Dr. Mommy Dentist

conversation with the cookie

2007-08-22T08:04:00.001-04:00

"mommy, maya and monisha called me a crybaby-head again. i'm not a crybaby-head!"

"of course you're not, sweetheart. don't play with people who call you names, they're not nice."

"i know, mommy. i need to find some normal friends."

heading back home

2007-08-12T21:36:00.001-04:00

so my flight leaves JFK tomorrow morning bright and early. i had originally booked a late afternoon flight but changed my ticket after my ride to the airport situation changed. i'm glad to be heading out earlier rather than not, as i do have the drive back from buffalo to conquer after we land. so i have some time to unpack and decompress after i get home, as i've got a busy week ahead of me. vacations are never relaxing.

it was a fantastic trip and felt wonderful to be back. a lot of conflicting emotions run through my mind when i'm here. i waver between i never should have left to i'm so glad i don't live here anymore about five times a day. i'm not sure i could ever go back to living here after living in toronto, but i would be lying if i said i didn't pine for the good old days and wonder how different my life, my family's life, would be if we'd stayed.

i will blog more about all that when i return. here is one of my favorite songs of all time. it's from the dudley moore film arthur and it's so 80's and is so NYC and i just love it.

gluttony and overstimulation

2007-08-11T07:57:00.000-04:00

i guess this is very typical when one heads back to NYC. i braved penn station at lunch hour, walked to the post office on 8th avenue in the pouring rain with the stroller and the umbrella and people weaving in and out, braved the NYC subway system (man, i forgot how gritty it was!) and made it to carmine's where one of my oldest friends and i ate so much it hurt. i walked it off for about forty blocks, then ducked into zabar's to by canuck a cinnamon babka, a favorite treat when we were in dental school. another ten or so blocks and i was down by lincoln center at my oldest friend's new apartment. it was awesome - a studio on 69th and columbus with exposed brick, a fireplace, and newly finished everything. the apartment is the size of my bedroom, but he can walk to the subway and to the zillion amenities he has within a 10 block radius. he refused to tell me how much he pays a month in rent because he knows i'll laugh at him. but such is the life of a new yorker.

the evening continued with even more food, which i had no room for but forced it down because it was just so damn tasty, then washed it down with a smoothy at penn station because i just had to. it was a miracle that i didn't puke on the train, but it's not like it hasn't happened to people before and i don't think anyone would have noticed!

i had a new york moment when i was at penn trying to call my dad to let him know what train we're on, and there's these special phones that if you pop a quarter in you get 30 seconds anywhere in NYS, very useful for people who are calling nassau, suffolk, and westchester and don't want to spend $1.50 just to let people know which train they're on. so i find one, put my quarter in and my sister answers, and just as i say the time, my quarter pops out and the call gets cut off. hmm, okay. i try again, and this time my dad picks up. i get to "i'm on the 9-oh..." and this time the call cut off but ate my quarter. dammit. so i try another phone across from me, and it happened again, this time my quarter popped out. i slammed the phone and bellowed out, "goddammit, doesn't any phone in this fuckin' city work!" no one even batted an eyelash. i made my way to the track entrance, found another phone, and it happened again, but i was able to get all the info to my dad and he was there to pick us up safe and sound.

i got back at 10:30 and returned to find all of my family who had come for dinner while i was gone but waited for my arrival. more food, dunkin' donuts with candles for my sister's 18th birthday today. all the conversation was gone from me, if you can believe it, so i chilled out to watch male gigolo with my sisters and called canuck to say goodnight. i slept very well.

today we're going to take it easy, maybe just relax at the beach. i miss the ocean, i could smell it when i landed at JFK (it's right on jamaica bay). cookie's been fabulous this whole trip, so well behaved, even in all the restaurants, and just too damn cute. she struck up so many conversations with strangers, especially on the train rides. the funniest was when she shouted out to the conductor, "hey, what's your name? mine's cookie!" hey, where's your boy?" i think she's used to seeing male conductors and that's why she asked, but it definitely drew laughter from the surrounding passengers. then she struck up a conversation with the girl sitting next to us and her boyfriend, both of whom were travelling from newark airport and were drinking smoothies like we were. the boyfriend got off first, and cookie asked, "hey, where's your boy?" then when the girl got up and picked up her red suitcase to get off the train, cookie said, "i like your red suitcase, how did you get it? did you find it in the dumpster?" we just laughed our asses off!

gluttony totals for yesterday:
bread, bread, bread, and foccaccia from carmine's
carmine's salad
rigatoni and meatballs
coffee and chocolate mousse cake from french roast
hamburger and french fries from p.j. clarke's
some of tony's fish and chips
20 oz. angel food smoothie from smoothy king
1 dunkin' donuts jelly donut
15 strawberries

they are going to have to roll me home.

back in the USA!

2007-08-10T07:44:00.001-04:00

cookie's up really early and the rest of the house is fast asleep (four teenagers, no one gets up past 10 a.m. here) and i've had LOTS of time to update the blog and facebook. it feels awesome to get back. the flight down rocked, but i almost missed it because i was a goon and didn't fill up the car before i left and had to find a gas station on the interstate so i wouldn't stall. plus i got held up at the border for a half hour! i breezed right through, but the customs agent deemed it necessary to detain each car ahead of me for a full five minutes, WTF!

i made my first trip into manhattan with my dad, who had to teach a class at 24th and lex. i met up with one of my friends from dental school and had my first slice of new york pizza in over nine months paired with a diet coke in one of those wax-coated paper cups. it was so meaningful i almost cried. seriously.

today's lunch at carmine's and hanging with more friends. i'm trying to hook up with as many people as i can, but it's hard - i do have famliy here, too! tomorrow's my sister's 18th birthday and we have something planned for her, probably dinner out.

it feels really great to be back. i miss canuck, as he opted out of this trip because of work, but i'm having a great time. i'm keeping tabs of all the new york food that i miss and am now stuffing my face with. here are yesterday's totals:

"official" NY Mets donut from dunkin' donuts
new york city pizza
new york bagel
anything that doesn't have french written on it
milk in jugs/cartons

feels good

2007-08-04T01:56:00.000-04:00

to enjoy the long weekend. it was wonderful to have the day off and furthermore topped off with an awesome party. my hygienist got married tonight and since the whole office was invited and the reception was kind of far up north, we decided to take a much needed and much deserved day off. i car-pooled everyone up there and because of long-weekend traffic and some miscommunication about who was giving a ride to whom and because some people weren't at the designated spot at the designated time, we were 45 minutes late and completely missed the ceremony and even arrived sans one invited guest. but that's another story for another time. it's about 2 a.m. now and although i just spent the last 10 hours partying and shuttling people back and forth, i feel remarkably wired right now. hence the late-nite post. but i'm so stoked to have three whole days with cookie and canuck, and i feel so relaxed and happy that i can sleep in and make pancakes tomorrow morning. yum.

the wedding was specatcular and the bride and groom looked so happy! he smiled a lot, and i can boast of at least being part of the reason as i did a crapload of work on him before the wedding, including anterior bonding. he hadn't been to a dentist in a long, long time (he was embarassed to divulge how much) but he was an awesome patient and we had a great time working together. he apparently was so happy with his teeth he walked around the house saying, "S, look at my teeth, aren't they neat? they look so nice!" i wonder how much he'll still like me after i do that treatment-planned endo on #36 when they get back from their honeymoon..... anyway, she's off to italy for three weeks and i told her to shop for paper in florence, my favorite city in the whole wide world, as it is renowned for its paper and she loves to scrapbook. who would have thought it, florence and paper, BFF? when she comes back it will be a short while before her time with us is up, as she's covering the mat-leave for our regular full-time hygienist who will be returning in november. it's very bittersweet, as we love P and she's fantastic, but we'll really miss S when she goes. i hope there's some way to keep the two, but such is the nature of mat-leave.

i think i may actually be getting sleepy now...

interesting story

2007-07-30T08:25:00.000-04:00

Dentist Wins Case Over Tusks in Mouth

('OLYMPIA, Wash. (AP) -- An oral surgeon who temporarily implanted fake boar tusks in his assistant's mouth as a practical joke and got sued for it has gotten the state's high court to back up his gag.');

By THE ASSOCIATED PRESS
Published: July 27, 2007
Filed at 2:45 p.m. ET

OLYMPIA, Wash. (AP) -- An oral surgeon who temporarily implanted fake boar tusks in his assistant's mouth as a practical joke and got sued for it has gotten the state's high court to back up his gag.
Dr. Robert Woo of Auburn had put in the phony tusks while the woman was under anesthesia for a different procedure. He took them out before she awoke, but he first shot photos that eventually made it around the office.
The employee, Tina Alberts, felt so humiliated when she saw the pictures that she quit and sued her boss.
Woo's insurance company, Fireman's Fund, refused to cover the claim, saying the practical joke was intentional and not a normal business activity his insurance policy covered, so Woo settled out of court. He agreed to pay Alberts $250,000, then he sued his insurers.
A King County Superior Court jury sided with Woo, ordering Fireman's Fund to pay him $750,000, plus the out-of-court settlement. The insurance company won the next round, with the state Court of Appeals saying the prank had nothing to do with Woo's practice of dentistry. On Thursday, the state Supreme Court restored Woo's award.
In a sprightly 5-4 decision, Supreme Court Justice Mary Fairhurst wrote that Woo's practical joke was an integral, if odd, part of the assistant's dental surgery and ''conceivably'' should trigger the professional liability coverage of his policy.
Dissenting Justice James Johnson said the prank wasn't a dental procedure at all and only ''rewards Dr. Woo's obnoxious behavior and allows him to profit handsomely.''
The back story, the court wrote, is that Alberts' family raises potbellied pigs and that she frequently talked about them at the office where she worked for five years.
Woo said his jests about the pigs were part of ''a friendly working environment'' that he tried to foster.
The oral surgery on Alberts was intended to replace two of her teeth with implants, which Woo did. First, though, he installed temporary bridges that he had shaped to look like boar tusks, and while Alberts was still under anesthesia, he took photos, some with her eyes propped open. Before she woke up, he removed the ''tusks'' and put in the proper replacement teeth.
Woo says he didn't personally show her the pictures but staffers gave her copies at a birthday party.
Woo's lawyer, Richard Kilpatrick, described the surgeon as a kindhearted, fun-loving man who was chagrined that an office prank turned out so badly. He was delighted with the high court's decision, Kilpatrick said.
Attorneys for the insurance company did not immediately return calls seeking comment.

it's funny how office dynamics work and the level of familiarity that people have and/or think they have amongst their co-workers. did this guy cross the line? it was obvious that this employee felt confident enough in his abilites and comfortable enough to ask this doctor to extract her teeth and replace with them implants, and it may be safe to assume that there was probably at least a certain level of familiarity between these two people (i never asked any of the dentists that i worked with for treatment until i'd been there long enough to establish a comfortable relationship, but that's just me). this may have given the doctor the false sense of security with this woman, and it sounds like he was a bit of a prankster himself so he felt like he could go ahead with such a "harmless" joke. personally, i thought it was kind of funny, especially if it was a joke between work friends. i could see how it was a lapse of judgement at the time and if he offended her, a profuse apology should have sufficed. i could even have understood the fact that she quit, as there was a breach of trust and now a lack of confidence. but to sue for $250,000 sounds preposterous to me. it's not like he took naked pictures of her and distributed them over the internet. the pictures were distributed amongst friends and coworkers at a birthday party, a party to which he was obviously invited and i don't know about you, but i don't invite random strangers or just any boss i work with to my birthday parties. is this another example of another good old american trying to bilk the legal system, or was this a truly legitimate complaint in which someone was horribly violated? when is that line crossed?

we as professionals do have to guard our words and our actions more stringently in the workplace. it is obvious that you cannot assume that level of familiarity with anyone, especially your coworkers. i had a very similar experience with this not that long ago. both of the offices i work in are very casual - the way we hang out after hours, talk amongst ourselves, and even the way we interact with the patients. we are all extremely friendly and comfortable with each other. the hygienist that i work with on saturdays has a page on facebook and when i signed up i noticed her picture on one of my friend's pages. it was an awesome shot of her in hot pants and a tight little top, and she looked absolutely stunning in it. so when i saw her again to ask if i could add her to my friends list, i said, "hey D, i saw your facebook picture, wow hoochie mama, it was awesome!" she didn't say anything to me but gave me this strange look and avoided me for the rest of the day. when i approached her the next week i worked with her and asked her what was wrong, and she told me what i had said to her was extremely offensive and that she does not use that kind of language, i was totally taken aback. i had worked with and chatted with this person for over a year, and even exchanged that word with my other co-workers and assumed no harm in it. of course i apologized profusely and she accepted, but the relationship has certainly changed and it will take time to build up that trust again on both ends. if i had learned anything from this experience, it is to not assume that level of familiarity with people, especially in the work environment. hopefully, she doesn't sue me or my malpractice insurance company.

My Simpsons Doppelganger

2007-07-23T08:23:00.001-04:00

hopefully i won't see this one walking around springfield anytime soon. doppelgangers are supposed to be bad omens.

the aliens are coming and i'm going to new york!!!

2007-07-22T10:18:00.000-04:00

either cookie's been watching too much t.v. or she was told something by the kids she was hanging out with at the pig roast, who knows, but she spent a good portion of time telling the other guests, complete strangers, btw, that the aliens' house was next door, that they left something in the backyard of ameloblast's house, and that they were coming for her. this kid is like a sponge, i don't know where she picks up some of the things she says. i really have to watch my mouth around her now, especially when i'm driving.

so it's been 9 months since i visited my old home in the big apple and i've traded enough trips to NY for trips to MI to warrant two place tickets to visit my old stomping grounds. this trip is going to cap off a pretty busy summer peppered with insanse hours at work, barbeques, weddings, and visits from my friends. cookie and i are driving to buffalo to fly jet blue my FAVE airline and the only one i'm convinced won't crash because because it has satellite t.v.'s on each seatback, into JFK. canuck will have the house to himself, free of estrogen for a few days. i'm so excited! i have a list of things to do when i get there, and of course almost all of them revolve around food and shopping. i'm also have to pencil in the tons of people to see, and how the hell am i going to squeeze this all in four days? my sister is also turning 18 on aug 11, and since i couldn't make it for her graduation i promised her i would take her to the beach. ooooh, i love the beaches on long island!!! if i'm going to parade around in my bikini, i should probably do my best to shed those excess 15 pounds in three weeks, which is not bloody likely but still a fantasy i like to entertain. ameloblast's pig roast didn't help much in that department.

here's a tribute list of new york things that i totally miss and will hopefully get to check off when i head over there in three weeks:

white castle a.k.a. "sliders"
grey's papaya - best hot dogs in the city
tasti-d-lite - as seen on sex and the city, who knows what's in there to make it taste so damn good and still low fat
zabar's - mine and canuck's favorite place to shop in dental school
dean and deluca - i used to work there! $55/pound chocolate! and i bumped into stephen baldwin, too.
the subway - the best in the world, rivaled possible only by london's underground
LIRR - we used to live in bayside before we moved here and my folks lived in hicksville (yes, that is the real name of the town)
central park
columbia university main campus

in other recent news, my dad got hit by a car when exiting the wantagh LIRR station (see above map) and is now holed up with a fractured thumb and a possible rotator cuff injury that may need surgery. of course, this happens on monday and i find out TODAY when i called to finalize my trip details, as me and cookie will be crashing with him for part of our trip. he is planning to sue the driver, the owner of the vehicle, and the insurance company, as is the good old american way. thank god he's alright, the chick that hit him apparently ran a stop sign and bolted out of the lot before smacking into him. it will be interesting to see how this pans out.

now i just have to get thru the next three weeks.

facebook

2007-07-14T10:06:00.000-04:00

because i have so much free time and no other obligations in my life, i relented and joined facebook. i've now officially perfected the fine art of procrastination.

i have to clean my house now. after i figure out which rfiend i should send my "free gift" to. and comment on all the other blogs i read. and check my e-mail, again.

man, this is going to be a problem.

bombed out teeth!

2007-07-08T09:05:00.000-04:00

okay, i've been getting a crapload of teeth with horrid subgingival caries. i've sent, like, six people to the periodontist for crown lengthening in the last two weeks! i've been kind of obsessive about the crown lengthening thing lately. i see so many teeth that should have had the surgery that didn't, and i think of all the crowns that i did that may or may not have needed it. i'm taking no more chances.

i had a guy shadow me over the last few days, a dude who is applying to dental school for next year. i liked having him around as i loved explaining all the stuff i was doing. i'm pretty textbook, but i was REALLY textbook when he was watching, i.e. using rubber dam for even the smallest occlusal cavity prep, not taking any shortcuts. i don't want this guy picking up any bad habits before he starts, know what i mean? friday was pretty busy as i'd sectioned a bridge (had to refer that one for CCL!) completed a pulpectomy on #16, final impressed a crown, completed anterior restos, and did two new patient exams, so there was plenty for him to see. he hovered over me wearing a white coat that was too big for him and holding a clipboard while taking notes. he reminded me of a USDA meat inspector, for some reason. and he followed me around everywhere, to the point i had to say, "hey, i'm going to the bathroom this time, i'll be right back, " because he followed me anytime i got up to get anything, be it a chart, an instrument, anything. anyway, yesterday was busy, but packed mostly with new patient exams and emergencies and only one extraction. so he says to me, "well, it doesn't look like you're doing too much, so maybe i won't come in tomorrow or i'll just come in to see the extraction." so i said to him, "hey, that's not true, there's a lot to learn from new patient exams, such as taking an accurate and thorough medical history, diagnosis, and most of all, patient management, seeing how we interract with people on the job. the main thing is learning to deal with patients, it's not only all about the procedures. you'll learn all that when you get to school. you don't have to answer to me, you can do whatever you want, but you may be missing out on a lot if you don't come." i think i scared him, as he was there bright and early and it was true, there was quite a bit to see, even if i wasn't "getting my hands dirty." i saw an 87 year old patient who unfortunately has to remove all her anterior teeth and add them to her partial because of endo abcesses, perio disease, and internal resorption. we saw some recall exams that were works in progress of my colleague, one of them a really great anterior implant case that was a treatment a of motorcycle trauma. overall, i think he had a really good experience, as he said he learned a lot and had a good time. it was fun having him around, and i think it made me a little more aware of the quality and thoroughness of what i was doing. and he'll be back next week, so that's a good thing. at least we didn't scare him away!

at some point i really do want to get into teaching, once i'm established and have a few more years under my belt. i think i'd be good at it and would really enjoy it.

happy independence day!!!

2007-07-04T13:53:00.000-04:00

how it all started. i particularly get a kick out of mr. morris from new york. sounds nothing at all like the new york i know and love today.

Happy Canada Day!

