Thursday, November 29, 2007

I've got a sticker!

Another patient made my day again.
Let's call this guy A. A is a 4 yr old boy, came in, sullen sulky, recipe for a crying,screaming kid.
He was a walk-in case, and had complained of pain, which disturbed his sleep for a night, and was painful when he bit down on food. The mother was worried, and had taken leave to bring the patient back for a consultation.
The previous visit was a relatively smooth one with acclimatization and 2 small fillings done, but the mother mentioned that he was reluctant and resistant towards coming back after that visit. Wow I thought, damn, how should I convince this kid to work with me, when he was already resistant towards treatment, and had severe pain the night before.
Starting from the entrance of the cubicle, the patient had refused to come in. Mother brought the kid around the other cubicles and showed him how the rest were responding well to treatment. Thankfully, no crying wailing kids were present at that time. If not, it would be a tough case of persuasion.
Next, he made the entry successfully,but refused to sit on the chair.He was totally unresponsive, didn't speak a word, didn't left an arm or leg to get onto the chair, his mother had to carry him onto it.
Coming on, opening his mouth. He pursed his lips tighter everytime his mother asked him to open for me. After using the big fat uncle threat and the 'going home with me,since you don't want to open for me' threat, he finally opened. Sticking my finger in, I refused to budge, lest he shuts his mouth when I remove it.
Taking an xray for him, I realised that the area that he pointed to was not giving him the problem, but the back tooth. Unable to give anaesthetic solution, I could only manage to scoop out decay with my insturments and used a little of my handpiece, amidst a crying, moving head. I was so certain that I'd mutiliate his cheek, but thankfully, I didnt. Stuffed a medicated cotton pellet in, and tampahed a temporary dressing. All this while, the mother helped by convincing the kid not to shut his mouth on my rotating handpiece.
The mother then egged me on to do the second filling for him, as she was convinced that the child would not return for a second time. I agreed and made the kid hook fingers with me, saying that he must promise me to behave, if not I'll be very sad. Upon lowering the chair, the kid shut his mouth tight again. Damn.. urgh, spent the next few minutes coaxing the kid and the mother was asked to leave. Miraculously, this time round, the child opened, and we were able to place in a permanent filling.
The kid was a completely changed person after getting off the chair. He was bubbly, smiling at his mother, and he even gave me and my nurse two stickers from his collection. He promised me to behave better the next time round. Well hopefully he keeps to his promise. I'm feeling rather happy that I am able to alleviate his pain for him, and you can see the transformation in his behaviour, from a sullen kid to a smiling one. This is the satisfying part of the job that keeps us going I guess, to be able to help others solve their problems and enjoy their food and playtime better.
Ok, back to work again! Let's hope this day will be as good a day as yesterday. Going to extract a tooth for my appointment kid later, let's hope it'll be a smooth one.

