April 1

FYI--anyone interested in our fitness goal competition, please sign up today. Rules and instructions are on the blog. We will probably go private soon so let me know if you'd like to participate or read.

www.alittlehealthycompetition.blogspot.com

Even if you are a blog stalker (I know I am), don't be embarassed if you want to get healthy with us. Add yourself to the followers list and get me your email.

New fitness blog!

As Abe suggested, I have created a new blog for anyone wanting to participate in our little competition. If you would like to participate, please add yourself as a follower and give me your email address to add you as an author. If you could do this within the next few days I would really appreciate it. I hope to have the rules up within the next few days as I think April 1 will be a good start date.

Once you are an author, feel free to add or change anything (background--I'm not so hot at the cutesy stuff, sidebar options, etc). I was thinking we could do the ads to make a little bit of money that can go into the incentive pot as well as somekind of graphic to track our progress.

Let me know if you have questions!

http://alittlehealthycompetition.blogspot.com

ACLS

Yesterday I finished a two-day course in Advanced Cardiac Life Support (ACLS). This is a requirement for my internship position next year.

The class consisted of me and 6 nurses. I felt very intimidated when they started talking about heart rhythms and other medical knowlege I have only very limited experience with. I knew I would have to be able to lead a team in a simulated "code blue" (emergency) situation and was very nervous. I would have to be able to initiate CPR and basic life support, as well as identify the heart status of the patient, whether to use a defibrillator, and what medicines to administer in each situation, the dosages, and the order. Eek. As a future "Dr." I knew I would be the team leader in a real life situation and I felt a lot of pressure to perform when these nurses had much more hands on experience than I in these situations.

Despite my anxieties (I felt like, "I'm just a dentist! I wish I knew more.") I got 100% on my test and did very well on the simulation. Phew. I feel a little more prepared on how to react if I have problems with a patient in my chair or even with a family member at home or stranger in the community.

Fun in the Sun

Yesterday I went to a CE course sponsored by Patterson, a dental supplier. The course was reviewing some of the new technologies in dentistry, particularly CEREC. CEREC is a system that can digitally take impressions and can even mill crowns and other porcelain restorations chairside. What this means to the patient is, no more gooey impression gunk, temporary crowns, or weeks of waiting. Instead, you can receive an easy digital impression (taken basically from a LED light camera) and a white crown (or other fillings) in just a few hours in one appointment. Pretty cool.

I am still unsure where my dental path will take me but I thought it valuable knowledge regardless of whether I do crowns or exclusively surgeries in my practice.

At the end of the course they had a drawing for a free trip to a more extensive CEREC CE course in Arizona. Surprisingly, I won! So, I get free airfare, a stay at a very expensive hotel, and a pricey CE course all for free. Pretty cool. I hope I can make it work in my schedule next year.

A little healthy competition

what a pun of a title, huh?

I am starting to think more of how this is going to work. Here are my initial thoughts. Please let me know what you think.

It will be an 8 week program starting on April 1 and going until the end of May.

I want this to be a support system with encouragement but also enough of a friendly competition for those who are motivated more by that. I am still not sure on a prize/incentive. We could have a small monetary donation to join which goes to the winner at the end? A group incentive would be nice as well. Of course, there is always the incentive of a healthy you. Obviously that isn't always incentive enough, though!

Each person will have a weekly goal that will be measured on a point system. The points can be acquired through both fitness and nutritional goals. For example, exercising will earn a certain # of points for how long while avoiding a tempting treat will be worth another point total, etc. This will probably be a standard goal for everyone (for example, 50 points per week) but can be attained through a variety of point combinations that can be catered to you.

Each person will also have a personal long term goal. This could be a weight loss goal, a fitness goal (example: running a mile in a certain time period, biking x number of miles, etc), or other goal you feel is appropriate.

We will also have an overall group goal that will be the number of participants multiplied by the weekly point requirement. This will be incentive to encourage each other along the way.

What do you think? Any ideas for incentives?

