Last quad of class 3

I brought my patient back who had high blood pressure.  I saw her 3 weeks ago, and her blood pressure was 170/100.  That is scary.  She has never seen a doctor or taken blood thinners before.  I referred her to a physician.  The amazing part is that she went, and she is now taking care of her health.  I got a physician's consult.  I brought her back again.  I was scared to see what her blood pressure was, but it was better.  It was 144/79.  That was much better.  She was excited about the results. I only cleaned half her mouth, and I left the other half for my peer pal.  I discussed OHI with her.  She has a hard time flossing, but she got so excited when I demonstrated the interprox brush and the soft picks.  It is these days that makes me feel like a good hygienist.

Another class 4

I am really sick of seeing class 4 patients.  This is the 5th class 4 patient I had to encounter this year.  At this point, nobody wanted him, so I had the opportunity to clean another class 4.  I was only able to get one quad done, since x-rays and OD took awhile. 
I am so thankful to have a translator in the clinic.  I spent 15 minutes discussing on OHI and describing periodontitis.  It is amazing how patients are in tune and are asking questions about their mouth.  It shows that they care and want to improve.  It made me think... I'm from mesa, az.  A lot of people are hispanic, and I am one of the few people who knows spanish.  I had the opportunity to take spanish classes, but I decided to take chinese instead.  Many of the hygienist I shadowed spoke spanish and english.  It is going to be hard to describe OHI with a spanish speaker when I go back home.  Those were just my thoughts.

VA on thursday

I had VA on wed all year, but a girl switched me.  What can I say... I love professor Mcconaughy!  I learned so much on perio and clinical attachment.  I was great to have a good perspective.
I saw a cute 90 year old man who only had 8 teeth on the man.  He only brushes once a day though.  When he opened his mouth, his teeth was completely covered with lunch... yikes.  I discussed about OHI before starting.  He was so stubborn that he wouldn't increase his brushing habbits to 2 times a day.  So, I told him to rinse thoroughly with water then.  I also discussed this with his daughter who takes care of him. 
Also, I never had a patient with high blood pressure.  He had 194/99... during his procedure.  Boy oh boy,  I stopped in the middle.  I had the doctor come over.  During his time with the doctor, his blood pressure went back below 180.  The doctor gave me permission to clean the rest of his teeth while continuing to monitor his blood pressure.  It was a scary feeling, but I'm so thankful to be in a hospital setting.

Bringing my Board patient back

One of the advantages of having Tuesday clinic is bringing back my board patient back soon.  I did the OD, and had Jen Wold check him.  I was hyperventilating!  I saw her exploring up and down.  To my relief, I only a tiny roughness that was hard to catch.  Oh... that made my day... I passed! 
The best part was that I was able to clean the rest of his mouth which was 2 quads of a 3 and 1 quad of a 2 in that appointment.  I didn't miss any spots!  How come it is soooo hard to clean one quad, and able to complete your patient in the same amount of time and not miss any spots.  Answer... stress.  Oh I don't like that!
My afternoon patient no showed... which is disappointing, but I didn't care... I passed!

Boards number 2!

So I took the other clinical portion of my boards on Saturday morning.  I shouldn't complain, because I had a Saturday and not a Sunday... but mornings are really hard for me.  I had a great patient who qualified and was so good to show up.
This is how it went... I was the last person to sign up to see if he qualifies.  He was only back there for 5 minutes, and he was back again... with the first submission.  5 other girls were still waiting for their patients to come back.  Cleaning him was easy.  That sounds really weird, but all this semester, I only cleaned class 3 and class 4 patients.  His calculus came off with no effort to put into it.  How did I get so blessed.  I only spend 45 minutes cleaning him.  However, probing took a half an hour.  He was bleeding like crazy!  If I couldn't see the probing depths, neither could the examiners.  I took him back after an hour and 15 minutes.  I explored and explored, but I couldn't feel a thing.  I hope I passed!
Lessons learned... I ultrasonic twice... and its worth it... it helps disrupt the bacteria!

BOARDS!!!