2007-07-01T10:11:00.000-04:00

we celebrated canada today by heading over to nonna and nonno's house for BBQ. i made my famous hummus and fresh brownies to give MIL a break. unfortunately we missed the pyrotechnics because we had so much to to before our trip. but i heard the wonderland fireworks from my house, and that was enough for me ;-)

yesterday canuck, cookie and i went strawberry picking in stouffville. we were warned about this season's crop, as it has been very hot and dry and we were told that the berries may be smaller and the picking slower. smaller they were, but we got some really great plump red juicy ones that were absolutely fantastic and we filled up our bucket relatively quickly. i'm telling you, nothing beats fresh-picked fruit. we also went on a tractor ride, pet some sheep (because sheep and strawberries always go hand-in-hand) and cookie played at the wooden park and hay bales they had set up. it was a really terriffic day. so now i have all these strawberries on my hands, and i have that cuisinart ice cream maker that's been sitting unused since my birthday in december. how fun would it be to make some fresh strawberry ice cream to go with those awesome brownies? it came out delicious, definitely not low-calorie but you can taste the difference with home-made. i'll never have to buy again! man, between the breads, the baking, and now ice cream, my family is mega-spoiled!

tomorrow we're off to michigan to celebrate the fourth. my mom's so excited to see us she's practically hyperventillating. given the foiled terrorist plots in london over the past few days, i'm hoping it won't take too long to cross customs. my mom also asked us to get some new single malt silver label jack daniels and some tequila at the duty free shop, despite the fact that they already have half a dozen bottles of both already. what is it about border crossings that compells people to hoard alcohol? even my FIL would ask for crown royale whenever we'd fly up here back when we were living in NYC. he has like five unopened bottles in the liquor cabinet and only opens it up once in a blue moon for special occasions, and even then he only takes about a shot glass full. anyway, my mom doesn't ask us for many favors, so we'll take a quick detour to the duty free shop to pick up some booze for her and grandpa. my plan for the week is to just hang out, spend as little money and energy as possible, and watch 1776 while snacking on fresh veggies from my mom's garden. i forewarned canuck, who absolutely detests musicals (especially watching old men in tights "mincing about and singing" about the most important document in my country's history) about the screening of this AWESOME movie, which is a tradition my family partakes in every year. but he made some DVD's to watch while my mom and i sing along to all the songs and quote every line before they are spoken. man, i love that movie! well worth the eyerolls and grimaces from canuck. i don't think i'll ever get him into watching musicals. he is the only person i know that hated west side story.

happy canada day to all!!!

80's music ROCKS!

2007-06-30T17:26:00.001-04:00

one of the best 80s songs around. love it, love it, love it.

btw, i got cookie hooked on the smurfs.

i need an aura cleansing

2007-06-29T19:45:00.000-04:00

i broke a mirror in my office on tuesday. i know it's seven years bad luck, but my patient and assistant who were trying to make me feel better told me that superstition arose because of how rare and expensive mirrors were back in the day, and that your reflection was your soul trapped in it and that breaking the mirror was breaking your soul. this mirror was $0.99 from honest ed's, and i myself hadn't looked into it (the patient did), so i'm hoping malocchio will gloss over me, or at least cut me some sort of break - the mirror was pretty cheap, after all, and my reflection was never seen in it. to be safe, i did some research on mirror breakage and the reversal of bad luck from such a mishap. turns out you have to bury the shards under the moon. now the incident occurred in my office and my assistant quickly cleaned up the mess. i wasn't about to go prowling around in the garbage and furthermore transport broken glass shards on the subway. that would elevate my psychiatric lunacy status from mildly insane to seriously wacko. however, i did find some alternatives. so i turned counter clockwise seven times, i'm waiting for a full moon to chant some sort of luck-changing poem/spell, and i need to find some white sage or sweetgrass to burn to cleanse the negativity from my aura and hence ward off the bad luck. any other suggestions would be greatly appreciated - and no, i don't mean "referrals" to the nice men in the white coats.

a saturday trip to the ER

2007-06-25T15:41:00.000-04:00

never a dull moment on a saturday, of course.

my second-to-last patient was a dude i had seen about two months ago. he had a few upper incisors remaining and a mutilated lower dentition with multiple carious non-restorable teeth, the only non-carious tooth being his lupper eft lateral incisor. he wants dentures for his upcoming wedding in september - the guy is only about two years older than me. we were trying to coordinate his treatment with the denturist, who sent him to my office for whatever treatment we decided on for the remaining teeth. he needed either endo and post, core crown on all but one of the upper with an upper partial, or full upper extraction followed by immediate complete denture, and lower extractions and lower partial denture. i opted for the extraction and denture, since finances were very much an issue and this guy has no insurance. i spent an fort-five minutes talking to him, as he didn't want full extractions on the upper but also didn't want to pay for RCT's he needed to save the remaining teeth, and he completely refused any and all treatment on the lower teeth. i wanted to make sure he understood what he was refusing and the implications of such refusal. he argued with me for another forty-five minutes about his treatment, demanded a discount, then got mad when i charged him for the exam and the six periapicals i took. he left in a huff and i wasn't expecting to see him again. so imagine my surprise when i saw him in the schedule for extractions. hmm, how 'bout that, we're rolling with it.

saturday afternoon he shows up and my receptionist says, "mr. r. is here, but he's swollen."

"of course he's swollen, he has multiple bombed-out teeth! seat him and i'll be right there."

i had never seen anything like this before. the left side of his lips, upper and lower, were swollen to over three times it's normal size. "whoa!" i blurted out. apparently, it had started this morning. now, it's impossible to get a story from this guy as he talks round-about in circles, jumps topics, repeatedly changes his story, and has a thick accent but after speaking with him and having him repeat it to me followed by my repeating it back to him twice, here's the story we got:

on june 12 he had swelling on lower lip on the right side after eating some cantalope. the pharmacist recommened some reactine for him. it worked for a while, then swelled up enough again to prompt him to see a physician at a walk-in clinic on wednesday june 14. this physician gave him pen VK 300 mg qid and another script for "an allergy pill" that he didn't know the name of. he had some relief again, and went to work the rest of the week. he ran out of the allergy pills that sunday and took the penicillin, which he was only taking three a day instead of the four, up until this past wednesday, the 21st, meaning he did not finish the medication. he started swelling again, this time on the upper left side, and the swelling then progressed to the left lower lip. he took another dose of the Pen VK and then came to his scheduled appointment to see me.

i examined him and ruled out odontogenic origin because, funny enough, the swelling was locates at the one site where the teeth were fine and he wasn't in any pain. my colleague, who also happened to be there, also saw it and we both agreed that it most likely did not have a dental etiology, as the swelling was not hot and hard and did not appear to be infectious. what concerned me was that the swelling started to spread across the midline and he slowly started to develop a "lump" in his throat upon swallowing. oh-kay, let's get you to a doctor ASAP.

now this guy doesn't have a PCP, or even an OHIP card, so there was no place else to go than to the ER. i didn't feel comfortable dismissing him alone in that condition even with a script, as who knows what could happen over the weekend or as soon as he leaves. there's an ER down the street from our office and one of the girls was going to put him in a taxi. but he had never been to a hospital in canada before and he was very nervous, so he asked me to go with him. i cancelled my last patient and i took him in my car.

anyways, the physician examined him and believed it to be a delayed hyper-sensitivity reaction of some sort, to what, we don't know. but he got a dose of steroids, some clindamycin to cover any remote possibility of a dental infection, and a referral to an allergist for testing. i'm glad i went with him. he's very difficult to understand and i since i had already correctly pieced the story together i was able to "translate" and move things along faster. we were there about two hours, not too bad. i took him back to my office, where he booked his next appointment to have his extractions completed. he asked me if there was any way he could thank me. i told him the best way to thank me was to take care of his teeth. he then invited me to his wedding in september. talk about gratitude!

disappointed with my score here!

2007-06-24T08:13:00.000-04:00

You Scored 65% Correct

You are a solid child of the 80s
You'd never confuse Tiffany from Debbie
And while you may not know Prince's first #1 hit
You know every word to Little Red Corvette

How Much Do You Know About 80s Music?

i need to study harder.

another one brought to you courtesy of ameloblast

2007-06-24T08:08:00.001-04:00

You Were a Giraffe

You are a high achiever - able to reach things others can't.
A great communicator, you are good at getting past superficialities.

What Animal Were You In a Past Life?

saturday, saturday

2007-06-23T08:07:00.000-04:00

and i'm off to work this morning. i'm tired, having missed out on an extra hour of sleep because cookie wakes up the minute light hits her face. which at this point in the year, is about 4:45 am! one more day of work, then one more short week, and then we're off to the states for the fourth of july! this will be the first time i've had an extended stretch of time off since christmas - not counting the day or two i take off for cookie's school stuff, driving to michigan for a weekend, etc. so i'm looking foward to it. this week went much better, either that or i just have a much better attitude. who cares why, i just feel more like my twisted old self again.

my social calender is busy this weekend as i'm attending a jack 'n jill stag tonight with some friends and tomorrow is a surprise baby shower for our best man's wife. wow, i feel so popular! monday will be time to relax and do stuff in the garden and canuck will be gone on a day-long job interview in barrie! since i faxed out all those resumes last thursday our phone has been ringing nonstop. i think i just have that magic touch.

a blast from the past

2007-06-18T20:09:00.000-04:00

i love the 80's. i think it's possibly the coolest decade ever (not counting clothes, i leave that to the 70's). not sure if it's because the stuff was actually cool (smurfs! he-man! cabbage patch kids!) of if its because it reminds me of a time when my only worry was learning to ride a two wheeler (i was a late, late bloomer and a spaz, i was nine!) or what the newest toy in my happy meal was going to be. it's been kind of a rough couple of weeks and i needed some sort of escape from the pressure and stress i've been feeling. tuning in to this wacky stuff takes me back to a time when i felt so safe and just plain GOOD, and the hilarity and goofiness of some of the commercials makes me laugh and just puts a smile on my face. it also reminds me of how much times have changed since i was a kid. it seems like my generation had it so much easier. too much technology now with cell phones, i-pods, $150 sneakers, text messaging, and all that crap, i dunno. i'm an old-fashioned fart like that and i worry for cookie because by the time she feels the pressure to have these things i'm going to be the bitch mom who says "NO, get a job and pay for it yourself!" like mine and canuck's parents did. then she's going to be all screwed up, and it's all because of us. but i will still hang onto my principles. i'm a tough broad like that ;-)

i had originially started a rather negative post about my crappy past two weeks, but after some time off, some socialization/relaxation, a quick visit from my mom, and a good, thourough cleaning of my house, i have a much better perspective and am ready to face another wonderful(or potentially crappy, whichever way the ball swings) week with a much more positive outlook. in a nutshell, it doesn't matter that half the crowns i prepped and impressed last week didn't fit this week despite the fact that i sent perfect impressions, because i sent them new perfect impressions and i would never cement anything that was below my standards and that is what makes me a good dentist. i feel much better about opening my first complaint/incident file with the RCDS, because while it really shook me up and i am dealing with a bit of a whacko, i did nothing wrong and i have a wonderful and supportive staff to back me up and boost my confidence at times like these when i really need it. i'm proud of the fact that although it really (and i mean REALLY) pissed off my dad, who said that i was "cheap" and that all i cared about was money like my cheap uncle out in california who hasn't flown to new york in 20 years, i still stuck to my guns and didn't spend $400 fly to new york for 36 hours for my sister's high school graduation this past weekened - because that money (and then some) eventually evaporated to repair the brakes and a transmission fluid leak on ned flanders, yet another monkey wrench in the cog of my week. i'm optimistic that although canuck is underemployed and repeatedly dicked-over by his current venue, and has gotten really raw deals as far as associateships go this past year and a half, the time that i spent on my day off frantically faxing out over 20 resumes for him has paid off, as he has gotten five interviews scheduled this week. this poor guy really needs a break, i'm telling you. i'm praying that things stabilize enough for us to start having more kids, as while we make enough money together to run things smoothly, canuck wants to be able to support the house on his income alone so that i can stay home as much or as little as i'd like. i'm really lucky to have a guy who's willing to work so hard so that i have to do less. but both of us are increasingly frustrated as to how long it seems everything takes, like we want to get started on all these things, like furniture, a new roof, a dog, perhaps. i worked so hard and paid so much money for my education, when is it going to finally pay off??? why is everything so dragged out and S-L-O-W????

i'm tired and i'm hopeful and i'm nervous and i'm greatful for all that i have, but at the same time i want more, know what i mean? i want stability, i want to go to sleep at night and not have to worry about money, for canuck to have peace of mind and confidence, for me to have faith in myself as a person and as a dentist. it's just so damn hard sometimes, and it's tiring and i'm just waiting for a break, just someone upstairs to cut us some slack. that's why i like to escape to the decade where i didn't have any of these worries. i can only hope that i'm able to provide as happy a childhood as i had to cookie, so that she can look back at the ipod and spongebob and feel that same feeling of security and well-being that i have now.

i think i have to delve into the nineties now, i need to re-create some of that teen angst to bring me back to reality....

it's been so long since i posted...

2007-05-27T11:09:00.000-04:00

...that i actually had to type in my password and e-mail address to log in. my bad, i've just had too much going on to post anything substantial. it's funny, the more that happens, the more i want to write it all down but the less time i have. like today, i have about 10 minutes to shower and change before we visit our friend's new ortho practice, but i'm squeezing this lame-o post in just to assure the few readers i have that i'm not abandoning my blog. a lot has happened in the past few weeks, awesome, good, bad, and just plain ugly. when i have a minute to myself, which seem to be few and far between these days, i'll blog about my awesome mother's day, our second date with ameloblast, my (finally!) fully packed schedule, the gardening wars/adventures, how homesick i've been feeling these last few weeks, and my very first case failure/patient complaint (not bad for four years out, it was bound to happen eventually and i'm sure there are many more to come. but it really rocked my world.)

off to get cleaned up! i like going on family adventures like this one.

damn you, obtura!!!

2007-05-04T12:25:00.000-04:00

okay, i CANNOT master the use of this thing. all my fills have turned out like crap no matter what i try. i've had to retreat/refill at least four out of the five canals i have cleaned, shaped, and loved oh-so-tenderly since i started at the downtown office. so i've put in my official request for a thermafil machine. i will beg, borrow, steal, or prostitute myself for one so i don't have to go thru this next RCT i complete.

i'm at work and cranky because the impression that i sent for a denture i'm repairing got to the lab, but the teeth that fell off DID NOT get to the lab, having been mistakenly chucked into the garbage and they are MIA. and of course, i did not send a counter model, becuase all they had to do was plunk them back on and re-flask. FUCK.

from awful to just plain bad

2007-04-23T10:48:00.000-04:00

that's the right wording to describe the state of our front yard at this time. yesterday canuck and i took complete advantage of the glorious weather and spent the entire day outside working on the front lawn. we pulled up two half-dead bushes, dug trenches around the soil-grass interface, pulled some weeds, raked a bit, trimmed our weeping mulberry trunks, and pruned our endless-summer hydrangea, which, much to our delight, has started to sprout. i was also ecstatic to see the daffodil bulbs that we planted this winter also starting to sprout, as well as our peony bush and hazelnut tree in the backyard.

unfortunately, our topsoil is clay-like and completely devoid of nutrients, there's more weeds than i can keep track of, and our lawn is just overrun with detritus. our neighbors were nice enough to give us gardening tips and lend us some gardening tools, but one of them politely confirmed our diagnosis - our lawn is crappola. actually, she was very nice and said, hey, rome wasn't built in a day and you guys are doing great, these things just take a lot of time. she was the one who taught me how to prune and told us where to get the new soil. did you know you can buy a "yard" of it and they just dump it on your front lawn? so you know what we're doing all next weekend. today when canuck gets home we're going to lay the fertilizer down as it's supposed to rain and be cooler tomorrow. the city girl in me just wants to throw in the hat - i didn't know it would be so much WORK! it's a joint effort, but i'm about to pick up the phone and call for professional help, just for the cleanup and setup. canuck vehemently refuses. we are going to tackle this ourselves, he absolutely insists. great. while our neighbors are sporting beautiful flowers and lush green lawns, we're just trying to bring ours back from the dead so it doesn't look like calcutta in a heat wave. but our neighbors are cheering us on. i think they find it adorable and amusing that we're trying so hard. we are first time home-owners, after all, and the youngest people on our block. maybe i'll just call the professionals when canuck's gone and have them do it , and then when he gets back he'll think that i did it all myself. hmmm.....

actually, it has been good for all of us. cookie hangs outside with us instead of in front of the t.v. and i've gotten tons of exercise from all this. plus it keeps us out of the kitchen and away from grazing. maybe i'll loose those 10 pounds i've been wanting to shed. and at least we're making a dent. awful to bad is a step up!

an interesting case

2007-04-23T10:05:00.000-04:00

last friday i was double booked with an emergency, my colleague's patient was coming to see me for "extreme facial pain that kept her up all night." mrs. s, a woman in her mid-late thirties, presented with a dull, throbbing ache that originated at her left TMJ and would periodically radiate sharp, stabbing and almost debilitating pain all the way through to her left upper midline. her medical history was unremarkable. she was in the process of seeking orthodontic treatment for a collapsed bite, which had been "corrected" by her previous dentist by placing composite resin on the occlusal surfaces of her molars to open up her VDO. percussion of the upper teeth was negative, all of her teeth in the lower arch were mildly percussion positive, and there was noticable TMJ crepitus on the left side. perio pocketing was within normal limits. her recent dental history was unremarkable, except for a resto that was placed by my colleague on #36 back in september that had some "sensitivity for a while" and she was meaning to come back to have evaluated but just didn't have the time. radiographic examination was also unremarkable. just as i left the room to discharge my other patient, she had another attack of debiliating pain that shot across her upper midline again, to the point that she was reduced to tears. i quickly got out some hot towel compresses (we keep them in the office as a comfort measure for patients) and the pain started to subside with its application.

at this point i had a suspicion that it might be TMJ-related or neuromuscular and she was only in my schedule for a look-see, so i spent a few minutes trying to find an oral surgeon that could see her immediately for evaluation. luckily i did, and i sent her off with a script for motrin and percocet to be taken alternately. i knew she was going to someone capable and competent. but after she left i had sneaking suspicion about that "sensitive" #36. no way, i told myself, i've never seen referred pain radiate that far on an upper. nonetheless, i quickly spoke to the oral surgeon and asked her to evaluate the six (i had performed all diagnostic tests but one, as my office had run out of endo ice, a fact which i was not all to pleased with, that's another story for another time) but i was pretty sure that wasn't it. however, there was still that nagging feeling and i felt more comfortable having someone else take a look.

the OS called me back to follow up after she was seen. she had examined her, no, it was not the TMJ but her symptoms were consitent with trigeminal neuralgia and she was referred to a neurologist for further evaluation. when i thought about it, it made sense because tic deleraux does manifest itself as brief, intense and episodic pain. the OS was also certain that it wasn't the six, either. she would have done the same thing i had done - pain meds and a referral. okay, i did the best i could with it, i hope she felt better and i wished her the best of luck. eek, still that nagging feeling...

on monday i get a call at home from my office manager. mrs. s was seen at the ER today for sub-mandibular swelling, she was placed on antibiotics, can she come in tomorrow for an evaluation. absolutely, i said, i'll come in early to see her. when she came in on tuesday, she looked like hell. her submandibular nodes were rock hard, there was noticable swelling on her left side, and she was having trouble swallowing. she was given a script for clindamycin 300 mg tid, real big guns. this time i had endo ice ready to go (i pretty much had chewed out my staff for not ordering it after i had written it on the dry-erase board a week and a half ago when we were running low, but again, another story for another time) and i tested all the teeth in her lower arch. sure enough, #36 had no response to cold and was precussion positive. my diagnosis was acute apical abcess. i told her to stay on the antibiotics she was on, and we booked RCT for the next friday. as she was very anxious about having a root canal, this was her first one, i gave her a script for halcion 0.125 mg to be taken 40 minutes before the procedure, and the night before, if necessary. on friday i got in early again, we medicated her and i completed the pulpectomy. sure enough, i opened up the tooth and completed the pulpectomy and while there was no pus, it stunk to the high heavens. the patient was nice and relaxed, left in wonderful spirits, and is coming back tomorrow to complete the treatment. she said afterwards that it was the first time she had slept in over a week and that she had actually enjoyed herself during the procedure. she also gave us invitations to her jewelry sale next saturday!

i really learned a lot from this case. first, i learned the really wacky patterns of referred pain, and it only reinforced the importance of testing BOTH arches when a patient presents like that. i learned that even only moderately deep resins can have very detrimental effects on pulp health, all the more reason to caveat when placing such restorations. i also realized just how vital and critical endo ice is in diagnosis, and that pulp testing can give you such surprising and conclusive results - hence my mild discomfort and unease at dismissing her last week without having used it. i also learned that sometimes pain and infection sometimes cannot be diagnosed immediately, that at times things have to localize. and last by not least, i learned to just trust my instincts - that sometimes a doctor's intuition is dead on, even when you're not sure of yourself. sometimes i actually do know what i'm doing!

a return to normalcy - well, sorta

2007-04-18T10:15:00.000-04:00

so the guests are out and i've vacuumed up the dog hair and washed and folded all the linens and got the house back in order. it literally took me all last monday to do it. i had a great time and all, but i am seriously rethinking doing the whole back-to-back famliy gathering thing any time soon.

the weather sucks and i'm sitting her waiting for spring. i'm cranky and moody and in desperate need of a haircut, which makes things even worse because i'm not feeling pretty. i just don't have the time to go out and get one. i want the sun to come out so i can get motivated. blech.

i start work at 1 p.m. today up to the evening and canuck is recording american idol on satellite so i can watch it when i get home. i hope sanj@y@ gets ouseted this time. i feel bad for the kid, i really do, and he's got a lot of charm and is a sweetheart, but this whole thing is losing it's novelty. i want either melinda or blake to win. i like l@keesh@, too, because she's a mom and lives in flint, michigan. for some reason i'm really attached to this group of contestants this year.

blech, again.

hostess with the mostest

2007-04-06T17:50:00.000-04:00

i'm now on the second batch of family visitors. my dad and 3/4 of the tireless tetrad of fun are on their way back to long island after a brief stop in niagara falls. they left on wednesday, which gave me approximately 14 hours to clean, launder the linens, and do a massive food-shop to prepare for the arrival of my mom, stepfather, grandmother, and the two doggies. my house is bursting at the seams.

man, i'm tired.

today is good friday, so i'm marinating some salmon and defrosting some shrimp for a fabulosa, religiously-correct supper. my nana is exempt from the no meat rule because she's 81, weighs 80 pounds, and is diabetic, so she's getting a chicken breast and pasta alfredo. i made her pancakes, waffles, and bacon for breakfast this morning (i slipped and had a piece of bacon, so i am now damned to hell, for a short while, anyway). easter is the one holiday i'm NOT hosting this year, so i'll get a little bit of a repreave. now we just have to plow through a few more days of picking up after people, vacuuming the massive quantities of dog hair, entertaining, and moderating the heated political discussions between canuck, the "bleeding heart liberal-canadian communist" and my parents, who are stauch republican bush-supporters.

all-in-all, it's been pretty fun!

wicked!

