images in folder #31 because that's the one that mattered.

So I sent him for approval and he was approved.  I removed all the decay and he came back from grading with no pink slips, ready to restore.  I restored and sent him for final grading and he was down there for an hour and a half.  What was taking so long?  He came back with two pink slips: I had apparently prepped and restored the wrong tooth surface and my filling on the distal of #31 was unacceptable.  What?!?!  The head floor examiner calmly came over to ask for an explanation.  Once he told me what the problem was, I knew exactly what had happened: they had not looked at the xray I took that morning.  I showed it to him, he was satisfied and went to explain everything to the graders.  They had not even bothered to open my #31 folder since they could see it in the #29 folder!  I handled myself very well (I think I had used up all my tears a few days before WREB in the clinic) and it was so amazing to have Erik there during all of it.  They regraded him and there were no issues.  He had lost a marginal ridge on the DO on #31 that Megan had done so that needed to be fixed by her but that was it. Everything else went well. Hallelujah.

I started this post a long time ago, but since then I've been busy working part time for Dr. Stuart, getting ready for baby and then taking care of Miss Audrey. It's good to finally close out this diary of dental school!

Dr. Abby Mann, DDS

I'll Drive Downtown Everyday for Four More Months, But That's It.

It snowed today and I'm supposed to go back to school tomorrow.
All I really want to do is watch movies on the couch for the rest of my life.
Not really.
That's why I have to go back to school tomorrow.
It's my last semester.
I started to read over my WREB candidate guide (trying to be responsible) and when I got to the operative  section, I really just wanted to throw up.
But it's my license, so I kinda have to pass it.
Then I have to find a job.

Pedo is Neato

I finished up my pediatric rotation this week and basically got confirmation that my stainless steel crown counts and I'm done.  I completed another case, and apparently doing the rotation counts as a completed case, so there's no way they can say I'm not finished.  One more set of requirements down!

I was assigned another perio patient, so there is hope : )  And I'll start another crown tomorrow.  It's something. Then I don't have to see patients until mid January : )

* 1/2 oral surgery progress exams
* 0/2 perio progress exams
* 3/5 root canals
* 6.5/9 removable units
* 1/2 partials
* 2/4 perio cases, plus 1/2 starts
* 1/2 community service credits
* 20/50 crowns - 9 in progress, one ready to cast, one at the lab
* 74/99 filllings
-------------------------------------------------------------------
Oral surgery extractions complete! (105/100)
Nitrous oxide sedations complete!
Molar endo complete!
Stainless steel crown complete!
Removable proficiency exam complete!
Pedo requirements complete!

At least the whole pulling teeth part seems pretty successful...

While on oral surgery rotation, I decided to make it as productive as possible and finish my oral surgery minimum requirement of 100 extractions (150 for an "A") and my "student choice" progress exam.  I have to do one more "instructor choice" progress exam and I'm D.O.N.E. with oral surgery as far as my graduation is concerned.

Speaking of graduation, we got a notice in our boxes that we will be doing cap and gown sizing as soon as we come back from the Christmas break.  Might be a little early to do that, huh?

* 1/2 oral surgery progress exams
* 0/2 perio progress exams
* 3/5 root canals
* 6.5/9 removable units
* 1/2 partials
* 2/4 perio cases, plus 1/2 starts
* 3/4 completed pediatric cases
* 1/2 community service credits
* 20/50 crowns - 8 in progress, one ready to cast
* 74/99 filllings
-------------------------------------------------------------------
Oral surgery extractions complete! (104/100)
Nitrous oxide sedations complete!
Molar endo complete!
Stainless steel crown complete!
Removable proficiency exam complete!

Happy Thanksgiving!

Mr. Angry Tooth and I will be sleeping in, quilting and studying for boards this week.  179 days.