Well, this week finally showed up.  I spent the first week just relaxing myself.  I didn't bother to study, because it only made me think of boards.  I had LA on Thursday and Clinicals Saturday Morning. This is who it went... for LA
LA... so I was scheduled at 1:50, which is pretty late.  They called my number an hour and 15 minutes ahead.  Luckily, I told my patient to be here an hour ahead.  They allowed me to set up and come back for my patient.  My lucky patient was my cousin who has been my second mom while at college.  I brought her back to the chair and explained the procedure of the local anesthesia.  I barely had any time to practice.  I put the topical, and it was my turn right afterwards.  I did a right PSA first.  My angles were perfect, and the insertion was good.  I didn't have any positive aspiration.  I was so successful with the PSA.  This boost my confidence for the IA.  I did the left IA.  My angles were right, and the needle perfectly slipped through until I got to the site of deposition.  I didn't get any positive aspiration.  However, placing my needle back into the cap caused some difficulty.  It fell out my tray!!!! Yikes!!! I rest my hand against the tray to provide stability.  I told the tester people that my card fell to the floor, and I was going to pick it up and put it on the table.  I did just that.  I handled it like a professional.
The only thing that made me nervous was when the tester people went and discussed together in their huddle group away from me.  It only took 5 seconds.  They came to me and said to clean up.  At this moment, my mind was stirring... they could of either passed me or failed me.  I dismissed my patient, and cleaned up my area.  A short time later, I found out my results... and I passed!!!!  It was a good feeling.
Overall lessons learned... act like a professional.  Second, if you are used to giving shots with poor anatomy, give it to a patient with poor anatomy.  I did just that and I was successful! 

Mockbeard

Finally, it's the last mockboard!  I didn't end it in a bang, but I passed.  The night before, I was next to the toilet and had a migraine.  It was not pleasant.  A few hours later, I woke up feeling pretty miserable, but not compared like the misery I had yesterday.  My stomach was feeling ok, but my head still hurts and in a cloud, and my nose is stuffy.
What I learned.... I only missed one spot!  I felt miserable, so I didn't bother taking x-rays.  But even in my misery, I passed.  That patient was the hardest one yet! That means, I can feel all the misery at boards and still pass.  It's a good feeling.  I will take airborne all week long before boards and pray for health. 
Also, this class is so amazing!  Girls were so kind and uplifting.

More on LA

So... I need a little bit of practice on the upper left PSA.  Jen taught me a new trick.  Simply, use your pointer finger and drag it along the buccal mucosa until you feel a depression posterior to the 2nd molar.  That is your spot.  Instead of using the thumb to pull the cheek... use your pointer finger.  Sure its hard to get the angles right b/c of the resistance, but it's possible.  Also for the IA, it is hard to see the premolars when the lip is covering it.  The corner of the mouth is your angle.  It works.... Ha ha ha... I'm going to nail that from now on!  Good learning experience day today!!! Thanks Jen!

LA Mockboard

So I failed... but learned a couple of things.  My angles were right, my site of deposition were right... everything was right until cleaning up.  Girls.... remember to never touch the front side of the card!  I passed until the last second... I touched the front side of the card when I disposed of the needle.  Good to know the nice trick of placing the card longitude and push it through without touching the front for stability. 
But... we will all pass the LA boards ladies... don't loose faith!  Think positive!!!

Clinic day

I got done early both morning and afternoon.  Both my patients were either class 2 or class 5.  I think it is about time to double schedule pt.  It is amazing that I have not seen 1B's so far.  That would be great if I could see them towards the end when all of my requirements are filled.  Wouldn't that be nice. 
Sometimes I forget some little things like checking their bite.  I need to wake up a little bit more.

Big Helper!

I'm a lucky girl.  My morning patient was a who had pocket between 5 and 10, mostly  7 and 8 mm with mobility on 8 teeth and furcations on all molars.  I switched pt's with Tanya since I already seen a class 4 pt.  I was so happy that she could do LA as well.  My afternoon pt was a class 3 and needed LA.  I let Karlie do the LA on that pt.  Hopefully all this good karma will come around at boards.  I got to pass of the oraqix pe too.
I went over the OHI with the class 4 pt before handing him off to tanya.  He knew little english, but his wife was there to translate.  He never had a cleaning before, so I explained the 2 month recall, his perio disease, and ways to improve his OHI.  It's great to have his wife there, so he has no excuse to improve on his oral hygiene.  They were great listeners, and they were eager to get started.  I love how much influence I have in dental hygiene.  It's a good feeling.