Also, I think our blogs could be a good way to keep track and accountability. If you do not blog or feel uncomfortable, I can keep track of your goals as well as your progress privately.

Other ideas I have: each participant can post some of their favorite healthy recipes or tips to share with others. Bonus points for trying another person's recipe or tip?

Please let me know your suggestions and if you'd like to participate.

Fit

I have been thinking a lot about my desire to be healthy. Part of it is wanting to be back at my pre-wedding weight and prevent any weight loss problems down the line. Maybe more so, I want to live an active and full life. I don't want to get diabetes, hypertension (high blood pressure), heart problems, etc. I want to be 80 and running marathons (not really, I know that will never happen since I wont do one now!). I want to have smooth arteries with no obstructions, be able to run and not be faint, and to have Michelle Obama arms (shout out to Abe here, who is an Obama fan. Evidently her arms are a BIG DEAL).

I am trying to figure out some kind of overall health plan that will encourage me in all areas. I thought it would be fun if others, particularly family members, would join me. It may help to have some encouragement/friendly competition and I want you to live long and active healthy lives with me, too.

Here are my thoughts: we could do a "biggest loser competiton." However, not everyone in the family (or anyone else who wants to participate) has much to lose. This shouldn't preclude involvment. So, I thought we could have a side goal of total weight lost as a family as well as other health goals to reach.

For example, every time you drink 8 glasses of water a day, you get 1 point. Every day you eat 5 fruits/veggies that is 2 points. Avoid dessert is 1 pt. 30 minutes of exercise is 5 points. Something like that. We could have a winner as an individual or a couple or parents/children, and even an overall family goal. Not sure what the incentives should be yet.

Let me know what you think. If you have any ideas for incentives or a way to grade that would be great.

Here's to healthy arteries!

I miss the sun and the sea

I just got offline from talking with some good old friends from Utila. After graduation from BYU I lived on a very small backpacker-hub island in Honduras. For three months, all I did was wake up early, dive, eat baleadas, dive, and meet people from all over the world. I miss the sun, my braided hair that turned almost blonde, my strong shoulder muscles from carrying tanks, and no phone, no car, loud rap and polka music blasting from shacks ("na na na Gasolina-a-a")and just friends and strangers for fun and companionship.

As much as I like what I am doing, sometimes I wish I could be a dive bum, living the dream. The taste I had was just enough to make me miss it sometimes. Even though I am a dive instructor, it is hard to listen to my friends who are actually traveling to exotic places, diving along the way, teaching others to enjoy the ocean. Iowa winters don't help.

It has been almost 2 years since I have been beneath the ocean. I am a long way off from my 125 dives in the Bay Islands. I wonder if I even remember how to do it anymore?

Can I cut it as a full-time mom?

I don't know how you stay at home moms do it. Home all day, every day. I had a day off today which I was looking oh-so-forward to, esp after the crazy weekend I had. However, I found myself oh-so-bored and somewhat lonely. You guys are much tougher than I to do it day in and day out. I just couldn't seem to find much to do outside of wasting time on the computer (hello fellow bloggers, give me some more to read, please!). Yes, there is laundry to be done. Dishes as well for that matter. Clutter to clear. But I just didn't feel up to it. No fun errands to run. I finally worked on some sewing projects I have been planning to do for some time.

As much as I wish I had more time off from school, it seems that when I do I almost wished I were there. Maybe the difference is that I am not a stay-at-home mom yet, just a stay-at-home-once-in-a-blue-moon-wife. That can be a hard adjustment.

Despite my boredom, I still dread starting up school again tomorrow! Irony.

Barely Done

Today was one of my craziest days ever!

My patient for the morning showed up only to say he was unsure he wanted to have the treatment done since his tooth wasn't bothering him. *WHAT?* I finally told him he could get a second opinion from the examiners and if he was approved maybe we could go from there. Then, it took over 75 minutes to get approved. I was so nervous. Turns out a computer glitch with the xrays. After all that, he was not approved! There were absolutely no backup patients at the school and few options left for even Monday. Eek. They decided to give me a 45 minute time extension since it was a malfunction.