2007-04-01T20:39:00.000-04:00

my dad and 3/4 of my sisters are visiting from LI this weekend and the youngest, who's 13, showed me this clip from you tube. like, wow!

couldn't nail this one

2007-03-27T14:48:00.000-04:00

abridged version - endo #26, MB2 canal, calcified, couldn't do it this time, had to send to my endo guy. well, at least i FOUND the MB2, that made me feel better.

rats.

it's just been that kind of day today!

holy crap, is that what i think it is?

2007-03-27T11:34:00.000-04:00

so i'm ready to restore my next implant case, a really great one because it's tooth #11 and we've been bleaching him, so i'm all over that procera thing and i'm very excited. implant was placed in a one stage surgery under IV sedation, as this patient has a history of syncopal episodes in the dental chair (and i REALLY can't wait to do the other two lower PFM crowns that are in the treatment plan - i'll just have the paramedics wait by the door).

he's a very nice guy, so we make our chit-chat and i seat him and i have my armamentarium ready to go. it's an anterior tooth, so i'm expecting that the surgeon placed the implant a little further below the crest of bone so we get a nice collar of gingiva to help obtain a aesthetic emergence profile for the crown. now, these healing caps are placed good and tight, so i always tell the patient to expect a little pressure when i'm de-torquing the thing.

"don't worry, the implant isn't going anywhere."

so i use my driver and move counterclockwise, and the patient says, "yikes!" and starts to sweat, his color a little off, too.

"are you okay?"

"yeah, just really dizzy."

crap. so we put him in trendellenberg, give him some cold water, and place a cool, damp washcloth on his head. i'm freaking out, i've never had a patient pass out on me, and i really don't feel like utilizing the info i've learned in my medical emergencies course. not today, anyway.

"wow, that feels great," in response to the cold compress. "you can go ahead, now."

so i'm gently twisting, turning this healing cap and loosening it and i'm thinking, wow, i've never gotten this much resistance before, must be really tight! and i'm turning and turning and finally out it comes, and it's gray and awfully long and i'm like, hey, i've never seen a healing cap like that...wait a minute. after the double take, i realized what it was.

the implant was right there on the tray! i was pulling out the actual fixture!

"um, mr. poor patient, a minor complication here, seems like your implant has fallen out. i'm going to call dr. perio's office and find out what we can do for you."

"yeah, that seems like a complication to me."

we put him in a taxi, given his near-syncopal episode today, and he was accompanied by my office manager and his un-integrated implant. i'll be seeing him in 6 more months, hopefully.

i guess there's a first time for everything, right? i nearly shit a brick today!

My Celebrity Look-alikes

2007-03-27T08:24:00.000-04:00

http://www.myheritage.com

time to pat me on the back, no?

2007-03-14T22:58:00.000-04:00

so i know it's late and i have to be up and butt-crack of dawn tomorrow morning (when it will be dark when i wake up, dark when i leave, and dark when i arrive at the office, and that blows goats but what can you do?). but i've had a pretty interesting couple of days in the dental department that i'm kind of stoked about and i just wanted to do a cyber pat on my back for several reasons (to offset the fuck up post from a few weeks ago, as we need to strike a balance.)

- surgical extractions, swore i'd never touch 'em again. but something in me changed, and now i'm not afraid to pick up a handpiece or a scalpel and drill some bone to get the tooth out. i used to shy away from root canal treated teeth or anything that had more than one root and/or 50% bone support. but this past week, i did TWO, read that TWO surgical exo's on RCT teeth with no post-op complications thus far. all by myself, not leaving any root tips behind or calling the OS to bail me out. and i got to place sutures, too, which is cool because i kinda dig sewing a little bit. so i'm kind of excited to introduce this new "skill" i've decided to develop into my practice. my next step is to get really, really awesome at cutting flaps so i can start doing some minor perio surgery. but i'll still leave impacted 8's and the implants to the experts.

- endo time (ameloblast, this one's for you!). so my colleague hates, and i mean despises in all senses of the word, doing root canals of any type and refers most of them to our trusty endo specialist downtown. now, he's awesome, hey, he fixed my tooth (more on that later) but as a specialist he does charge quite a bit more and requires payment upfront, and some patients are strapped for cash and are hence hesitant to seek treatment at specialists offices. that combined with the fact that the office manager is putting gentle pressure on all of us to keep more procedures within our practice and the other fact that my endos are actually halfway decent, has driven her to refer some of her cases to me, which makes me feel pretty darn good. until i got a beast of one on saturday. silly me, she sent me this case weeks ago and i (wrongfully) assuming the case was a slam dunk because she referred it to me, never got around to looking at the radiograph until the patient was actually seated in my chair (around 45 minutes late for an hour and a half appointment, i might add). it was then that i discovered that this #36 had had a pulpotomy completed god knows how long ago, but the IRM was shoved all the way down into the pulp chamber sans cotton, and had made it's way down some of the canals. fuck, how am i going to get this crap out? maybe i should send this out. but wait, it's just IRM. let's back out of my comfort zone and see if i can actually pull this off. very slowly and gently, i worked my way into the chamber, flicked off peices of the nasty, old and hard IRM, got to the pulpal floor without perfing, and with a series of very small gates glidden drills and peaso reamers, was able to successfully locate and instrument all four canals. since he was so late, i was only able to complete the pulpectomy, but i set it up so all i have to do is some light rotary instrumentation and obturation when he comes back. that felt really good!

- two porcelain jacket crowns i prepped two weeks ago on #14, 15 were cemented and looked B-E-A-U-T-I-F-U-L. color was perfect, margins were sealed, everything looked nice. the patient was once in the russian army and had dentistry done with no anesthesia, so he was very pleasantly surprised when i completed all the work without hurting him and he left as one very satisfied customer.

i like it when things go my way. really. and just as i am quick to point out my mistakes, i will never hesitate to pat myself on the back.

hurray for me!

we're all grown up!

2007-03-02T20:55:00.000-05:00

and i'm not just talking about cookie anymore, either. one of my oldest and dearest friends just gave birth to a beautiful baby boy on february 28! she was my roommate from college, and to think that the girl who i partied with, the girl who's shoulder i cried on and who's puke i cleaned up, the girl who was there the first time i got drunk and stoned (two separate occasions, i might add, and she was there and the supplier for both!), the girl who did a drunken handstand while wearing a skirt before she realized she went commando that night, the girl who i could look at in the morning and just know that she got laid the night before, and the girl who showed our whole campus the video of her skydiving topless, is now a mom. and i couldn't be more proud of and excited for her!

this one kicks off a string of births-to-be and future nuptials. my other old and dear friend (and you know who you are, girlie!) is due in early may, our best man's wife is expecting in july, and several of my hygienists and another doctor i work with are also expecting in the upcoming spring/summer months. there are so many moms-to-be out there! and i also just found out that my other buddy is planning on popping the question to his girlfriend. this was the guy who's toenails i would paint black (okay, he was/is a little strange but that's why i love him so much) and who was the first person to rush to my house to take me out for margaritas when i got my acceptance letter to columbia. he also used to carry his stash in a little kraft macaroni and cheese tin that had all these little cartoon dinosaurs all over it, and now he's going to be a husband and eventually a father. can you imagine!

and it's funny - i don't feel old, i feel TERRIFFIC! as i'm typing this, i realize what great friends i've made and held onto through all these years, and how lucky i am to have them in my life. some of them are quite far away, but only in terms of miles, and i'm so happy for them to be experiencing the tremendous joy that i've already gone through (and hope to be going through again someday soon!). i was the first to get my professional degree, get hitched, have a kid, and buy a house, and all of them were on the sidelines, cheering me on and supporting me as i plowed on. i can't wait to return the favor and i hope i can give at least half as much great friendship as was given to me all these years.

btw, this new little junior is on his way to full fledged stylin'. since i am a wannabe canadian now, i have to spread the cheer to my american family and i blew over $150 at the roots outlet. my friend went crazy for the stuff i got her, and they'll get tons of use out of them if they want to have more (hey, we have a whole bunch of roots stuff waiting for baby #2, good as new).

man, i'm just so giddy!

grrrr....

2007-02-27T22:16:00.000-05:00

dentistry is hard, hard, hard! especially when you are picky and want everything to be perfect. it seemed as if everything was working against me today. here's a breakdown of today's events, nothing unfixable, but annoying enough to throw a monkey wrench into the day.
-RCT on #26 is going swimmingly. i clean and shape three canals, but something tells me that there's another canal, an MB2 that has been overlooked. so right before i obturate i poke around a bit and i catch an orifice, a tiny one, with my endo explorer. i'm having a very difficult time finding it with a file, but i finally sink it right in with a size 8 and man is this thing calcified! good news: after a half hour of hard work i managed to get a NiTi rotary intsrument all the way down there and thoroughly clean and shape this thing so he doesn't have to see the specialist (sorry, ameloblast!) bad news: i run out of time so he has to come back for the obturation.

-two PFM crowns i prepped, temped, and final impressioned last week return from the lab, #35, 36. these were a beast to prep, as #35 was rotated 90 degrees and #36 was tilted mesially (it may have even been #37 after the 6 was removed, but patient has no recollection of that). take a bitewing, as i do for all crowns before i cement them to check the interproximal margins. #36 is flawless, perfectly sealed. #35 open margin at distal. it took 2 tries to get the impression right again to send to the lab. and have you ever tasted impregum? it's nasty shit!

-RCT #17 on five month pregnant lady, pulpectomy completed a MONTH AGO (she's a hairdresser and rescheduled numerous times). all is well with this RCT, no calcified canals, nothing unordinary. patient does not want me to take films during procedure, so i rely on my apex locator and i get consistant readings at each canal. fill 'em up, place a core, take a final film at my insistance and the MB and DB canals are filled beautifully and the palatal is 4 mm short! of course i let her know and she's cool, so i will bring her back after she delivers for the retreat of the palatal.

arrrrgh!!!

it's funny, though. i feel like such a fuckup, but at the each of these appointments every person was so nice, thanked me for doing "such a great job" and i was like, do you even know how i fucked up, or am i just being too hard on myself???

enough of this. i'm going to watch american idol.

so tired i'm wired!

2007-02-24T19:39:00.000-05:00

two weeks and we've survived the following - runny noses and green snots, my first solo drive to michigan to visit nana, meeting the new dog, cookie barfing on nana's couch, trying to get cookie to sleep in her own bed at a normal, regularly duplicated hour, and five straight days of crazy dentisty. i'm tired.

i worked today, the first saturday i've been on in a while. i really enjoyed having my weekends off, but reality always sets in. this one was a doozy. i arrived at 9 a.m. , my first patient who was booked an hour and a half for Q3 resto no-showed and has no number where we can reach her. all of that was compensated for as i tried to leave twice when i thought i was done for the day, once at 3 p.m., once at 4:30, and it was finally at 5:15 when i got to go home. what is it with people that prompts them to phone in their dental emergencies at 4 p.m. on a saturday???? i recbonded a cracked veneer for a patient of my colleague (which is going to be replaced, i kinda had to do a jigsaw puzzle thing with it but it actually came out pretty nicely. thank god he saved the piece), dolled out antibiotics and pain meds for two endodontically and periodontically hopeless teeth that i will be extracting next week, cemented another old, crusty post, core, and crown that needs to be replaced but the patient doesn't want to pay for it, and adjusted another crappy denture (a nesbit appliance that the same crown patient can't seem to part with). this was not counting the recall exams and real dentistry i did as well. so much for leaving at 3:00 today! but it was nice, i had pepperoni pizza and french fries waiting for me, which i wolfed down because i didn't get to eat all day and hadn't eaten since my tiny bowl of shreddies at 7 a.m. this morning. it feels really good to be home after a hard day's work. and i'm looking foward to my long weekend.

what a week, i need to unwind...

2007-02-24T19:22:00.000-05:00

(i kinda have been on a sean paul kick lately, his music is so up-beat and fun it's impossible not to be boucing when you listen to it!)

i'm positive everyone's seen this one so far, but it's funny enough to watch over and over again....

2007-02-05T18:45:00.000-05:00

i like happy songs....

2007-02-05T18:30:00.000-05:00

Suits XL "Play"

I used to be the one that never gets in the way,
never did have a single thing to say,
I used to think that I would never get any break,
nor did I think that it would be a piece of cake...
Well, well was I wrong, wasn't even close,
the only way to go is to keep moving to and fro,
Well, well who could tell, who did ever know,
the only way to go is to keep moving with the flow

Play, Today, don't you worry,
just be and play, before you sulk and say you can't
Play, obey., tear up the field, get dressed to kill and get set for real!

I always thought this could ever happen to me,
it's like in my dreams but it's reality,
the only way to go is keep playing with the pros...
and if you're like me you should know how it goes

Dont stay still, goodness grief
Don't stand there, move your feet
Take the wheel, hit the streets
Yeah, I've got to take a chance and get out of here...

another happy song that i bop along to in my office. we're tuned in to CHUM FM and the patients really do dig it, except for that one cranky old lady who once complaned that the radio was "too loud".

i have a new brother

2007-02-05T17:36:00.000-05:00

a few months ago, nana and grandpa moved from long island, new york, to lansing, michigan, a smart move given the soaring cost of living there (that was what eventually drove us out, but that's another story for a different time). it's great because not only will they actually be able to retire in their sixties and have their mortgage paid off by then, they are only a five hour drive away as opposed to a ten hour drive away (acctually thirteen if you account for traffic in new jersey). they just bought a house in de witt county and now have a lot of room and a nice chunk of property. so who needs new furniture when you can get a new doggie!

his name is shadow, he's seven years old and he's an australian sheppard mix. nana and grandpa adopted him from a local shelter. we're going to michigan in two weeks and cookie can't wait to meet him! aparently, he and zelda are starting to co-exist relatively peacefully, but zelda is very territorial when it comes to cookie's grandpa (he's alpha) and her bones. shadow is the name he came with and nana says she sees why - he follows her everywhere!

let there be bread!

2007-02-05T16:56:00.001-05:00

yesterday it was just way too effin' cold to do anything (i even turned down an opportunity for furniture shopping so it must be bad). canuck and i had no big plans for the superbowl and the rest of the house was freezing so i holed myself up in the kitchen and baked away. i was nice and toasty, since there was about a 20 degree difference between the kitchen and the rest of the house.

now, i love to bake and and i have about eight different books with various recipes, some just dedicated to baking and some that have a smattering of pastry, cake and pie recipies thrown in with suppers, main courses, and appetizers. i use them pretty religiously and i've gotten my pie crusts, cakes, and doughnuts down t0 a science, but it seemed like my breads where always on the dense side, kinda heavy but definitely still edible and pretty tasty. i always tried to get that store-bought softness and springiness rather unsuccessfully and i always wrote it off as, "oh, it's the preservatives that make it that way, mine is the REAL DEAL." so a few days ago, my office manager and i were talking and i found out that she also makes her own bread, with a bread machine. that's cool, i said, while simultaneously turning up my nose at the idea of a "bread machine". hah! i scoffed. i knead it all by hand, all by myself (man, i'm such a brat). and she laughed at me and directed me to the feischman's website. i'm a regular user of fleischman's yeast, i haven't yet tried the compressed cake yeast that my bread book calls for because i can't find it anywhere and i'm just too lazy to look. anyways, i saw some great recipes for NON-MACHINE, die hard, old-school-that's-what-i'm-talkin'-about users like myself and i came across this recipe for soft pretzels. mmmmm, that looks yummy. then i came along another recipe for mulitgrain bread, mmmm, i could definitely do that! but when i scrolled down the list of ingredients i was like, NO! quick rise yeast???? that's the anti-christ of bread makers like myself! yeast is yeast, how the hell can you get it to make it rise quickly without altering the composition some way, shape, or form? why does everything have to be "quick"??? is NOTHING sacred anymore??? okay, i quickly got over that and thought, what the hell, i'll give it a whirl. and canuck was just so excited about the prospect of fresh pretzels that his eyes just glazed over when i told him about my reservations with the yeast. in his eyes, the ways justifies the means, it's fresh pretzels for crying out loud who cares! i will never expect him to understand.

so off i went, and i even did something else different for me this time - i specifically used a flour that was labeled "best for bread" as it claims to have a higher protein content and yields a more elastic dough than all-purpose flour. man, what a difference! my dough was soft, pliable, very easy to work with and quickly became super elastic. and that quick-rise yeast - wow, that stuff flew! the pretzels were PERFECT, golden brown on the outside, soft and chewy on the inside. my multigrain loaf made me want to cry. not only was it perfectly shaped and sized (i yielded 2 loaves) it was spongy and light and tasted absolutely wonderful. i made canuck his lunch for work and he said the sandwiches brought meaning to his life (his exact words). everything tastes great on that bread, i have to stop myself from snacking on it! moral of the story - never be a food snob, you may just miss out on something spectacular! my next project is going to be lahmacun, turkish flatbread wraps that are seasoned with ground beef, onion, peppers, and cilantro. i'm going to stick with the traditional yeast for that one, but if it turns out like crappola i will always have my beloved pretzels to fall back on.

man, i am just soooooo proud of my creations!

mommy ramblings

2007-02-01T17:19:00.000-05:00

when cookie is napping and canuck is still at work and i don't have to cook, clean, or do laundy and i finally have time to post!

it's been a busy couple of days, and february looks to be just as hectic. i can't believe how january flew! then february's gone and we're in march and it starts to warm up a bit, or at least the spring is somewhere on the horizon and not in the distant future. i love wearing my uggs and all, but the cold weather starts to get old after a while.

