Sunday, October 25, 2009

What is a 'Hoe'


I was browsing the blogs and ran across an interesting read (can't remember the blog now, but when I do I'll post his link..). Anyway, one of the blogs spawned comments that lead to an age old debate: 'a hoe or not'. There was question about if you are dating someone, do you share your 'number' or not. If you don't share your number does that make you 'slutty' or 'whore-ish' by default? If you DO share your number and it was a GIGANTIC number from your past, are you STILL that 'slut puppy' from then or are you the you now?

My take on this is:
If you are dating someone, don't ask about a stupid 'number of past partners'. I think it's perfectly okay to talk about safe sex practices. I mean I don't really wanna know that the dreamy guy I'm dating has slept with 100 women!!!! However, I'd certainly like to know that if he did sleep with that many, that he wrapped his 'member' up each time... that's more important to me than the number. I'm afraid the number would 'scare me off' or 'put up walls' to knowing a POTENTIALLY good guy now who USED to be a man-whore.

This is the hypothetical scenario I pose when in this kind of discussion:
You are let's say 40 years old, single and looking. You meet a 35 year old. You guys hit it off very well, date for months and months and months. You two decide to go 'further' with your relationship by introducing sex, so of course the 'sex' talk comes into the convo more often. Let's say, you two decide to discuss numbers. Let's say the woman who is 35, admits to sleeping with 30 men in her youner days. Are you now turned off? Do you wanna know more? If she continues to say "yeah, I had a pretty tough teenage and young adult life. I didn't know my self worth and self value. I was looking for someone to love me and I too often transposed 'sex' for the 'love' I was seeking. That was a sad time in my life when I was about 17-21, but I've been celibate now for about 7 straight years. I've grown so much. I know my worth and my value now... and well, I haven't had sex with anyone yet because I haven't found anyone I've deemed worthy enough of me.. until maybe now'. What now? Is she still a hoe? Is she 'redeemed'? What?

What is that 'magic' number that solidifies one as a 'whore'? I mean to some more than 3 could mean the biggest whore in the world! To some more than 20 wouldn't matter at all... so again I ask.. What is a Hoe? (or Whore for everybody who refuses to read and use 'slang' LOL)

Sunday, October 18, 2009

You know you grew up in a black church if...

If you can you fill in the blanks!!
Don't cheat!!!
"First giving ______ to God, who is the _______ of my life, I'd like to say I'm glad to be in the ________ of the Lord one mo' time. Cause he brought me from a ___long_____. I coulda been dead, sleeping in my________, but God is_______ all the ________, and all the_____, God is _______. He's a _______ over troubled waters. He's a mother to the ________, and a_________to the ________ __, a doctor in a ________ room, and a___________ in the courtroom! (smile) He's the_______ of the valley, a bright and ________star He got up early one __________ mon'ing,with all __________ in his _______. Pray for me that I grow _________ in the Lord." Also, as you look in your church_______, under the special _________ please keep in your prayer _______ Sista Buela-Mae Jenkins who will be having her ________ surgery this week. And while you give your tithes and _______ we humbly ask that you contribute to the church_______ fund and we will be celebrating the pastor's fifteenth________ so anybody please who serves on the _______ board please meet in the ________ following_________. And the women's auxiliary will be selling ________ dinners for $7.00 a _____ along with the youth ______ who will be having their annual ______ sale to help fund their trip to the national youth ministry_______in Tennessee this summer. Parents please be _______that vacation_______school begins June 19, please have your child________ by May 13.

You knew them all, if not most of them, didn't you?!!! You must go to or grew up in a black church!

