Thurs., April 24
My board pt came in at 8 so I could do film BWs to match his film fullmouth series. I ended up doing 2 more PAs per an instructor's recommedation, and they were an improvement.
My next pt was a "regular" perio maint. man who wanted to have one more cleaning before the summer months. He did have about 3 pockets of 6-8mm, so we checked those. There was some improvement in pocket reduction from the previously-administered Arestin and lots of tissue improvement due to his home care. During tx we used nitrous and air powder polish, and then I placed Arestin in the 3 deepest pockets. It was a very good experience.
My PM pt had cancelled earlier in the day, so I decided to go on down to the Women's Health Day at the Adams Midtown in the afternoon. It was super busy, and we saw everything from healthy with no problems to severe gingivitis with life-long calculus. Most of the pts spoke little or no English, so we had a crew of interpreters on hand. I think we came up with a number of potential back-up board pts., so we will know more during Tue. PM screening.
Then, I bounced back to clinic for the final Pod Wrap, and ended the day by preparing a Board Cassette. Hone, hone, hone. . . .
Friday, April 25, 2008
Sunday, April 20, 2008
Wed., April 16 and Thurs., April 17
Wow! It's the last VA Day! Hey hey hey! Had a very interesting pt all day. There was a cancellation in the PM, so as I hadn't finished him in the AM, he came in the PM also. He went about in a wheelchair due to leg problems, and he preferred to travel backwards. He hadn't eaten or taken his diabetes med. that day, and he said he hadn't slept in about 4 days due to his meds and sleep problems. Brother! He'd driven in from Logan, so before he left Diane and I made sure he had some food and drink. He said his doc is trying to get his diabetes under control, but his blood sugar often is very high. He also had a dx for major depression, so according to him "depression has taken over my life."
By the PM, he was talking with enthusiasm about his great love, scuba diving. He required LA AM and PM, and had 2 quads of a II and 2 of a III. He seemed receptive to OHI, and I hope he follows through.
My WSU AM pt was my "perio project" pt. I'd last seen her in Nov. Ah, what a difference for me (and hopefully for her!). She is a class III, 82 years young, and always looks elegant when she comes in. Her pockets showed no worsening though there were more suspicious areas and despite her report of TBing and flossing there was more plaque than I'd like to see. So, gave her some OHI customized for her situation, and I hope it helps. It's tough to get old.
My PM pt was a class V and had had a cleaning at her DDS in Dec. That, added to her home care, obviously had made a big difference, showing in reduction of pocket depths and almost no bleeding. Due to her medical issues, she is trying to stay on a regimen of cleanings every 3 months. She really likes WSU clinic, not only because of the price but because of the professionalism of the students.
By the PM, he was talking with enthusiasm about his great love, scuba diving. He required LA AM and PM, and had 2 quads of a II and 2 of a III. He seemed receptive to OHI, and I hope he follows through.
My WSU AM pt was my "perio project" pt. I'd last seen her in Nov. Ah, what a difference for me (and hopefully for her!). She is a class III, 82 years young, and always looks elegant when she comes in. Her pockets showed no worsening though there were more suspicious areas and despite her report of TBing and flossing there was more plaque than I'd like to see. So, gave her some OHI customized for her situation, and I hope it helps. It's tough to get old.
My PM pt was a class V and had had a cleaning at her DDS in Dec. That, added to her home care, obviously had made a big difference, showing in reduction of pocket depths and almost no bleeding. Due to her medical issues, she is trying to stay on a regimen of cleanings every 3 months. She really likes WSU clinic, not only because of the price but because of the professionalism of the students.
Wed., April 9, and Thurs., April 10
AM at the VA! And Spring is in the air! My AM pt was a very interesting character as well as a class III who needed LA. He also had two areas in his mouth he needed PAs on, and as I needed 2 more PAs, I said thank you to the Powers that Be. It turned out that one of the areas (#13) was sensitive due to root exposure and the other area (#30)was OK, according to the DDS who did the exam. My PM pt was a class V, a very nice, gentlemanly man.
Back at WSU, it was the dreaded last Mockboard!
My great pt was early, as usual, and I went in the AM, which was the first time this semester. I cleaned his LL quad using ultrasonic and hand instruments. I missed 3 little areas, but passed with an 82. WHEW! And now, I know I must get into those ant. interproximal areas with more authority than previously. My pt didn't need LA, and I know I am concerned about tissue trauma. But,I also know that it's most important to remove those deposits! And, when in doubt about recession, if you can't decide between a 0 and a 1, put a 0!
In the PM I got to watch everyone else sweat, all while helping out, of course.
Back at WSU, it was the dreaded last Mockboard!
My great pt was early, as usual, and I went in the AM, which was the first time this semester. I cleaned his LL quad using ultrasonic and hand instruments. I missed 3 little areas, but passed with an 82. WHEW! And now, I know I must get into those ant. interproximal areas with more authority than previously. My pt didn't need LA, and I know I am concerned about tissue trauma. But,I also know that it's most important to remove those deposits! And, when in doubt about recession, if you can't decide between a 0 and a 1, put a 0!
