Asheville!

Hey all!
     I've been working with the Mission-St. Joseph Children's Hospital doing pediatric work in the OR. Mostly my days start at 6:30a and we treat 2-3 kids under general anesthesia each day ending around 4 or 5p. These children range from 1-9 in age (mostly pre-K) and have the saddest mouths I've even seen - mostly due to juice in bottles, Mountain Dew in bottles, this popular flavored sugar water called "Bug Juice" and horrible, horrible parental neglect (Fun fact though: on every questionnaire I've seen, the parents say they brush their child's teeth 2X a day). The patients are referred to us from all over Western NC and usually every tooth in their mouth has a cavity. There is certainly no shortage of practice on stainless steel crowns and pulpotomies! Our saddest case so far was last Friday when we had a 22 month old with completely bombed out teeth - so bad we could only save two canines with stainless steel crowns and had to pull all the rest.. The group I'm working with has been on a huge campaign in this part of the state to push for oral health education and even has a ToothBus with two dental chairs to provide work to elementary students in rural areas.
     Asheville is wonderful - Tyler Banachowski, Tim Chang, Vincent Ha, Matt Parr and I are all here scattered over various rotation sites. We've also met up with some GPR residents who graduated from UNC last year for baseball (and I see them occasionally on their anesthesiology rotation through the hospital). The food is marvelous, the hiking great and this past weekend we were here for the Bele Chere street festival, one of the largest in the US.

     Pictures below:

ToothBus - somewhere outside Brevard, NC

Inside: Two ADEC chairs, x-ray equipment, an autoclave and lots of Pixar movies!

Matt Parr and I with some recent UNC grads: Chris Planer, Jessica Oliver and Kasee Metcalf at the Asheville Tourist's baseball game 

Street graffiti downtown.
My favorite shirt so far has been "If you're too weird for Asheville, you're too weird". 

Vincent, Tim, Matt and I downtown at The Southern. Yes, that is lobster mac and cheese. And hell yes, it was delicious.

Bacon and Maple Syrup ice cream - AMAZING.
Going to get fat (and poor) eating my way through this place.

My mom came up one weekend and we went hiking along the Mountains to Sea trail right off the Blue Ridge Parkway.

Yay! We're halfway through this round - keep up the great dental work I know y'all are doing and please keep posting! If you're having trouble - shoot me an email.

E

Howdy from Clay County (Murphy)

Hey guys,

I laughed so hard from the previous post by Keyvan- but I do hope that your living situation gets better.  I'm really thinking that if they're doing drugs, the school should provide you some other housing there.  Have you notified anyone about this?

My rotation has been really great so far.  I also see a lot of kids but to my surprise the Clay County Health department- Dental Program started seeing adults as well.  I came here with low expectations but have been so pleased with the clinic and my living situation.

So, at first I was told that there is no AHEC housing close to the clinic and they asked the people in the community if anyone could provide me housing.  Luckily a very nice family practice doctor offered her beautiful home to me and here I am in a huge house with access to internet, kitchen and staying in a spacious room.  I have already started cooking in her kitchen and sharing the food with her since she doesn't like to cook and we spend our nights playing boggle or trying to find nerdy games on our iPads.

As far as the dental clinic, it's only about 5-10 mins away from this house which is awesome!  There are two dentists (very nice older gentlemen) with 4 dental assistants and 2 dental hygienists.  One of the dentists works only on Mondays and Tuesdays and he does all the extractions for kids and adults and SSCs and more complex cases for kids.  The other dentist works all 5 days (Mon-Fri) and only does fillings.  So the first 2 days I only hung out with the extraction dentist and he basically let me do whatever I wanted.  I later found out that he used to be an orthodontist for many years before he decided that he wanted to do general dentistry before he completely retired (interesting huh?).  The rest of the week the other dentist gave me all his appointments so I go by his schedule while he only checks the hygienists.  It has been so great because I'm really getting a feel for the real world dentistry and what it's like to be an actual dentist in a rural dental clinic.  I love the little kids here- they all have been super good.  I had a 5 year old girl who got up after her filling a couple of days ago and hugged me and said "I want you to always be my dentist."  That really made my day :).

One funny story is when I had a 26 yr old guy come in and the receptionist ran up to me before I saw the patient and she warned me that he has a really bad attitude and that I can get her if he causes me any trouble (being rude and such).  Well as soon as the pt walked in his whole demeanor changed and he said "I would have shaved if I knew this".  He then went on to tell me that he's been trying to pull out his tooth but all his attempts have failed and so he finally came to the dentist.  I introduced myself and told him that I would be taking care of him.  He said "YOU'RE GOING TO PULL MY TOOTH? GOOD LUCK WITH THAT".  So when I finally extracted # 30, he was so happy and walked out with a smile on his face saying "I'll let you pull out any of my teeth any day."  The receptionist was telling me that his attitude was completely different from when he was in the waiting room to when he walked out.

