So, So Tired

I've decided to update my "stats" as the weeks past. Reminds of me of when I would post my practice DAT scores so I could watch as they improved. My first scores were really ugly. These numbers remind me a lot of my first scores. But they continue to improve.

I'm at a minor standstill with some as the holidays approach and I can't start new dentures and patients don't want to go through the holidays with temporaries. Who would? I don't blame them. So I'm just getting all my ducks in a row to wipe out 3 crowns as soon as we get back. I should start two full dentures in January. I should have my 2nd perio patient finished before Christmas, but I don't have another on board, yet. That's not good. I signed up to get some serious extractions and preprosth after Thanksgiving, and I'm thankful for the experience and credits. It includes mandibular tori removal, so that'll be neat. I sent more endo to grad last week, so it's the same story there. I did 3 fillings last week, so I really feel like I'm less afraid of the operative faculty and learning what I need to do to speed up. My progress exam is just around the corner, and after watching the results of the first one, I'm not very optimistic. It's pretty brutal.

I'm in desperate need of a Thanksgiving break as the weekends don't seem to refresh me much. My allergies are horrible and my head is fluffy and my eyes are just tired. I'm so thankful that we celebrate Thanksgiving, I just wish that maybe the pilgrims had done it in October, like the Canadians.

Removable: 1.5/4

Perio: 1/4 to graduate

Endo:0/2 (please pray for endo for me!)

Surgery: 11/35

pre-prosth: 2/2

Operative: 7/50

Fixed: 1/10

DAU: 5/10

Nitrous: 3/6 to graduate

All assisting is complete.

A message:

I take it that this means I will be moving on to 4th year by the end of the summer. ; )

Requirements are slow in coming, but once everyone is diagnosed (by Thanksgiving!), it will be all treatment, all the time. With a silly rotation thrown in here and there.

Just for the record:

Removable: 1.5/4 (with one pt healing, and one set for ext before Thanksgiving)
Perio: 1/3 (start #2 on Tuesday)
Endo:0/2 (please pray for endo for me!)
Surgery: 10/35, 2/2 pre-prosth
Operative: 4/50 (yikes! I'll be at 10 by Thanksgiving. I hope to be around 20 by the end of the semester - 4 weeksish)
Fixed: 1/10 (with one prepped and waiting to seat right now - I should have 3 maybe 4 by semester)
DAU: 4/10 (+1 after tomorrow)
Nitrous: 3/6 to graduate
All assisting is complete.

It'll be crazy this Spring!!

The Moments

The moments that make all this horrible, horrible stuff I have to put up with and endure worth it all are the moments when I can do something for someone that makes their life better. Generally, this means completing a treatment and lately, that's been pretty slow in coming.

Today, I got to do it for a little girl who had a cavity on the front of her canine. You could obviously see it when she smiled. Jennifer and I had to privilege of restoring that today and it was absolutely the coolest thing to send her off with a smile of pretty, healthy teeth.

Here's the story: Big pharm test = very little sleep. I've made a pact with myself that I will not perform irreversible treatments when on very little sleep. You're welcome. I'm still a newbie and my patients appreciate this rule whether they know about it or not. When on pedo rotation, however, you don't get to make those calls. After the insanity of our 7:30 am test and a 30 min nap in the library, Jennifer told me I was listed as the operator for a composite on a canine for a little girl. Great. An entire hour to sit in class prepare for this in my head. So I sat down in my seat for our operative class and we covered esthetic facial composites. Great. Whatever.

I raced to the clinic after class and pulled up her chart and we started to get ready. And the patient needed...an esthetic facial composite. See how God takes care of me? : ) This happened the entire course of my first denture and the day I cut my first crown. I don't deserve it.

We didn't even have to numb her up - bonus! I even scraped most of the decay out with a spoon. Mr. Bumpy did make an appearance, but she didn't mind at all. The pedo dispensary probably thought we were crazy asking for a shade guide and two different shades of composite, but we wanted it to look right. Even if it's a primary tooth and will fall out in a few years.

Let's just say that it's always a relief to find that God really has gifted me with the random talents a dentist needs to be successful as I seem to have a decent eye for shades and matching composite (remember the star I got from Dr. Miller?). It's so super easy to feel inadequate and untalented in dental school. The truth of the matter is that I am inadequate and can only do any of this by the grace of and with the help of God. He gives me what I need when I need it. Manna. So when the resident couldn't find where I'd placed the restoration because it blended so well (we switched docs in the middle and he didn't see the prep), it left me on cloud 9 for the rest of the day. These moments are few and far between. And I'm super thankful.