"First giving honor to G0d, who is the head of my life, I'd like to say I'm glad to be in the house of the Lord one mo' time. Cause he brought me from a mighty long way. I coulda been dead, sleeping in my grave, but God is good all the time, and all the time, God is good. He's a bridge over troubled waters. He's a mother to the motherless, and a father to the fatherless, a doctor in a ;sick room, and a lawyer in the courtroom. He's the lily of the valley, a bright and shining star He got up early one Sunday mon'ing,with all power in his hands. Pray for me that I grow stronger in the Lord." Also, as you look in your church bulletin, under the special announcements please keep in your prayer request Sista Buela-Mae Jenkins who will be having her hip surgery this week. And while you give your tithes and offerings we humbly ask that you contribute to the church building fund and we will be celebrating the pastor's fifteenth anniversary so anybody please who serves on the usher board please meet in the sanctuary following services. And the women's auxiliary will be selling chicken dinners for $7.00 a plate along with the youth choir who will be having their annual bake sale to help fund their trip to the national youth ministry convention in Tennessee this summer. Parents please be mindful that vacation Bible school begins June 19, please have your child registered by May 13.

You knew them all, if not most of them, didn't you?!!! You must go to a black church! IF YOU MISSED MORE THAN 3 YOU NEED TO BE IN CHUCH NEXT SUNDAY!!!

Friday, October 16, 2009

...Venting and venting... just No passion and no purpose! WHY?!?!

~ Passion and purpose go hand in hand. When you discover your purpose, you will normally find it’s something you’re tremendously passionate about. ~Steve Pavlina

**I like to think that the majority of us do what ever we do in life out of passion and or neccessity. Right? Some of us are actually blessed enough to have careers that suits a portion of our 'purpose' in life and fits right along wiht some of our passions. For example, for as long as I can remeber, I've always said I wanted to be a doctor. As a kid, I never really cared what kind of doctor, but I just knew I wanted to help people. I agree that there are several jobs and careers that help people, but being a 'doctor' seemed grande to me. I set my plan into motion and years later I am just that!
**My personality is over all can be described as all of these descriptions 'helpful person', 'friendly', and 'passionate about life and people'. I AM a people person. I LOVE helping people when and how I can.
**When I started dental school, it wasn't easy at all. Several times I thought about giving up. I didn't though, because my desire to want to be a doctor to live out one of my purposes in life of helping people wouldn't die. So now that I've graduated, I'm really having a blast doing what I love!
**Every patient I've treated, I've done my very best at it. I'm not afraid to say sometimes 'you know what, I'm not very sure about this procedure, so you can give me a few days to read up on it, or I can try to find you another dentist who can get it done ASAP." Or I'm never afraid to ask for help when I need it. I feel like if asking for help and seeking 'team work' is best for my patient and would benefit them then I'm all for it. I've treated a variety of patients. Healthy ones. Little ones. Fat ones. Some with great teeth. Some with HORRIBLE teeth. Some with NO TEETH. Rich ones. Poor ones. Intelligent ones. Not-so intelligent ones. Deaf ones. Mentally retarded (MR) ones- and the list goes on. EACH patient, I treated just the same. With compassion and with a desire to address his or her dental concerns TO THE BEST OF MY ABILITY! I didn't do a better job on the rich patient than I did on the poor patient just because of finances. I didn't give the MR patients inferior care and the intelligent one superior care. That's just not me.
**Now I've pretty much said all of this because of something that happened today. Fridays are our Operating Room procedure days. Today was no different. My co-residents and I prepare for the case. We take radiographs. A quick (re)exam. Scrub in. Get to work. Today was a little different in that we did composite restoration along with extractions. (Typically it's just a cleaning and extractions). Our patient today was a young 21 year old. He had a motercycle accident a year ago, which left him paralyzed from the shoulder area down. He couldn't talk. He was fed through a PEG tube (which means he didn't use his mouth to eat...) Well, this young guy had some dental issues going on prior to the accident, that had gotten worse afterwards. Our job today was to repair what needed to be repaired, and remove what needed to be removed (of course after consulting with his family). So there were 3 of us today. One resident was a runner, 2 of us scrubbed in for the procedure. One of us did the restorations and one of us did the extractions (me). Well, in the midst of the procedure, some things were said that are not resting very easy with me. My co-resident started doing some work (some work that was of a lesser quality than what I feel he's capable of doing). I don't like to 'question' a person's methods of work, but I will 'hint' or 'ask questions' if I feel something can be improved. (Example: Instead of saying: You should use this instrument. I'd say "Hey, do you want to try using this one?")
**Anyway. On a particular procedure (that I questioned), his (the operator) response was 'why, I mean he's paralyzed, he can't use his mouth, why should I ". THAT pissed me off! BUT he does have a weird sense of humor, so I brushed it off as such for a second...until it happened again 3 mintues later. At another procedure, someone else in the OR 'suggested' a method (because it should be done...not wrong to NOT, but more benificial TO do it..). The (the operator) responded: 'I mean seriously, does it really matter if I do this like this or not? I mean, he can't eat. His teeth are just 'THERE'. I mean this guy doesn't and can't use his teeth so why should I be so concerned about this"? ARE YOU SERIOUS?!?! why should you be concerned?!?!? BECAUSE THAT IS YOUR JOB YOU MORON! Your job is to treat dental issues! YOU signed on for this! Your job is to RESTORE teeth to proper function and proper occlusion REGARDLESS of how the patient can or will use his/her teeth! I don't care if this young man can NEVER IN THE REST OF HIS LIFE put his teeth together again. I don't care if this young man is paralyzed. He is STILL a person. He is STILL a patient. I am still his dental care provider. I am to restore and repair! I just don't know if I can look at him (the operator) the same least not right now. I mean those comments today made me feel like he has no passion for dental work. No passion for helping people with dental problems. Makes me wonder, is he really just in it for the money?!? Money is good, but I think I'd rather be at a job I enjoy, a job I'm passionate about and not make as much than make boatloads or money at a job I couldn't care less about. (sigh)