* 3/5 root canals

* 6.5/9 removable units
* 1/2 partials
* 2/4 perio cases, plus 1/2 starts
* 93/100 extractions, I really just need to do my progress exams and call it done after rotation in December
* 3/4 completed pediatric cases
* 1/2 community service credits
* 20/50 crowns - 8 in progress, one ready to wax
* 74/99 filllings

* 3/5 root canals
* 6.5/9 removable units
* 1/2 partials
* 2/4 perio cases, plus 1/2 starts
* 92/100 extractions, I really just need to do my progress exams and call it done after rotation in December
* 3/4 completed pediatric cases
* 1/2 community service credits
* 20/50 crowns - 8 in progress, 2 to be seated tomorrow, will wax one soon
* 74/99 filllings

Ending the Beginning of the End

This is my last full week of patients this semester.  Then I go on rotation *a much needed break* and see a handfull of patients right before the Christmas break to seat a few crowns, do a few fillings, and prophy with the best of them.

* 3/5 root canals
* 6.5/9 removable units
* 1/2 partials
* 2/4 perio cases, plus 1/2 starts
* 92/100 extractions, I really just need to do my progress exams and call it done after rotation in December
* 3/4 completed pediatric cases
* 1/2 community service credits
* 20/50 crowns - 8 in progress, 2 to be seated tomorrow, getting a gold crown ready to turn in for approval
* 69/99 filllings

School is Beating the Life out of Me.

* 3/5 root canals
* 6.5/9 removable units
* 1/2 partials
* 2/4 perio cases, plus 1/2 starts
* 92/100 extractions, I really just need to do my progress exams and call it done after rotation in December
* 3/4 completed pediatric cases
* 1/2 community service credits
* 19/50 crowns - 9 in progress, 2 back from the lab, will cast one tomorrow to seat on Monday
* 69/99 filllings - I've done a lot of fillings lately, but apparently didn't know how to read the record on Axium, hence the big jump!

The Final Numbers are In

My numbers are 50 crowns and 99 fillings.  Really?  99?  We couldn't just make it the full 100?  And we'll see just how close to that 50 crowns I can get.  This basically means I will be working my tail off until the porcelain deadline.  My entire tail.  It will all be gone.

* 3/5 root canals
* 6.5/9 removable units
* 1/2 partials
* 2/4 perio cases, plus 1/2 starts
* 92/100 extractions, I really just need to do my progress exams and call it done
* 3/4 completed pediatric cases
* 1/2 community service credits
* 18/50 crowns - 10 in progress, 4 back from the lab, waxing one up right now
* 57/99 filllings

Onward and Upward. Or Something Like That.

For a week where I only saw 2 patients, a crown, 2 fillings and 2 extractions is pretty good, right?
This week: a denture reline, crown lengthening surgery, 2 completed cases (Please, Lord!), a completed denture proficiency exam, and maybe more.  I might be at 6.5 removable units by the end of the week.  Crazy.  I may even start a new partial on Wednesday.


* 3/5 root canals
* 5/9 removable units, 1 in progress
* 1/2 partials, 0 in progress
* 2/4 perio cases, plus 1/2 starts
* 92/100 extractions, I really just need to do my progress exams and call it done 
* 3/4 completed pediatric cases
* 1/2 community service credits
* 17/40ish crowns - 10 in progress, 4 back from the lab, two at the lab as I type
* 57/100ish fillings

Because Every Crown Seated is Worth Writing About

But this one was a long time coming.  I took off the old crown sometime around April.  I impressed in May, I think.  1st attempt to seat in June.  2nd attempt to seat post re-tx endo in August?  Something like that.  Re-impressed about 3 weeks ago.  Seated 10.12.10.  Hallelujah.  My patient agrees.

Requirements Completed

* 3/5 root canals
* 5/9 removable units, 1 in progress
* 1/2 partials, 0 in progress
* 2/4 perio cases, plus 1/2 starts
* 91/100 extractions
* 3/4 completed pediatric cases
* 1/2 community service credits
* 15.5/40ish crowns - 8 in progress, 6 at the lab as I type
 57/100ish fillings

Bleh

I have my first WREB-type progress exam tomorrow and I'm trying to put off thinking about it for as long as possible.  I'm also hoping to seat another gold crown on Wednesday.  I've got to get where doing crowns this year is like doing fillings.  Quick, easy, often.  I'm booking them as fast as I can.  I have a new root canal patient that I hope will work out better than the last two.  I seriously need perio.  Seriously.  I finished Nanna's partial, I'm just waiting on lower posterior teeth to come in so I can finish up my F/F proficiency, and I have 2 other partials that just need survey crowns seated to get started.  I should also finish my 3rd and possibly last pedo case this week.

