Wednesday, March 27, 2013

Open Wide

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This is a picture of me and a patient taken during my senior year of dental school by the Des Moines register.

My job as far as it comes to kids is a LOT easier than it was in dental school. While I had to learn maneuvers like vocal control (trying to show firmness with your voice) and a new vocabulary ("Here comes Mister Whistle!"), I am lucky enough to be able to "drug 'em" into cooperation for most of my procedures now. This makes my life a lot easier. After four years I don't remember as much about how to place silver caps or sealants like I did before. But there is one thing I will never forget--how much parents can help (or hurt) the process of routine dental care for their children.

As a rule, people are afraid of dentists. I am told on a somewhat regular basis that people “hate (me) the dentist.” I get it, I do. This phenomenon can range from annoying to very frustrating. I have been told on multiple times by patients that I “can’t come at” them with “sharp tools” that ironically are necessary for my job. I have been walked out on. I have listened to crying and screaming, cussing, and have been blamed for dental problems because of a “bad experience as a kid.” I’ve even been grabbed or pinched. It can be annoying to be told multiple times how much people are unhappy to see you and it is frustrating when you can’t get the job done because of anxiety (I’m lucky to have drugs to help with this), but it is very sad when people, especially children, are debilitated by their dental fear. I have worked on children and sometimes adults who are so afraid of the dentist they cannot tolerate ANY dental work. Think about the negative effects over a lifetime of a young child who is unable to undergo dental exams, cleanings, simple fillings, etc! 

It is unfortunate that so many of us pass on these fears to our children.

I see a lot of examples of this both in my personal social life and as a dentist over the years. In dental school we learn all sorts of techniques to explain, show, and reduce the anxiety associated with the dental appointment. We talk about "Mr Thirsty" (the suction "straw"), "silver stars" (silver fillings), and "my rocket ship" (the dental chair). We don't give shots, we "squirt sleep juice" on teeth and we try to be brave and not cry or scream because there are "sleeping babies" that we don't want to wake. Often times this special vocabulary and a little extra time with a caring/competent/patient/skilled dentist is all that is needed to make a smooth dental appointment with a happy child, proud of their shiny teeth and the sticker they received at the end. And sometimes they had no idea they even got "a shot."

Unfortunately, the fear and anxiety the parent feels often gets passed on subconsciously. Simple things like explaining in every detail what is going to happen during the procedure to “prepare” the child can be counterproductive. Mom remembers and describes in detail the horrible SHOT that they STAB in your mouth before they POUND in the filling, not the SLEEPY JUICE which is SQUIRTED on the tooth and the TAPPING in of the SILVER STAR. Not to mention when parents or siblings goad the patients with comments like, "You're gonna get a shaw-ot, you're gonna get a shaw-ot!" And please don’t use me or the appointment as a punishment or threat. I remember seeing a four year old on a dental school rotation who was screaming and thrashing around. I needed to look in her mouth to check quickly for large cavities. Her mother was scolding her and threatening her with, "If you don't stop she's going to give you a shot!" I was less than pleased with this. First, I wasn't going to give her a shot as punishment, so I couldn't follow through and two, if I needed to give her a shot later she would think she was being punished.

So here are some tips:

1. Start young! If your child is used to going to the dentist often from an early age they are likely to be less fearful. The pediatric dentistry association recommends the first dental appointment being by age 1.

2. Let them see you or other children having a positive experience. Emphasize your shiny clean teeth and your new toothbrush.

3. Some dentists will let you do a tour of the office prior to the upcoming appointment so the child can see what it is like beforehand.

4. Don't try to prepare your child too much for the appointment. Remember, most dentists (or at least ones good with children) have been trained to interact with your child in an age appropriate way. Trying to describe exactly what will happen often makes things worse and is an easy way to pass on your own fears.

5. Try to avoid comments like, "Don't worry, it wont hurt!" This often makes the child worry about what is coming next. My mom tells a funny story of a dental appointment she had when she was a kid. Her sister and brother were screaming and crying during their appointments. When it was her turn they told her she better watch out for the shot. She gripped the chair in fear until the end of the appointment when they said she was all done. She asked, "When am I going to get the shot?!" They told her she already had and was completely done. She had no idea.

6. Helping your child brush and floss until they are able to write in cursive will prevent decay and more extensive (and unpleasant) procedures at the dentist. Think about it, most adults probably can't brush their teeth well enough to avoid cavities at times and yet we expect young children who can't perform fine motor skills to perform this somewhat dexterous task. I have people tell me proudly all the time, "My two year old loves brushing his teeth!" That's great, but you really should do it again for him after he finishes.

7. Avoid sugary drinks, even juice and milk. Only water should be placed in a sippy cup and they should never go to bed with a bottle or sippy cup filled with anything but water.