Thursday, October 15, 2009 today I look like a gorilla!

Here we go again!
Today was a scheduled IV sedation case. Typically, these cases are reserved for patients requiring full mouth extractions, multiple tooth extractions, MR patients, or severly anxious patients.

Today's patient, who I will refer to as Ms. Bully, for privacy matters, HAD to be the most interesting case I've ever had the pleas..eerr umm... I've ever had to work with!

Ms. Bully had a reputation for being pretty brash, and inappropriate at times. She had been described as a 'know it all' and had been described as extremely demanding. She was INDEED a bully! No problem though, because I've dealth with those kinds before, and I was pretty good with calming patients down and getting them ready for their surgeries. Well Ms. Bully was the exception. The appointment went a little something like this.

Ms. Bully's appointment time: 8:00am... she shows up at 8:30am. She is to check in with the nurses and get her vitals recorded, then to my chair for me to do an H&P, then start her IV line. Well at 8:45am, the nurses told me they were finished with vitals and wondered if I had seated her. I hadn't in fact. So, Ms. Bully is missing- for almost 20 minutes. She finally makes it to my chair, and I begin the patient interview.
Me: Hey, how are you today? Well, before we get started on the procedure, I have to do a little interview, find out somethings first.

Ms. Bully: Wait... looka here, I need you to know that demerol does NOT work for me at all... so ya'll gonna have to do something more for*t!

Me: Well, we'll get to that in a few minutes . Okay, so I have a few papers for you to sign.

Ms. Bully: (OBVIOUSLY nervous- sweating, extremely talkative and fidgety). Umm hmm, I ain't crazy, these the papers in case ya'll kill me in here, I'll sign this and it'll say that ya'll are innocent and sh*t. You know my sister is a lawyer and I have a degree in psychology, went to undergrad at the age of 16.

Me: no ma'am. This form is just saying that you have agreed to undergo moderate sedation for this procedure. This one is just saying that you agree that we will take out these teeth. This one is saying that you realize you'll be a little groggy afterwards, and that you are aware that you shouldn't make any important decisions immediately after surgery. And finally, this one is the post-op instructions that I'm about to go over with you.

Ms. Bully: Awww hell! This that sh*t that say I can't smoke for blah blah blah time huh? Well does weed count? Is that smoking? Hey, I'm obviously gay right?

Me: You got it! You can't smoke for at least a week...INCLUDING weed and...

Ms. Bully: Hmphf. I know you heard know I'm gay huh? well look, umm you single? when you getting married? Naw, seriously though I'm glad I just went outside and rolled me a fatty before I came back up here!

Me: Ummm, excuse me- what did you just say? Ma'am, did you really? I need to know if you've used ANYTHING in the last 24 hours. And I don't care if you're gay, just wanna get you comfy so we can get your teeth taken care of okay..haha, ummm okay, well, lay back and let's get started.

