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!
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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!

Yeah, I like pedo, but not enough to stay in school any longer...yeesh.

Spent the last week in the pediatric clinic.  This time around, on 3 of the afternoons, a group of us were scheduled to work at 2 community dental clinics.  It was nice to have a little field trip with some fun buddies and make some new friends, too.  Highlights of the week?  Another filling on another permanent tooth, a nitrous assist, a lap exam for a 6.5 mo old precious little girl, and a stainless steel crown.  We have to do one in pedo to graduate, so this is a nice thing to have on my progress sheet : )  I had all the good kids this week, too ; )

Back in 3rd year land, I managed to finally get my molar endo swiped, get two crowns waxed and one ready to cast, and rearrange my last Friday so I can seat a PE and take impressions on another patient so the crown can be made while we're on break.  Whew!

Next week is it. It will be insane.  I'll see you on the other side : )


Fixed: 4/13 - #5 mostly waxed, #6 is sent to the lab, #7 ready to cast, #8 cut and scheduled to impress and #9 mostly cut

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

Fixed: 2 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, 1 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! (46/100 ext to graduate)
Finished with Pre-Prosth! (4/6 preprosth cases to graduate)
Finished with DAU! (forever)
All assisting is complete!

Pretty Much Done

My last full week of clinic was exhausting but I got a lot done.  I also had 2 cancellations, but I used my time to work on those gold crowns and get my fixed case presentations done so I can push forward as much as possible so that hopefully, they'll let me slide on by with what I have.  If not, I'll spend some time during the summer as a 3rd year in fixed, but that's ok.  It's not like I haven't tried or am not capable.  My goal was to avoid remediating operative at all costs, and that I have done.  My progress exams have graded preps and at least one of them will be seated if not both.  I'd love to seat the other gold crown, but it all comes down to time.  I have some moving around I can do, so we'll see.  I'll finish up two rotations, a filling, a crown seating or two, maybe some work on Nanna, and something like 5 finals, and I'm done.  After not much of a break, I'll come back for what will most likely be my last year of dental school.  Hasn't it taken forever to get here?

Fixed: 4/13 - #5 mostly waxed, #6 is sent to the lab, #7 poured, #8 cut and not impressed and #9 mostly cut

------------------------------------------------

Progress Exam Status:

Fixed: 2 in progress/2

DONE - Perio, Operative, Oral Surgery, Endo, Removable

------------------------------------------------
D3 Finishes!

Finished with Operative!
Finished with ENDO! (2/5 to graduate, molar complete)
Finished with Perio! (2/4 to graduate, 1 tx planned)
Finished with Removable! (4/9 to graduate, 2 in progress)
Finished with Nitrous! (3/6 nitrous to graduate)
Finished with Oral Surgery Extractions! (46/100 ext to graduate)
Finished with Pre-Prosth! (4/6 preprosth cases to graduate) (2 more planned 4/28)
Finished with DAU! (forever)
All assisting is complete!

This Week is Basically Over

Instead of prepping two crowns tomorrow, I'm doing a prophy.  This, my friends, is how dental school works. 6.5 days of clinic left.
*************************************
Rotations left: Pedo, OMS emergency

Fixed: 4/13 - #5 finished next Monday and I'll wax it up and cast and #6 is sent to the lab, #7 cut on Tuesday, #8 and 9 on Thursday
Operative: 46/50 (9/13 class IIs) - last 4 class IIs on the schedule plus a buildup
------------------------------------------------
Progress Exam Status:

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

Finished with ENDO! (2/5 to graduate, molar complete)
Finished with Perio! (2/4 to graduate, 1 tx planned)
Finished with Removable! (4/9 to graduate, 2 in progress)
Finished with Nitrous! (3/6 nitrous to graduate)
Finished with Oral Surgery Extractions! (46/100 ext to graduate)
Finished with Pre-Prosth! (4/6 preprosth cases to graduate) (2 more planned 4/28)
Finished with DAU! (forever)
All assisting is complete!

I Mean, This Was a Big Day

Rotations left: Pedo, OMS emergency

Fixed: 3/13 - #4 will be seated on Thursday,#7&8 will be cut on Friday, #5 finished next Monday and #6 is sent to the lab

Operative: 45/50 (8/13 class IIs) - last 5 class IIs on the schedule plus a buildup
------------------------------------------------
Progress Exam Status:

Fixed: 2 in progress/2
DONE - Perio, Operative, Oral Surgery, Endo, Removable
------------------------------------------------

D3 Finishes!

