Snowed Out and Week 4.4

I had to wait a few days to make last week seem like anything productive.  Not that this week has proved to be any better.  The snow last week put a wrench in my schedule and I'm still recovering from the set-backs.  Such is life.

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Removable: 1.5/3 to pass (4 to get an "A") - I'm delivering a denture on Thursday and a flipper on Friday = 3

Perio:  2/4 completed cases to graduate (I'm scheduled to do a Diagnostic workup progress exam on the 26th)

Endo: 0/2 (I've been assigned a case and will take impressions - since I'm going through a crown - next Tuesday)

Fixed: 3/13 - prepped #4, have some leads for a bridge

Operative: 28/50

DAU: 9/10 to graduate

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Progress Exam Status (apparently, this is the key to moving on):

Operative - 1/3 (last 2 are scheduled for this month)
Perio -0/2 (one scheduled)
Fixed 0/2 (one in progress)
Oral Surgery - DONE
Endo - DONE
Removable - DONE
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D3 Finishes!

Finished with Nitrous! (3/6 nitrous to graduate)
Finished with Oral Surgery Extractions! (44/100 ext to graduate)
Finished with Pre-Prosth! (4/6 preprosth cases to graduate)
All assisting is complete!

Christmas in February and Week 4

Last week was very uneventful.  No-showed on Monday, did my oral surgery progress exam on Tuesday, crazy patient issues on Wedensday, jaw relations on Thursday (set teeth all night long), and anterior/posterior try-in and crazy patient issues on Friday.  I finished up the denture at home over the weekend and turned it in today! 

I also made a visit to Dr. Gannaway's office due to all the crazy patient issues to ask - PLEAD - for another patient.  Since my fixed seems to be vaporizing before my eyes and I have no bridge, I'm a little panicked.  He filled me in on Friday that he earmarked a patient for me, and I got her in my box today!  Answered prayer.  She needs a bridge (!), some fillings (!), and might be type II perio (!).  That means I need to get her through consults, in and out of perio, hop on that bridge, and get those fillings done - all before April.  I hope she's good!  I'll keep plugging away as if she's not, but pray that she is : )  Early (late?) Christmas!

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Removable: 1.5/3 to pass (4 to get an "A") - turned in denture #2 to the lab today and started Nanna's flipper = 3

Perio: 2/4 diagnostic workups, 8/16 quads SCRP, 1/4 re-evals to graduate (I've arranged to share a pt to get my progress exams done)

Endo: 0/2 (I have one promised for February, but I need another!)

Fixed: 3/13

Operative: 27/50

DAU: 9/10 to graduate
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Progress Exam Status (apparently, this is the key to moving on):
Operative - 1/3 (last 2 are scheduled for this month)
Perio -0/2
Fixed 0/2 (one is scheduled for this month)
Oral Surgery - DONE
Endo - DONE
Removable - DONE
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D3 Finishes!
Finished with Nitrous!  (3/6 nitrous to graduate)
Finished with Oral Surgery Extractions! (40ish/100 ext to graduate)
Finished with Pre-Prosth!  (4/6 preprosth cases to graduate)
All assisting is complete!

Week 3

I was supposed to start a new denture today, but my patient cancelled...again.  I seated a crown last week and did 3 fillings.  Things are really slow and it's kind of depressing.  I've lost all my bridges and even the crowns are starting to look grim.  Ah, but the Lord will provide.  The Lord will provide.  The Lord will provide *it's my new mantra*...

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Removable: 1.5/3 to pass (4 to get an "A")

Perio: 2/4 diagnostic workups, 8/16 quads SCRP, 1/4 re-evals to graduate (I've arranged to share a pt to get my progress exams done)

Endo: 0/2 (I have one promised for February, but I need another!)

Fixed: 3/13

Operative: 27/50

DAU: 9/10 to graduate
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Finished with Nitrous!

Finished with Oral Surgery Extractions!

Finished with Pre-Prosth!

All assisting is complete!

2 Weeks Back

Slow week, but short week!  I have 2 more fillings and finished a perio case.  I also got my operative progress exam approved pending one filling that needs to be done next to it.  Whew!

Next week is good for fixed, as I take off a crown on one pt and do a buildup on another.  I also hope to get a crown back from the lab and get that thing seated as my pt's temporary came off and she didn't call the school over the break get another one since she lost it.  Praying that that one seats!