Happy Day

Much fewer files stacked up today, fewer crying kids( for me at least), and that really made my day. At least I didn't make anyone cry, and I was able to help my colleague finish up treatment who was being difficult.
However, I shall blog about this patient who made this day special, in a way.
Let's call her S, she's 12 and was referred for a filling on a baby tooth. When I saw her, she looked like any 12 year old, dressed in ill fitting jeans too long for her legs. S was accompanied by her grandmother who was more conversant in Malay. I noticed that S hardly spoke a word, and most of the talking was done by her grandmother. I took it as a sign that she was really scared and didn't take too much notice of it.. I mean, who wouldnt be scared of a visit to a dentist for a large filling, which may involve needles and all.
Upon examination, the decay was so severe, so I decided to take an xray to check whether adult teeth were present underneath, to decide on the next course of treatment. In the xray room, I asked S to stand straight to take the large Xray, since she was unable to tolerate the small film, threatening to throw up on me a few times. She started crying and was being difficult. In my mind, I just wanted her to listen to me and get it over and done with.. it was just an xray, I thought and more treatment may need to be done after that and it was close to the end of the day. After coaxing and adjusting her final position and asking her not to move for the umpteenth time, we managed to coax a xray out of her.
While waiting for the film to be developed, I chatted with S, with me doing most of the talking, I lifted the salivary ejector to remove some saliva and she did a little jump, which shocked me cos tears started rolling down her eyes. When I tried comforting her, I realised that her body was very tense, and her hands were cold.
The film came, and her grandmother was asked in to discuss the treatment plan A Malay nurse had taken over as interpreter. Plan was to chabok(take out) the 'rosak'(bad/spoilt) gigi(tooth), I explained in halting Malay, since the adult tooth is erupting soon anyway. S did what any other kid would have done, she cried and shut her mouth. Since she was 12, I didn't want to force treatment on her, and tried rationalising. She opened reluctantly, and the tooth was removed successfully, after my story about swallowing the worm into the stomach and giving her very painful stomach aches, not moving when I'm injecting (I'm blowing a magic balloon into your mouth, so you better not move, if not, the balloon will burst).
After which, unexpectedly, the grandmother shared with S's story. S is studying in a special school. Her dad had passed on, mum is working 12 hr shifts and she has two brothers and one sister. The 2 brothers are being taken care of by her grandmother, while S and her sister stay in an orphanage, as her mother has no time to take care of them, rushing to make ends meet. S would probably have been through a lot during this while, and I wonder if I could have been more understanding towards her behaviour.
Many a times, kids in our clinic come and go, some are really difficult on the surface, but there could be other underlying reasons that we don't know about, that have caused them to behave that way. They may be crying, wailing their lungs out, but that could be their way of seeking attention from their parents who may be too busy to interact with them during other times. I must admit, that it is hard to be understanding towards the kid's needs, when you get a hysterical kid screaming into your ears, threatening to burst your ear drums. However, the lesson behind this incident is that people behave in a certain way for a particular reason, and you may only truly understand when you interact more with your patients. I'm honoured that the grandmother had decided to confide S's background with my nurse and I, and I'm also thankful that the system in the clinic allows me to spend time to interact and understand more about my patient. In other clinics, due to manpower constraints and the large number of patients who are waiting to seek treatment, dental treatment is a drill,fill,bill job and it's hard to inject a personal element into a dentist-patient relationship, when you're just getting your job done and waiting to send off this patient and see the next. That's a common trait in most public healthcare systems in many countries, and I guess it'll be hard to change this deeply entrenched trait locally.
Ok, enough of rambling, countdown to Leave Day! 5 more days!

Monday, November 5, 2007

Pottery 101

Venue: AMK CC, next to a old town centre, where the newly renovated hawker centre appeared as the most modern piece of architecture. Surroundings appeared stuck somewhere in the 80s, which I like.
Time: 7 to 10pm
Instructor: Mr L@#, someone who appears to be of Prof Yao's era, the sort who would throw your piece into the bin if it's not satisfactory to his taste. Emphasised on teaching and mastering the basics. Condemned use of machinery and use of ANY shortcuts. Spent a considerable length of time lecturing on harmful side effects of disposable wooden chopsticks, 'chicken' glass bowl (the ones found in old hawker stalls) and any glassware with patterns found on them.
What we did: kneading the clay to get rid of air bubbles, rolling them into cylindrical shapes. Drawing perfect circles on clay. We will probably end up with rather nice arm muscles towards the end of the course.
Next lesson: We'll make a cylinder, and some animal of our preference. I want to do a chicken.

Any good recommendations for a digicam? I'm deciding between a sleek, point and shoot camera, and a camera with more manual controls but thicker, less sleek. Hmm...

Monday, October 29, 2007

Tuesday, October 23, 2007

A-Z of dental school

A: accuracy, precision and aesthetics. You would never realise the importance of a millimetre until you enter dental school. In optech, we had to drill a cavity prep on fake ivorine teeth measuring 2 by 3 by mm I think.. if you missed it by 0.5mm, REDO!

Aesthetics: choosing the right colours for your fillings, teeth set up for dentures, wax ups, blah blah..

Articulator: one of the priciest item you can get, 1.5k. If you lose the incisal pin(one single metal rod measuring less than 10cm in length and less than 1mm in diameter), please fork out $150.

B: Bintan! Our class outing for Dec 06. Had a lot of fun travelling on the magic schoolbus lookalike to search for cheap local seafood, and venturing into the other half of Bintan Island, where few tourists would visit. And also playing the ' 4th grade pig' game.

C: Clinics and competencies. Calling patients, preparing instruments, writing instrument lists, passing competencies (yay!), failing them(give me Baygon..). all part and parcel of dental school

D: determination. Dental school really saps up a large part of your energy, but you just have to grit your teeth together to pull through the course.. and in the end everyone will make it.

E: anndoe. Enough said, I'll never touch another root canal if I have the choice. No way.

F:Fire. We get burnt quite a bit in dental school. I've got a few battle scars on my hands, thanks to the invisible bunsen flame. Some of us had our hair burnt, and had to snip off the curly fringe, plus the smell that you get when you burn hair.. eew. Fires had occured in the clinics as well. During our last term, we were at clinic 2, and the bunsen burner was upset into a cup of alcohol. Luckily no mishaps happened, hehe

F is my clinical group as well! The field trips that we had, the really small group tutorials that we had(just 4 of us), and the presentations that we had to do, and the pranks that we played on the 2 guys for pontang-ing OS postings at AnnDiSee.. haha.