Ms. Bully: what happens if I can't NOT smoke for a week? What's gonna happen.

Me: Well, there's a really good chance that you could develop a dry socket. And it's painful! Can't really be treated by OTC, you'll have to come in to a dental office and have it treated...

Ms. Bully: can you just give me a lil bit?

Me: No ma'am. You need to not smoke and you won't have that to worry about now will you?!? NOW, please lay back, relax and I'm about to give you a lil happy juice!

Ms. Bully: see girl, I told you this sh*t ain't gone (yawn) work (yawn) for me. I need something stron...ZZZZzzzzZZZzzz

The procedure begins, goes PRETTY well other than the occasional/usual 'ouch', 'uh-uh', 'moan.moan.moan'. Meds were continuously monitored and administered as needed. After such a rough start, with her anxiety and endless questions, flirt attempts, and plain ole inapproptiateness, the top teeth had been taken out and sutures were beginning to be placed, when BAM- it happened...

Ms. Bully: Wait, what the f*uck you doing? you told me I was gonna be sleep during this procedure. Sh*t I'm scared, this ain't what I signed on for. Ya'll need to just stop, I can't handle this sh*t it hurts! I swear it hurts. My sister is lawyer and I have a degree in psychology. I went to college at the age of 16..blah blah blah.

Me: I know Ms. Bully, I know..none of the meds are really helping you at all, BUT by you being here, I have to give the meds to TRY to help out- okay? (all the while knowing that she was JUST snoring!!! classic sedation!)

Ms. Bully: get your ass over here and help me. this boy is hurting me and nobody's trying to help me!

Me: Ms. Bully, you're going to have to try your best to calm yourself down. You being so worked up is working against the sedation meds.

Ms. Bully: Sedation! Sedation? you call this a Sedation! I'm lucid. I'm lucid! I'm as lucid as I was when I defended my thesis! Sh*t I can feel everything ya'll f*cukin doin in my mouth!

Co-Resident (who did the procedure): ma'am, if you could just breathe for me, try to relax and calm down, the meds will work for you and help us all out.

Ms. Bully: F*ck YOU and F*ck this hospital! My sister is a lawyer! ZzzzzzzZZZZ

As we are all recovering from the almost 2 hour ordeal, our assisant calls me into the treatment room where Ms. Bully was supposed to be SITTING down and recovering. I walk in to see Ms. Bully rambling through our dental materials shelf! I saw her grab a few items, read the labels, and place them back. I saw her grab the 'dry socket paste', cut her eye towards our direction, pretend to look out the window and then sit down. I pretended to get gloves from the shelf to find that the dry socket paste was missing! (she had obviously planned to smoke and wanted to steal the paste to keep from coming back to the office when she gave her self dry socket!). One of the assistants was about to call the hospital police when my co-resident walks in...sticks out his hand and says in the CALMEST voice ecer: 'so, I hear you have our dry socket paste...if you do, Imma need that back'.
Ms. Bully: What? I got What? Are you serious? Ya'll sit up here and kill me hurtin my mouth and NOW you accusing me? awww man, but Imma need that though

Co-resident: no, you won't. dont' smoke!

Ms. Bully: that's F*cked up man... I came for ya'll to help my ass and ya'll stressin me more. That's why I hate all of yall!

Co-resident: here is your pain meds script.

Ms. Bully: think this lil sh*t gonna work for me? Hell naw, I need something stonger and I'm not leaving in pain and not gonna have pain tonight so SOMEBODY gonna get me something that will work!

Co-resident: well guess what? I am that SOMEBODY who you need to talk to. I AM that somebody who is making the call on what you need. You can take it or leave it, but this is it. Take it and manage pain, don't and be in pain!