8. Try not to worry so much! Trust your child’s resiliency and expect them to handle it well. Fueling their fears and not expecting them to manage their anxiety only makes things worse in the long run.

9. Trust your dentist. If you aren't sure about how they are with kids, ask them – there are many dentists who do not feel comfortable seeing children and they will probably let you know. Or find a well respected pediatric dentist in your community if you have any question or concerns.

 

And finally, a real life example of a great dentist at work, taken from my great dental colleague and friend Dr. Jada Kurth:

8yr old: was that the shot?
Dr K: yeah not so bad huh?
8yo: yeah easy stuff. Now I'll just wait for you to clean the tooth, and then the star dust goes in, and then some tapping and them I'll be done!
LOVE COOPERATIVE KID PATIENTS!!! Especially during spring break week when I'm seeing SO many!

 

I'm no pediatric dentist but I hope these can help! I don't think any parent wants to pass on a dental phobia which may prevent their child from receiving the care they need in the future. I have seen too many people who lose their teeth because they were too afraid of the dentist for routine care. Hopefully the idea of dentures is scarier for our children than the minor discomfort and anxiety a dental visit can bring!

Sunday, March 24, 2013

The Cool One

I talk a lot about my twin sister Amber, but I haven’t talked much about the rest of my family. I am the oldest of five children, the youngest being “C,” the only blondie in the group (except for my bro-in-law Russ). Unlike the rest of us POSERS (funny pun), she and my brother Colt are the only ones who actually really have mastered the guitars we are showcasing, with the rest of us on a spectrum of dabbling.

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My family, minus new babies with the custom made guitars my dad made for each of us

If I had to choose a label, I’d say C is my “Cool” sister. She’s the one with the funky style – the pretty and punky combination with floral dresses and pink hair. She isn’t afraid to be herself which I think is especially admirable at her age. She’s the one that not only rocks in her multiple rock bands (winning battle of the band competitions as the lead guitarist) but also in the band at school. She plays piano, bass clarinet, and guitar (and I think bass guitar). She is very musically talented. I always wanted to play electric guitar and I’m so impressed she does like a boss! Not to mention she is so pretty and the only one with blonde hair and blue eyes in our family (jealous!).

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Unfortunately with C having the biggest age difference between me and her, she is the sister I have spent the least time with. She was just a little girl when I left home for college and I have been in Iowa for much of her older teenage years. But I love the times I get to spend with her and I remember her as the cutest little girl! Maybe that is why I can’t believe my baby sister is graduating from high school this year! I feel like I have missed so much of that time.

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C has always loved animals. When she was very little I remember she was always pretending she was a “puppy dog.” This was a very realistic representation, right down to the “puppy dog kisses!” I’m not sad she outgrew that one. This is a picture of us from long ago at the Channel Islands. I think we were waiting on the beach for seals.

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I am impressed with her interests. She has been cooking and experimenting in the kitchen for years. She has a fascination with international cultures, languages, music, foods. I like coming home and playing in the kitchen with her.

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She is an amazing artist, especially in digital art, and is applying for a very competitive art school. I hope she isn’t mad that I swiped this picture from her facebook account but I think this one is so interesting. I don’t know where she gets her ideas but she is obviously way more creative than I ever will be!

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All in all, she is a beautiful and sweet sister.

I’m so excited to see where life takes you!

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Love you C!

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Thursday, March 21, 2013

Unconventional

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I remember a few years ago at work a conversation with the women at work. One was telling about a friend’s wedding, noting that her friend was the “only person I ever knew who was a virgin when she got married.” The other women seemed to agree that this was strange to even think about and that they didn’t think they knew anyone like that themselves.

I didn’t take that opportunity to make it known that she indeed knows at least two people who fit into this category. I don’t know why I didn’t say anything at that moment. The fact I was a virgin when I married has never been embarrassing to me, but maybe right then it felt a little weird or strange. Or maybe just private. Whatever the case, it felt a little awkward to pipe in at that moment, “I was, too!” as they were marveling at how weird and unbelievable the whole idea was that someone would do that.

So why the sudden announcement? If you remember, I am a Bachelor fan. Although embarrassed (and somewhat ashamed) that I get sucked into this show, I’ve already ‘fessed up to this guilty pleasure of mine so we’ll move on in the thought process from there. I was reading a magazine last week talking about the most recent proposal and the Bachelor Sean’s decision to wait until their wedding day. A quotation from the magazine stuck with me:

“The pair sat down to talk …about their unconventional path to the altar” (italics added by me).

I always knew I would “save myself.” Although I think it is a common teaching in many religions, I think it is often viewed as outdated or unrealistic. But for me (and most of my LDS friends) this was something I planned to do, for not only God and my future husband, but myself. The culture at BYU definitely promoted this ideal with a strict “Honor Code” that included wearing modest clothes, a curfew for when members of the opposite sex had to be out of your apartment, and a strict no-boys (and vice versa) in the bedroom policy. If you are a basketball fan, you may remember the Brandon Davies controversy where he was not allowed to play in the NCAA tournament despite his importance to the team and their high ranking because he broke this tenant of the Honor Code.

