So, yesterday Prof Costley came in and said that there was a lady that was worked on, but the senior working on her wasn't able to finish. I was told that everything was done outside of 3 quads of scaling. Well, when I arrived today the story changed a little. There was really nothing done but her probe depths. It took quite a while to figure out what was going on because I was getting conflicting stories. She was also 100% Spanish speaking. So I had to do and OD and try to scale 4 quads of a 2 in order for her to be ready for her DMD appt on May 3. When I finally got to the cleaning I started to discover many areas where there were tooth anomalies. I also was able to learn some new angles of scaling because of the way her teeth were. She had two retained root tips and missing #8,9. I got very creative today with my fulcrums. I did finish though, and it was a great experience!!!!
It was a good last day!
Wednesday, April 22, 2009
Wednesday, April 15, 2009
The end of a 3
What a day!!!! I can say that I have never quite had an experience like I did today. I always go into things with great optimism and then my hope are crushed as I start working and realize that my goals are not going to be so easily obtained. That is definately the scenario in which I found myself today.
I came in this morning booked for the entire day, but that quickly became a nonreality when my first patient no showed. I called her at least a dozen times and was not able to talk to her and never heard back. I guess she really wasn't that interested in coming in to get a cleaning even though she made it seem like a dier emergency that she get in as soon as possible.
Then about 1 1/2 hours before clinic my class 3 called to cancel. She told me that her children were sick. At that point I was very torn. I know how it is to have sick kids. It is horrible because they are miserable. On the other hand, I really was needing to finish her 3 quads today because Hailey asked me if she could have my chair on Monday. Her class 3 was coming in and it was the only time she had to see him. I told her that I would try my very best to get done so she could have my chair. Like I said, I was torn... I did make the decision though to press the issue with my class 3. I told her that my grade and me passing the semester depended on her coming in. I asked if there was anyone who could watch her children for her while she came in. She said that she would call her brother and then call me back. An hour later I still had not heard from her, so I called and she said that she was on her way.
When she arrived the fun really started... She was very high maintenance to say the least, and her calculus was really tenacious. She had a harder time getting numb, and then when I started scaling I had a hard time even seeing, let alone to position myself to be able to remove the calculus. My patient was a larger woman and my chair would not go down as far as I needed it to. I was straining with my shoulder and my wrist to be able to get to the areas that I needed to work on. I asked Prof Costley to come over and help me, and it was a good decision. After she left I felt much better about how I was working. When I finished my first quad (UL) that is when the fun really started. I knew that I was going to need some extra time so I asked Prof Costley for a time extention. I explained the situation about Hailey and why I wanted to finish today and she agreed to let me have some time. There was an hour left, but I knew that it would take longer than that because I was having to stop every so many minutes to let her rest and and rinse her mouth. She insisted on watching me clean but the blood was making her sick. I had to stop and rinse her after about every other tooth. She also said that she was still feeling a lot of the cleaning even though we numbed her. It made it difficult for me to use the ultrasonic because every time I went subgingival she said that it was hurting too much to keep going. I was able to use the instrument for the supragingival calculus but then had to go back with my hand scalers for all of the subgingival calculus. I was pulling off huge chunks of black calculus with every tooth. I definately got my workout. By the time I got to the last quad I was very tiered. Prof. Costley really numbed her for this last quad and she couldn't feel a thing but she also kept choking on the water from the ultrasonic. I worked as fast as I could and still be thorough with my cleaning. We finially finished after she almost threw-up on me because of the prophy paste, and walked her out at 4:00 pm. I was only 45 minutes late, scaled for 87 minutes, and missed 9 spots of calculus. To say the least, I was not feeling that great about myself when I was done.
It was a hard day, but I learned a lot and was greatful for all of the experience that I had today. It was no where near any other day that I have had in clinic.
I came in this morning booked for the entire day, but that quickly became a nonreality when my first patient no showed. I called her at least a dozen times and was not able to talk to her and never heard back. I guess she really wasn't that interested in coming in to get a cleaning even though she made it seem like a dier emergency that she get in as soon as possible.