An Update

This post is dedicated to Megan Miller: I know you're reading ; )

I've been in the pediatric clinic all week. My patients are patiently waiting for their next appointments while I'm placing sealants, twiddling my thumbs, holding hands, drying tears, and handing out Sponge Bob stickers to the kids at BCD.

What I've learned so far:

1) I find that I do really well when I'm the one in charge. Whether it's a kid or an adult, if I'm the one that greets the patient, takes the history, and initiates the relationship, I feel better about being the one providing treatment. If someone else does all that and then we do the ol' switcheroo, it's just not the same. There's just something about being idenitified as the "doc".

2) You should not schedule your patients to come back for treatment that has already been performed. That's how I lost the chance at some more sealants today. The sealants were already there. What can you do? Nothing. That's what.

3) 2.5 hours going over a case you've already studied makes for a long afternoon.

4) Don't tell a kid that you're going to give them a "mosquito bite". NOBODY likes mosquito bites. Kids aren't stupid. There's no way you're going to get them numb that way. Also, don't try to trick a kid. There's no regaining their trust.

5) Maybe it's not such a good idea to have an open pediatrics clinic. One crying kid 2 feet away from another crying kid makes for a lot of fun!

6) Kids on nitrous are hilarious! Couple that with a half-numb face and you've got some seriously funny antics.

7) Parents out there - be careful about how you talk to your kids about the dentist. Please. I know I'm the childless one saying this, but there's really a lot to be said about how kids are taught to be afraid of the dentist. I heard a parent today tell a kid that couldn't complete treatment even after getting an injection, "You'll just have to get another shot." Yeah, that kid's going to be a bundle of fun the next time he comes back.

Ok, enough of that. I really do like the kids. I absolutely will see kids in my office when I'm out. Absolutely. When I'm not pregnant the nitrous will flow! I'll be blowing bubbles, painting teeth, putting raincoats and rings in their mouths, and using that tooth tickler like there's no tomorrow. Sleepy juice, tooth pillows and super soakers will help get the job done, and my background in psychology will be implemented for both the freaked-out parents and the little ones.

Hmmm...

I know it's been a while since an update on anything...crafty or dental. I'm just so busy all the time and absolutely exhausted when I get home that nothing gets done and I have no desire to even type about what I did. I blow it off as "nobody cares" - not in a depressive, unhopeful way - but it's just not anything that I'm that excited about, so why take the time to do it? Throw in studying for classes like pharmacology, and I'm done. There's nothing left. I have a finished quilt that I have yet to take a picture of and post about on my quilt blog. If you know me at all, that says a lot about how busy I am!

I love having patients! I love talking and getting to know them and developing relationships with them. I like fixing things for them. Filling a cavity, helping them make their smile pretty, or giving them a whole new smile and a way to eat. God has blessed me with amazing patients. I'm so thankful for that. A new Christian, a quilter and her husband, the sweetest old lady ever who's lived a trial-filled life and is still so joyful, an old friend, a young nanny, a really nice lady I met on the sidewalk outside the school, one of 3 sisters who have matching handbags and come to the school every Tuesday (so cute!), and a sweet old lady who just wants to be able to smile again.

I don't like the hoops, I don't' like the missed lunches, I don't like the rat race - I try to buck that all the time. Classmates will race through a diagnosis appointment and then race around all morning trying to finish all their consults. - in 2 hours or so. I don't want to push the limit and I sure don't want my patients to feel like I'm rushing through things and then dragging them around the school. I did that to one of my patients - once - and I'm so thankful he's still coming to see me. I felt horrible for doing that to him. That first appointment is when I start developing a relationship with them and I want them to know I'm listening, that I'm thorough, and that I have their best interests in mind. Not that I'm only interested in getting through the process as fast as possible. Even if that means they have to come back for an extra consults appointment. Maybe I'll regret this philosophy when I feel behind, but I doubt it. I'm aiming for patients that trust me, and will therefore come to their appointments on time and finish out their treatment. That's my goal.

I'm just plugging away. Working on the patients that I can, and trying to get everyone else to that point. If you have any interest in coming to see me, I'm game if you are! You won't be a "guinea pig" at this point - my firsts are all over - except the ever-elusive root canal that I have yet to see come my way...

Seen This?

Now watch this:

Yeah, I'm back in school, and kinda feel bad for not documenting it. It's pretty *blah* since there's nothing new and exciting seeing that we've done this for 6 weeks now. Doesn't help that I have zero patients this week. But I'm being somewhat productive, I'm enjoying the chance to get all my ducks in a row before I get busy, and I'm so glad I'm not waiting 45 mins in line for instruments now that they've changed up the system. Maybe by next week they'll have it figured out???? That'd be great!