Ms. Bully: aight, I'll take it...
REMEMBER- this was a moderate sedation case. These patients are typically WAYY too groggy to move on their own until about 30+ minutes afterwards, but this lady, who darn near BEAT all the sedation meds recovered from the meds and was completely ambulatory in about 10 minutes afterwards. She REFUSED a wheelchair and/or escort to downstairs! And BTW- the fact that she did combat the meds so effectly, and caused us to max out the dosages led ME to believe that she may have acutally smoked prior to the procedure. And her difficulty to remain sedated for longer periods of time led ME to believe that she has PROBABLY done a little more than just 'weed' and had done it more recently than she would ever admit - of course, because her sister is a lawyer and she has a degree in psychology LOL, anyway, she leaves all angry, but her bad teeth are out and she'll be much happier and healthier in a few weeks or so. Mind you... 5'5 258 and THAT afraid! College graduate and THAT ignorant and disrespectful! Please understand that I am not trying to down play dental phobias. I KNOW they exist and I KNOW they are real, but an anxious patient who is ALSO a 'know it all' and who is also so 'exacting' is a heck of a mix for a patient to try to manage. Over all though, I think we as a team did a good job to manage her. Lord knows if she had gotten any more aggressive though...whew it would have been smoke in the city!

That just goes to show no matter how big you are, you can still be a big baby. And no matter how many 'degrees' you have, it doesn't always qualify you as intelligent!

AND always remember... If you keep regular maintenance on your teeth (INCLUDING PROFESSIONAL INTERVENTIONS), the pain is slim to none... Ignore your teeth and they WILL go away- and almost certainly NOT pain free!

Tuesday, October 13, 2009

Just another day in the hood...

Well today, wasn't much 'drama' per se...
just a little of my ramblings and what not....
#1- I felt so sad for a patient today who came in for some treatment on the Oral Surgery side. I was writing notes at the desk and heard one of the assistants telling somebody 'well it'll be okay, you can just hold on to my prayer book for a little while if it makes you feel better'. I then hear a male's voice respond, ', it's not that easy, I don't have anything, just nothing...only thing I had was my moma and she don't even like me any more... I just need to end it all'. Moments later, they moved the guy into the examination room. Almost immediately, the treating doctor came out of the room and went straight to the phone to dial for the doctor who was on psychiatry rotation to come up ASAP for an evaluation because a patient in the room was 'asking for assistance in killin himself'.
I dont' know why that still throws me off. I think I'm old enough to know that people have problems. That people handle their problems VERY differently, this was just his way of TRYING to cope. Suicidal patients aren't new to me, but each one still rips my heart out, especially knowing that nothing I could say or do was going to deter his intentions. ANYWAY- that was just on my mind...

Secondly- MY patient today. TINY little guy, really quiet, and very patient! (well you have to be patient in teaching hospitals/institutions because procedures tend to take a bit longer than private practice). Anyway, the only thing I really knew about this guy was that he was a 'trauma' patient. He was being treated for a gunshot wound to the face. He had about 7 surgeries to correct his facial wounds over the past few years. Now, he's my patient and I'm just continuing his treatment plan. Well, I learned at Meharry Medical College School of Dentistry that you 'never treat a stranger'. So I always try to get to know my patients. I like to try to be nice enough and calm enough and gentle enough with my patients so that they aren't so anxious about treatments. (Without being a braggart, I have been known to be quite soothing and fair in my treatment rooms...and I've been known to give 'painless injections). Anyway, well today was a little more 'rushed' than others. But for some reason I took a little extra time to hang out in the treatment room this patient was being seen in. My assistant, was just being her friendly self and asked, 'so, you're getting implants right? What happened, did you have an accident?' The patient looked at both of us and said, in his quiet little voice, 'no, it wasn't an accident, I put the gun in my mouth and pulled the trigger on purpose'. I had my mask on, but my mouth dropped! My assistant's mouth dropped too and all she could muster up was 'are you serious'? He went on to explain that he had attempted the suicide because during Hurricane Katrina, he had lost everything. They came back to New Orleans to try to rebuild but he wasn't able to get a job, so they (his family) went from bad to worse. He said he couldn't take it anymore, not being able to provide for his family. He drank himself into a stupor and shot himself....but didn't die and is ONLY wound was his jaw was fractured! He then went on to tell us how he knows why he didn't die. He said he didn't die because God had a bigger plan for him, and he had accepted that plan- what ever it would be. A few months after his suicide attempt, his daughter-in-law was killed in a car accident- leaving 2 children that his son couldn't take care of (due to his lifestyle). The children had NOWHERE to go, BUT to him (my patient) and his wife. He said that God kept him alive so he could take care of his grandchildren. God wasn't ready for him yet, because God wanted him to work on him self a little while longer, and that his daughter-in-law was an angel on earth and was surely an angel in heaven. NOW- this story (to me) was quite touching, but even more touching for my assistant. She has been going through a bit of trouble with finances and with some things at home. She came to work this morning, eyes red, fatigued, angry, and fussy. I asked if she was okay, and of course she said yes, but went on into what was really wrong. She complained about how bad she had it and how she was tired of trying and how enough was just enough. So, now she's heard my patient's story. By the end of the appointment, she was in tears again. I was worried that she was angry again, so I sent her to the break room and let her have her moment then asked what was wrong. She just simply said 'I always think my problems are big, but then I meet other people with problems too, who can't handle it like I can, and it reminds me of how strong I am and how things HAVE to get better.
That was just on my mind one persons trauma can inspire somebody else to look upwards... and be encouraged.