my new years resolution was to be more active. that means in everything - getting up and moving around and not sitting like a veal on the couch, being more active in my community and in cookie's life, being more active in my career, etc. the socializing and career thing i'm starting to get the hang of, the physical part, eh, not so much. it's at the point where i don't even bother resolve to lose the 15 or so pounds it might behoove me to shed, i just have to get my ass out the door three times a week. i thought about joining the gym where canuck lifts (religiously) because they have some cool classes, but none of them fit into my schedule and i know i won't go there to work out consistently so that's money wasted there. i wanted to do karate or tae-kwon-do, but again, i work evenings and i don't know how i can fit the classes in with cookie and child care and everything. it's too damn cold to run outside (i know, i did it on monday while cookie was in school and i'm still recovering from frostbite) so i bought a balance ball and a stott pilates DVD and was actually really good for about two weeks before i petered out. why am i having such a hard time getting motivated to just work out??? how the hell do people do it? i wonder how many calories one burns doing five loads of laundry up and down two flights of stairs all day. doesn't that count as exercise?

i made bread last night, a basic loaf in which i used kamut flour instead of my usual spelt or wheat flour. for some reason this loaf seems a little salty and i'm not sure if it's the flavor of the kamut that i need to get used to or if i added to much salt to the recipe (also very possible). it's okay and we'll eat it, but i'm going to plow through this loaf before i make another one (a lower sodium version). plus it's cold in my house and the dough takes bloody forever to rise! i also made corn bread last weekend to go with my vegetarian chili. this recipe has fresh corn kernals and two kinds of cracked pepper, so it was a really nice compliment to the sweeter chili. my next project is going to be whole wheat pretzels, a recipe that i found on the flieschman's yeast site. man, i have such a love-hate relationship with winter. i can't wait to break out all the cute clothes and flip-flops and i'm tired of layering, but there's no way my family eats this well during the summer!

hey, maybe i should be doing my pilates DVD instead of writing this post....

not sure i like where this is heading for numerous reasons

2007-01-22T18:39:00.000-05:00

A Proposal to Ban Spanking Sparks Debate

By JENNIFER STEINHAUER
Published: January 21, 2007
LOS ANGELES, Jan. 20 — As a general rule, legislators tend to begin their attack on bills once they have actually been written. But not much proposed legislation involves the backsides of children.
Skip to next paragraph

Rich Pedroncelli/Associated Press
State Assemblywoman Sally J. Lieber of California plans to introduce a bill to ban spanking.
A Democratic assemblywoman from Mountain View says she will submit a bill next week — once it is officially drafted — proposing that California become the first state in the nation to make spanking of children 3 years old and under a misdemeanor. Penalties could include child-rearing classes for offenders to one year in jail.
Just the mention of the bill has become a minor statewide perturbation, sparking denouncements from many Republican lawmakers (the State Senate minority leader, Dick Ackerman, declared, “I’m trying to pick a word other than crazy, let me see, not well thought out.”), heated debates among parents (“A bill should be passed to allow other parents to smack the parents of undisciplined children,” wrote one Internet poster) and some self-reflection on behalf of the governor, whose proclivity for calling others girly men has been replaced of late with dialoguing about his feelings.
In an interview with The San Jose Mercury News, Gov. Arnold Schwarzenegger said that as a child he “got smacked about everything. That was the way Austria worked.”
The governor said that when disciplining his four children, he and his wife, Maria Shriver, declined to spank. “I think any time we try to pass laws that say you’ve got to protect the kids, it’s, in general, always good,” he added.
The bill’s sponsor, Assemblywoman Sally J. Lieber, said that her office had been inundated with calls since word of the proposed bill — which she will probably introduce next week — surfaced. The majority of the calls, she conceded, were against such legislation, which she said she found puzzling, since it covers only the state’s youngest and most vulnerable children.
“I have to question why our society holds so tightly to physical discipline among the very young,” said Ms. Lieber, who does not have children. “We’re very addicted to violence.” She said that the rejection of a bill that would remove the latitude of parents to physically discipline the smallest of children was analogous to protests against the protection of women of domestic abuse.
The speaker of the assembly’s office said it could not comment without reading an actual bill.
Roughly 15 countries have laws banning corporal punishment, and numerous states, including California, forbid spanking in schools. Proponents of such laws argue that spanking — especially for young children, who cannot connect the punishment to the crime — is ineffective at best, and cruel at worst. Opponents of this type of law argue that parents, not the state, should be the arbiter of how children are disciplined at home.
“California has garnered a reputation over the years of supporting these extreme legislative measures,” said Bill Maze, a Republican assemblyman from the Central Valley. “Disciplinary action is up to the parents. This is a wrongheaded measure, and there is zero support among the Republicans I have talked to.”
When it was pointed out to Mr. Maze that the Republican governor had shown some support for the measure, citing his own upbringing, Mr. Maze countered, “The only thing I can say about him is that I guess he needed some discipline, otherwise he wouldn’t have gotten where he is today.”
Ms. Lieber appears undaunted by the criticism of her proposal. “Right now the law is very unclear,” she said, noting that jurors are specifically instructed to take into account that California gives parents discretion on punishment that is not outright abuse. “It makes a lot of sense to me to set a very bright line in this area.”

2007-01-22T16:58:00.000-05:00

cookie's finally down for a nap, but of course it's right around the time when i have to jet to the post office so i can mail out my student loan payment and the check for the two outstanding parking tickets that canuck doesn't know about (yet, and i'm sure that conversation will be all shits and giggles). stupid canada post upped the postage to the states, right after i bought a whole book of stamps to the US, and i'm not sure where i can get "filler" stamps. i'm so confused! so i decided to let someone else handle it so that if/when it gets lost i have someone else to pass the blame off onto. i just have to get my arse out the door and into the cold so i can get this done. argh, why do i keep putting this off???

today was my day to volunteer at the co-op playschool, and i loved it! the kids are absolutely a blast to hang out with, and all sorts of different personalities and maturity levels. there was one girl who invited me to her house for hot chocolate and to play with her dog, and another girl who wanted to sit in my lap each circle time, and the little boy who made "purple poopie tea" and was nice enough to share. kids are a rip! but there was also a kid who was very aggressive and kept punching and shoving anyone who got in his way - he even growled at one little boy over a play-do arguement. he was placed in time out three times in the span of two hours. canuck warned me about that kid, and i could see why. cookie was one of the five kids he made cry today.

it was also cookie's turn to bring something for show and tell, and of course, she brought her most beloved and treasured barbies. "pink barbie" and "j-lo barbie" were the guests of honor. she was all excited at first and we even prepped for it before hand, like asking questions about the color of her dresses, who brought them, et cetera. but she had a sudden change of heart when it was time to present at the end of the class, and not because cookie is afraid of public speaking. she was terribly worried that the boys and girls were going to take the barbies home with them! so i took her aside and after a little bit of coaxing and reassuring that the barbies are coming home with us, she reluctantly went up to the front and allowed the kids to ask questions. i gave her a big hug and told her how proud i was of her sharing like a big girl. when i asked her about show and tell again she cried, "never, never, never, it's not for the other boys and girls!".oh-kay, so much for that sharing thing....

pink barbie is seated on the left. she is wearing the orange tutu that usually adorns j-lo barbie (seated on the right), but she usually wears a pink tutu hence the name "pink barbie". j-lo barbie is wearing the rainbow dress and was given that name because personally i think she looks like j-lo, cookie heard me say that and that name just stuck. these are her two favorites and cookie likes to say that they are married (i officiated). btw, the prince is around, he's just not in the picture, both literally and figuratively.

tomorrow canuck and i are going out to dinner after work. nothing spectacular, just a free meal and tobacco cessation course at the novotel toronto. because we can't afford anything better. and because the couple that does CE together stays together. we're just so romantic that way and it works out so well. actually, we're purposely going to take the nitrous oxide certification course together in february even though it will be tight because canuck thinks "well, it would be more fun if we did it together!" (i have pictures from our dentsply endo course in september, and that was a great time there) so i'm going to make this a special occasion and actually dress up to go to work, no sweats! i normally go to work in sweats and change into scrubs when i get there, since it's so bloody cold it's impossible to look stylish and stay warm at the same time. but tomorrow will be different, i will brave the elements so i can not only look presentable and professional at this thing, but i can be nice eye candy for my husband. i'm such a good little doctor mommy ;-)

at the dentsply course in september. all it takes is some free lunch and some extracted teeth to make us happy. i knew there was a reason why i married this guy!

rudeness

2007-01-18T08:46:00.000-05:00

i'm at work, been here since 8 a.m., got up at 5:45 to get here on time, and my first patient, who we scheduled as emerg this morning when i did a look-see yesterday, doesn't show and has no valid excuse. i'm tired and cranky and i charged him $25 for making me drag my ass out of bed when it was still dark outside, leave my daughter, stand at the bus stop in the bitter cold, and wait here for him like a veal. what, like my time's not important? like i don't have a life that i have to put on hold to fix your teeth, which are jacked because YOU neglected them? and then people get all upset when the office charges for missed appointments. okay, i understand death in the family, illness, childcare issues, whatever. but "i can't come today" is not a valid excuse, especially when the doctor is coming in EARLY to specifically see YOU.

unappreciated. man, i need a cup of coffee and a prozac right now.

i must have a lot of free time on my hands today...

2007-01-14T14:45:00.000-05:00

Your 2005 Song Is

Feel Good Inc by Gorillaz

"Love forever love is free.
Let's turn forever you and me."

In 2005, you were loving life and feeling no pain.

What Hit Song of 2005 Are You?

okay, so what's the other 8%???

2007-01-14T14:09:00.000-05:00

You Are 88% Democrat

You are a card carrying Democrat, and a pretty far left one at that!
There's no chance anyone would ever mistake you for a Republican.

How Democrat Are You?

You Are 4% Republican

If you have anything in common with the Republican party, it's by sheer chance.
You're a staunch liberal, and nothing is going to change that!

How Republican Are You?

the little story of how the MD scared the crap out of the DDS big time

2007-01-14T11:25:00.000-05:00

on january 3, i finally got a chance to take advantage of the universal health care system and went for a complete physical. i got it all checked out, blood pressure, cholesterol, thyroid levels, the whole shebang. being a health care professional and constantly being exposed to pathogens known and unknown, i asked the doc to test me for EVERYTHING under the sun. now, i haven't been tested for anything since i was pregnant with cookie over three years ago, and that was when i had just started practicing and hadn't really got my hands wet doing anything and the HIV test was mandatory in new york state (i still reeled while waiting for the results despite the fact that i was "low risk"). but i do have a tattoo and also remember i was exposed to hepatitis C over the summer when i was careless and scratched myself with a flame-shaped (read SHARP) composite finishing bur that had gone subgingival on a Hep C positive patient. it's not like you can do anything when that happens, either - you just wait for your liver enzymes to go up to detectable levels in a few months or test for RNA traces in about 4 - 6 weeks.

usually when the blood work comes back, no news is good news, right? so i nearly shit a brick when his office called and wanted me to come in to "discuss the results."

"oh, don't worry, he always gives hepatitis results in person. it's just policy."

"can't you just give me the, uh, results over the phone? especially if it's negative, just give it to me over the phone, right?"

"we'll be here until 3:30."

oh. my. god.

i raced home early from work, was shaking when i got to office by 2 p.m. and i waited for what seemed like days but was really only a few minutes.

he called me in, sat me down, and pulled out my chart, page by page.

"hey, thanks for coming in, there are some things i want to discuss with you. okay, here's you cholesterol, good, your thyroid levels are good, all your titers are up to date, HIV will be back in a week. now for hepatitis...."

oh god. here it comes...

"you are negative for hepatitis C, and your vaccination for hepatitis B was successful, but you have no protection against Hep A."

"so you mean i am healthy and i don't have hepatitis? i'm okay?"

"what? yes, of course you're great keep up the good work! i just want you to fill this script and come in for the vaccine, that's all."

"you scared the hell outta me, doc, i thought something was wrong! no one ever calls unless something is wrong!"

"oh, no, that's why you looked so worried! no, it's just policy to discuss those results in person, is all, you know with PHIPPA and PIPEDA regulations."

he handed me the script, i breathed a huge sigh of relief, and i went home.

i think i just aged about 10 years...

i really, really like this song...

2007-01-14T11:18:00.002-05:00

because it's happy and peppy and the guy is singing about how much he digs his girl. i'm not sure if it's even been released in the US yet.

Happy Birthday Cookie!!!

2007-01-12T07:43:00.000-05:00

three years ago today, she heralded her arrival in the typical T.V. cliche that very rarely happens in real life but, of course, happened to me. my water broke in the middle of the night when i laughed while watching seinfeld reruns. Twenty hours and an epidural later, she was born, all 9 pounds 3 ounces of her, and i thankfully managed to pull it off without a C-section. sucks, i had to work all day today, but canuck was home and actually had daddy duty at school today. i wanted to make cookies or cupcakes for the kids in her class, but everyone is so peanut-phobic and allergic nowadays with all that cross-contamination stuff (i think it has something to do with genetically modified peanuts), so the teacher told me to get something store-bought that was labeled "peanut free". turns out NOTHING on the market is guaranteed "peanut free", every bloody thing out there, even the stuff that's been baked on store premises has maybe, possibly come into contact with some sort of nut or a distant relative and is therefore off limits. so i scratched that idea and made little gifty bags filled with bubbles, scratch and sniff stickers, and noise-maker clapper-thingies for the kids (i'll bet the moms will LOVE that!). it's probably better that way, seeing as that i am dentist i probably shouldn't be loading little kids up with fermentable carbohydrates. speaking of which, i caved in and brought home mc donalds happy meals as a treat for the family, as that is cookie's definition of a "special" dinner and it is her birthday so she gets to pick.

it was canuck's turn to volunteer at school today and he said it was "interesting" which in canuck-speak means, "damn, it was hard work i'm glad i did it but i'm also glad it's over." it's my turn on the 22nd and i'm meeting the day with both excitement and trepidation. i'm curious to see how cookie is at school, how she behaves and how she treats her teachers and the other kids. canuck says she's pretty good but definitely needs to learn to listen when given instruction. i think it may be a funciton of her age, she only turned three, but at the same time we realized that our kid needs a little more structure and some sort of a schedule if she's going to turn into a functional member of our society (now that's an oxymoron!). i think a set bedtime and not allowing her to sleep in our bed might be a good start, but it's so hard to stick to something like that, especially when one or both of us works evenings. i don't even know where to start....

blowing out the candles!

my big girl's three years old today!!!

Monday, January 8, 2007, Cookie goes to school!

2007-01-10T10:57:00.000-05:00

My little baby/devil/angel/buddy has officially started formal education. we enrolled her in the neighborhood community center's co-operative pre-school program. on monday, wednesday, and friday she'll be out of my hair for about 2 hours in the morning, where shell learn to play with others, make arts and crafts, and hopefully listen to grownups( gee, i wonder how that will pan out...). here are some pictures of her first day, all dressed up and on the stairs!

why is it so impossible to get this kid to pose normally for the camera???

this shot is better, at least she's not making a goofy goober face ;-)

apparently, she was pretty good at letting go of me and entering the classroom, no drama, tears, or anything. that actually felt pretty good, i didn't have that surge of emotions some moms feel when dropping their kids off for the first day. i didn't feel abandoned, torn away from my child, and i didn't fret while she was away because i knew she was having a good time (i also got some crap done around the house, too!) she'll always be my baby, but i love to watch her grow up, say new intelligent and hillarious things, and see how she interacts with other people. i wonder what kind of person she's going to grow up to be. will she be a nice kid (i hope so!)? easy-going or extremely sensitive (like her mommy!). what will she like to study in school? what will her friends be like? what five million things will she want to be when she grows up? i can't wait to find all these things out, and as limited as her time in school is right now, we're on the road to discovery! so i guess that's why i feel the way i feel about the whole deal. it's great, my kid's growing up!

Christmas pictures!!!

2007-01-09T23:19:00.000-05:00

yay, finally got a chance to unload the pics from my camera onto my computer, and now onto the blog.! i forgot how easy it is, i'm kicking myself for not doing it sooner...

cookie surveys the tree (she approves).

here's cookie in her nightgown on christmas eve - good luck trying to get her dressed in the morning whenever she wears that to bed, she absolutely refuses to take it off. sometimes we just have to put it on top of whatever she's wearing to keep the peace.

nana, cookie, and zelda on the stairs. it was a surprisingly very difficult picture to take and this was the best shot i could get of everyone (toddler at christmas plus skittish dog plus cranky mommy that still has a ton of cooking to do).

opening the first of a zillion barbies.

zelda, the wonder dog.

wrapping up 2006

2006-12-30T08:40:00.000-05:00

so christmas was an ultimate success this year. it was hosted at my new casa and we managed to pull off a tasty, well-organized event. canuck and i learned our lesson the hard way from thanksgiving and started cooking and freezing on friday night. we served manicotti (homemade noodles, too!), apple pies, pound cake, ham, mashed potatoes, veggies, biscuits, and fresh salad (with the expensive, red-leaf lettuce). i also laid out my chocolate fountain, of which every year i am reminded of why i only lay it out once a year (it's a bitch to clean!) and i spent over $15 on un-seasonal fruit which could be dipped in the $20 worth of chocolate i bought from bulk barn (canuck nearly had a heart attack at that bill). the house exploded with presents, paper, dog hair (zelda crashed at our pad), pine needles, and leftovers. my parents left on wednesday, just as i headed out the door to go back to work (i'm still a little early in my career to take weeklong vacations) and we're just starting to get the house back to normalcy. which will then be disrupted by our new years' shindig.

the theme for cookie this christmas was "barbie and the twelve dancing princesses". i think she got a total of around 7 new barbies this year, plus the barbie "prince", the horse and carriage set, and the vanity and console. she got so many gifts i have to ration them out over the year. and she's got a birthday coming up in two weeks! canuck and were are trying to put the kaibosh on excessive, but she is the first and only grandchild and nothing was stopping my folks or my in-laws. funny, even after all the new barbies, cookie has undying loyalty to the barbies at my MIL's house, the ones that once belonged to her zia decades ago. they have broken legs, no necks, shorn hair, naked torsoes, but cookie plays with them faithfully and still loves them with all her heart.

my birthday was on the 28th, and i got a nice and early start to my day by heading downtown at 8 a.m. to work. canuck and cookie met me at my new office (which is a closet, but i love it!) and we walked around downtown toronto for a few hours. then we headed back up and i made fondue for dinner in my new fondue pot! i have a fondue cookbook that i got back in the day, so this thing is going to get plenty of use.

i have a ton of pictures to update my blog with, but i've been terrible with getting them off my camera and onto the computer, never mind getting them on this blog. but i'm working on it, and it will be worth the wait!

2007 is just around the corner! i have a really good feeling about this year....

christmas is coming!

2006-12-20T09:02:00.000-05:00

man, i am just so excited! it's kind of hard focusing at work when i'm thinking about my mom coming in 3 days, wondering if my tree is watered enough (yeah, canuck kept up his end of the bargain and we got a real one this year!), constantly changing my mind over what to serve for dinner, and all those presents burning a hole in my closet! i'm the hostess this year, and christmas in my new house is going to be the best one yet!

i start a new office downtown today and i'm very excited. i don't expect it to be too busy - new doctor + december/end of year + christmas = lots of free time for dr. mommy, but i have a few patients booked and the office had 82 new patients last month, so i'm hoping to get booked up quickly. i love working in the city - i love the environment, i love taking public transportation, i just love the feel of downtown toronto. needless to say, i'm pumped and ready to start working!

psycho office messed with me for the last time last week when they wanted me to come in for 2 hours in the evening. i probably would have gone in as a favor, but this was the fifth or sixth time in a row that this has happened. it literally kills my whole day - i can't make doctors appointments, book play dates, or do anything because i think i have to work that day and then i get a call, "hey, your start time is at 5:15." get the hell out of there! so i said, no, i'm not coming in, and don't bother booking me anymore. i'm not doing you guys any more favors. what really pissed me off is that i had this conversation with boss lady when i quit and she asked me if i could fill in a few days when she doesn't want to work (which is all the time). i said, sure, but a full day, it's a waste of my time to come in for only a few hours. oh, yeah, sure, that won't happen again. my life and my schedule have revolved around whether i not i have to be there and that has come to an end. it's sad, though. she doesn't realize what a great staff and patient base she has - these were some of the nicest and most professional people i have ever worked with and i'll miss them terribly. but when i was wavering about quitting, just thinking about spending another minute working with her turned my stomach. so i left. but someday, when i grow up and open my own office, there will be jobs waiting for all those wonderful people - and i know they would snap it up in a heartbeat.

eek, back to work!