Removable: 1.5/3 to pass (4 to get an "A") - 1 complete denture in progress, and clearance to start another in 2 weeks!  I'll also start a flipper next week and deliver as soon as we extract - gotta bump up that "0.5".

Perio: 2/4 diagnostic workups, 8/16 quads SCRP, 1/4 re-evals to graduate (I've arranged to share a pt to get my progress exams done)

Endo: 0/2 (I have one promised for February, but I need another!)

Fixed: 2/13 and one prepped and sent to the lab - 2 buildups scheduled and 1 just waiting on me to prep!

Operative: 24/50

DAU: 9/10 to graduate

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Finished with Nitrous!

Finished with Oral Surgery Extractions!

Finished with Pre-Prosth!

All assisting is complete!

1 Week Back - Just Plugging Away

I decided to re-work my tallies here, keeping in mind that all I need to *not* worry about right now is getting through 3rd year, not graduating.  It also looks more exciting to say I'm finished with things! : )  I just need to finish something significant, even removable will do!

Removable: 1.5/3 to pass (4 to get an "A") - I started a full over full on Friday (1)
Perio: 2/4 diagnostic workups, 8/16 quads SCRP, 0/4 re-evals to graduate (I've GOT to do my PEs)
Endo: 0/2 (I have one promised for February, but I need another!)
Fixed: 2/13 and one prepped and sent to the lab - 2 buildups scheduled and 1 just waiting on me to prep!
Operative: 22/50
DAU: 9/10 to graduate
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Finished with Nitrous!
Finished with Oral Surgery Extractions!
Finished with Pre-Prosth!
All assisting is complete!

5/8 of a Dentist

I've gotten some more operative done, scaled and root planed another patient, and prepped a PFM since last entry.  I've also gotten Nanna ready to go and Tammy's still in progress.  Unfortunately, I have a re-do alveoplasty in my future and that's just hard for everyone to put off a denture even longer.  But even if I lose this patinet due to impatience, if I complete all of Nanna's treatment, I'll pass.  That's good enough for a pass/fail situation!  I have my favorite patient coming in for a progress exam the morning we come back (eek!), but I don't want to lose him, and I'll do whatever it takes to get him here and give him "free" dentistry as long as possible.  I have a perio patient who cannot do a good enough job brushing his teeth to pass re-eval, but they're going to let me do some limited fixed and operative to help facilitate healing, so that's something.  I'm handing him a new toothbrush and asking that he brush his teeth before walking into the perio clinic next time!  The good news is that every professor that I've talked to about my requirements is comfortable with where I am and not concerned about me finishing.

Finals week this past week was insane.  I have never been this tired in all of my life.  8 finals, all but one of them cumulative.  I drank way too much coffee, got way too little sleep (avg 4 hrs), and did just fine on every one of them, hallelujah. I actually saw a pt on Tuesday afternoon to prep a crown post-root canal and despite my lack of sleep, I did a pretty darn good job and got the impression I needed to send her PFM to the lab - soooo nice to not cast the crown and do all the lab work!  At least it was early in the week!  I also saw Nanna and Tammy on Friday after the last final, but a cleaning and some impressions are nothing and it's nice to have them a step further along.  The good news?  I don't have to study for any boards over Christmas this year!  3 weeks of sleeping, bumming, sewing, and skiing!

Removable: 1.5/3 to pass (4 to get an "A")
Perio: 2/4 diagnostic workups, 8/16 quads SCRP, 0/4 re-evals to graduate
Endo: 0/2 (I have one promised for January, but I need another!)
Surgery: 32/35
Pre-prosth: 4/5 to graduate
Operative: 18/50
Fixed: 2/10 and one prepped and sent to the lab
DAU: 8/10 to graduate
Nitrous: 3/6 to graduate
All assisting is complete.

Priorities when I get back:
1) Finish progress exams in operative (will be done by Feb. if all are passed)
2) Coordinate and do my endo from Tyler, find another case
3) Finish out both perio patients, get new patient for PEs
4) Finish parital cases
5) Get moving on operative and fixed (incl fixed PEs)
6) OMS PE and last few ext (will happen on rotation)
7) Last few DAU appointments (probably with Nanna)

The Week in Review

I came back from Thanksgiving break to my Progress Exam in operative (fillings) on Monday morning.  I woke up to a phone call from my mother at 6am to find that a full fuel tanker was on fire on I-30 (my route to school).  I went ahead and got ready and left by 6:10 to take the back roads to 80 to bypass the insanity.  I even had time to make coffee and grab a piece of pumpkin bread.