Winding Down Summer Clinic

This past week and a half was quite eventful! I delivered and closed out my denture case (whoop!) (and he really likes them - they fit great!) and I waxed, casted, and cemented my first crown yesterday (what a relief and answer to prayer!). I feel like I haven't done half as much as most people have in summer clinic, but the two things I started and finished were actually pretty big deals. The minutia of fillings and pulling teeth will come - my patients need plenty of that. But to actually finish out and send my patients on their way with new prostheses is a really good feeling and I'm glad I got to go through the process from start to finish during these weeks. My denture patient doesn't really need any more treatment unless he needs adjustments, so we had a "good-bye" moment which was strange after working with him since April? May? My crown patient is a really cool guy who recently met the Lord and I'm so excited that he's excited about growing in the Lord (and coming back to get the rest of his teeth fixed!) What great patients! I have 3 ladies waiting in the wings and we will get all of their treatment started when I get back...I really like them all and so far they seem happy with the way things are going. I see my cousin tomorrow to get her started in diagnosis, so now I get the experience of treating friends and family which can be an entirely different experience, although it's one you have to get used to.

So 2 more patients this week and I'm done! I really had to get used to the idea of "real world" dentistry and not the world of perfection they beat into our skulls during 2 years of lab work. Apparently there is something called "good enough" otherwise known as "clinically acceptable" - a line which I never understood because most of us were trying to be really good at what we were doing in lab. You know, to get good grades. So now, even though I think a margin on a gold crown kinda sucks and would never want to turn something like that into Dr. Miller, in the real world, it's clinically acceptable and we're cementing it on! Allrighty then. Of course my skills will improve over the years and I can move beyond clinically acceptable, but for now it kinda freaks me out. And that's a good thing.

I Did It.

I cut on a tooth. The assistant handed me the high speed handpiece with a 169L bur and I cut into a maxillary 2nd molar (#2 to be exact). The total crown prep took around 1.5 hr with packing cord and trying to smooth the insanely deep distal margin that I'm still not sure is good enough. The rest of the 3 hr appt was vitals, injections, making the provisional and 2 impressions, and getting approval and advice from my professor.

Thank God for a great (patient) patient! I'll find out how well it really went Monday when I pull the casts from the 2 impressions we took. And I'm anxious to call my patient on Monday to see if his temporary stayed on over the weekend. I got a "well done" and a "pretty good job" from my prof. Not bad, I guess.

Everything else, I'd done before: injections, impressions, even making temporaries. I didn't think there would be any decay since he'd already had a root canal, post and build up, so it was a bit of a surprise when I broke mesial contact and found some soft, tan, diseased dentin. But I got it all out and got it covered well, so we should be good until I can wax up and cast his gold crown. My patient and I are hoping the next time I see him is to put the crown on, and that I won't have to bring him back to smooth out that margin. But I know I'm learning and certainly can't expect my first live crown prep on an insanely-hard-almost- deemed-non-restorable tooth to be perfect the first time around. I do kinda wish my prof would have "fixed" anything questionable for me so my pt wouldn't have to come back...they do that all the time. Que sera. I've jumped off the cliff and I'm no longer a restoration virgin. Well, at least I'm half way there. Gotta cast a crown.

Summer Clinic - Week 2

Procedures accomplished:

• preliminary denture impressions
• made custom trays for final impressions
• prophy
• impressions for diagnostic casts
• MOD onlay and DO inlay preps for typodont exams

It's nothing glamorous, like the occlusal preps a few people got to do, or even scaling and root planing, but it's progress. Those diagnostic casts mean I'm one step closer to prepping a crown - craziness for a first go round, but that's how it works around here.

Up for next week:

• final denture impressions
• record bases and wax rims for dentures
• custom trays, templates, mounting of diagnostic casts for crown prep consult
• cast MOD only and DO inlays by Thursday

Let's just say I need to get used to short lunches and staying late to do lab work....

Summer Clinic Week 1

All I can say is that so far, this is not at all what I expected.

Monday, we got our ginormous "comp care" binders which have this huge threat? warning? whatever it is, it's telling me that I better figure out what's going on and fast! And then, in true BCD fashion, the page quickly tells me that all of this could change in a second so everything I learned before will then be useless. Classic. The problem was that I didn't get much of a chance to sit down with this book all week. And come Friday, I wished I had. That whole "knowledge of the contents" part, you know.