2006-11-30T21:53:00.000-05:00

i can get used to this whole staying home bit, but then my brain gets kind of fried and i get caught up in the whole daytime t.v. (unsolved mysteries, raymond and law & order re-runs, etc.) and i got absolutely nothing done today. it really is true, the more free time you have, the less you actually accomplish. i'm back to work tomorrow after my recuperation and i have a doozy of a schedule to greet me when i arrive - implant impressions, molar endo, crown impression, 3 new pedo exams, and dozens of hygiene checks await my eyes and hands. gee, i hope i remember how to do actual dentistry after all this time off!

i've been using my free time to delve myself into all things cookie, who has lately been walking around commanding orders like tarzan. "me want more milk!" "me want to watch sponge bob 'lil bit." "mommy, me want a sandwich." i don't know what's driving me more crazy, the incorrect grammar or the incessant demands. she's recovering from some sniffles herself, poor kid, but that certainly has not quashed the little dictator inside. mercifully, she seems to have escaped whatever tummy bug i was carrying around, but she seems to have transmitted her little sickness to canuck. and just in time for the holidays, too. viruses - the gift that keeps on giving...

gastroenteritis, part deux

2006-11-29T16:27:00.000-05:00

okay, wtf??? i never get sick, but this is the third time this month that i've been ill with something. two weeks ago it was 24 hour "fever and ague". over thanksgiving weekend it was "hey, my left sinuses are going to be perpetually stuffed and drip down my throat all night" and today i'm holed up in my house with a stomach bug. this one takes the cake, though, crossing that line from kind of annoying to mildly debilitating. i woke up at about 3 a.m. tuesday morning feeling like i had rocks in my stomach, like something was just not right. i had some adventures in the ladies room and tried to sleep it off until i had to be at work at 10 a.m. when it was time for me to leave by 8:30 my stomach was reeling, but it was too late to cancel my first patient who has to premedicate with antibiotics (and they wreak havoc on her system and i didn't want to put her through all that for nothing), so i hauled my ass into work. it took me two hours to prep, temp, and final impression her crown because my hands were shaking (came out great, though!) and i couldn't even cement the temp on myself because i broke out into a cold sweat and had to run to the bathroom to dry heave (there was nothing left at that point). my colleague bailed me out and cemented the temp for me, and the office sent me home, green and feverish. my patient and i are very friendly and she was incredibly appreciative that i came in feeling like that, so it was worth it. i spent the rest of the day holed up on the couch, bundled up and shivering, and i managed to keep down some advil, one piece of toast and a coke. today i ate three small meals and i felt well enough to clean the bathrooms, so i'm well on the road to recovery! i think next time, though, i'll just stay home when i feel that crummy...

wicked accurate!

2006-11-29T16:18:00.000-05:00

yup, in 29 days, i'll be 29.

Your True Birth Month Is December

Logical
Patriotic
Ambitious
Not egoistic
Loves praise
Loves to joke
Fun to be with
Not pretending
Loves attention
Short tempered
Hates restrictions
Loves to socialize
Loves to be loved
Loyal and generous
Impatient and hasty
Changing personality
Good sense of humor
Honest and trustworthy
Influential in organizations
Takes high pride in oneself
Active in games and interactions

What's Your True Birth Month?

thought i'd take a crack at this one...

2006-11-29T16:14:00.000-05:00

You Are a German Shepherd Puppy

Intelligent, quick witted, and a bit aggressive.
You've got the jaw power to take a bite out of anyone you choose.

What Breed of Puppy Are You?

mmmm, bread....

2006-11-14T10:37:00.000-05:00

now that the weather is colder and i'm having a little more free time on my hands, i've thrown myself into my kitchen. some time ago, i read a fabulous book called the omnivore's dilemma, and it's about the challenges we face in north america as a socitey that is surrounded by so many food options. why is it that we have this abundance of food, and yet our nation is one of the unhealthiest countries on the planet? how does the military-industrial complex play a role in what is served at the dinner table? what are the differences between the industrial, pastoral, and personal food chains? and how has the definition of "organic" changed over time? oh, this book was a real treat, absolutely wonderful to read because i simply adore food and cooking (funny because i am a picky eater, but what i do eat i chose very carefully and am a bit of a food snob) and it shed light on a lot of things. this is a great compliment to fast food nation because it takes things to a bit more of an intellectual and esoteric level, but at the same time is very imformative and completely changed the way i view food.

this book actually sparked my interest in vegetarian cooking for numerous reasons which i will not go into detail right now (the timing was impeccable because i read it right around canadian thanksgiving) and i've always loved to bake. so i've been cranking away in the kitchen, making crispy fried tofu with stir fried greens, vegetarian fried rice, vegetable hot pot with cheese triangles, fresh tomato lentil soup, the list goes on. i've also started up making my own bread now. last week i made a loaf with organic spelt flour and sesame seeds. it's called a grant loaf and the recipe was made accidently by an English woman during WWII. it's fabulous - really easy to make because it requires no kneading and only one rising, and has a very high vitamin B content. it supposedly cured all of the inventor's digestive problems. last week i also made a maple pecan loaf. this one was way more labor-intensive. i had to knead this dough for a good 20 minutes or so before i felt any semblance of elasticity and the dough is so coarse that you really have to work it. what a work out! ah, but it was worth it! my whole house smelled like a bakery for days and i got two loaves from the recipe. makes wonderful ham and cheese sandwiches, too!

pulpotomy or pulpectomy, shouldn't you know the difference?

2006-11-11T22:49:00.000-05:00

so this happened about a week ago, but i've been waiting until i had the time to jot this down in completion. this was the situation that took place and the conversation that ensued:

got called into the office an hour earlier than my start time to see an emergency. sure, no problem. boss lady pulls me aside and says, "hey, this emerg is actually a classmate of my daughter, he's in a lot of pain. they actually want to see me, but, well, i just can't right now, i don't have the time. just take a look and see what you can do."

"okay, sure no problem."

a brief history, 6 year old boy had a bunch of restorations completed under general anesthesia about 2 weeks ago and was having spontaneous pain in his upper right quadrant. i seat him and take a quick peek. no fistual or parulis, but #54 has a composite resin resto, is very percussion tender (all other teeth WNL) and is slightly mobile and extruding from the socket. my assistant takes a periapcial which showed a deep MO resto on #54 touching the pulp horn, but no evidence of furcation or periapical radiolucency. my diagnosis was pulpal necrosis with resulting acute periapical abscess, pretty much a no-brainer. the only treatment of choice for a non-vital tooth is pulpectomy, but on a primary tooth that treatment has a very limited prognosis due to the tortuous root canal configuration and limited use of obturation materials (can't use gutta percha because it can't resorb during exfoliation). i decided that the best thing to do would be to extract and place a space maintainer. now, i see kids and they're alright, and i do some extractions, but here's a six year old who goes under for treatment and who is already antsy and fidgety in my chair. needless to say, this was not something that i felt comfortable enough to take on. also, the infection was pretty nasty and that would make it even more difficult to freeze him completely. my recommendation was to place him on antibiotics and have him return to have the tooth taken out in about a week, with subsequent placement of a band and loop space maintainer on the #55. i was all ready to go and was just finalizing things with the mom when you-know-who walked in and starts examining my patient, asking him where it hurt, et cetera.

i told her, "i already made my diagnosis, #54 is necrotic and needs to be extracted and we're going to place a space maintainer."

"well, it's better to save the tooth whenever possible. you should try to do that."

the mom says, "just do whatever it is that will guarantee that he will not longer be in pain and that he won't have to come back here again."

boss lady: "oh, sure, baby teeth root canals have a great prognosis."

mom: "but if they take it out, i know there will be a problem with shifting, right? my other son has a space maintainer."

boss lady: "oh, he doesn't need one because the canine and the second baby molar are there, the teeth won't move that much, right dr. mommy?"

me: "actually, i would place a space maintainer, just to be on the safe side."

boss lady: "well, maybe that's what they teach in the states!" chuckles, then exits the room.

at this point i'm fuming, but i know that woman was an acquaintance of hers, so i wasn't going to make her look bad in front of an acquaintance. i go to the ladies room and when i come back she's in the room with the mother again, talking.

"so dr. mommy will go ahead and start that root canal for you." and she indicates she wants to talk to me.

"okay, go ahead and start the pulpotomy on him."

"um, dr. boss, the tooth is necrotic, and you can't do a pulpotomy on a necrotic tooth."

"right, okay, go ahead and start the pulpotomy and bring him back to finish it a nd you'll need formocreosol, too."

"the tooth is necrotic, you use formocreosol for a pulpotomy, which is for a vital tooth. i think the tooth really should be extracted, because it's necrotic and has a very poor prognosis. i want to place him on antibiotics and bring him back for the extraction when the infection has cleared up."

"yeah, but he's in a lot of pain and i told the mom that you would treat him today. and now she wants to save the tooth."

now, i should have told her then and there to fuck off. i should have told her that if she wanted to save the tooth, go ahead and do it herself, good luck. she interefered in my diagnosis and treatment, completely contradicted what i said in front of the patient, and was now ordering me to do her scut-work. but i didn't. i had a kid in pain in my chair who was now prepped for me to start work and a mom who just wanted some relief and a good night's rest. man, was i in a pickle. so i went in there, numbed him up, and opened up #54. pus came up thru my access and the tooth stunk, but surprisingly there was a vital nerve in the palatal canal, which i removed. as expected, he was crying and uncooperative and i felt horrible doing putting the kid through all of that. i wasn't able to modify my access in any way or open it up more because after a while the poor kid just pooped out. there was probably some pulp tissue left, but the tooth was opened just enough to relieve the pressure. i irrigated with some saline, placed cotton in the access, gave some to the mom, telling her to change the cotton several times a day, and put him on 300 mg Pen VK three times a day for a week. when i called later that evening to see how he was feeling, she said he was sleeping for the first time in days. without the boss breathing down my neck behind me, i told her to have the tooth taken out, and she did a few days later. and he WILL be getting a space maintainter.

the best was when i had stayed behind for over an hour after the office closed to see two walk-in emergencies. one of them was a patient who hadn't been there in over two years. #37 was broken, ML cusp sheared off. i told the patient the tooth definitely needed a crown, spoke to him about the treatment, insurance and financing options, et cetera. he was good to go, wanted to book it ASAP. now why is it that i and the other associate had all these openings in our schedules and this guy had to wait three weeks to book the crown with her? even though i was the one who stayed behind and treatment planned it? and she never even said thank you for staying late, even after those emergencies that i stayed behind to see booked hygiene appointments for themselves and their families.

i officially gave them notice last week. and i've never felt better.

best halloween ever!

2006-11-01T12:00:00.000-05:00

it was a beast to carve, but with the help of a stencil and a wicked pumpkin carving kit (two knives for bulk and precision carving) canuck and i cranked out this beauty. cookie went nuts for it!

We didn't get too many trick or treaters, just a few larger groups of kids so now we have all this excess candy lying around. which is bad, bad, bad, 'cause you know who will eat it...

cookie went as a princess - she's wearing a tutu under her "princess fur coat" and these plastic beads/pearls that i bought from walmart for $2 that stunk to the high heavens like skunk - maybe it was the plastic or something, but man, did they reek! cookie didn't seem to mind, tho. she refused to take them off when we got home!

yeah, i'm cute. now gimme some candy!

three years and counting...

2006-10-25T12:06:00.000-04:00

happy anniversary, my wonderful canuck!

dental woes (or whoa's, whatever)

2006-10-24T09:28:00.000-04:00

so i've been gone for a while, but not for lack of goings-on. in a span of a week my dad, sisters, mom, and her dog were in and out of our house at various points in time. my dad came with two of the tetrad of sisters (it's impossible to get them all to come at once) and my grandmother to celebrate canadian thanksgiving, which i successfully hosted at our new digs. we had so many people we dined in the basement (fully finished, of course) on a HUGE table that canuck and FIL built for that purpose. the turkey was perfect, wine and conversation flowed, and a good time was had by all. they left that monday, only to be succeeded by my mom who recently moved to michigan to be closer to us, on thursday night (my parents are divorced, if you haven't figured it out already). she brought zelda, the coolest dog in the universe, with her, and we hung out, shopped, and did all that great stuff. i love having my family come and visit, but i'm always so sad to see them go :'-(

work has had it's ups and downs. i love my downtown office and i went through a period where i was super busy, but i've completed treatment on all the new patients that have come in and there just haven't been any more new ones these past few weeks. the hygienist and the other doctor also have huge gaps in their schedules, so i guess it's that time of the year when insurance runs out and people don't want to have treatment anymore because there's no more money. the saving grace is that i have three or four HUGE implant cases that are almost ready to restore, and i'm very excited to get those rolling. the periodontist we work with came by the office today (with a bottle of wine for both myself and the other doc!) and so did our rep from nobel biocare. we chatted, went over some cases and some info. in two weeks i'm delivering an immediate CD/RPD for a guy who is having all his teeth extracted under IV sedation and is getting bone grafting for implants. we're going straight to teeth, no extractions of the posteriors first, nothing, the surgeon needs to graft everything immediately. so i got good impressions, took as accurate a bite reg as possible, sent the case off and am currently keeping my fingers crossed but not holding my breath. we all know that this is a temporary denture, but i would still like the thing to fit relatively well for the time being. it's going to be very interesting - the patient has ankylosing spondylitis, takes a ton of meds, and has an alcohol problem. he should be a real peach to sedate!

the office up north is driving me crazy! i've had over a dozen crowns taken away from me, patients that i've treatment planned, sold the procedures to and haven't even gotten paid for the new patient exams despite all the effort on my part, and they've just disappeared from my view. it's like every crown that gets done, i've practically gift wrapped it for the chief dentist to take away from me. i have patients that want to see me and i start out with them, but then they get transfered over to the other associate because they have to fill her schedule too (one little girl actually started crying when i told her i wasn't doing her fillings that day). if something i do fails (i had a streak of bad luck with the 3M onestep and two of my restos fell out of some pedo teeth i restored) i should be the one to fix it. nope, got moved to someone else and the production got deducted from mine, and i never saw the patient again. people get flopped around and i feel like there is no continuity of care - if i treatment plan something or if something that i do goes wrong, that patient should be seen and/or fixed by me and only me. and that's speaking only from the dentist's point of view, but think about it from the patient's perspective. wouldn't you only want to see the same doctor you're comfortable with or who initially saw you? it also makes me look bad, because i can't speak for myself or my mistake when i'm not there. argh, and crazy boss lady gets on my nerves - she makes comments about my weight (pats my tummy and repeatedly asks if i'm pregnant, and i'm not overweight by any means) my skin (oh, you have a pimple, what's wrong with you?) and even said that cookie is "chubby" ("what are you feeding that kid?") so i'm currently looking for another office that might be a wee bit more of my cup of tea. i'll hang out there for the time being and just do my thing, smiling and nodding the whole time - i do like the staff and i've grown attached to the patients there and i don't want to leave on bad terms. but long term is definitely not an option for me at this place. i had an interview last thursday and it seemed to go well but i think they want more saturdays than i can commit too, so i'm just keeping my fingers crossed.

so, it's been an eventful couple of weeks, to say the least. hopefully things will fall into place, i just have to be patient and everything will eventually work out for the best. it's just the waiting that's the hardest part (wait, isn't that a tom petty song???)

this is probably a good thing, since things have been kinda rough lately...

2006-10-24T08:48:00.000-04:00

You are the World

Completion, Good Reward.

The World is the final card of the Major Arcana, and as such represents saturnian energies, time, and completion.

The World card pictures a dancer in a Yoni (sometimes made of laurel leaves). The Yoni symbolizes the great Mother, the cervix through which everything is born, and also the doorway to the next life after death. It is indicative of a complete circle. Everything is finally coming together, successfully and at last. You will get that Ph.D. you've been working for years to complete, graduate at long last, marry after a long engagement, or finish that huge project. This card is not for little ends, but for big ones, important ones, ones that come with well earned cheers and acknowledgements. Your hard work, knowledge, wisdom, patience, etc, will absolutely pay-off; you've done everything right.

What Tarot Card are You?
Take the Test to Find Out.

man, i miss new york

2006-10-02T18:11:00.000-04:00

www.overheardinnewyork.com

!

2006-09-16T11:02:00.000-04:00

so i go to canadian tire to get my oil changed on thursday, no biggie, just routine maintenance (did i spell that right???). i go to pick the car up and i'm told that the "boots and shaft" on the front axel is torn and corroded and needs to be replaced. well, okay, that sucks, but my car's 8 years old and hasn't been serviced with anything major since i bought it so. it's a '99 subaru forrester with over 103,000 miles on it and i absolutely love it and am not planning on getting another one anytime soon, do what you gotta do. oh, btw, the power steering fluid needs to be flushed, too. sure, go ahead, what's another $70 on top of the $550 i'm already spending, right? i take the car in today to get all this done and i get another phone call about an hour later. guess what, your brake pads are worn down and out of alignment, and one of the recepticles or whatever you call is is cracked and leaking brake fluid. um, okay, i guess that should be fixed, too, i use the bloody car every day it would probably be a good thing i could stop the car properly, right? how much is this going to run me in total? $1300???? ho-ly shit! damage, it hurts, it hurts!!!

it's so funny, because surveys have pretty much placed dentists and mechanics at the same level of the "trust meter" (which is pretty damn low, as you can guess). so i suppose today i got a taste of what it feels like when someone comes in for a "chipped tooth" or "my filling fell out" and i take a radiograph and whoa, nice PAR, you need a root canal and a post, core and crown and then the jaws drop to the floor. it's going to cost me $2000 to save this tooth? are you kidding me? i was absolutely dumbstruck-flabbergasted at the cost, and i was really torn between are these guys trying to soak me and i should just do what needs to get done and trust the experts? what kind of response would i expect if placed in the same position, as i am every single day i come to work? most people are pretty honest, right? well, as you can guess i went with the latter (gritting my teeth the whole way, but still, it needed to get done). i hope some good karma comes my way now ;-)

a busy few couple of days, past and present

2006-09-13T12:40:00.000-04:00

i'm off again today, nice! i have a ton of things to do before my parents come to visit this weekend! i'm very excited because this is the first time my mom will be seeing our house. and what's really cool, we even have real bedroom furniture (which i personally refinished) and a room for them to stay in, the days of the air mattress and futon are so over!

my endo course is on friday and i'm really excited. i have a nice bunch of extracted teeth all accessed and ready to go. i made sure to tell the oral surgeons to give me the wackiest molars they could find, lots of curved and twisted roots since i need the practice. canuck's taking the class with me, what a romantic way to spend an autumn friday afternoon together. and because i really, really love him, i'm even sharing my most prized extracted teeth with him. nothing says love and devotion like the gift of extracted teeth, especially when they're in a a container of javex. i think it will be a good day. i really do enjoy doing root canals (the "sadistic" part of me, as my mom says) and want to get very proficient. i actually was planning on specializing, i still do think about it often, but life, kids, and a house changed things a bit. that's okay, someday when my debt's paid off and i have cash to burn i might go back to school. until then, i'll just focus my attention on getting cookie to poop in the toilet and not in her pants.

case from HELL, why why why???