Monday, October 5, 2009

My first ER call...

So..While on call this week, I get a call at 4:30am. The emergency, as explained to me via phone, is an 11 year old, bike accident, avulsed tooth and intruded tooth. I ALREADY know this means 'splinting teeth'. Fine right? WRONG! Why? BECAUSE I AIN'T DONE NO DARN SPLINTS! LOL so Imma have to wing it... Well when I get there, my co-resident is already there who knows how to splint teeth so..all is well...I go in the room to talk to the mom (my co-resident had already spoken to her and had already walked out). The convo goes something like this:
Me: Hey, I'm Dr. Trotter, what's going on here?
Mom: Yeah, man, shoot, I'm glad you in here now, maybe I can get some answers. Look, her tooth is over there (in a cup on the table). Can you put it back in? She's only 11! Would you wanna be 11 with a missing tooth?
Me: Okay, I'm going to see what it looks like. There is a possibility to put the tooth back in, but that depends on the time it's been out of the mouth.
Mom: good, cause shoot that other guy was acting like nothng could be done.
Me: so when did this happen?
Mom: oh, yesterday at 4:30 in the afternoon.
Me: Oh, about 12 hours ago, huh? Well that certainly changes the chances of us saving that tooth. Typically you wanna get those back ASAP, and by ASAP I mean IMMEDiATELY... an hour at the latest!
Mom: but she only 11, would you wanna go without a tooth at 11?
Me: No ma'am, I wouldn't but the chances of this tooth replanting is slim to non at 13 hours.

I go to the lil girl sleeping on the chair. I say 'hey 'Lil Missy', how are you? She wakes up and instantly starts to cry.