I guess with this background, I never thought this aspect of my history was that weird. And certainly not unconventional. But perhaps it is. I may be weird but I know I am not the only one. I am suspecting there are more of us than you realize. We just don’t talk about it very much. “Hey guys, by the way, did you know that I am/was a virgin? What about you?”

I don’t expect other people to make the same choices I have but I was surprised to realize that “traditional family values” may no longer be “conventional.” I think there are advantages to waiting and I am grateful that is a part of me that I share only with my husband. I guess what I’m trying to say is, if you choose to be one of the weirdo’s, you may be weird, but you aren’t alone.

And as for Sean, I hope he can do it!

Friday, March 15, 2013

Date Night

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Hot date night at our most frequented pizzeria

Unfortunately, I think all of the rest and relaxation from my vacation last week has been quickly erased. I actually wasn’t dreading coming back to work as much as I usually am. But I also wasn’t expecting to be on call all week again.

I’m getting to the point in my residency where taking call generally isn’t a big deal any more. For the most part I don’t mind it and at least I have the perks of the “trauma diet.” But this has been a grating week. I think part of it has to do with just coming off a full month of trauma. And maybe taking a few days of both first and second call (being the only resident on call instead of two). But I think a lot more of it has to do with Abe’s busy schedule. I rely on him a lot more than I even realize and not seeing him much at all this week and knowing he will probably be this busy at least the next few months is kind of lonely. I went to bed last night without him, only to toss and turn for hours, angry at the doctor gods for keeping him awake and away for so long and on the OTO INTERN DIET, which unlike my “trauma diet” which consists of eating whatever I want, means not getting a chance to eat anything. His lips are visibly chapped (from dehydration), he is getting a little scruffy (which really isn’t like him), and I think pretty skinny.

He is just starting his two months of the ENT team for his first year of residency (He has mostly been working with General Surgery teams). So far this month his hours have been crazy. Yesterday he was gone from about 5 am- 11:30 pm (and he wasn’t on call), only to be back at 4:00 am the next morning. I stayed after work for two or three hours hoping to catch him for dinner. We had a romantic date in the cafeteria eating pizza. (See Mom and Dad, keeping up the Friday Pizza Day tradition—not on purpose, though.) Just as I walked in the door to write about the stress of my long and busy week, I got paged about an “emergency tooth extraction” I will need to go to the OR to help another team out with tonight. This will be my first middle of the night tooth extraction, at least performed in the OR! And on a day I was so looking forward to some sleep.

And it’s now past 10:30 and still haven’t seen Abe walk in the door. I hope to catch a glimpse of him before he comes home to bed and leaves in the morning for another (I’m anticipating) 16 hours of work.

Wednesday, March 13, 2013

Merry Wednesday!

 

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Anna and Abe are the best at celebrating!

Every day is a special occasion.

I came upon this thought recently from a talk given by the prophet of my church, Thomas Monson. He is very similar to the pope (in the news!) of the Catholic church. Below is an excerpt I really liked.

I remember reading the account of a man who, just after the passing of his wife, opened her dresser drawer and found there an item of clothing she had purchased when they visited the eastern part of the United States nine years earlier. She had not worn it but was saving it for a special occasion. Now, of course, that occasion would never come.

In relating the experience to a friend, the husband of the deceased wife said, “Don’t save something only for a special occasion. Every day in your life is a special occasion.”

That friend later said those words changed her life. They helped her cease putting off the things most important to her. Said she: “Now I spend more time with my family. I use crystal glasses every day. I’ll wear new clothes to go to the supermarket if I feel like it. The words ‘someday’ and ‘one day’ are fading from my vocabulary. Now I take the time to call my relatives and closest friends. I’ve called old friends to make peace over past quarrels. I tell my family members how much I love them. I try not to delay or postpone anything that could bring laughter and joy into our lives. And each morning, I say to myself that this could be a special day. Each day, each hour, each minute is special.”

I try not to wish my life away, but I certainly am not celebrating it like I should. Lately, it seems like I am quite often struggling just to get by: hoping to get some lunch or sleep at night, wondering when I will get the next trauma patient discharged, or awaiting 5:00 when I can hope to maybe go home soon if I don’t get any new patients.

But, this thought is a good reminder for me to take time to remember the important things in my life and to be grateful for what I have. Things like family, health, talents, and opportunities. On long days at work, remembering that although there is a lot of stress and responsibility that comes with my skills, that I am lucky to be one of only a handful of people in the entire state who can treat these patients. And that hopefully at some point I will get to see Abe after my 10+ hours at work(and usually even longer for him).