Finished with ENDO! (2/5 to graduate, molar complete)
Finished with DAU! (forever)
Finished with Perio! (2/4 to graduate, 1 tx planned)
Finished with Removable! (4/9 to graduate, 2 in progress)
Finished with Nitrous! (3/6 nitrous to graduate)

Finished with Oral Surgery Extractions! (46/100 ext to graduate)

Finished with Pre-Prosth! (4/6 preprosth cases to graduate) (2 more planned 4/28)
All assisting is complete!

Schedule for the Rest of the Year (Apparently)

I went to school this morning and was surprised to find that all but one of my appointments for the rest of the year are booked.  So here's what I have left to do to finish up.  If all goes according to plan (hehe) I'll be finished with everything but fixed and will have 11/13 crowns cut, 6 seated.

4/20 Tuesday: 10am: endo/non-vital buildup
                       1:30 pm: oral diagnosis/consults
Wednesday: 1pm prophy
                    4pm denture adjustment
Thursday: 10am class II filling
                1pm seat crown
Friday: 10am crown preps 8 and 9
            1pm ???
-----------------------------------------------------------------
4/26 Monday: 10am crown prep #28
                       1pm class II filling
Tuesday: 10am oral diagnosis/consults
               1pm crown prep #4
Wednesday: 1pm full mouth extractions/alveoloplasty
Thursday: 10am crown prep #19
                1pm non-vital buildup and crown prep #14
Friday: 10am class II filling
            1pm class II filling
--------------------------------------------------------------------
5/3 Monday: 1pm class II filling
Pedo rotation
-------------------------------------------------------------------
5/10 Oral Surgery Rotation
Friday: 10 am rest preps and impression for partial
            1pm seat crown

*********************************************************
Rotations left: Pedo, OMS emergency

Endo: 1/2 - I will finish TOMORROW!
Fixed: 3/13 - #4 will be seated on Thursday,#7&8 will be cut on Friday, #5 finished next Monday and #6 is sent to the lab
Operative: 44/50 (8/13 class IIs) - last 5 class IIs on the schedule plus two buildups
------------------------------------------------
Progress Exam Status:

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

Finished with DAU!
Finished with Perio! (2/4 to graduate, 1 tx planned)
Finished with Removable! (4/9 to graduate, 2 in progress)
Finished with Nitrous! (3/6 nitrous to graduate)
Finished with Oral Surgery Extractions! (46/100 ext to graduate)
Finished with Pre-Prosth! (4/6 preprosth cases to graduate) (2 more planned 4/28)
All assisting is complete!

Oral Diagnosis: Wannagetfinisheditis

I have a gloriously long weekend as the 4th years have WREB, the licensing exam, Fri-Mon.  Yeah, get ready to get an earful about that this time next year.  Speaking of exams, I did go ahead and buy a study book for National Boards Part II.  I will not ruin another Christmas studying for that exam.  You heard it here.  I'd rather ruin summer.

On to the numbers:

Of course, none of these numbers changed after my week on oral diagnosis rotation, but my schedule has been beefed up to finish out those class IIs and get crowns in to the lab.  I've done a lot of patient trading for my own needs as well as others' and it's paid off so far.  Two of my last five class IIs are Rudy's pt that I've shared before and Ben's wife.  Those are definitely reliable.  The last 3 are, too, but a different level of reliable : )  I'll get 'em done.

Crowns, well, I'll get done what I get done.  6 cut isn't too bad, and I have 3 more on the schedule = 9.  There are 2 more I've requested appointments for = 11.  That's close to 13.

I'm running out of open chairs in the clinic for the few things I have left, so I'm trying to get everything booked NOW.  I already lost out on next Friday, so unless I stay on top of things I may be finishing out my nitrous or maybe some pre-prosth/extractions - then I can start a "D4 Finishes" list. : )
___________________________________________________

Rotations left: Pedo (May), OMS emergency (May)

Endo: 1/2 - I will finish on Tuesday
Fixed: 3/13 - #4 will be seated on Thursday (#7&8 postponed), #5 mostly cut and #6 sent to the lab
Operative: 44/50 (8/13 class IIs) - last 5 class IIs on the schedule plus a buildup
------------------------------------------------
Progress Exam Status:

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

Finished with DAU!
Finished with Perio! (2/4 to graduate, 1 tx planned)
Finished with Removable! (4/9 to graduate, 2 in progress)
Finished with Nitrous! (3/6 nitrous to graduate)
Finished with Oral Surgery Extractions! (46/100 ext to graduate)
Finished with Pre-Prosth! (4/6 preprosth cases to graduate) (2 more planned 4/28)
All assisting is complete!