Then about 1 1/2 hours before clinic my class 3 called to cancel. She told me that her children were sick. At that point I was very torn. I know how it is to have sick kids. It is horrible because they are miserable. On the other hand, I really was needing to finish her 3 quads today because Hailey asked me if she could have my chair on Monday. Her class 3 was coming in and it was the only time she had to see him. I told her that I would try my very best to get done so she could have my chair. Like I said, I was torn... I did make the decision though to press the issue with my class 3. I told her that my grade and me passing the semester depended on her coming in. I asked if there was anyone who could watch her children for her while she came in. She said that she would call her brother and then call me back. An hour later I still had not heard from her, so I called and she said that she was on her way.
When she arrived the fun really started... She was very high maintenance to say the least, and her calculus was really tenacious. She had a harder time getting numb, and then when I started scaling I had a hard time even seeing, let alone to position myself to be able to remove the calculus. My patient was a larger woman and my chair would not go down as far as I needed it to. I was straining with my shoulder and my wrist to be able to get to the areas that I needed to work on. I asked Prof Costley to come over and help me, and it was a good decision. After she left I felt much better about how I was working. When I finished my first quad (UL) that is when the fun really started. I knew that I was going to need some extra time so I asked Prof Costley for a time extention. I explained the situation about Hailey and why I wanted to finish today and she agreed to let me have some time. There was an hour left, but I knew that it would take longer than that because I was having to stop every so many minutes to let her rest and and rinse her mouth. She insisted on watching me clean but the blood was making her sick. I had to stop and rinse her after about every other tooth. She also said that she was still feeling a lot of the cleaning even though we numbed her. It made it difficult for me to use the ultrasonic because every time I went subgingival she said that it was hurting too much to keep going. I was able to use the instrument for the supragingival calculus but then had to go back with my hand scalers for all of the subgingival calculus. I was pulling off huge chunks of black calculus with every tooth. I definately got my workout. By the time I got to the last quad I was very tiered. Prof. Costley really numbed her for this last quad and she couldn't feel a thing but she also kept choking on the water from the ultrasonic. I worked as fast as I could and still be thorough with my cleaning. We finially finished after she almost threw-up on me because of the prophy paste, and walked her out at 4:00 pm. I was only 45 minutes late, scaled for 87 minutes, and missed 9 spots of calculus. To say the least, I was not feeling that great about myself when I was done.
It was a hard day, but I learned a lot and was greatful for all of the experience that I had today. It was no where near any other day that I have had in clinic.
Monday, April 6, 2009
Class 3
So today was my big day. My first experience with a class 3, and I must say... I now understand why it might take 4 actual appointments to clean one mouth. When I first heard that 4 appointment might be needed I didn't think that it was possible. Well, I learn something new everyday. It took me over 30 minutes to clean one quad and I still don't feel 100% confident about what I did today. The patient was even numb and it didn't quite go the way that I was expecting it to. I thought I could just get in there and work with no problems, but my patient was definately telling me otherwise. She said that she could still feel things and I am not sure if that is true or if it was just the pressure that was bothering her, but I can say that it was a high maintenance appointment. I was only able to get one quad done and I really wanted to be able to get to half of the mouth, but there is always Wednesday, right?
I did finish my last PE today, though, and it feels great to have all of those out of the way!
I do hope that I will be able to work well on Wednesday, so that she doesn't have to come back, but there is only so much that I can do.
I did finish my last PE today, though, and it feels great to have all of those out of the way!
I do hope that I will be able to work well on Wednesday, so that she doesn't have to come back, but there is only so much that I can do.
Score: Kara 0, Calculus 1
My patient on Wednesday taught me a couple of things about humility. She was just a class two which I have now done multiple times here in the clinic. They have all gone well for the most part. I decided that I didn't want to use the ultrasonic because I wanted to really be able to feel the calculus and see if I could get it off myself. I have now decided that the ultrasonic is a magic tool and I don't know if I would ever try to clean another 2 like that one without it. There was subgingival, interproximal, radiographic calculus everywhere. I don't know if I have ever had such a hard time in someone's mouth before. I had to ask Prof. Costley to come over and help me with the mesial of #3 because there was piece of calculus that I was working on for a good 10 minutes, used every instrument on my try, and still couldn't get it. When Prof. Costley came over she really started to work. I don't think that I have ever seen lateral pressure used like that before. Next thing I know out comes the overhang on the filling in that tooth as well as the calculus. Will I have get to that point? After watching her work, I am not sure if I will ever be able to do that. It was a good experience for me and I was greatful that I had it. I will say, however, that I didn't win that battle.
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