G: graduation. The end point that all of us work towards throughout the four years, by planning our schedule, selecting patients, exam cases, the studying that we have to do after a hard day's work..

H: Happiness! When you finally get out of hell..

I: instruments. Instruments in dental school cost a bomb(ok.. make it three). Some are really priced ridiculously. Take for example, a $15 bib holder. I can achieve the same function with a raffia string and two clothes pegs, but 2 crocodile clips strung together by a clear plastic costs $15! Not to mention, our handpieces, worth $700 to $1K each. Not fun to lose them. Our combined class bill has not been the highest in history, thankfully.

J: Jokes, mostly lame ones. Next time, don't name your daughter Monica Chng.

K:kick-your-ass instructors. Some acts include, threatening to kick you out of clinics for an undisclosed period of time, threatening to throw your articulator/denture/denture design sheet/provi into the bin, performing a David Copperfield stunt... at 1230/5pm.

L:Lab 4. Where I literally spent more half of my life in the past two years at, breathing in doses of acrylic dust, laughing at crappy jokes made by people across the lab, fretting over broken casts, chipped teeth, trying not to get myself deaf from the drilling and trimming, polishing casts... and celebrating my 22nd birthday! The things we do in the lab..

M: mugging in the medical library. I've not studied so much in my entire life as compared to what I did for my final exams. It was stressful, but when you see your other classmates slogging with you, you are motivated to work as well. The library is also a fridge, especially in rainy days, do pile on more layers, if not, you'll be chilling your toes off. I wonder how some girls can survive with so little cloth around them.

N:Nepal, the grad trip destination for 9 of us, including myself, together with 4 other medical students. It was definitely an experience that I won't forget, and the scenery was equally breathtaking, esp the sunset that we saw at Tukuche. The river crossings were awesome too, but they made my blisters hurt a lot when I came out from the water. But well, we're only young once.

Nurses: They've helped me a lot through my clinical years, both the part time and full time nurses. I remembered that one of the part time nurses had even willingly stayed back with me after 530 cos I was held up in my clinical session, during my last term. When I asked her to go back she said ,'It's ok, you guys are very busy this term also, we don't mind helping lah, since we are not busy after work also.' That was a really nice gesture, and thinking back, I was really lucky as a student. Now in the working place, such acts are harder to come by.

O:orientation, both as a freshie, and as a organiser. I don't really fancy orientation programmes in general, because I'm not a person to warm up that fast. Some highlights from my year 1 orientation: WS imitating the sexy timer during our good night song(damn I should have opened my eyes), being in the same OG as the crappy guys like MJ, Stanley, Yee Hau, and being contented with our position as the 3rd best(when there are only 4 groups).

Highlights for my yr 2 orientation: being dressed as a ghost for fright night, together with Linlin as my partner; cutting cutting and more cutting; painting, painting and more painting; our phoenix, which turned out looking like a KFC brown bird (we used it as a decoy later to lead other people into thinking our float really looked screwed up); and of course, the sumptious meals that we had, with ZX and Nijam as our food ICs (soya beancurd, fish and chips, drinks, as opposed to our year one diet of chicken rice, chicken rice, and more chicken rice)

O also stands for the trying occlusion classes we had during special term in year one. Your willpower is put to the test as you try to be awake, after lunch, and for a darn boring lecture, showing you videos that doesn't really make sense to you. That, my friends, is determination at its best.

P:priority. This is the system where different clusters of students get priority for booking of clinical sessions. Thanks to our class reps, who've taken much effort in making it as fair to everyone as possible, we had our fair share of different clinical sessions each week. Kudos to them!

Q:queue! The perennial favourite activity of Singaporeans, queueing for Hello Kitty dolls, queueing for good food, blah blah, but over here, we queue for the turn to use the trimmer, the broom and dustpan(back in lab 2!!!),for the turn to consult our instructors, to draw instruments.

R:Redo! The dirty, cursed 4 lettered word that all abhor. I recall the 'cemetery' I had for all my frasaco teeth from optech days. $2 for each redo, and when the darned screw breaks off when you're changing the tooth, another $2 again. Urgh.

S: staff canteen at NUH- where we get our daily nutrition from the chicken rice, wanton mee, ban mian and of course the teh ping, where you get a caffeine rush for just 60 cents. Guaranteed to keep you hopping like a happy bunny in clinics. Potent remedy for the lethargy that you get from long nights of studying and lab work.