We tried to find another patient with little success. Then, my friend (now my best friend ever) suggested I get a few xrays on her sister (who was her assistant), that she may have a class III. Bingo! Right under her nose! We quickly submitted her and waited some more. We were all so relieved when she was approved. My friend sacrificed her assistant so I could have a patient. After each step we received grading checks that took probably at least 30-45 minutes each again. At 1:20 I submitted her for the final grade, the dispensary clerks cleaned up my unit, and I rushed off to the endo exam that began at 12:45. I had until 5:40 to finish the endo with my extension but luckily got done early, about 5:00. I rushed to have a few more forms signed and got everything turned in about 5:20 as the examiners were leaving.

So now, I have a huge headache, am starving, and I think relieved. And thank goodness I have the day off tomorrow and don't have to go back for one more day.

Thanks for everyone who helped me out today! Esp Rachel Culmer my wonderful and patient assistant and my wonderful backup patient and her sister.

1/2 way done

Today was the first day of the WREB board exam. I felt very lucky that last night I slept like a baby and woke up feeling great. All of the nervousness, anxiety, butterflies were gone. So much so, that when my patient was a 1/2 hour late and I called to find out she had missed her alarm and had not left her house yet (30 minutes north) I sat and calmly enjoyed one of the bagels I brought.

So, as I said, we started at 9 instead of at 8, two hours after I arrived. The prep (drilling on the tooth) went very well overall, I thought. It was one of my prettiest, at least from a polished/neat perspective. My patient did not like the rubber dam and started crying about an hour in. We talked her down and kept going. When I did the silver filling, I had some trouble and so redid it. However, the next time I thought it was great, took off the rubber dam, and checked with some floss. Oh no! The contact between the teeth was open, meaning the floss slid right through without much resistance (a potential food trap). I had a feeling my patient would not sit through me doing it again (and the rubber dam was already off, too) and after debating with myself, I turned it in.

She came back with a pink slip. That means, "The patient may need follow up treatment" (meaning a new filling) because of the contact (or lack of one). As far as I know, this is not a failure and is only one of many criteria. I am hoping I did well enough on the rest of the tooth that it is okay! If anything, it means I must do very well on tomorrow's cavity since they are grading them together.

I only got really nervous when I was waiting for the examiners to accept my perio patient (my cleaning). She had some very tough tartar to get off but I think I got her teeth overall nice and smooth. I can miss 3 pieces of tartar and still pass. I am hoping I did!

One more day to go...

Here it Comes

I keep having dreams about the board exam (starting tomorrow). Some of them are, my patients keep failing to get approved for use on the test because of weird rules I "forgot" about. Rules like, absolutely no talking once the procedure begins. At least they aren't real rules I have to worry about failing in real life.

We have orientation this afternoon. I have to turn some things in today and prepare my forms and x rays.

Tomorrow morning I will be at the school by 7:00 am. If all goes well, I will finish my first cavity followed by my periodontal disease cleaning. I have all day to do it, so plenty of time. I think the scariest part will be having patients approved for use on the test.

For Sunday morning I finally found another cavity patient. Phew. I will be doing a less familiar procedure (done it once!) but I think it will somehow be okay. Then, in the afternoon I will do root canals on two extracted teeth that are mounted in a plastic mannequin head. If all goes well, I will be done Sunday afternoon!

I am most nervous about: 1) patients being accepted to be used on the test; 2) my root canal teeth being mounted slightly wrong and rejected by the examiners; 3) my second cavity patient procedure I haven't done for 2 years; 4) my cleaning patient having such hard tartar it wont come off (she hasn't had a cleaning for I think close to 20 years!).

Wish me luck. I promise you wont have to hear about this much longer! I guess it is all I can think about.