2006-09-03T07:55:00.000-04:00

had a really difficult case last friday that i worked overtime to complete. about two weeks ago, a woman in her late 50's came into the office with a loose bridge 11-12-13-14-15 (pontics in pink). she's had the bridge for about 20 years. the abutments 11 and 13 were completely rotted out so that when the bridge was seated there was about a 5 mm gap between the margin of the crowns and the edge of the tooth, #11 had a periapical lesion and both had caries near the level of the bone and would probably require crown lengthening. #15 was actually in pretty good condition, the only tooth physically holding the bridge in place. she was squeezed into my schedule as an emerg recement, so i had about 15 minutes with her. i scooped out the caries from 11 and 13, cemented the bridge back onto 15 with rely-x (and that was the only tooth holding the damn thing in place) and basically gave her the ideal treatment options. a) extract the teeth and get a partial denture (keeping #15) or b) extract the teeth and get an implant supported bridge. note how the word "extract" is repeated in this conversation. now, she has no insurance and wanted a "quick fix". since so much decay had obliterated #11 and #13 and they could no longer support the exisiting bridge, the only "quick fix" option would be to root canal those teeth, place a post and core, and retrofit the bridge she had, since it was not worth it to make a new one with such poor-guarded prognosed teeth. i knew this was going to be a beast of a case, but i felt obligated to present her with all the options, the good, the bad, and the ugly and i wanted to help her out. i repeatedly told her that this was extremely short term, who knows how long it would last, very limited prognosis, yadda yadda yadda. no, no, please just save the bridge.

so she came back a week later, and lo and behold, the bridge was still on there, wobbling around but permanently cemented to #15. i couldn't remove it with a hemostat, so i had to tap the thing off, took me a bloody half an hour to do so i was almost ready to cut this damn thing off. lo and behold, poor oral hygiene and the gingiva had grown over the root tips. how the hell am i supposed to access these teeth for root canal with all that gum tissue in the way? answer - gingivectomy! of course, this office doesn't have an electrosurge machine, so i performed the gingivectomy old school with a scalpel and fine diamond burs. so much freakin' blood everywhere, it took a galloon of hemodent and multiple papillary epinepherine injections to stop the bleeding to i could proceed with the RCT. and forget about putting a rubber dam on these babies, there was abolutely nothing to grab onto. why why why did i do this to myself? so i instrumented these horribly calcified canals to a #40 file (too small for teeth that size), irrigated with copious NaOCl and EDTA, obturated the teeth (lateral condensation), and managed to squeeze in well fitting titanium posts in both #11 and #13. next, bring on the Ti-Core, pounds of it, and i just went to town. the #13 fit like a glove, but there was so much loss of tooth structure from caries on #11 that i had to fill in the remaining gaps with ti-core, and i even ran out! i had to order more and bring her in to fill in the distal portion of #11. four hours later, the whole shebang was permanently cemented with rely-x and the patient is asymptomatic and pain free, so far the bridge is holding tight and she's eating like a champ but for who knows how long? and here's the thing that really miffed me: i had to charge her for the two root canals, the posts, and the core build-ups (never mind the surprise gingivectomies, those were on the house) which added up to about $1400. she came prepared to pay over $1800 in CASH (estimate error from the front desk) and i was like, if you had that much cash on you, enough to pay for at least IMPLANT SURGERY or a DENTURE, why the hell are you shelling out all this money for treatment that won't last? i mean, i did the best job i possibly could, and i even had a lengthly discussion about this with her and her family (nicely, of course) and i felt so bad i cut her an additional 25% break. what was she thinking? what was i thinking? am i on crack for taking on such a thing? or was i really helping this person out? what will happen when this thing fails? i can't say "i told you so" and i don't know how i can patch this up anymore than i already did. why don't people listen? and why am i such a sucker?

office gossip

2006-08-30T22:08:00.000-04:00

so i was in the 'burbs today, nice and quiet day because school starts in a week and everyone's away before crunch time. i actually prefer quieter days even though i get paid on comission/production because i can take my time, chat with the patients, and really do a good job even if it means seeing fewer people (less stress). it's just not my style to be an animal at the office and "make a killing, go go go $$$" - even my quietest days are quite productive and i'm satisfied just if i get out on time and i'm nice and relaxed all day. so that what was pretty cool about today, plus insane boss lady was away! i thought i was going to have tomorrow off because the schedule was dead and the few patients i had they diverted to the other associate (which was FINE with me!) but the hygienist called in sick lsat minute and just called me to cover for a few hours :-( i'm not above doing hygiene, but i really wanted the day off. shouldn't be too bad, though, only for a few hours and i have the morning off with cookie. did i also mention that insane boss lady won't be there tomorrow???

oh, and apparently there's a pickpocket amongst us. it's been caught on camera, someone has been repeatedly stealing cash out of one of our associate's purse, totalling over a hundred bucks worth. someone's going to get canned really soon, and it won't be pretty. i think even the cops are going to get involved. only the boss knows who it is and won't tell anyone until this person is let go, so everyone is just waiting for that one person to not show up anymore. and of course everyone is speculating. i wonder, do they have that whole "innocent until proven guilty" thing in canada? this should be an interesting chain of events...

cookie and mommy paint the town red (er, princess purple)

2006-08-28T19:33:00.000-04:00

a day off, a day off, a day off! i cherish these moments, so few and far between. and i mean a real day off, sunday doesn't count because of all the crap i have to do around the house. canuck had crazy hours today, 9 - 8 at his new office up north, so cookie and i had the whole day to chill out. i made the beds, dusted, did the dishes, tidied up a bit, and plunked down and watched the news for a few hours (CNN because it reminds me of home). then cookie and i painted my toenails this really wicked color from revlon, silver something-or-other, but it really is like a metallic purple. she watched me do my nails and begged me to paint hers "princess purple" just like mommy. of course, i had to oblige. and she actually managed to stay still long enough for it to dry, miracle of all miracles! then we made grilled cheese sandwiches, which i cut into the shape of a heart, and settled down for a nap after lunch (mommy too!). later in the afternoon, we walked to payless where we bought cookie some new shoes for the fall - both pairs PINK, of course. then i picked up some pretty hand towels for the downstairs bathroom at linens 'n things, browsed for fall clothes, and stopped for gelato as a real treat, yum (cookie had chocolate and i had hazelnut, my favorite). we had time to play at the park for a while before it started raining and made it back in time to make dinner. now we're watching the little mermaid (for the hundredth time) and waiting for daddy to get home. tomorrow, back to work *sigh* but at least it's a short week and a long weekend for both me and canuck.

my day off rocked!!!

stuff to look foward to!

2006-08-25T21:50:00.000-04:00

so i'm really excited about work next week - my schedule's packed at the downtown office, the long weekend's coming up so i'll have a saturday off for the first time in forever, and crazy-boss-lady's on vacation, yippee! i'm looking foward to a productive yet uneventful next couple of days. tomorrow i go into the city again, and it'll be good but i do have a case that i'm kinda dreading a bit.

one of my patients is a very, very nice girl, but extremely phobic of the dentist. she's from bulgaria, where she said when you have a toothache you basically have to decide which is worse: staying at home with the pain or going to the dentist where you knew the pain would kill, maybe even worse than leaving it alone. my predecessor completed RCT on #27 and she had a very difficult time freezing, which is suprising for a site that you can pretty much 100% successfully infiltrate (septanest usually does the trick for me). i vowed to send all RCT that she will (hopefully not) need to a specialist because of this - just something my gut tells me. anyways, she has a ton of interproximal caries and her schedule is limited to saturdays (of which i'm there only twice a month), so we've been working by quadrant very, very, very slowly. uppers, not a problem. but the lowers, what a disaster! very difficult to give an IA block and when i do, she just eats through it like crazy. and on saturdays, i get tons of interruptions from all the emergencies and hygiene checks that i got to do, so i have a very limited window of time that i can work with her. she's so sweet, very understanding and extremely apologetic, and i'm like, no, it's my fault, i failed to numb you up, and she's like, no, it's my fault, i'm a freak of nature! and we go on and on for hours. after two appointments of extremely short duration and/or complete failure to obtain profound anesthesia, i gave her a script for 5 mg valium a half hour before her appointments. i heard that often does the trick in a pinch. i also have an intra-osseous anesthesia (stabident) system, but i'm not all that comfortable using it yet and i don't want to experiment on this person. right now she's in temporaries on her lower right and still has 2 cavities on her lower left. so if the drugs don't work, i don't know what on earth will. needless to say, i'm keeping my fingers crossed.

after tomorrow's over, canuck and i are going to see a bluejay's game! so even if tomorrow's craptastic, i at least have something to look foward to. there's always something to look foward to ;-)

minimally invasive dentistry... where do i draw the line?

2006-08-15T23:12:00.000-04:00

when a patient comes in and asks me "how long" something will last, i usually give them ballpark averages from what i've heard and read (ie. fillings about 5-7 years, crown and bridge about 7-10 years, etc) but i always give them the caveat that no matter how well any work is done, all of the materials we work with have a limited life span and that things may eventually wind up being replaced or repaired. in fact, about 95% of what i do is replacing and/or repairing old and failing work. the fact is once you open up a tooth, you are officially married to it (so at this point i can safely say that i have about 1000 husbands!) and it becomes your responsibility. the mouth is a very harsh place, and even the tightest margins can leak, the strongest porcelains may fracture, the most disinfected canals become re-contaminated. but it never ceases to amaze me - how some of the most pristine, carefully executed work can fail, and yet some of the crap that passes for clincially acceptable by some standards has managed to last all these years. go figure.

take today, for example. about 2 months ago i did some restos on a guy, about college age. he had kissing cavities on #37 M and #36 D, just at the DEJ. could they have remineralized with some fluoride and floss? possibly, some may argue. but the guy's oral hygiene was absolutely abysmal and they looked quite broad inciso-gingivally on the radiographs, that something told me to go ahead and do them. i pulled out all the stops - rubber dam isolation (because yes, i do use them, especially when placing posterior resins), very conservative slot preparations, two step clearfil prime and bond system, beautiful margins, perfect occlusion, all good to go, right? nope, guy's been sensitive to biting ever since i touched the damned teeth so there was nothing left to do except remove the fillings today and place IRM. it broke my heart to remove all of my hard work, and it was so well-done (and i don't often pat myself on the back, either) but he was just not comfortable and when that happens, the treatment has failed. i worked on those teeth, they are now my babies. but what was i to do at that time? leave the asymptomatic caries there and allow them to potentially get worse? or "fix" the teeth but potentially cause him discomfort and/or inconvenience?

and then here's the real kicker - new patient walks in just a few hours later, HUGE amalgam overhang on #25 D, as if the dentist didn't even use a matrix band, and it has an associated localized perio defect. the tooth is completely asymptomatic, just "bleeds a little when i floss". not even noticed by the patient until i point it out. how the hell does this happen??? how does such negligence go undetected? and why is my hard work "cursed" with problems while this guy can get away with something like that? why, why, WHY???

it feels like no matter how hard one may try, dentistry is just not an exact science. i guess that's what can be so frustrating sometimes. you try to do good work , and in the end it just so happens that you can make seemingly okay situation worse. so when patients ask me to guarantee my work, i simply say, "the only tooth i can guarantee is the one a dentist has NOT worked on, so you better take care of the ones you got." and that is why i definitely espouse the philosphy of minimally invasive dentistry. my question is, though, when do you cross the line from a conservative approach to supervised neglect? how can you distinguish the two? what do you treat, and what can you leave alone? what is more harmful?

man, i wish i had an office job....

implants, implants, and more implants!

2006-08-08T15:26:00.000-04:00

how many patients have i recommended/referred for implants who were turned off by the cost and/or time involved? so many people walking around with edentulous spaces, and i'm just itching to restore but i have met so much resistance. but times have slowly been changing, as three of the referrals i have sent have not only followed through and have agreed to financial arrangements with the surgeon, but one patient actually underwent the surgery on july 18 at sites 14/15, 25, and 47 and will be ready to restore in 3 months following confirmation of integration! i haven't restored implants since i was a resident about three years ago, and i've been waiting to use my knowlege for some time but haven't found the right practice/patients to do so. needless to say, i'm super duper excited!

a day that i wished i had my camera!

2006-08-07T18:37:00.000-04:00

it just so happened that by coincidence canuck and i had the day off together, which happens about once in a blue moon. today was a holiday that is new to me, Civic Day, and he managed to get the day off from his office. i myself was actually asked to work today, but turned it down because i mistakingly thought cancuk was working and the in-laws were in montreal, hence no one to watch cookie. in fact, i kept asking him, so what time do you have to be in tomorrow again? and he's like, why are you asking me that? i keep telling you i have the day off! oops. it was like i couldn't believe it, it was just too good to be a reality!

so we headed downtown and over to centre island, where the three of us had a nice picnic lunch, strolled around the park, and saw the mini-farm/petting zoo. cookie made it through the whole day without having an accident! i could have gotten some great pictures, but our camera is somewhere in transit, all freshly repaired and delivered from HP (see the may post about the day cookie and the digital camera went swimming in lake ontario). it was a lovely day - sunny, not too hot, and i managed to not get burned. i wish i could have taken some pictures!

back to work at the office downtown tomorrow, where i'm delivering a full gold crown on #27. man, that thing was a beast to prep - so far back there, strong cheeks and lips, a large old failing amalgam (i cleaned out the defective parts, placed vitribond, and used the rest as a core, forget trying to remove the whole thing, isolate and bond core paste in that a tight space) i'll also be delivering a white gold inlay on #47 on the same patient next week. i love doing full gold restorations, inlays, onlays, you name it. when done properly, they last, and last, and last. i myself have three full gold crowns on my lower molars, and i love them. easy to keep clean, no irritation to the gingiva, and i don't have to worry about any porcelain flaking or snapping off.

i'm also all set to attend the dentsply advanced endodontic training course on september 15, where i'll learn some tips on access, rotary instrumentation, and obturation. i'm very excited, because i love doing root canals and want to get truly proficient, expecially because i feel my obturation results have not been as consistant as i want them to be. hurray for CE!

doc mommy and the cookie puss

2006-08-06T11:56:00.000-04:00

my kid's the cutest. for real. and yes, minutes later, she dropped the ovaltine jar and it shattered all over our backyard.

my daughter is half potty trained, what a big girl!

2006-08-06T09:16:00.000-04:00

meaning that she wears big-girl undies and always asks to make pee-pee on the potty. she hasn't wet herself in about a week and has almost completely abandoned diapers! she even sleeps in her undies, princess ones that i bought from the disney store that she picked out herself! so, we're making great progess on the road to being a big girl.

only one small catch. while she's adept at holding the pee in for long periods of time, something i thought would be even more of a challenge, she absolutely refuses to poop in the toilet! even when we take her every 2o minutes around the time she goes (she's very regular and predictable) she'll still manage to have an accident, or not so much an accident as sheer defiance in this case. i guess she'll just have to keep pooping in her pants until she tires of it, since i don't want to regress to diapers (i think that will be giving her a mixed message, you know?) any suggestions???

argh...

2006-08-03T22:02:00.000-04:00

so i've been at the office in the 'burbs now officially for two months. i make damn good money and the staff is phenomenal and the patients are terriffic, but the place is not without it's kinks. no place is perfect, of course not. but did some things ever just rub you the wrong way, even if when you break it down mentally and there's no rational or logistical reason for it, you kind of just get a hunch or an unsettled type of feeling? that's kind of how i feel about my (newest) boss.

it's great to have a colleague there to bang ideas around with, consult with, ask questions to when you're completely lost, and she's great for that. but every day i'm reminded, both intrinsically and sometimes literally verbally, that it's her practice and she's got the final word. "don't use a new silicone polishing point for each composite and don't throw them out when they become nubs, this is my practice and i decide when things get thrown out." "i don't agree with this treatment plan, it's too aggressive/not aggressive enough, this is my practice and we all have to be on the same page." "i'll be doing this crown on this patient because it's my practice and i'm not familiar with your work." "these aren't your patients (even though you treatment planned them), they belong to the practice." ummm, okay, i get it. really. i'll just crawl back into my cardboard box now...

i've only been out about three years, so i know i'm still the low man on the totem pole. at the same time though, it's like, dang i've been out for three years now, am i ever going to stop being the low man? i've worked for people before, people who have invested a lot of time and money into their offices, and of course when i have an office of my own i'll be a bit of a megalomaniac myself. it's only natural to want to protect your business. and i completely understand where this person is coming from. but why is her particular approach and her constant reminding me of my place just not sitting well with me? am i being hypersensitive and should i just accept this as the way things are until i've "proven myself" and/or it's my turn to be in control? or do have enough experience under my belt at this point to warrant a little more trust and respect, and is this really not the right kind of environment for me?

and the icing on the cake of the day: geting scratched on my hand by a composite finishing but that had just been used subgingivally on a Hep C positive patient. gotta love the health professions!

on hiatus for a while, but i'll be back...

2006-08-02T09:56:00.000-04:00

it's been about three weeks since i last posted (holy crap!) but not for lack of material! my offices need me more these past couple of weeks, so i'm working about 6 days a week now. the money's good, but damn, i need a rest...

but i have lots of good stuff to talk about! when i have the time ;-P

craptastic

2006-07-14T22:07:00.000-04:00

some days you're so on the money - everything flows, things are going great, and you're cranking along on fire. then you have days where everything you touch turns to crappola. which is what it was like for me yesterday. i just couldn't get any of my materials to work for me, i squeezed in one too many emergencies ('cause i'm a sucker for a dude in pain) and i fell way behind. i got home around 9:30 last night, tried to enjoy some quality time with canuck, then plopped down for a night of fitful sleep a.) because it's so bloody hot and our room is like a steam bath and b.) cookie kept waking up every hour on the hour and repeatedly tried to climb into bed with us, "us" meaning "me". i'm tired, cranky, and sick of working, and i have to be at the office tomorrow, a SATURDAY, all bright-eyed, bushy-tailed, and ready to work, and all i want to do is sleep, hang with my kid, and do all the stuff that needs to get done around the house.

i need to buy an iron, so i can leave the house looking presentable. i need to do laundry. i need to clean up our yard. i need to wash the floors. *sigh* the list is endless.

but on a happy note, canuck and i finally stole away and saw X-men tonight, and it was awesome! i wonder what kind of mutant power i would most likely possess...

viva italia!

2006-07-12T23:18:00.000-04:00

i know the game was on sunday, but i was just sooooo busy cooking, hosting, partying, and cleaning up after aforementioned activities that i haven't been able to post (working evenings doesn't help, either)! we had the in-laws over and i made an italian feast - chicken cutlets, pizza rustica alla neopolitana, and a devil's food cake (homemade, not the box kind!) with homemade icing colored like the italian flag! it was all a hit, i'm still taking the leftovers to work, yum...

my nieghborhood is italian central, to say the least. i think we have more here than rome itself! everyone was driving along the streets shouting, blasting their stereos, waving the italian flags - it was a lot of fun and really nice to see people so proud of their country (other than canada, of course). the funniest scene was the dump truck filled about 20-30 people waving their flags and shouting. man i hoped they cleaned that thing out before they climbed in!

saturday in the 'burbs

2006-07-08T15:43:00.000-04:00

i'm off today, but i pretty much have to kiss my saturday's goodbye, since both offices want me to work on the busiest day of the week. they fill up fast, let me tell you, even faster than those cherished evening appointments. but that goes with being the low woman/doctor/mommy on the totem pole. the other docs that i work with at both offices are starting to scale back themselves (and i'm picking up the slack, lucky me!) but they've been at it for a number of years so they've paid their dues. hopefully it will soon be my turn to get a break!

it was back to work on thursday, and i had a nice, calcified root canal ready to greet me. i had already taken out the nerve the day before canada day when he presented to the office with a nasty infection (it actually stunk when i opened it up) so he came back so i could finish the job. two of the four canals were blocked and i had to instrument for about 45 minutes to open them up. and after all my hard work, my last rotary file separated in the mesiolingual canal. damn it! so i told the patient, and my boss, and filled the remaining canals as beautifully as i possibly could. at least it was the last file and it went all the way down to the working length, so i know i adequately cleaned and shaped the canal. hopefully the separated file will act as a sufficient enough obturation material. we'll cross our fingers and hope for the best, no? worst comes to worst, i'll send him to and endodontist to have a look.

the list of projects that probably won't get done anytime soon is as follows: clean up trash that previous owner left in backyard, such as speakers, oil cans, and for real, a 50 pound bag of cement that got wet and set; take out the cigarette butts that said owner also left from the planters in the front of the house and replace with pretty, hardy marigolds; hopefully not kill the marigolds in a record amount of time; replace light fixture covers in upstairs bathroom and put up a shower curtain so that our guests don't get everything wet; replace nasty flourescent light in master bedroom with nice, soft incandescent lighting so that i don't look like i have jandice and/or plague every time i venture into my bedroom. am i forgetting anything else? probably!

back to the US!