I had my phasing conference, and I'm not sure what my numbers are yet.  I'm not really sure that it meant a whole lot in the long run, except there's a list of treatment I don't have to do because those patients are unreliable or need entirely too much for me to finish in time.  I guess that's a start.

Next up on my plate: part II of boards.

Requirements Completed


* 3/5 root canals
* 5/9 removable units, 1 in progress
* 1/2 partials, 0 in progress
* 2/4 perio cases, plus 1/2 starts
* 91/100 extractions
* 2/4 completed pediatric cases
* 1/2 community service credits
* 14.5/40ish crowns - 8 in progress
* 57/100ish fillings

Because A Good Day is Hard to Come By Lately

A completed pedo case officially gets its own post.  I'm delivering a partial tomorrow.  Get excited!

Requirements Completed

* A ridiculous number of patients
* 3/5 root canals
* 4/9 removable units, 2 in progress
* 0/2 partials, 1 in progress
* 2/4 perio cases
* 84/100 extractions
* 2/4 completed pediatric cases
* 1/2 community service credits
* 13.5/50ish crowns - 8 in progress
* 57/100ish fillings


What I Never Really Have to Do Again If I Don't Want To

* pre-prosth
* stainless steel crown
* molar endo
* nitrous credits

Back on the Wagon

Since I took my blog off Facebook, Rudy can't whine about my requirements posts, so I'll start again.  It's nice to see how it all evolves throughout the year.  I seated 3 crowns today so that was kinda huge for me.

* A ridiculous number of patients

* 3/5 root canals
* 4/9 removable units, 2 in progress
* 0/2 partials, 1 in progress
* 2/4 perio cases
* 84/100 extractions
* 1/4 completed pediatric cases
* 1/2 community service credits
* 13.5/50ish crowns - 6 in progress
* 57/100ish fillings
 
Besides, what else do I have to post about?  I sure could do an awful lot of whining on this here blog, but who wants to hear that...besides, who really reads this anyway?

I Don't Know...

...what the group of interviewers thought of this when they toured through the lab today, but there you have it.  And we've only just begun...

OK, Fine.

I'll actually post about the first week back this fall.

It wasn't great.  It wasn't horrible. It was school.  BCD clinic in all it's glory.  9 months to go.

How has this week as a fourth year been any different than a third year?  I think if anything, I was given more opportunity to be the one thinking like a clinician.  In third year, you present your patient for diagnosis with what you think, and the professor tells you what they think.  You see how you disagree and learn from it.  Then you repeat with consults in every area (root canals, fillings, crowns, etc).  Once you have the final plan, you just do it. They check every little step and intervene when things get hairy.  This week, there was a lot more consulting away from chairside.  This means that your story was all the professor got before they gave you advice.  No professor looking in the mouth, no professor seeing with their eyes what you were describing.  I had to take the advice and run with it.  One day, all of it led to pulling a tooth.  Today, it all led to saving the day and seating an impossible-to-seat crown.  The crazy part was that each time, I figured out exactly what was going on in a crazy situation and made what turned out to be the right call all on my own before having it confirmed by a professor. 

They have to kick you out of the nest sometime.  And then one day, I'll have to pick up a phone if I need one of those consults.

I'm a Fourth Year.

They've always been a revered group.  So smart.  So skilled.  So grown-up.  I watched a group of my classmates casually chatting down in the cafeteria this morning as I paid for my coffee on our first day of summer clinic and realized that they were a group of "fourth years".  So. Cool.  And I'm apparently one of them.

We spent a good 3 hours this morning going over the D4 manual which I had actually already read because it is only 1/10th the size of the D3 manual.  (I didn't fully read the D3 comp care manual until about 1/2 way through when I panicked a bit about finishing and decided I should know the rules in and out regardless of the size of that monster.)