In the PM I got to watch everyone else sweat, all while helping out, of course.
Wed., April 2, and Thurs., April 3
The VA has been such an excellent experience! The range of pts is broad in their needs, medications, and personalities, which affords great opportunities (and sometimes challenges!) to expand DH skills. Today was a day of IVs and more LA injections. The IA injection used to cause me to pause, b/c I lacked confidence in finding the proper landmarks, but this is no longer the case.
My WSU AM pt turned out to be a IB instead of a II or a V, as I'd hoped. It is good to see the way so many recall pts progress after their initial cleaning at WSU. Many become impoved classifications, and though this may make finding certain pts more difficult, it's still good to see.
In the PM I was able to trade pts with Shandee and get some quads of a II and a III, which she didn't need. Again, I was impressed with the teamwork of my classmates. And, she expressed thanks for the IB, because she had not had one in a while. The program works!
My WSU AM pt turned out to be a IB instead of a II or a V, as I'd hoped. It is good to see the way so many recall pts progress after their initial cleaning at WSU. Many become impoved classifications, and though this may make finding certain pts more difficult, it's still good to see.
In the PM I was able to trade pts with Shandee and get some quads of a II and a III, which she didn't need. Again, I was impressed with the teamwork of my classmates. And, she expressed thanks for the IB, because she had not had one in a while. The program works!
Wed., March 26, and Thurs., March 27
My AM VA pt needed a pano as well as local anesthesia as he was a class IV. I notice a distinct improvement in administering LA as I gain experience, which is a wonderful thing. Applying knowledge of root morphology is so important when working on these pt types!
OK, today was my Clinic Simulation Day! I began by completing a IB by 10AM and then seeing a pt for subgingival irrigation and caries risk assessment. I wonder how many DDSs actually use this system. I did see a Diagnodent in one of the offices during my mentor experience, but my mentor said they don't often use it.
In the PM, I saw a delightful IA for BWs and a prophy, and next kept busy with placing sealants on another IA.
It was a good experience, and the time scoots when I'm so busy. Ah. Shades of real life?
OK, today was my Clinic Simulation Day! I began by completing a IB by 10AM and then seeing a pt for subgingival irrigation and caries risk assessment. I wonder how many DDSs actually use this system. I did see a Diagnodent in one of the offices during my mentor experience, but my mentor said they don't often use it.
In the PM, I saw a delightful IA for BWs and a prophy, and next kept busy with placing sealants on another IA.
It was a good experience, and the time scoots when I'm so busy. Ah. Shades of real life?
Wed., March 19 and Thurs., March 20
OK, back to the VA. AM pt was a class V, and I was able to place arestin. Prof. Alexander says she sees it actually used about 50-60% of the time. My mentors use it 20-30% of the time. Of course, this will vary a lot from practice to practice.
My PM pt was 2 Qds of a III and 2 Qds of a IV. Much more challenging with the deeper pockets! Thank heaven for ultrasonic instrumentation!
Back at WSU, my AM pt was my Board pt, so I did his OD and took 14 PAs of the film variety. So far he's been great to work with, very punctual and easy to communicate with.
My PM pt surprised me by being a IB, but it's all good experience for me. He was a new pt and spoke little English, though he understood a bit, so between that and my bit 'o Spanish and Nicholas' help, we did fine.
My PM pt was 2 Qds of a III and 2 Qds of a IV. Much more challenging with the deeper pockets! Thank heaven for ultrasonic instrumentation!
Back at WSU, my AM pt was my Board pt, so I did his OD and took 14 PAs of the film variety. So far he's been great to work with, very punctual and easy to communicate with.
My PM pt surprised me by being a IB, but it's all good experience for me. He was a new pt and spoke little English, though he understood a bit, so between that and my bit 'o Spanish and Nicholas' help, we did fine.
Monday, March 17, 2008
SPRING BREAK WEEK!
I don't know why this blog is not getting saved so I can edit it and then post it, but it's giving me problems, and quite frankly I don't have any more time to expend on this, so i will try for the 3rd time and click on the Post button. Hopefully it will work.
Spring break was great even though we all felt the specter of the LA and BIG BOARDS hanging over us. I'm so relieved to say I passed my written and clinical LA exams. Russ was my pt., and I was his the next day. This worked well for both of us, and he did a good job and passed his tests also.
Now, it's into the final stretch for the BIG BOARDS on March 25!
Spring break was great even though we all felt the specter of the LA and BIG BOARDS hanging over us. I'm so relieved to say I passed my written and clinical LA exams. Russ was my pt., and I was his the next day. This worked well for both of us, and he did a good job and passed his tests also.
Now, it's into the final stretch for the BIG BOARDS on March 25!
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