2006-07-02T00:07:00.000-04:00

so we're leaving in about 9 hours and i still gotta pack the clothes, lunches, extra diapers, and other necessary items to keep us and the cookie entertained for the 5 hour drive to michigan. it's nice, though, it's only 5 hours as opposed to the 10 to NYC. we've rented a car so as to give ned flanders a rest on the mileage, canuck's going to pick it up first thing in the morning. i'm so excited!

and go lansing lugnuts!

oh, canada! oh say can you see?

2006-06-30T19:40:00.000-04:00

tomorrow's canada day, my first ever as a wannabe canadian! we will be celebrating canada's heritage by doing more crap around the house (the list is neverending) and going to a barbeque at the in-laws house. canuck's family will be visiting from montreal, and for the first time in the 7 years that canuck and i have been together, i will be meeting the infamous "uncle frank". then we leave bright and early sunday morning to head back to the states to celebrate the fourth of july! i'm very excited, i haven't seen my mom in three months!

the house is coming along quite swimmingly, although there is a loooooong list of projects and things that need to be taken care of. for example, i have always wanted my kids to have a nice, big backyard to play in. that is until i realized that when the fanstasy is over, you actually have to cut the grass, water the lawn, dig out the weeds, and make sure there's no garbage lying around so the wildlife don't set up shop on your property. forget about planting any vegetables or flowers! the goal for this year is to just not let any of our weeds make their way into our neighbor's backyards, since apparently that can happen and it really pisses people off. canuck's better at the outdoor stuff, so he tackles that on his days off. my project is to refinish our old bedroom furniture from new york to put in the guest room and/or for use for more future little doc mommy's. i am also going to paint the finished basement, as the previous owner used to smoke down there and it's kinda stinky ewwww....

friendly neighbor story: gary, the self proclaimed "wingnut who lives across the street" is a really nice guy, now retired and a former canadian military man (don't see much of that around here, let me tell ya!). he's been hanging up the italian flag in honor of the world cup for his italian wife and the flags of ontario and obviously canada in honor of canada day. anyways, we saw an american flag hanging outside his garage and we were like, hmm, that's interesting (since canadians are not exactly pro-american at the moment). when canuck ran into him the other day, they were chatting for a while and it came up about all the flags on his front lawn, including the US flag. which, it turns out, he hung in my honor to "welcome me to the neighborhood". what can i say, that's awesome!

so much to do, so little time

2006-06-16T12:17:00.000-04:00

we're all moved in, and we're now officially homeowners! i even think the first mortgage payment is due this week, hmmm... this will be a short post, since i have a crapload of stuff to do, but we're still alive and kicking and very happy to be in our new home! i already have a ton of stories about our house, our neighbors, cookie's new room, and other adventures new homeowners experience.

and i love it all!

the joys of homeownership!

2006-06-06T22:15:00.000-04:00

as of may 31, i can officially say that i am a homeowner! not that i've been able to spend a night at my new digs, since 3/4 of our crap is sitting in the garage and the remaining 1/4 is scattered all over the house, looking for a place to call home. so much to do, which is why i haven't posted in a while. but i have a house, i have a house, i have a house, so i can't complain!

canuck is agonizing over which TV and internet service provider he's going to choose. i myself do not care much about these things, as long as i can access ebay, the news, and watch my thursday night lineup. i myself agonize over crap like color schemes and what kind of duvet cover would look best with our shiny new/used bedroom furnitre (i caved on that one). all of the wedding china has been unpacked, but i just can't seem to find my regular cups and dishes. and i found my toaster oven and blender, but seemed to have misplaced my microwave. i have pans, but no pots, and i have a waffle maker, but no griddle. a mish-mash to sort through. i'll make a full meal sometime next winter.

summer is arriving, and that means death in the dental office. no, no, no, not dead people, just more dead time and more patient cancellations. can't say i blame them, especially with the beautiful weather and FIFA going on. canuck works in a predominantly portuguese community, and his office was a ghost town these past couple of days. soccer is like a religion to the europeans, much like hockey is to canadians (and i can't quite grasp either of those concepts, but that's okay, i've just learned to accept it). this bolton office is working out pretty well - the staff is nice, the patients are pretty friendly, and the equipment is SWEET. but it's hard getting used to working in the same office as the boss again. the practice owner is pretty nice, but you can tell she's a total type A and is the tiniest bit of a megalomaniac. she even checked one of the fillings i did on a patient when i asked her for help with the electrosurg machine (great stuff, btw, i highly recommend it!) and i almost shit in my pants. but then i realized that hey, this is her practice, these are her patients, and she has every right to do that. and apparently she occasionally does that with all of her associates (i'm one of three). but it still made me feel kinda wierd, you know? so i keep it light and simple with her, and make sure that i'm on my A-game when i go to work there. the end result is that i'm super critical of my work and i really try to crank out some good dentistry. and she also says that anytime i have any questions about anything, feel free to ask, and even vice versa. apparently, the practice is very open with dialogue and critique, passing opinions around et cetera, while in new york if someone checks your work or even remotely glances over your shoulder, it's a sign of bad faith. which was why it was such a shock to me when she did that. but she said she wasn't doing it to "check up on me" she was merely curious (she liked it, btw). so for now, it's all good, but the new yorker in me will always be on guard....

friday night puke fest

2006-05-27T19:55:00.000-04:00

yet again, a plague is upon the house, and yet again poor cookie caught the worst of it. my FIL was up all wednesday night vomiting and feeling miserable and took two days off of work as a result (and it has to be real bad for him to do that). i was wondering when it was going to float our way, and all seemed well up until last night. cookie had a bit of a diaper rash, so at about 10 p.m. we took a quick dip in the tub to wash up. after about an hour of struggling and putzing around (because bedtime is a nightly adventure for us) we got her down for the night. she finally fell asleep and canuck and i were just settling in ourselves when we heard that dreadful, liquidy gagging noise. "oh crap, she just threw up." all over the place, all over our room and her bed 'til there was nothing left, what a mess! we changed her pajamas, stripped the beds, cleaned up best we could and took her downstairs so she wouldn't wake everyone else up. we got her settled, but the poor kid, as soon as she would fall asleep she'd wake up dry heaving and crying for mommy every twenty minutes. this went on for about 6 more hours. so we slept, or should i say lay down 'cause i didn't sleep at all last night, downstairs on the living room floor with cookie on a sleeping bag (ceramic tiles so it was much easier to clean up the puke). i was literally covered with puke and phlegm and spit all night long, because after a while it was pointless for me to keep cleaning myself off (ahh, mommyhood!). i had to be at work at 9 a.m. and was ready to drag myself up to the bolton office when the dry heaves hit me, too, big surprise. i called in and today cookie and i were two sickies hanging out together. she's keeping down fluids now, but now the diarrhea has arrived and now we're putting it back into her as fast as it's coming out. and to boot, now my MIL is sick to her stomach, too! stupid plague.

it's funny, because i remember a time long, long ago when my friday night puke fests involved bars, movies, sex (!), and alcohol. those days are long over, but at least i had quite a bit of experience dealing with the puke part and i put my acquired skills from those years to the test. at least college was useful for something....

and it really wasn't all that bad. my poor cookie puss ;-(

"the latest adventures of dr. mommy and the great cookie-puss," or "cookie takes a dip"

2006-05-24T18:01:00.000-04:00

it was a beautiful day today - warm, sunny and, even better, my day off. i'm working tomorrow and friday, so i wanted to take full advantage of my free time with cookie. i really try to take her out to various places downtown on my days off in order to get her exposed to city culture so she can occasionally step outside the bubble of suburbia. being a city girl myself, i don't want cookie or any future cookie monsters to grow up sheltered from the city environment, as that is always a risk when growing up in the 'burbs. downtown toronto is pretty damn cool and very foot-traffic friendly, so we head on over there every free minute we get. she loves taking the subways and street cars, and that's all it takes to keep her entertained so she's a nice, cheap date! last week we went to the st. lawrence market on front street and picked up homemade pierogies and fresh bacon-wrapped scallops for canuck's birthday this past monday, and the week before that we met him at work on college street for a quick picnic lunch. today we headed down kipling avenue to the lakeshore, where there's a terriffic park to walk around and hang out and dip your feet into lake ontario.

after a walk in the park, a quick snack and a pee break for mommy, we went to the lake, took our shoes off and dipped our feet in. the water was freezing, but refreshing! there happened to be a group of dogs playing in the water - their owners would throw tennis balls into the middle of the lake and the poochies would swim all the way out there to fetch 'em! cookie went nuts, she absolutely adores any kind of dog and they were all quite friendly. just as we were about to leave and i bring her to the edge of the lake to rinse our feet off, she literally takes off and jumps into the lake, fully clothed and everything! she was almost completely submerged, and i had to run in there myself to snatch her before she went under! we both wound up sopping wet and muddy, and of course i, not anticipating a day of full swimming, did not pack accordingly. so i stripped her down, put on a dry diaper and put her in the carseat (mud and all) for the short drive home. then it was straight into the bathtub for both of us! and during the whole ordeal, our digital camera happened to get wet and is now destroyed, but i did manage to get a few good shots in beforehand!

beautiful shot of the downtown skyline. can you see the CN tower???

cookie throwing stones into the lake, trying to make them skip.

this is the only head-on shot i could get of her, since she's constantly in motion and it's impossible to get a good still shot!

free donuts....sooooo not worth it

2006-05-23T09:56:00.000-04:00

my junk e-mail folder in hotmail is packed with exactly that - junk. i go in every now and then to purge and to make sure someone long and lost isn't trying to reach me, as i have all people not in my contact folder automatically sent to the junk mail pile. so on saturday i saw a message with the subject "dunkin donuts or krispy kreme?". if any of you know me at all, you know that i LOVE donuts, any kind, i absolutely love 'em and even make them myself on my days off. i could eat tim hortons every day without batting an eyelash, and have even had lengthly converstations with people about KK vs. DD and the implications of each (because this is very important and valid subject matter). so of course a message like that would pique my interest! i opened the file and the message asked me to pick one or the other for a chance at a $100 gift certificate to either. i clicked "krispy kreme" and was told that i won $100 gift card, yay! all i had to do was fill out the address to send it to and complete a short survey. hmmm.... okay. i wanted it sent to my mom so i put her name and mailing address, and my e-mail address and that's it. then there were some questions about online education and what courses i would be interested in, so i fudged the answers and clicked on the "next " button. another survey about more online education degree programs. feh, okay... yet another questionaire about products i use and want free offers on, i clicked "no" on all 50 of them. then another form to fill out asking for my SSN and that i would be charged $9.99 shipping for my new sprint cell phone. WTF??? sorry, i don't need the donuts that badly, so i closed out the program thinking that would be the end of that nonsense.

yesterday i talk to my mom and she says, the strangest thing happened - i get a call from a car dealership in paramus new jersey saying that i've just been approved for an online auto loan, call us back to reply and follow up. whoa! when she contacts them to find out what the hell was going on, it was my e-mail address linked to it! holy crap, all i did was look for free donuts! i didn't fill out any auto loan questions!!! good thing i didn't give them my SSN, could you imagine what a disaster that could have been? i didn't even complete the whole thing and already they're soliciting. and of course, i check my junk e-mail box and its FILLED with messages to my mom (remember, my mom's name, my e-mail address) about free offers and all that other crap she should claim.

i can't believe i did something so bone-headed. all for free donuts. i mean, jeez, i'm a dentist, you would think i could afford all the donuts i want! from now on, i'll just get my stuff the old fashioned way - with cold, hard cash.

i heart rubber dams!

2006-05-19T21:12:00.000-04:00

since my last post was a rant, i have to counter with some happy stuff. i just switched bonding agents and i am ecstatic with the results! i also started using a rubber dam for all my composite fillings and it gives me such piece of mind to not worry about tongues and drool getting into the way of my nice, dry field. you get a perfect bond every time. ahh....

i heart you, rubber dams!

first day on the job!

2006-05-19T20:28:00.000-04:00

so i made it through my first day on the job in bolton office! this office was a well-oiled machine, let me tell you. i didn't have to get up, or ask for, or switch anything, as my assistant anticipated my every move and as a result we flew and flowed quite swimmingly. i did some extractions, some restorative, some exams, and i managed not to kill or piss anyone off! i only ran behind beacuse of this one girl i was treating who had massive decay on her front teeth, and i was trying to bond them but her OH was so poor she kept bleeding into my field. i successfully removed all the caries, but after about an hour of heroics i had to temporize her and put her on chlorhexidine rinse and then told her to come back when the swelling and puffy gums have improved. she was only 14, and i felt really bad doing that to her, but i know how especially important her front teeth are and i really wanted to do a good job. i thought she would be pissed after all that time and no results, hell i would be at least disappointed, but she wants to see only me from now on because she says she feels very comfortable with me. and that made me feel good.

then back at the office downtown today and what a world of difference. we just got another new assitant to replace V, who left suddenly (and not too pleasantly, i might add) and she really is a sweet girl and i love her as a person, but she just graduated assistant school and she doesn't know ANYTHING! i ask for a perio probe, i get a root canal explorer. i ask for crown and bridge material (tooth colored, right?) and i get pink denture reline material. nothing was set up for my root canal this morning, and i wasted over a half an hour looking for stuff that should have been set up before i started, which i asked her to 3 times before the patient arrived. when i finally finished, i couldn't do the post like i had planned because all of the reamers were missing/mixed up/MIA. and just as i threw in the hat and was like, screw it, let's just temporize, she shows up with the reamers i need. by this point it was too late because my patient already had an appointment scheduled with the hygienist next and i couldn't let her run behind. so an hour and a half of wasted time in which i should have done a root canal AND a post, time wasted on getting up and getting crap that should be set up for me and explaining things that even a person fresh out of school should know. and i'm not trying to be a hard ass or a prima donna, but in order for things to run efficiently you have to hustle and anticipate. and forget the hassle it causes me - what about the inconvenience to the patient? now this poor woman has to come back for another long appointment to do something that should have been done at today's long appointment and wasn't. i've been really trying to teach her tricks along the way, trying to be helpful and understanding even if it means i fall a bit behind because i know what it's like to be the new kid in town. but at this point i don't even know how she graduated assistant school! how could you not know what a perio probe looks like??? how can you not distinguish between crown and bridge acrylic and denture reline material??? and finally today my patience wore very thin when it compromised my treatment and i lost it. what happened was completely unacceptable - i have to draw the line somewhere.

a day off!

2006-05-17T16:24:00.000-04:00

ahhh.... so with all the long weekends and stuff coming up (my first victoria day in canada!) and with me consolidating my days AND starting this new position, my schedule's been wonky. but at least i had today off and cookie and i took advantage of the break in the rain to head downtown and hit the pavement. we accompanied daddy on the train on his way to work and walked to u of toronto's campus where we had a home-packed lunch (i refuse to buy food nowadays and bring my lunch everywhere, hey, it's saved me thousands of dollars) in front of hart house. then we walked all the way down yonge street to the st. lawrence markets where i picked up fresh pierogies and bacon-wrapped scallops for canuck's birthday on monday. i LOVE cooking and shopping for food and am eagerly looking foward to when we move and i can dominate in the kitchen once more. we close in two weeks!!!

by the book means nothing...

2006-05-14T11:11:00.000-04:00

my first day of dental school we got a huge lecture from one of our profs about ethics in health care, our responsibility to the public, et cetera. this was followed by a speech from another prof (who incidently had it in for canuck and almost failed him in his course, despite the fact that canuck was in the top 10 of our class) who basically told us, "at some point in your career, you will get sued! doesn't mean that the lawsuit will come to fruition, but someone will bring a complaint against you to the office of professional discipline (the royal college of dental surgeons here in ontario) at least once in your lifetime." since then, i've pretty much been petrified and every little thing, right down to that tiny little margin on a crown, is taken within the context of that conversation. don't get me wrong, my dentistry is not soley driven by litigation - i care very much about each of my patients and the quality of my work because morally and ethically i'm obliged to do a good job, and hey, my calling card is pretty much in that patient's mouth and who wants a bad rep? but litigation is always in the back of my mind. that's why i try to do everything pretty much by the book. i try to keep good and accurate records, explain things over and over (and over) again, don't cut corners on procedures, and if i make a mistake, i try to let the patient know immediately and then fix it. all that effort, though, doesn't mean that i always get the outcome i want.

you would think that the "trickier" procedures like molar endo, extractions, crowns, etc. would be more difficult to master and would most likely have post-op complications and keep me up at night thinking about it. so imagine my surprise when about 40% of the resin fillings i've done have post-op sensitivity to biting. in two cases, the sensitivity was so bad it developed into irreversible pulpitis and i had to do root canals, even though the fillings weren't deep at all AND i removed the resins and placed ZOE sedatives. i called my endodontist friend and asked him what the heck was going on, am i doing something wrong, is this normal, and he actually gave me so great insight. apparently, he says that about 1/3 of his business is from composite resin cases run amuck, and that i've done nothing wrong, but he thinks posterior composites are garbage. now, i'm not one of those dentists that runs around and claims that amalgam is toxic and can kill you and rip 'em all out, whatever. there is absolutely NO science behind that twisted logic. i have amalgam in my office and am equipped with the traps and everything, but patients simply don't want silver fillings any more because they are "ugly". so i'm going to try some new things that dr. endo suggested: first, i switched bonding agents from a one step to a two step (the stuff we have now is crap and i never had a problem with the system i used in new york) and second i'm going to use a rubber dam for ALL restorative procedures, not just RCT, so i can get a perfectely dry field and ensure proper bonding. AND i will always give patients the option of amalgam restorations and talk about side effects of composite. and the irony of it all? ZERO post op complications from endo, crown and bridge, and surgical extractions!

so, it's a bummer, but i guess the only way to perfect your trade is to have things go wrong so you can tweak and perfect. but what a blow to the ego sometimes!

on being a mommy..

