"Welcome to the VA..."

I heard the above phrase from a dentist today and it is so fitting because, you never know what your gonna get patient wise at the VA! My first patient was an older guy whose chart noted that he had made inappropriate remarks to the former student and that he should be seen by the staff hygienist only. I was told I would be "fine" and that I needed to plan on seeing him today. Well he was alright for the most part until his arm kept sliding off the chair and touching my knee, (considering the circumstances I doubt this was un-intentionally) had to keep repositioning myself... aside from that and his conversation of how he gets kicked out of places for his suggestive behavior he had heavy heavy biofilm and even the rubber cup polish wouldn't take it off. He also had bad back pain so mid appointment he stood up said he had a leg cramp, then he positioned his arms against the wall and attempted these calve stretching exercises, poor stefanie in the next room got an unfortunate view... at that point he had had enough, we put some varnish on him and dismissed him to the front. May I just add he was very demanding and told you what to do without saying please or thanks, but this is all apart of the experience, you have to learn to deal with all kinds of people. My afternoon patient was a 1b, no complications at all, (thank heavens) and at the end of the day I was sure ready to go home. Another day completed at the VA, which means one less to go :)

Files and Gracey's

Today really got me. First class IV patient  and boy are they difficult I scaled the full upper arch and had like 11 errors :( but it was cool I actually used my mini graceys and regular graceys pretty much for the second time in my life, I also got to use my files, which are amazing little things! My afternoon patient was pre-medicated and as I finished going over her health history I kept finding out that she was on more medications than she put on her form and she didn't know the names... luckily some were in the previous notes and she had one of the bottles in her purse for the other. She has hypertension, went to take her blood pressure with my regular cuff her response was "Oh your not gonna get that around my big fat arm!" Didn't really know what to say to that so I got a bigger cuff... She was a class II and I got her upper arch done, wished I could have finished her since she had to pre medicate but today was kind of a sucky day of scaling for me, I swear some days I get it and I am awesome and other days I feel like I don't know what I am doing! Tomorrow is another day of clinic at the VA, stay tuned

It can be done

Today went well. I finished a 1B this morning and passed of the selective polishing PE. In the afternoon I had a returning patient who was seen in march by a previous seniors student, she ended up being class II again because of her heavy calculus that had accumulated between now and then. She didn't speak english so I was able to have a translator for part of the appointment, he informed me at 2:00 that she had to leave by 2:30, great I hadn't started scaling, and she wanted me to complete her treatment. I decided to take the challenge, my adrenaline kicked in, I scaled her 3 quads (which was all of her mouth) in 25 minutes, dang I have never scaled so fast in my life, this must be a one time deal because I am not even sure how I did it... I walked her out completed at around 2:40ish. Up until now I really questioned if I was getting better or worse at seeing patients, but I gotta say, when you are put under pressure, you can do a lot more than you think is possible, so ladies keep going, we are going to make it!

class IV

So today was good and not so good. My first patient was a class IV, sweet! I was able to finish his OD and take x-rays, it took forever to probe because wow it was the first time I had seen a pocket bigger than 5 mm... plus there was biofilm everywhere I had to continually wipe off my probe just to see the reading. He was really nice and was okay with coming back, I am using him for my eagle soft patient on the computer and possibly for my mockboard, we shall see. My second patient came in, little did I know she had an artificial joint placed in February, I asked her for her Dr.s information to send them a physicians consult, looked it all up and called to verify everything, turns out she gave me the name of her primary care physician so they had to look in her chart to find out who did the surgery, once I got that information I called the right office and was told she would need pre-medication, but since they wanted her to have 8 tablets of the antibiotic, which was quite high, we decided to have them call in the prescription for her to get at the pharmacy. So in the end we had to send her on home, I wasn't even able to take x-rays :( But on the bright side I was able to get most of my previous patients info into eagle soft and I really like computerized charting! I didn't accomplish much today but I learned quite a lot. Back at it tomorrow at the VA, stay tuned

A Day Of Cancellations

Well this first one is my fault, I forgot to confirm my morning patient last night, she didn't show up. Called, left a voicemail, she called back said her daughter was sick she couldn't come in. Okay so I look at my list of patients that I was emailed, call almost all of them, no answer. One lady talked my ear off trying to schedule her and her husband for another time (I couldn't understand her english) so about 9:20 Mr. Solomon finds a lady that wants to be seen. She gets there at like 9:30, has to fill out a new health history, doesn't speak english...Well all I had time to do was an OD, apparently that's all they did last year when she came in so she really wants her teeth cleaned soon, good, I schedule her for next week. Eat lunch. Patient in the afternoon, spanish speaking, doesn't show up, Mr. Solomon calls like three times, nothing. Okay great. Hey there is a guy in the waiting room that wants to be seen its now like 1:00. New patient, I take him back, prepare to take 4 btws and 1 pa.. I SUCK at xrays today, 3 retakes, boo, seriously don't know how that whole process took an hour but after that I was able to complete his treatment, 4 quads 1b, better than nothing (by the way he had a wheeled backpack as well as a regular back pack with him, musta had a lota stuff, and he was either singing or talking to himself as I wrote in his chart, what a character). sigh, glad today is over, better luck next time!

They say there is a first time for everything...

Well today was by far very interesting. This morning was learning the computers and the set up of how everything works yada yada. In the afternoon we had a patient, I can now say I have seen my first transgendered patient, yes you heard right, I will call her a she, but I was not entirely sure... I was told ahead of time that I should be aware and ready and for odd remarks or conversation, great, I was already nervous! So she is wheel chair bound and we brought her back, I didn't know quite how to ask if she preferred being called miss or mister, but she had a female name, so I assumed she thought of herself as female, (she was also wearing massive heels, a mini skirt and a tank top, keep in mind this is an older woman) but then my instructors at times called her him, yeah, just a little bit awkward. All in all I was able to complete her appointment (with some awesome help) and she turned out to be very nice and cooperative. (might I add when I lead her back up front she put her power chair on full speed, and almost ran me over, that chair got some serious air!) Considering it all I things went great and I was able to treat her as any other patient. I am sure glad tomorrow is my day off because I am one tired girl!

What is flossing?

Well today was a little rough, first day bringing back patients in, lets see, three months! My first pt was a class II and didn't know what flossing was, she had never flossed... I was happy to introduce it to her! She had green/brown calculus and I spent so much time trying to get it off (I should have used the ultrasonic, why did I hand scale the whole time?)... needless to say I didn't complete her treatment (felt like a failure) but hey did I say it's my first day back? ha ha. My afternoon pt was a 1B, so glad to have an easy pt. She had great oral hygiene and just a few areas of calculus on her lingual bar. I was able to finish her treatment so I felt good about that! My ergonomics went out the window, oops, and my sore back is paying for it right now, I think I'll go do some yoga...Tomorrow I am headed to the VA (veterans hospital) so wish me luck :)