We (and by "we", I mean my group) also found out who our group leader is this year.  We were left in the dark all break while our classmates blissfully enjoyed their time off knowing who their leaders were.  I was left in terror - literal terror - after a well-meant warning from an unnamed faculty member.  I mean some of the people at the school really are scary - make you crawl in a hole and cry kinda scary.  I couldn't imagine spending a year with one of the scary ones.  That terror was completely unnecessary but always a good lesson of just how much I really trust God, and shouldn't fear anything in this world.  Lesson learned for now, right?  Thankfully, after crying, praying, and allowing my body to return to some state of normality, I regained my sanity and could peacefully enjoy my break.  I think it will be a great year.

After Tuesday, I spent the rest of finals week quilting, going to the gym, buying fabric, spending way too much money at Target, swimming at the community pool with Erik, and going to the concert by the lake.  The first full week off, I spent at two different dentists' offices for a preceptorship (i.e. class credit).  My first 3 days were ultimately boring and miserable.  I didn't jive with the dentist, his office was way too intense and overbearing, and when I left my lunch bag in the fridge at the end of the 3rd day, I didn't want to go back and get it. 

The next day and the following Tuesday (after Memorial Day), I was at an office just down the road and it was night and day.  Laid back but productive, totally got along with the dentist, and left with the possible hope of spending some time there after graduation.  But there's a lot to do between now and then - we'll see what the Lord has for us. 

My 2nd full week off was too short, but Erik and I finished it with a trip to Granbury counting dentist offices, going to a drive-in movie (Shrek!), drinking a little Texas wine, and spending an afternoon at a sandy beach on Lake Granbury. 

We hit the ground running on Wednesday in clinic.  I've already been doing lab work.  I'm going to be busy fast!  Got to finish up everyone's work!
---------------------------------------------------
A ridiculous number of patients whose treatment needs to be completed
2/5 root canals, molar complete
4/9 removable units
0/2 partials
2/4 perio cases
50/100 oral surgery procedures
4/6 nitrous credits
4/6 pre-prosth credits
0/4 completed pediatric cases
0/2 community service credits

Just to Clarify

Several good friends have expressed concern for me after my last post.  Let me explain:

I'm not really in the pit of despair.  I do this a lot. I finish doing something really exhausting and then have nothing to do but think about how crazy it was.  Then I get all emotional about God's faithfulness and provision for me and the tiredness just completes it all to make me an emotional wreck.  I also cite my first 10K where I cried at the finish line and my breakdown after finishing organic at UT.  Same deal.  Lots of hard work all over at once = breakdown.  And crying seems to be my m.o. when it comes to emotional release.

This reaction was completely uncharacteristic after D1.  I think I was still in shock.  That can be the only explanation. 

I looked back at the end of second year and found nothing.  Nothing.  I think that's because there was no break.  It just flowed right on into 3rd year without a minute to catch my breath.  No wonder this one was so pronounced.

I'm a little worried about what will happen when I walk across the stage at graduation next year.  If I see my mom before hand, it's game over.  She'll already be crying, and if anybody else is crying, I'm along for the ride.  If not, I'm sure the sobbing will start as we all sit there in anticipation.  Yeah, I'm pretty sure I'll need to tuck a large box of Kleenex under my chair before the ceremony starts.  The long rectangular one, not the cube, and definitely not the purse size.

Now, don't get me wrong - I do have a huge climb ahead of me.  Maybe bigger than I know.  We'll see how that one goes.  I'll have to tell the story of getting out of the Grand Canyon here sometime.  It's pretty funny.  Oh, that pita bread!

Veni, Vidi, Vivo

So third year came and went and yesterday I had my "bottom of the Grand Canyon moment".  I'm still getting used to the feeling.  If you weren't there at the bottom of the canyon with me that day wearing a 30 pound pack full of tents and sleeping bags and pita bread, let me fill you in.  Our senior year at A&M, Erik and I, along with 8 other friends went to the Grand Canyon for Spring Break.  We liked to camp every break, and senior year meant we had to do something big.  I was in pretty decent shape, but I had no idea what was ahead of me. Oh, how closely this story parallels my third year of dental school!  (Just you wait, second years!  You have NO idea.)