2006-05-07T15:27:00.000-04:00

we just got cookie down for a nap, FINALLY. man, she really is a handful. she's a very willfull kid - very sweet, bright, articulate, and has great disposition, but extremely willfull. i don't know if it's the age (she's approaching two and a half) or if she's a particulary tough kid but man what a ride these past few months have been. she won't listen to me or canuck, and we're both simply at a loss for disciplining her. she constantly tortures poor maui, who's not my favorite pooch in the world, but the poor animal does need a respite from her once in a while. she runs around, doesn't come when you call her, crawls under the table at mealtimes chasing the dog, says "no, no, no!" all the time, takes a nap all by herself when nonna's watching her but refuses to sleep when canuck and i are home - it's just a constant uphill battle. i've tried everything so far and i can't make her seem to get that i'm serious when i punish her for being bad. so far, we've tested "time out", standing in the corner, taking away toys and t.v., swats on the tushy, distraction - everything. i don't want cookie growing up into some spoiled punk, but at the same time i don't want to be a monster who yells all the time, which is what it feels like i'm turning into. i guess all parents feel like this during this phase of development - to use that old cliche, "they call it the 'terrible two's' for a reason," i suppose. but it doesn't make me feel any better. cancuk and i both have a theory that maybe all the people in the house may be a contributing factor to her acting up. it's really crowded here, and we are anxiously awaiting our move and some more space. today nonna, nonno, and zia were out at a function and it was just me, canuck, and the cookie in the house. it was blessedly quiet and we actually have had a nice afternoon togther, just the three of us. i miss those days and am eagerly looking foward to returning to normal. now that she's asleep we're going to watch the rest of good night and good luck. i think when we move, we might enroll her in daycare part-time so she gets a chance to socialize and have some structure and routine. she plays with the kids on the block, but i think she needs something more organized.

these creatures should come with an owner's manual.

and that' s my blurb on being a mommy - the good, the bad, and the ugly.

on being a dentist...

2006-05-06T19:38:00.000-04:00

convincing people that they need treatment when a tooth is asymptomatic is a real challenge that i face every day. and it's amazing what supervised neglect over time can do, and how you can throw a curveball both at someone and surprise even yourself. take this gentleman i saw today who was visiting our hygienist for his recall and perio maintenance visit. i pop in for my five-minute exam when she's through and i see his bitewings, noticing a rather deep, old amalgam that clinically looks intact but is pretty darn close to the nerve. i think there may have even been some zinc phosphate base in there, the filling must have been done when he was small (dinosaur stuff, he's about my age, late twenties, early thirties, and they used that when we were kids. it's real old school). when i see something like that, i'm like, hmm, maybe we should get a periapical (root view) of this tooth, make sure nothing's going on under the nerve. i wasn't expecting to see anything significant, really, it was more for my edification and his peace of mind. imagine my surprise when i see a nice, big old radiolucent area on the distal root, right on the side where the filling has barely touched the nerve. in a nutshell, the tooth is dead, has been for quite a while, and now the low-grade, chronic infection has infiltrated into the bone. this probably took at least a few months if not years to develop. so now i had to explain to this gentleman why he needs a root canal on a tooth that has never caused him any pain whatsoever and had never been singled out for anything of significance in the past. didn't anyone tell him that this filling was deep when it was done and that it may cause problems in the future? didn't previous docs before me take a fleeting glance at this tooth and say, "hey, let's keep an eye on this one because it looks like it could potentially be trouble"? so when i, a doctor who has never even seen him before today and who he knows from a hole in the wall, propose this expensive and invasive procedure, why wouldn't be thrown for a loop? and i have to ask him to soak about $700 to save a tooth that isn't even bothering him. i took him to the consult room and explained everything to him and he certainly seemed to understand and accept what i was saying, but the first thing out of his mouth was, "why didn't anyone else take a picture like that?". ummm....how do i annwer a question like that??? yikes!

and then the next patient totally threw me for a loop. a young gentleman walks in for a complete exam but complains of some nagging discomfort on his upper left side. so i take a radiograph and find an existing filling that wasn't deep at all, but i did notice significant pathology at the root. i was so baffled i had my assistant re-take the picture three times to make sure it wasn't an artifact, because i don't want to schedule something like a root canal without being totally sure. but there it was, and the tooth was sensitive to percussion, no evidence of fracture or anything. the nerve just....died, i guess. i suppose these things happen from time to time and you read about them in dental journals and textbooks and see them in lectures, but you don't expect to see them in your chair. it's like that saying, don't go looking for zebras in barns (or something akin to that!). but every now and then you get one.

and that's my blurb on being a dentist.

2006-05-05T19:43:00.000-04:00

i got this link from margaretf's blog - she always has the best quizzes!

Your Toes Should Be Dark Red

Sexy and a little dangerous, you give off a totally vampy vibe.

Your flirting style: Straight forward and seductive

Your ideal guy: Powerful and a little intimidating

Stay away from: Mama's boys

What Color Should Your Toenails Be?

coming up for air at last

2006-05-01T18:11:00.000-04:00

so it's been over a week since my last post, but certainly not 'cause of a lack of goings-on. we had our second viewing of our house on thursday and i love it more and more every time i see it - it will make a perfect home for our family. they guy who's selling also had a content sale yesterday and we managed to pick up 2 leather couches, a leather loveseat and chair, a deep freezer, a lawnmower, a rug, two lamps, and a kitchen hutch for about $2 grand. he also has this bedroom set that's solid cherry wood, imported from italy and of i'm sure impeccable quality, but it's just so, so...shiny and glitzy and ornate and too tony soprano for my taste. he wants to sell it to us for another $2 grand which is less than a quarter of what he paid for it and canuck's salivating over it because it's italian and imported, but it's really just not my scene. and then my father-in-law was trying to haggle the guy over the price while i was standing there and i was like but i don't really want this stuff... at the same time, i didn't want to insult the guy by emphatically saying NO! just because something's expensive and high quality doesn't mean i have to like it. so canuck and i are hammering this thing out, he's trying to convince me and i'm really resisting. ugh, married life. arguing about furniture. it can be so banal sometimes.

my sister-in-law contracted a new version of plague, which was passed down to cookie, which was then lovingly transmitted to me. the fever's passed, but the poor kid's still congested and snotting all over the place and has become quite crusty. nonna and i have developed a new technique to get the medicine down without her upchucking and it's been very successful, so she was way more comfortable this time around. daddy and nonno also just put up a swing set in the backyard so she can run around and have a great time. i'm not going to take her to the park down the block anymore - there's so much glass and garbage everywhere! i can't believe a country and city that pays so much in taxes doesn't clean up their parks. canuck and i are actually going to write to the city and complain, since cookie almost picked up a shard of glass when reaching for her ball on the tennis courts. yucky! but the backyard is nice and roomy and we saw 2 ladybugs on one if the rose bushes - that means good luck! cookie named them "lady" and "baby".

slow week at work again, but i had a job interview on saturday in an office outside the city. this office was insane - LCD t.v.'s in each operatory, three associates (one of whom i will be replacing) three hygienists, all new chairs and beautiful furnishings, and quality materials to work with. they can guarantee that i will be booked three days a week, which is really nice. downside: young family practice which means A LOT of kids. the day that i spent shadowing the owner there was a 5-year old girl who cried so hard it was impossible to get anything done on her. she started the work, got her numb and even prepped the tooth for a filling and the girl completely freaked out midway and wouldn't even let the doctor put in a temporary. so she left with a big old hole in her tooth. the doc couldn't do anything but give the mom some cavit temp material to put in the prep when the girl calmed down at home, and gave her a referral to a pediatric specialist who will probably use nitrous. now, i love kids and i love dentistry, but i don't love the two together at all. it's kind of like peanut butter and hamburgers - each are wonderful on their own, but i wouldn't put peanut butter on my hamburger. some people might, sure, and that's okay. but not me. i simply can't stand to see a child cry and be afraid of me. anyways, i also have two more interviews downtown, which means fewer kids but you never know what you're going to get there. some of this places are insurance mills that are incredibly unethical.

i don't want to give up the gig i have now, since despite the fact that i'm not making as much money and the office is loaded with freaky people, i still like the place and i have a sense of loyalty to my staff and patients there. but i do have to scale back if i wind up taking this position and i really don't want to break the news to my office manager who's been trying so hard to get me booked. there's just not enough new patients to go around and i've completed treatment on the ones that have been compliant. there's nothing left to do, except doing unecessary dentistry on virgin teeth just to make a quick buck. it's also hard to be as booked as my colleague, someone who's been there for seven years and already has an established patient base and referral system all set up. i really don't want to, but i may wind up working over 5 days a week now, as opposed to the 3 1/2 i wanted so i could spend more time with cookie. but this is how it goes when you just get out there and are starting from scratch, which is essentially what i'm doing now. i guess i'm paying my dues, right?

so enough about my week, hopefully i'll have some good news in the next coming days. i hope the two ladybugs in the yard were a good omen ;-)

amazing discovery!

2006-04-22T19:47:00.000-04:00

okay, i've never been what some would consider a "high maintenance" kind of girl. but i do like to sport a look that's a step above just getting up in the morning, even if i'm hanging around the house in sweats and a tee-shirt. i don't wear a ton of makeup at all, but i like to keep my toenails polished and i carry lip gloss everywhere i go and use it very liberally (shiny lips make me feel pretty). my latest feat has been to try and grow out my hair. those of you who know me very well know that i've gone through several phases of pixie short to (relative) rapunzel lengths. i chopped all of it off in college, grew it out to below my shoulders all through dental school, and promptly chopped it all off again when i got pregnant because my hair grew like a weed and i just didn't want to deal (horrendous pics during that phase, lemme tell you!). canuck loves me no matter what, but he fancies me in long hair and refers to the pixie years as "when you were hacking at your hair like a redwood tree." so he's happy that i'm going the longer route again. anyways, i've been going stir crazy with this in-between length, and because i had bangs AND layers, it's even worse. the bangs are too long to wear, too short to stay put swiped to the side, and the back has about 5 different lenghts. plus it's very fine and likes to go together in one piece. very attractive. but i'm committed to this and have not cut my hair since november, and do not plan to do so until june. it's been a real bugger holding out for so long, but i swore restraint. anyways, my sister-in-law has a ceramic straightening iron that she uses (she has fine hair like myself, but it's nice and long and looks good on her) when she goes out and wants to look extra nice. she has a date tonite and left it out to cool, so i figured, what the hell, and tried it on myself. i was really surprised, it came out pretty cool! i never thought i would use one of those things ever in my life, simply amazing! i'm really pumped, anything i can do to get me through the next month-and-a-half will be a godsend. now i really feel like a high-maintenance chick!

cookie, nonna and i went to the doctor today. she still has a lingering cough from mc donald's petri dish so we went to get it checked out. no fever, lungs, ears, and throat look good, it's just a stubborn little bug with lingering congestion. no worse fo wear, she's running around like crazy, tearing things up, torturing maui, and getting into things she shouldn't be. her latest thing is to help me clean the bathroom by splashing around the toilet brushes in the toilet (ick). and yesterday i was wearing a purple fitted top and she says to me, " look, mommy, purple," and i said, "yes, honey, you like my purple shirt?" and she says, "no, mommy purple boobs!" she's a real rip, this one! now we're trying to get her to take naps on her own at a set time. i don't understand. when nonna puts her to bed and i'm not around, she's a good girl and just rolls over to sleep in her room, no problems. with me, it's a song and dance, she wants me to take a nap with her, and she refuses to let me leave. "mommy, go to sleep!" today i had to play bad cop when daddy came home just as she was winding down. now this kid is getting good at playing us against each other, and she's got daddy wrapped around her little finger. so fo course after 45 minutes of me trying to get her down in her room and her crying and resisting, he climbs into bed with her and she's out in a minute! i wanted to kill canuck for sabotaging my efforts, but i couldn't blame him. i had to do everything in my power not to do the same, except i was home all day with her and my patience was wearing thin. i think i'm more of the enforcer when it comes to stuff like that. but that's what being a mommy is all about, right???

what kind of fae are you???

2006-04-18T10:30:00.000-04:00

What type of Fae are you?

so, i'm a nymph, but i'm definitely not a psychiatrist. which is what i essentially was yesterday at the office. i wouldn't mind, except i don't get paid to be a psychiatrist, i get paid to be a dentist. one lunatic after another walked through my door yesterday. my only sane patient cancelled, and i saw a very nice gentleman with a horrendous infection, but he was not my patient and i could only treat him on an emergency basis. what i did get was a schizophrenic who i have treated 3 times in the past have a psychotic episode and tell me that i was not her dentist, she wanted to go home right now, and that she was doomed to go to hell. so i spent the 2 hours that i had booked to complete her restorative treatment talking to her about god and the devil. then enter the guy who wants me to rip out all of his "mercury fillings" because they are causing "physical and psychological" problems (no kidding!). and that guy who drilled his own tooth who was in my schedule? officially banned from my practice, no more ms. nice doctor mommy. i won't even get into it, but let's just say i let him have it and this time he won't be coming back.

so, it's been slow in my office lately. i'm going to look for another gig sometime this week and consolidate my days at this place, as i don't think they have enough sane patients to book me for a solid three days. we need the extra money once we take on that mortgage. and i'm ready to do a lot of dentistry. and i don't want to be a psychiatrist anymore because i'm simply not good at it and the pay is sucky.

holy crap, i have a house!!!

2006-04-16T21:05:00.000-04:00

i just had to say it again!!!

what goes around comes back around again...or the "circle of life"

2006-04-16T20:42:00.000-04:00

wow, it's really amazing how things can turn around, like just when you think that door's closed and locked, someone's found the key and you're staring right back into that what you thought was an empty room.

so, i'm checking through my schedule next week and guess who's on it.... guy who drilled his own tooth wants to book restorative work with me. i pretty much kicked him out of my practice for drilling his own tooth with an endodontic infection on one side of his mouth, but i had placed sedative fillings on two molars on the other side after removing two large amalgam restorations. remember, they were causing systemic candidiasis in this patient.* the teeth, numbers 46 and 47, need crowns but at the time i wouldn't start anything until i got a guarantee that he won't go and usurp all my hard work and make his own crap in his basement. which he didn't, he just went ahead and drilled his own tooth. he's been back several times since the debacule to pay the remainder of his balance, and we've chatted a bit. he's upset that i'm mad at him, but he stands by his decision to drill his own tooth. and yet, he STILL wants me to finish his work after i chewed him out. and i'm like, fine, but as long as you understand that i am the doctor and you are the patient, and i went to school for a reason and i know what i'm doing. if you don't like what i'm saying, go somewhere else, as is your right, and don't waste my time again. i never like to pull power trips on patients, but c'mon....and i never thought he would actually book an appointment with me ever again. but he did, and he's my last patient on tuesday evening. thank god i have wednesday off. unreal!

*insert sarcastic voice here.

that was part one. here's the real kicker... canuck and i put an offer on a house several weeks ago, one that was overpriced and the agent very rude (see previous post). i vowed that i would never even take a sneaking glance at that property again, screw all involved, i won't do business like that. anyway, cancuk and i saw around ten more houses since then, all of them totally wrong, totally overpriced, or both. moral was starting to get pretty low. while we were pulling into the driveway of the next hell-hole to view, our agent's cell phone rings, and it's the creepy seller's agent again! the house is STILL on the market, an offer is being placed, are your clients still interested? at first we were pretty reticent, i mean, the place was nice but overpriced. then we saw a few more places that were dumps and overpriced and we were like, yeah, why not, what the hell? after some phone calls, some debate, some yelling and some interesting dialogue between our agents, that house is now ours! we close may 31, and will be moving into our new home a bit after that when we get it spruced up and to our liking. luckily, it won't take much, some paint and and a little elbow grease, but the place is pretty much rennovated and ready to go. unreal!

so, it's really funny how things work out in the end, no? nothing is ever really final and some things just come back to haunt you, some good, some bad, some just unreal.

fresh new faces

2006-04-12T09:03:00.001-04:00

back to work after a little break. last few weeks, i felt like i lived at the office. but i was just making up time because of the days i took of last week and the shortened week for the easter holiday. so this week i only work two days and have a three day weekend!

yesterday was an interesting day, full of adventure and excitement. we started out with our "quarterly meeting" with our regional manager. remember, i'm in a private office that's run by a corporation, so they have to do these fiscal meetings 4 times a year to make sure everything's on track. there's percentages, metrics, reviews, clinical audits, and other crap that both me and my colleague who's been there over seven years just roll our eyes at. sometimes i forget that it's even like that, we dentists just "do our thing in the back". i really love my office manager, but she's relatively new to this position as well and she had picked up where the last person had left off (with the office in financial disarray). this was her second Q meeting, so she was a little stressed out about the numbers and stuff. we're definitely improving from where we were before and we're on target to meeting our yearly goals, but the numbers were a little short for her taste, even though our regional manager said that we rocked AND that the revenue from the second doctor (moi) was only generated in February, the last month of Q3. as for me, for a new dentist i'm apparently doing very well, and that's good to know. i could always be doing better, but that will come with time and more new patients.

we got a new assistant yesterday, praise the lord! i like her already, and even though it was her first day and she knew absolutely nothing about where anything was, she was fantastic. she tried to anticipate my every move, she took initiative, and the patients felt comfortable with her. we ran a bit behind, but hey, that always happens, right? we worked through the break but she still hustled, so i bought her an ice-cap from second cup. all-in-all, i think this may work out really nicely.

i've been getting a rash of patients that have been having some post-op sensitivity to bonded resins lately. i just ordered some gluma, a step i'll add in the bonding process that will hopefully take care of it. but i already had to remove one patient's fillings and place a ZOE sedative and wait for things to calm down. i hope i don't have to switch products, since we just ordered two more bottles of the prime-and-bond from 3M. that crap is expensive!

best flight ever!

2006-04-10T14:52:00.000-04:00

everyone who knows me also knows that i can't stand flying. i'm one of those white-knuckled, teeth gritting, rosary-praying, hyperventillating passengers, especially during take-off and landing. but my flight back today KICKED ASS! it was a new plane, an embraer 175, smaller than the usual airbus 319/320 that air canada usually uses on their LGA-YYZ route. it was a brand new aircraft, and had tv's at each seat, just like jet blue (my favorite airline!). there weren't satellite channels like on jet blue, but on-demand television where you could choose from a number of movies like chronicles of narnia and syriana, different t.v. shows, and kids movies. i watched law & order and cookie watched the simpsons. on our final approach to toronto, we flew over niagara falls and i actually saw the falls, it was a perfectly crystal clear day! kinda makes me not afraid to fly anymore, right???

last note, my dad sent me this great article from the new york times about ancient dental practices!

back home for a few

2006-04-08T22:03:00.000-04:00

april 5 was my nana's 80th birthday (happy birthday nana-nana!) and my family threw her a huge birthday bash at a pub in stamford, connecticut. all 20 or so of her neices and nephews showed up to wish her a happy one, and she got some really great gifts. she was so cute, saying, "wow, they spent so much on me, i can't believe it!" and i was like, "nana, of course you deserve it, you were everyone's favorite aunt and my favorite nana!" in all reality, my nana is pretty darn cool. she's sweet, laid back, and has something nice to say about everyone (unfortunately, even george bush, "he really means well"). i really miss her, but i try to call her at least once a week just to chat and catch up.

so, cookie and i boarded a flight out of toronto at around 6:30 a.m., sans daddy. airfare is really quite ridiculous nowadays and there was no way all three of us could afford to go - cookie is now a full price ticket, despite the fact that after the seatbelt sign goes off, she's plopped in my lap looking out the window. we got up at around 4 a.m. and it's 10 p.m. now and i'm just starting to unwind. it was a long day, but really good to see everyone. tomorrow, cookie, nana and i can hang out, maybe do some shopping. i need some cheap sweats. i miss target up in toronto, and the days of spending $70 on a pair of track pants from roots are over if we want that house in the near future (btw, canuck was NOT happy about that last purchase, but in the end even he conceded that they were cute).

strange dental story of the day - a patient asked me to check his teeth for STDs and is convinced that periodontal disease is sexually contagious. just try keeping a straight face while explaining this, i mean you feel really bad about the misinfo, but how can a dentist say "i don't see any signs of STDs on your teeth." btw, all this was going on while a woman who was waiting for her husband in the lounge area boldly confronted a disabled patient of mine on why he had no hands. my receptionist told me that a melee almost broke out before the poor woman realized she shouldn't ask such personal questions to complete strangers. thankfully, the situation diffused before i got involved and i heard all of this secondhand. so, yesterday was a very interesting day, to say the least!