VA 2

Both my patient had major recession.  I did a follow-up with an aggressive periodontitis pt, and I only got 2 quads done.  He only counted as a class 3, but I already have a class 4 pt.  It was my first pt with a bad stench... he smokes a cigar a day.  If you haven't smelled cigar smoke before, its worse than the cigarettes.  Does he want to quit.... no but I did tell him about the affects of cigar smoke and the oral health, which is not good.  He also needed LA, which I don't need, so I allowed Tori to do the injections.  I know Prof Hansen did not want us to do the lingual anesthesia, but she made Tori do it.
Another note, this patient was seen only by SLCC students.  When I took my instrument, I went all the way into the pocket.  He was surprised.  The SLCC people did not do that.  He had a SLCC girl do him as her first pt ever.  Poor girl, but it shows how WSU students are better when it comes to instrumentation and everything else.  I'm very grateful that I attend WSU. 

Mockboard

I was a lucky case.  My pt lost a tooth, so he had only 5 teeth.  Fortunately, there was 4 anterior clicks and 8 posterior clicks.  Even though I missed no spots, I stink at probing.  Seriously, after 5 mm, I cannot distinguish between a 6 and a 7.  So probing by itself and recession, I was docked 10 points.  I got a 90 which is passing, but for future notice, I need to borrow some loopes to be 100% successful. 
This mockboard went more smoothly and not stressful at all.  I had a good night's rest.  I am really feeling confident about my skills.  
The LA test was not so bad, I just need to review the generic names.  I lost my paper with questions I need to work on, but I got a 82. 

2nd day of clinic

Well, I was able to find another mockboard, so I gave it to tanya.  It was a busy day.  Both my morning and afternoon pt were class 3's.  I was able to finish the other side of my pt from last week.  He actually listened during the OHI.  He tried the sensodyne toothpaste b/c he is sensitive with exposed root surfaces.  He really like this toothpaste b/c it worked. He also has some open contacts that caused food impaction.  He had a tuna fish sandwich for lunch.  I was able to demonstrate the interporx brush to him.  He got so excited.  It made me feel like a pot of gold.
Professor Alexander taught me a simple thing like inserting and instrument the right way.  I was angling it rather having the terminal shank parallel to the tooth.  It makes a big difference, such as no tissue trauma.  Good luck on Mockboards next week ladies!!!

VA

So, both my patients had attitude problems, luckly one of them was a class 3.  Connie, Tori, Jamie, and Jodie could hear it, but they commented how I was professional about it.  My afternoon pt had a knee-joint replacement 10 months ago in which I caught from questioning about the health history.  ( Lesson #1... make sure you question about any changes to their health history b/c you can catch something major like this)  I explained to the patient that pre-med is required for every dental/dh visits from now on at the VA b/c bacteria from the mouth can affect his new knee joint.  I had a whole hour of just chit-chatting which Shera came to help.
I gave 11 injections that day.  It is such a great opportunity to have inst Dixon and Connie to watch me give those injections b/c they judge at boards for clinical and LA.  I had many wrong case scenarios, but I was able to recognize the problem for the most part and try it again.  For example, I had a positive aspiration, my syringe broke and could not inject, I touched my glove, I couldn't see the bevel (that would have been a fail).  I was grateful for these situations now and not at boards.  It is alright to make mistakes.  Just recognize your mistake and try again.

Hitting it with a BANG!

I can hardly believe its January.  Since I only carried 7 quads of class 3 and 4 last semester, I desperately need 29 quads of class 3 and 4.  It creates a lot of stress.  Fortunately, I had 2 midtown patients from Clearfield who sat in my chair. Surprisingly, my morning patient was a class 4, and my afternoon patient was a class 3.  I took every minute in clinic to get half their mouth cleaned.  On top of that, I did LA, and I am done with the LA requirement.
My morning patient had a tongue piercing and chews tobacco.  On top of that, he never had his teeth cleaned before and has poor OH.  You can see the effects on his mandibular anterior teeth and tissues from years of chewing and that piercing.  His dentist wanted his mand ant teeth cleaned, so he can extract them.  I was able to educate him of pre-canerous tissue if he continues to chew tobacco, and I showed him the leukoplakia areas of concern to him. He says he going to quit, since he won't have mand ant teeth to chew.  I hope that is true.  I also talked about the effects of tongue piercing and the teeth.  So in future reference, I had a patient who needs extractions because he got his tongue pierced and played with it on his mand ant.