So, I guess I’ll get out those fancy clothes for a night at home with Abe (what better reason to dress up?), wear make-up a little more often to work (even if I am just wearing scrubs and a pony tail), make a cake just because, and I really probably should try using our china at least once!

Even better would be to send a note or card to a loved one or call just to say hi instead of only to say “Happy Birthday” or “Merry Christmas.”

Tuesday, March 12, 2013

New Diet



I just happened to gain a few pounds (hopefully transiently) on our vacation last week.

I guess the diet gods felt I needed an extra bout of success and placed me back on the trauma diet.

What is the trauma diet, you ask? It's much simpler than some of the other diets I have been researching, but not really realistic long term and unfortunately it may not be a very feasable plan for most. Here are it's basic principles:

(1) The key is being Trauma Chief. Technically, I shouldn't fill this role for another number of months as I just finished taking call for the entire month of February. Unfortunately, a colleague had a death in the family so I am covering this week for him.
(2) Eat whatever you want (mostly), subsisting mainly on cafeteria food (which isn't low-carb, low-cal, or low-fat, but is often low-yumminess and low in nutrients)
(3) Stay busy and stressed enough to eat at strange and inconsistent times
(4) Walk to and from the OR multiple times during the diet period
(5) Wonder how you have lost a few pounds when you've been horrible about what you are eating without any formal excercise

Enjoy!

Sunday, March 10, 2013

Country Bumpkins

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We just arrived home from a much needed vacation (especially after one month of trauma call) to Southern California.

The land of “cold” 60 degree winter days,

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expansive beaches and palm trees,

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In N Out Burger,

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Cafe Rio (a Utah favorite which has migrated West which is like Pancheros on steroids except it actually isn’t anything like Pancheros because it is so much better),

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giant red strawberries,

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and “the Happiest Place on Earth” had me all but wondering why we aren’t living there now (despite the almost $5/gal gas and crazy traffic) or at least have serious plans for a relocation in about five years.

But I did have a moment of Iowa appreciation…

On our way from our hotel to the airport this morning we met a woman from Florida. She had a lot to complain about from the suspension on the (FREE) hotel shuttle, to the beds and sheets at the hotel. She asked us where we were from and we were told that she was from Florida. She mentioned that she knew nothing about Iowa and that she could never live in the Midwest--being from Florida, of course, it would be such a devastating adjustment.

I was feeling pretty eager to give up my Iowa home in exchange for some sunshine and the beach but I guess in my almost 8 years here I have gained a little pride for the Hawkeye State and I felt defensive about our corn country. Yes, it can be hot and humid (just like Florida). And we don’t have the ocean but we have managed to develop our own culture without the ocean and somehow an associated social life outside of corn at least part of the time. And crazy enough, No, Iowa City isn’t the ONLY city in the state. Hard to believe, I know, but there are actually people living amongst those cornfields thank you very much. Soon after we arrived at our terminal. We smiled and wished her a good trip but what I wanted to say was,

“You’re right. I think the people in Iowa (City) are much too educated and gracious for someone like you. I don’t think you’d fit in at all. “ (Did you know that Iowa City is one of the two most educated cities in America?)

I guess what I’m trying to say is, it’s nice to be home sweet home in Ohio….

I mean Iowa.

Even if we wont get much sunshine for another few months.

Sunday, March 3, 2013

Don’t be mad…

I was snooping in some old pictures I found of Abe’s on our computer today. I had never seen these before from his time at BYU. He’ll probably be mad at me but I couldn’t help but post a few…or a lot.

Look at that curly hair! I forget that his hair was similar to this when we met. Maybe the stress of medical school took it out of him?

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I wonder what this dinner was? He is there with his grandpa…I never met him while he was alive but I did attend his funeral.

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BYU basketball players? (Look at that hair! I’m still amazed)

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I’ve never seen him in a tux.

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I recognize her from Facebook (and those pants…didn’t know they were so old).

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Abe’s cousin and her boyfriend Tyler were in my ward at BYU. Here they are at one of Abe’s cousin Nan’s famous pie parties. It seems like everyone I knew went to these but me—I was never invited. Too nerdy studying maybe? Was anyone else from my past there too that I should know about?

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Looks like he’s always liked babies. She is so big now!

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Look at these little cuties!

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I found one of Abby

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and one of the whole gang (minus Aaron)

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This is my favorite!

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And this is my least favorite! I have a high suspicion she (at first I wrote “it”—oops) is one of those Cougarettes (BYU dance team) he was “always” dating.

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or maybe this one. (The girl on the far left looks very familiar. I don’t remember her name but I feel like she was a runner on the track team. It is so weird that Abe and I have mutual contacts and overlapped at BYU but never met. He even dated a few girls I knew from high school.)

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Good thing I know there’s only one girl for him!

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Love you “The Sheffield”, with or without curly hair! and even in a hat…

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