T: Two CD machine. The holy machine that dispenses Milo, 100 plus, coffee, tea at a discounted rate of 20 cents. I still have not figured out why it's 2cd(2 cents drink), since it's 20 cents. I always looked forward to the pilgrimages that we made, after clinics, to bitch or complain about our day, and find strength to carry on with the drudgery in the lab

U:UROP, aka FYP. Days spent on figuring out how to use the fancy machine that we purchased, breaking tips that were as thick as your hair but cost 300 per piece. Editing the poster for the 100001th time, changing the colour scheme, layout and so on.. Going to Jarkarta for the conference, being well fed for 3 days, 5 full meals daily, with sumptuous pastries... heavenly

V: see E.

W: wax up. Learning how to sculpt a tooth in wax back in year one, observing every curve, angle, width and so on. Trains your eye for details, but can be very frustrating, when you dont' have enough reduction and your wax pattern keeps breaking.

X:exchange at UNC. I remembered boarding the 5 pm flight on Friday, rushing back home to wash up and do last minute packing after school was released at 1pm. The SIA flight was awesome, UNC was 'to die for'. Other highlights include the Duke Chapel that Kim brought us to, Wilmington beach, Micheal Jordan, Jodie Foster in the flightplan premiere, Universal Studios, Disneyland, Zhang Shan Wei, factory outlet shopping. The desserts there were sedap..

Xmas party: It's an annual class event, usually at some body's place. I've not missed any of them and we had gift exchanges, pot luck and so on, the last one we played charades and watched 'Road Trip'. The event is proudly brought to you by Stan and Yong He.. hehe, i'm looking forward to this year's (hint hint)

Y: YEP. Something meaningful that I did in year 1. We(I, Anqi, Lin) raised funds and went to Khon Khen to teach the villagers health education, and set up a children's library. The project was together with pharmacy and arts students. Did newspaper collections and t shirt sales for fund raising. Made a few good friends, both Singaporeans and Thais as well

Z:Zen-like attitude. At the end of the day, take a deep breath and look at the people around you. Never mind if you've got to redo the special tray due tomorrow, never mind if your provi for your competencies had slipped off, and you can't find it ever again amidst the mess on the floor. No use kicking a fuss, cos it doens't help much. Just do it.... again.

Monday, October 1, 2007

The new T3

I've always been a fan of airports, since young. Going to the airport gives me a surreal feeling, and a sense of excitement. Maybe the thought of the airport is linked to leaving for some new experience overseas, that's why I never get sick of going to the airport. During my Cedar days, we had one learning journey trip that was to the airport, and one of the CAAS staff brought us around, telling us about the big golf ball lookalike radar that was on top the control tower, telling us about the baggage capacity and how everything was planned right to the most minute detail to ensure the operations went smoothly, from the luggage, to the customs to check in, whatever.
After which, Yunling and I went there after our exams to sit and watch planes land and take off. There were timings when traffic was light. (You have to ask the taxi drivers to get a clearer picture, cos they're pros at such information.) But nonetheless, everytime when we saw a take off, it always looked as majestic as before.
After the As, Boon Hui and I would rent bikes from East Coast and cycle all the way to Changi Coast Road, where the planes will land/take off. It was v close to the runway, and the sounds were deafening, but it felt that the planes were within reach. Quite shiok, haha
The new T3 will be opening in 99 days time. You can check out the website http://www.changiairport.com/t3/. It's got some really cool features, such as fully automated underground baggage handling system, skylight roof (ok, that's rather common in the new airports), 300m tall vertical garden and my fav: floor to ceiling viewing gallery! Really looking forward to visiting the new airport!

Tuesday, September 25, 2007



My first post

Hi there! I've decided to upload some of my sketches from yesterday. This blog will be for me to share some of my.. random sketches. I'm no artist, so don't expect much. Why the title? My dental classmates have very kindly nicknamed me dodobird, so this title is derived from it. This is a little known fact about me, other than bumming around at home watching hk dramas(current fave is drive of life), I also do some sketches occasionally. It's relaxing, and also takes your mind off some worries. So there you go!
Actually, I had more sketches in my precious green scrap book, all the way from my upp sec days, but it's since disappeared into thin air.. urgh, no use crying over spilt milk. I suspect it's probably mixed into my stack of exam notes, and since I've organised my notes painstakingly into something resembling the national library archives, I shall not attempt to sieve through it, cos I won't be able to pack them up nicely again.
Shall attempt to build up on my collection again, but till then!