One thing that I've realized is that being in a rural area + a dental clinic = gross decay, no money, lack of education.  I also found out that there is no fluoride in the water here and that is not helping the situation at all.  And I was also told that the clinic I'm at doesn't really do amalgams because they started out as a pediatric clinic and so they only placed composite then and now it's too costly for them to add amalgam?!  I saw a 11 yr old girl yesterday who had all these deep cavities and I'm thinking in my head wow how did her situation get so bad.  First, she was super scared of the needle and I had to explain everything to her and finally convince her that it will just be a pinch.  Well she did really well and said it wasn't bad at all.  So I go to excavate the caries on #5 occlusal and it goes deep and deeper and finally I stop to feel the pulpal floor to see if I'm even getting close to any sound tooth structure and my explorer just goes right in the pulp (can we say carious pulp exposure).  Then I found out that luckily there is a really nice endodontist in the area that treats the kids with Medicaid or HealthChoice for free so we referred her there.  The dental assistant later told me that the reason why her teeth are in such bad shape is because her mother never brings her to the dentist and actually this time it was the grandmother who finally stepped up and brought her granddaughter.  It was just so sad and I felt so bad for the kid because that seemed like child neglect to me.

I have another interesting/crazy story that I faced yesterday and today I found out that it is somehow related to Eric Rudolph (The bomber and terrorist from Murphy, NC!!!).  Since I have already typed too much in this blog, I will share the story later so more to come...... ;)

Hoda

Kiddies, not so bad. Germs and pot, BAD!!!

Greetings Dental People!

My 3^rd rotation is at Stanley County Dental. For those of you who are not familiar with this location (i.e. you are not a pedo gunner), this is an all pediatric place; as in all kids, 99% under 12 and most of them are referred to us by their dentists who refused to treat these little rascals (or, cutie patooties). Also almost all of them are Medicaid or HealthChoice patients. I must say I was dreading the fact that I have to treat kids from 8 to 5 for the next month, but honestly it is not that bad. My preceptor and the office staff are all incredibly nice and helpful.  The best part was going to OR for the first time yesterday, which I really enjoyed.  I did my first (actually first 5) SSC and pulpotomies and it’s a whole lot easier doing in on a knocked out patient.

HERE IS WHERE IT GETS INTERESTING:

On the other hand, what has been my nightmare so far is my living situation. I live in an old dormitory at Pfeiffer College in Misenheimer, NC. That’s right Misenheimer; google it. Their campus probably consists of 4 or 5 buildings and is in middle of BFE.

First day that I moved in, I was given like 3 different keys by the RA guy who took me into the apartment for a little tour. Before going in, as we were walking up the stairs he goes, “so we cleaned up a few days ago, but we were cooking last night and it may be a little messy around the apt”, then he opens the door to the apt and… O M G!!! The place looked like a tornado hit village that was rampaged by rats the next day.  I am talking about filthy dirty. Trash, dirty cloths and unidentified objects everywhere on the floor. Beer bottles on every corner. One beer bottle sitting on the table and half full was Corona but the “beer” inside was black. Later I saw a pack of chewing tobacco and found out that that “beer” is actually saliva and chewed tobacco!!! Then I see this 50 inch TV in the living room with a surround sound system (so much for no TV in the information email). According to the RA guy, my room was “specially” cleaned up for me. A bed with a dirty and stained mattress as if they snatched it from a hobo off of Franklin st. and lots of feathers (?!) on the floor and dust everywhere. Maybe my room was rented to a chicken with bladder issues, who knows? Bathroom was even more dirty. The toilet bowl looked like they poured tar into it; it had thick black stains in it. The RA guy then joyfully noted that I have a shower curtain as an addition to my 5 star luxury room that looked ok from outside but when I went to take a shower the next day and saw the inside was covered by colorful moldy spots. I think I spent  about 30 minutes Lysoling everything in the bathroom before putting my stuff on the counters.

Every night at around 10 o’clock my suitemates and a couple of others from other suites walk in with a stack of shooting-and-drug-cartel redbox movies and start watching movies until like 2-3 AM, putting their surround sound system into good use (my room is right next the living room). You may ask how they can stay up this late? The answer(s) is(are):

1-      They don’t have real classes or education for that matter that they need to worry about for the next day

2-      They drink about a 6 pack of energy drinks every night (not exaggerating)

3-      Sleep during the day…AND…

4-       I woke up the first night at like 1 AM to the sound of a guy coughing his lungs out followed by others laughing at him telling him that he can’t get high if he keeps coughing all the smoke out and that he is wasting all that pot!!!! They also have munchies and lighters all over the living room. Lovely!

5-      They probably take Adderall everyday since I heard one of them yelling at his GF telling her he needs only enough Adderall for the next few days and he can’t give her any.

Anyway, I have tried a couple of times telling them to turn the TV down after 11 PM so that we can have a symbiotic relationship for the next 4 weeks, but then they get high and so does the TV volume after an hour.

I was told by several people that I’m being “tested.” Here is my response:

I don’t know why or by whom I am being tested, but this four weeks better be deducted from the time- I’ll-be-spending-in-hell sentence.

Keyvan

p.s. I hope everybody else is enjoying their rotation J

Columbus wasn't a hero - he was a murderer.

Hello from O-high-O, my beautiful friends.  I drove in yesterday, and Columbus is a bigger city than I was expecting.  Similarly, Nationwide Children's Hospital looks to be a bigger children's hospital than I was expecting, also.  I've been drowning my loneliness in premium root beer and books about ancient evils.

So far, I can sum up my entire experience with the following photograph:

More to come.