Well, the countdown is on until boards. Just a few days away and I find I am still without one patient. I know it will be okay. People have been stockpiling patients as back ups. They should become available once the test begins. I am hoping to find a patient before the exam, however. I like the idea of preparation rather than procrastination. It hasn't been a delay on my part, but things just haven't worked out. It makes me a bit nervous but I know it will be okay.

On a positive note, my sister and her husband are in town which is nice.

Board Un-luck

Well, less than one week until my clinical licensure exam. I am relieved to have a few days off this week to prepare, regroup, and relax.

As for the progress in finding patients, as of Friday afternoon I thought I was set with all three of my patients. As of Friday evening I was down to just two.

My friend had recently found a patient for us to share. It looked like a golden opportunity and just what both of us needed less than 2 weeks before the exam. She chose which tooth I would do and I was to use the patient Sunday morning and she would use her Sunday afternoon. However, my friend at the last minute (Friday night) decided she didnt feel it was fair that I would get to submit the patient first and potentially use up a qualifying cavity that she may need. So, one week before the exam I was pretty much left to fend for myself again.

Luckily, I have two cavities in my other patient. However, that means instead of a filling in the front tooth that I have done dozens of times, I will have to do a different kind of filling on a back tooth that I have not done since sophomore year. I would rather not practice this again when my whole dental license rides on it but it will have to work.

We'll see how it goes. I could really use your prayers this weekend!

Health Care

The healthcare issue in this country is one of huge concern. Being a healthcare professional, I hear many sides of the story, both from patients who feel entitled to all care and from providers who feel pressured to make a living. It is a hard balance and a huge issue of personal philosophy I as a dentist will need to develop, whether I think health care is a right or a privelege.

It seems everyone is trying to solve the problems to help access improve and account for the millions of uninsured Americans who put themselves at medical risk each day.

My Dad seems to have found the answer and it has been recently implemented into Utah legistlation. Congrats Dad! Maybe with some time the rest of the country will follow suit.

For more details:
http://sterlingdiver.blogspot.com/2009/03/what-is-being-hailed-as-landmark.html

75% done

I finished my 10 weeks of rotations today. I can't believe how quickly the time went. This means I have 10 weeks left of school and am officially 3/4 done with my 4th year of dental school.

My rotations helped me gain a lot of confidence and speed. It also gave me even more senioritis than I had before. It will be hard to be back at the school again.

I have all of my board patients...I hope. However, I cannot get ahold of one to confirm with her a time. I have not spoken to her for weeks. Her phone is not taking messages. I just got her mom's number and am hoping she will help me track her down.

So, I am looking forward to a few days off, to regroup, and relax before boards. The stress has gotten to me much more than usual. I need some time to unwind. (Too bad it wont be in the sun).

Please call me patient if you are out there! 8 days to go.

Truck Stop Dentist

What do you think for a potential new business plan? Does Iowa have room for another truck stop dentist or did he steal my niche?



http://www.cnn.com/2009/POLITICS/03/08/greene.truckstop/index.html

Spring Break Plans

Spring Break is coming. With that thought in mind (and rain outside instead of snow) I figured wrongly that today would be appropriate for a knee-length springy skirt. Oops. Still cold. I always forget that spring break in Iowa doesn't feel like spring.

I am starting to feel the doom of real life coming upon me. Not that I am dreading working and making money. The doom is that I can no longer have whole summers off to live in Honduras or travel Asia. This is sad, esp as I am finally going to have more financial room to do such things. Thus, I feel I really need to take advantage of the breaks I have.

I was hoping to do something fun for Spring Break. The problem: boards. This will make any spring break plans a little less than ideal. There are some great cruises right now, some for only $199 for 7 days in the Caribbean. Wow. What could be more perfect--Sailing in the sun, eating great food, relaxing on ship. Unfortunately, again, boards and no opportunity for a long trip.

We decided to visit Abe's sister in DC. We talk about going since I have never been. Finally decided to just go...a day later, flight prices were up again. So bummer.