I talk to her a little bit. We had about 3 minutes of 'it's okay, imma try to help you blah blah blah' talk before she calmed down enough to let me look in her mouth. I look in and I see what appeared to be 2 missing teeth. One of em was on the table and I couldn't figure out where that other front tooth was. I try to look and she snatches away (anticipating pain). I say Lil Missy, did you lose 2 teeth or just one? She said 'just one, the other one feel like it's in my nose'. I get a mirror and look again and bam- there it was! Sooooo at this point my job is to pull that tooth back down and put a splint on the teeth to keep them stable. BUT I have to anesthetize her first. I prepare to do that and what happens? She goes bananas! LOL COMPLETLY CUH-RAZY! LOL I coaxed her enough to let me at least 'spray sleepy juice' on her gums with no stick. When she trusted me enough on that, she didn't realize I had actually injected her a few times. When she saw the needle though, she went crazy again. I stopped and asked 'Lil Missy, have you ever gotten in trouble in church and your Granny or Moma pinched you?' She shook her head 'yeah' through a flood of tears. I said 'well look, this is going to feel like a little pinch. Like that pinch, the sting is going to go away fast and it will make your whole mouth feel better, will you trust me to pinch your gums for a second?" She agreed, but wanted to hold her mom's hand. Mom came up and I told Lil Missy, 'if it doesn't feel good, squeeze yoru mom's hand as hard as possible!' Her mom asked her 'you wanna pray while she does the SHOT'? Lil Missy started to cry again and said "YEAH..We gotta pray hard moma", Her moma gave me the nod, and started to pray, during that injection, Lil Missy didn't move a bit, didn't whimper a bit, didn't feel a thing! (Don't tell me there isn't power in prayer!). After that one, she looked at me and said 'I can't feel nothing now, are we done'? I told her now and proceded to fish for that tooth. She got a little ansy and asked through her whimpers, 'Hey, miss..this hurt so bad, you just don't know... you ever had a shot in your mouth'? I said "if you let me finish, I'll tell you a story after we' She agreed and I finished up the procedure. Pulled #9 down into place and stuck #8 back in there (with no confidence of it replanting). I splinted them all together (with the help of my co-resident). Stitched her up and we wer done. When I finished, she said 'oooh, miss, you done?' I tell her yeah and she said 'I gotta pee, but don't leave you said you had a story to tell me.' I do paper work and chit chat with her mom about the prognosis of that tooth and future treatment options. Moments later Lil Missy walks back in and says 'Miss, can I eat when I leave?' I say 'yeah, but only soft foods, soups and mashed potatoes'. She said 'ohh miss, can I drink'? I said 'you can drink any thing you like except alcohol'! She died laughing and said 'Moma, she funny, I like her and she didn't even hurt'. I said 'umm hmm told you... you wasted all those tears for nothing didn't you?'. She laughed and said, "umm hmm I shole did!' Then she said 'wait, miss, what about the story you said you had'? I said 'okay, when I was about 10 or 11, I was playing baseball and I got hit in the mouth with a baseball. I was kinda like you. I was all fussy, I was crying and going crazy. I was so crazy that my dad had to sit on me so the doctors could fix me, so I knew how you felt, that's why I was tyring to talk to you and help you calm down'. She said 'ahh, so you got fake teeth?' I said 'no, i had braces kinda like what we put on you and my teeth are fine now because I did what the doctor told me.' She said 'oh okay, Imma do what you say to do, cause I want all my teeth when I grow up and Imma be a doctor like you cause you were nice. You a DENNIS now cause you had did this when you were little?'. I said 'as a matter of fact, yes, that had a lot to do with me wanting to become a dentist'. She hugged me and then said 'wait, Imma be a model AND a doctor too, can I do that?' I said 'yeah girl, do what ever you wanna do!!! But you gotta start my keeping good grades in school.' She said 'oh yeah, I do good in school, but umm look, do I GOTTA go to school tomorrow? you see my lip!?' Told her she could go tomorrow if she wanted to, but it was up to her and her mom. She gave me a high five and I left!I left feeling darn proud of myself! LOL I managed a fussy kid, who after injections said I was nice and funny and wanted to be like me! awwww!

Sunday, October 4, 2009

I'm currently in my residency program in New Orleans at LSU. As part of my program, we do call rotations. I'm on ER call right now. We also do Operating Room cases every Friday, I've done 3 so far. Two of these particular cases kinda stand out for me. One because it was cute, and other because it really broke my heart. I'll start on the 'down side'.

***To not identify the patient, I'll use fictional names and will refrain from 'specifics' about the patient... not trying to get into any legal troubles while trying to share my experiences***

Patient "Mr. Man" presents to our clinic for clearance for radiation therapy. (I didn't know what this was either until I made it to LSU). Anyway, "Mr. Man" presented with Posterior pharyngeal cancer, and other health issues. Our main concern was to get the bad teeth out so that he could start his radiation treatment. I'm not a physician, but this poor man looked like he was ankle deep in a grave. He had a trach tube also. WELL on the first day he came in, I was a little sick on tummy. I go in to do my little patient interview. I walk in notice this hugggeee mass on his neck and am like 'WELL SHEESH!' (to my self of course). I begin my interview: "Mr. Man, what brings you in today'. "Mr. Man' takes a breath in and HUFFS out a response: my teeth, need radiation'. Instantly I caught a whiff of that bile smelling breath and had to make up and excuse to leave the room so I could gather my thoughts. I say 'Mr. Man, I'll be right back, I need to grab another form'. I walk out calmly until I got around the corner- then broke into a full out jog to the bathroom where I proceded to release my breakfast! I then went to the resident's room and asked for back up! My co-resident goes in to complete the exam. Scheduled Mr. Man for IV sedation in a week.