The first night we camped on the rim in the snow and ice - I don't do cold, just so you know.  I woke up with my sleeping bag incased in a thin layer of ice.  ICE!  I immediately ran to the car and turned it on, praying that the heater would heat up faster.  It didn't.

We packed up our backpacks and even had a scale so we could distribute our provisions as evenly as possible.  We had a lot since we planned to camp at the bottom 3 days or so.  Full of adrenaline and naivety we started down the teeny, tiny narrow path.  We did know a few things: we knew that it was a long downhill hike, that we had to navigate the mule droppings and other visitors as we made our way down, and that if you get into trouble (i.e. fall off the side), no one will come to get you.  They're sure to let you know that when you sign up.  What we didn't know, was that, just as there was snow and ice on the rim, there was also snow and ice a good ways down at the top of the path.  Remember that part about falling of the side?  Yeah.  Since we, in our ignorance, did not have ice picks on our shoes to help us down the treacherous areas, we chose to sit on our bums with our big backpacks on our backs and scoot down the icy patches until we reached solid ground again.  Nerves = on edge.

Now, you may be thinking, "Going down can't be that bad.  At least you're not climbing up."  Oh, contraire.  It was terrible.  My pack was just weighing me down.  My legs started shaking about half-way down.  Visibly.  I was constantly hydrating and eating as much trail mix as I could to get some salt and sugar in my body.  I'd recover and keep going, only having to stop and rest again.  And the worst part of it was the mental game.  See, with every step down, there was a step UP in my future.  How in the hell was I going to get out of here?  Are you kidding me?  Can they just send a helicopter and lift me out?  Can I build a raft and float down the Colorado river to Mexico and fly back to Texas?  On we went.  Down into the beautiful canyon.

My legs were rubber.  Mush.  I got to the campground area at the bottom, took off my pack, sat down on a bench and cried.  I was spent.  I gave everything and I was stuck down there.  I could not walk anymore.  I got a hold of myself, but as I did, the overwhelming dread of the hike up began to creep in.  I was not in a good mood.  Believe it or not, there was a pay phone (remember those?) not far from the cabins (not where we were staying).  I called my mommy.  I did.  I told her I was at the bottom of the Grand Canyon and I asked her to get me out of there.  That didn't work.  This was my reality.

 

My friend let us know that the site where we would make camp was further down the trail at the bottom.  Like 2 more miles or something ridiculous like that.  As unbelievable as that news was, I put my pack back on, and mustered up whatever was miraculously left and followed along.  We made camp, ate dinner and I slept. The next few days I didn't want to move.  Yet another obstacle to getting out of the hole.

The recovery process at the bottom was two-fold:  fight the anger and fear about the climb up and make my muscles work again so I could physically do it.  I spent time alone walking the river bed, spending time with God, and taking pictures of His creation around me trying to psych myself up and rest my spirit.  I went on little day hikes with my friends to stretch my muscles and make my body do something with all the lactic acid buildup - lots of stretching.  Gradually, things got better, and then the big day came.

So here I am.  I just got to the bottom of this hell-hole and I have 2.5 weeks to get ready for the climb up.  After taking 3 more finals next week, that is.  Before dental school, I'd tell people that hiking the Grand Canyon was the hardest thing I've ever done.  That is not the case anymore. 

I did get out of there alive, in case you were wondering. 

****************************************************

Fixed: 6/13 - #7 is back from the lab and my patient didn't show up, #8 is impressed and I'm going to pour it up and pindex it if I like it and #9 is mostly cut

------------------------------------------------
Progress Exam Status:

Fixed: 1 done/1 in progress/2
DONE - Perio, Operative, Oral Surgery, Endo, Removable
------------------------------------------------
D3 Finishes!

Stainless steel crown in pedo...check.
Finished with Operative!
Finished with ENDO! (2/5 to graduate, molar complete)
Finished with Perio! (2/4 to graduate, 2 tx planned)
Finished with Removable! (4/9 to graduate, 2 in progress)
Finished with Nitrous! (4/6 nitrous to graduate)
Finished with Oral Surgery Extractions! (50/100 ext to graduate)
Finished with Pre-Prosth! (4/6 preprosth cases to graduate)
Finished with DAU! (forever)
All assisting is complete!