So, looks like we will be here. Good for board prep I guess if necessary. My sister and her husband may come out. I am excited but feel the pressure. I love Iowa and always encourage people to come visit. However, once here I fail to find nice things to do, at least during the cold and rainy spring break season.

Any ideas?

Mad Patient

This week I had my first patient walk out on me! Last year we did communications exercises where a simulated patient walked out on me. That was shocking and I really wasn't sure how to react. Sadly, I didn't learn anything from the exercise because I still had no idea what to do. Fiddle for an apology? We (my assistant, the assisting student, and the center aisle assistant) were all shocked.

The patient was upset when she was asked if she has any trouble with abuse at home. This is a standard question for patients at this clinic. Then, when I got started, she kept asking if I had the right tooth. We told her we would need to use a rubber dam (a stretchy piece of latex that goes over the teeth to keep them dry --we call them a "raincoat' with kids). My instructor started talking to me about a root canal on another patient and she got confused and thought the rubber dam had something to do with the root canal. I tried to explain that it had nothing to do with the complexity of the procedure, it was just a tool to help us get it done.

She had a difficult time opening wide enough for me to put the clamp on her tooth that holds the rubber dam in place. When I put it on, it pinched her gums (common but usually goes away in a few seconds). However, she kept complaining. I decided to numb her palate to make her more comfortable and she really did not like that. For whatever reason, I strayed from my habits and didn't warn her before hand. She scolded me for doing so. After some fiddling, we got the RD on. By now, she was fuming and told us to take it off. We reminded her we needed it for our treatment. She angrily demanded we remove it as she was leaving.

So, we did.

Oops. I don't know what went wrong!

Back to DM

I thought I would catch you up a bit before I head to Des Moines again in the morning with limited internet/computer access.

I have 2 more weeks in Des Moines. I had to drive to IC on Friday, back to DM on Sunday, back to IC on Monday, and am going to go back to DM early tomorrow morning before clinic. Lots of driving.

I finished my computer test for boards today. Yay. Glad that worked out.

Unfortunately, I did not win anything in my research competition. My mentor thinks I was at a disadvantage since all of the judges were non-clinical and my project was on clinical application. I am excited to write my paper and have it submitted for publication.

My friend Tina found a board patient we are going to share. What a relief! As long as they all meet the criteria and show up, I have what I need. Yay.

BTW I also got the dress situation figured out. Phew.

Funny how when it rains, it pours. It seems like everything was stressful and crazy all at once. Now, everything is resolving together as well.

Cold Case

I'm not sure the case of the missing sonic will ever be solved.

However, the Iowa City Public Library for unclear reasons decided not to press charges and took our word that we turned it in. Wow, thank you ICPL! Now, if we buy the game it will be for ourselves and not the residents of Iowa City, although that would have been admirable.

As for the game itself, I enjoyed it. However, I prefer the traditional sonic mode with running obstacle courses than the "were-hog" (like werewolf) levels.

On another note, my research presentation went well today. I by far had the most questions which means people understood and were interested in my project. One professor even asked me to present in the freshman evidence based dentistry course this afternoon. She seemed very excited about my project. I will have to rush from my last board computer test to get there but I am glad my research may have an impact.

The case of the missing sonic the hedgehog

We are lucky that our city library rents video games. With the recent purchase of our nintendo wii, we have enjoyed checking out games we are interested in trying for free.

However, last week we returned a game and forgot about it until we received a library notice today in the mail. The notice unfortunately states that the disk is missing from the case that was returned over a week ago and that we will incur charges until all parts are returned.

Abe and I both remember him placing the game in his backpack to return to the dropbox on his way to school last week. He even remembers double checking to make sure the disk was present (since we have returned empty boxes to the movie rental store before). We have checked everywhere it could be, including our game console and entertainment center (the only place we ever put it) with no luck. This is not like a set of keys that we would have set down anywhere in the house.

So, my only thought is...somebody (library worker?) stole the disk from the box. How can you prove to the library, though, that you are not the one responsible for its loss?

This turned into a more expensive "free trial" than I thought!