I was away at an off site rotation and found out later that Mr. Man was unable to under go his IV extractions due to difficulty breathing. Now Mr. Man is scheduled for OR extractions. GREAT- Friday morning, OR day. Patient is to present at 5:30am to check in and get worked up for surgery, surgery scheduled to begin 7am. 6:00am we can't find the patient. His group home personelle says he's at the hospital..but we can't find him. Finally at 7am, a nurse says 'ya'll waiting on Mr. Man? He's sitting outside'. I run downstairs to find Mr. Man and his care giver outside... Mr. Man in obvious pain. I get them to the check in floor, they give him pain meds until surgery time. Needless to say, our 7am time was bumped, and we started surgery at 10am.

Mr. Man is in the OR, we prep for the procedure, before we touch him our faculty memeber is like 'STOP!- dont' touch him, get Oral Surgery down here, this patient has what I believe to be an impending Ludwig's Angina!'. Oral surgery comes in checks things out, agrees to take over the case after we extract. We start procedure (27 teeth..all severly periodontally involved..) teeth pop out like popcorn pop, pop, pop, pop... blah blah blah... We're done! He's in recovery. I get a page.. 'Mr. Man won't stop bleeding'. I go back to recovery to try to handle that situation. Get it fixed, and go home.

Phone rings.. co-resident on the phone: 'they [oral surgery] want you to round with them on tomorrow morning about Mr. Man'. Cool- I'm doing rounds in the morning at 7am with the oral surgeons. I get to the hospital, find Mr. Man, I peek in the window and notice him trying to get up... I open the door and BAM!!! FFFUUUNNKKK flipped me back out the room! I had to gather myself again and ask 'Mr. Man, are you okay?" Because he has a trach tube he can't talk, so he communicated to me by pointing... and he points to his nakedness and a pile of ummm POO he was stewing in in that hot room! (ummm EWWW was all I could say). I remained as professional as possible and reported it to his nurse (at 7:30ish). We make it to his room for rounds at about 8:30am to find the nurses JUST getting to this poor man. It was pretty much determined that this poor fella would probably not make it much further than a treatment or two of radiation, but we had done our part to try to get him ready for his next phase of treatment. NOW- with all of the light hearted stuff aside, on to the part that breaks my heart:
#1- why would someone not try to seek dental help? He was living in an 'insitution' for years, and they never thought to get him any dental care!!!! We (dentists or SOMEBODY) could have POSSIBLY gotten those HORRIBLE teeth out months ago and he could have POSSIBLY started his other therapies MONTHS ago- that could have possibly improved his condition somewhat? WHY people WHY?
#2-WHY did it take an HOUR for somebody to come help this poor fella get cleaned up? He's barely ambulartoy, and he can't exactly call the nurses and TELL them what's wrong. He can't speak! AND when I told the nurses (twice), I get this response the 2nd time 'well miss, look, we have things to do, we can't just stop what we are doing to go clean up one patient. When my aide gets done, then we'll go take care of that, we are aware of the situation'. WTF! Your aide is putting blankets in a closet! What can't she stop about that for a few minutes? YOU are stapling some papers.. .WHAT can't you stop about that for a few minutes to help this poor man?!? Anyway, but this time the Oral Surgeon Chief walks up, and I immediately tell him the situation. He went to the nurses and pretty much lit a fire under em and they got Mr. Man cleaned up. I just don't get it... what ever happened to human kindness? If that was YOUR father, brother, uncle, cousin sitting in there, unable to speak and stewing in POOP, would YOU want a nurse to say 'I gotta get my blankets put up first'? Are you SERIOUS PEOPLE!! Have we lost touch with humanity? SHEESH... anyway, that's the end of that story... I think Imma write the other story in another note because this one is quite lengthy! LOL the next one is a little better though! LOL Peace out HomeFries until next time