 

It was nice to get to school early, collect my thoughts, look at my x-rays, add in the treatment that needed to be approved, and go over strategy with some friends.  I just tried to relax during class and breathe and pray.  Between classes, my patient for that morning called to tell me he wasn't going to be able to make it - Just kidding.  I know he's a prankster, and I know that he would never cancel on me like that unless it was the end of the world, but there was still a part of me that was ready to deal with the fact that I didn't have a back-up, and that means an "F".  It was good to know he was coming and would be there early : )

 

Class was over, and I ran upstairs to get in line, get a few things I needed and check my set-up.  My "assistant", Natalee, got there and was the biggest help imaginable - she was really on top of things for me.  I brought up my patient, presented my treatment and got it approved, and we were ready to roll!  It was the tiniest cavity, but I still took an hour to prep the ideal ouline form like the good-ole days of operative lab.  I got it checked, and now it was time for the big moment - complete removal of decay and the moment when the instructor inspects it and then looks up and either says, "Ok" and you pass or "Do you see this area right here? You need to remove that decalcification" and you fail.  The moment came and went and all was good (!) and I had around 35 min to restore - good thing I'm pretty fast!  I finished in time and was even able to reseat my patient's temporary that came off while eating a Chick-fil-a brownie (we discussed how this qualified as sticky and gooey).

 

The next morning, we received our grades and I got a 3.0 and a 3.5 - not too shabby!  That's one down, and two to go for operative.  I've completed my removable  progress exams, but have not done any in the other disciplines.  Just haven't done enough yet.

 

I spent the rest of the week mostly filling teeth and catching up on all my operative.  I finished up Erik's case - for now.  I also had my meeting with my group advisor, and I'm all on track and he's happy with where I stand with my requirements.  Whew!  Thursday was our endo practical in the sim lab, and it went pretty well - especially for someone who hasn't done a root canal since last spring!  I have lots going on next week, too: a crown seating, my Nanna's consults and maybe a cleaning, a filling or two, lots of perio, and starting another crown.  All that, with 2 finals mixed in and a whole week of finals the week after that.  I'm so ready for Christmas!

• Removable (dentures I've made): 1.5/4
• Perio (crazy yucky gums/teeth I've cleaned): 1/4 to graduate (scaling pt #2 this week!)
• Endo (root canals):0/2 (I have one promised for January, but I need another!)
• Surgery (teeth I've pulled): 32/35 (I rocked and rolled with extractions this week!)
• Pre-prosth (bone I've smoothed out for dentures): 4/5 to graduate (I should have them all, but that's another story altogether...)
• Operative (fillings): 16/50
• Fixed (crowns and bridges): 1/10
• DAU (working with assistants): 6/10 to graduate
• Nitrous (laughing gas administrations): 3/6 to graduate
• All assisting is complete.

My Break Cold

My body does not deal with stress well, as far as immunity goes. So 3rd year + cold and flu season + never-ending tiredness = I'm sick. I've had that tingle in your throat thing for about a week now (please note: that's when I last saw my then sick brother). Gradually got a cough/congestion, but my friend Claritin D took care of that. But starting last night, after my beginning of break celebration of margarita night with the family, it hit. It alway does as soon as my breaks begin. Always. I think my body just gives up knowing that I'll have plenty of time to lay on the couch with a box of kleenex. Even pseudoephedrine isn't working and I'm really upset about that. I'm praying that this passes by Sunday so that I can do all the things I've planned during my 9 days of bliss before hell starts again. Yes, I said hell.

Removable (dentures I've made): 1.5/4
Perio (crazy yucky gums/teeth I've cleaned): 1/4 to graduate
Endo (root canals):0/2 (please pray for endo for me!)
Surgery (teeth I've pulled): 26/35
pre-prosth (bone I've smoothed out for dentures): 4/5 to graduate
Operative (fillings): 9/50
Fixed (crowns and bridges): 1/10
DAU (working with assistants): 5/10
Nitrous (laughing gas administrations): 3/6 to graduate
All assisting is complete.

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.