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So much sitting and listening, just like D1 orientation. But this time, we get the clinic directors rotating in and out telling us how things run in their clinic. Of course, we get information that contradicts what we've been told before, and most of the time, people can't answer our questions. I spent Mon-Thrusday without patients, so I used my time to consult with professors about my denture patient, plan out his care, and study up on the xrays for my patient on Friday. I also had time to clean out my locker and get all my instruments sterilized for the upcoming rush.

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Wednesday, I was in class until 10am and then spent the day at lunch and then shopping with mom. That's my idea of summer school.

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Thursday we placed rubber dam on each other, and all I can say is I hope to never have to enjoy that experience again. It's just that I'm a mouth breather (which is a bad thing) and it kinda made me panic a bit.

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Friday was slow in the morning, but once 1:30 rolled around, I was sprinting until 5pm. My poor patient. He told me he wanted to finish the consults since he lives an hour away, but I don't think he (or I) knew what all that would entail and we were both exhausted when all was said and done. Oral diagnosis was great. It took an hour, and I actually did a pretty good job diagnosing all the cavities and my patient is great.

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Now, up to the 3rd floor for consults. Thank God Stephen was up there and free to help me get set up and on the right track (this would be the point at which knowing that entire binder would have helped).

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Operative consult, check. Preventive consult, check. And then they decided to take intraoral photos which was a bit of a circus, but that's ok. Fixed consult, here we go. This turned into an endo consult and then back to preventive and then we're throwing in nightguards and fluoride scripts and on and on. Once we finally got that all into Axium (grrr...) I had to go back to the operative consult to enter in the treatment because that professor was not helpful enough to guide me through the process (for my first time) and ask to sign off on my treatment plan. So, I finally got it all in the silly computer and got the script signed (to which the professor said, "Your patient is still here?) and we could finally go home (well, I could after I raced downstairs to clean up my chair, then back upstairs to clean up that chair).

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Did I mention that I had a runny/stuffy nose all day? By the time I got to Mom and Dad's to meet up for margarita night, I was officially working on being sick and now I've been on the couch all weekend. Gotta get better to see a patient on Monday!

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Please, Lord, let him come back and get treatment from me! I sure hope I didn't scare him away with our marathon appointment! Lesson learned: 2-3 appointments are the absolute limit with 2 being a much better option!

Going Back Tomorrow

It was a short two weeks. 6 weeks of school and then 4 more weeks off. Let the countdown begin!

First of all, I need to write down a few things I've been pondering so hopefully, I'll keep pondering them enough to maybe actually do something about them.

1) Been thinking about my lack of community. We really just observe at church, observe in our neighborhood and in this town. I go to school in Dallas and Erik works in Duncanville, and we just sleep here in Rockwall and go to a church service on Sunday. Last night, I thought about Zaccheus and how he tried to get away with just observing Jesus and what he was doing. He got called down out that tree super fast. Observing is not acceptable. Then Jesus went to his house with no notice - today. No time to run to the market or cook a lamb or sweep the floor - just straight up said "you don't get to just watch, in fact I'm going to be a part of what your life is really like - you don't get a chance to put on a show." Just some thinking.

2) Been thinking about my selfishness. Seriously, when I was in high school and college, I can't even name all the community service what-not I was involved in. I am so careful with my time now and so jealous of it. My time is so precious to me...but it's not mine and I tend to forget things like that. Guess that goes back to community...I'm not even very quick to give up time just to hang out with people. What is wrong with me and my reclusiveness? So not what Christianity is about.

3) Been thinking about what takes up my time. I had a bit of a FB hiatus that kicked off this thinking. It was great. I've totally revamped how I do FB and I'm still thinking about why I do it and what benefit it is. I've found that there are a good number of things that just kinda popped up in my life that are perfectly harmless, but take up my time and I never really thought through what "good" is in them. You know that passage of "whatever is good, whatever is noble...think about these things"? I found some of these time consumers (esp FB) creating issues in my life that weren't "good" for me. And none of the other things in that passage either. And even if chatting with friends seems harmless, a lot of it is mindless and useless and what place does that have in my life? I wondered, when did I just start doing things because it's something to do? When did I stop thinking about whether or not it was a "good" thing for me to do? It sure is cool though. At least I thought it was. There is so much good in simplicity. In making sure the important things are taken care of before spending 30 minutes on FB. Like studying. Or doing laundry. Or cooking a healthy dinner. Or working out. Or spending time with God. Or time with my husband. Or, heaven forbid, a new friend. 30 min in real life with a real person (possibly with coffee involved!) vs. 30 min on FB with random tidbits and maybe an encouraging word somewhere out there for good measure. Poor FB. It's not just that, there's a list of things I'm thinking about (including quilting...). I'm just glad I started thinking again.