No rain...but is it pouring.

Friday - yeah baby!!!

You know that it is smack dab in the middle of hurricane season here. While there have been a couple of named storms this year, not one has even threatened Florida. But even without the threat of hurricanes, we do still get a lot of rain and thunderstorms.

Yesterday it rained. Not alot - just a late evening rain for about 40 minutes. What's the big deal, you ask? Well, it hasn't rained here in 32 days; it has been driest October on record. So, while it wasn't much, we will take it. I tell you about the weather because, even though it is not raining outside, it is pouring in my office.

I have to tell you that I usually am a free-flowing idea kind of guy, but lately my mind has been on only one thing. I didn't want to tell you because I am kind of embarrassed. Not embarrassed, more ashamed.

As you know, I pride myself on being a very good dentist and treating people with exceptional service. But this year has been kind of rough. I don't have too many issues with patients, but lately I have had a rash of them. I have put off telling you, but now I am just going to come out and say it.

A woman come into my office for her first visit. She had gone to an endodontist and she didn't get along with him. Every tooth in her mouth crowned. Now, five years after her full-mouth reconstruction, she has 4 abscesses in the lower anterior.
The endodontist had diagnosed everything and even sent me a letter. I turned on the charm when she got here, and everything went really well.

I told her I would do 2 pulpectomies the first time I saw her, put some calcium hydroxide in the canals, and let them sit for a month. Then she would come the second time and we would do the same thing on the second two teeth. She loved me and told me so. She said she didn't have any money, but paid in advance for 3 of the root canals.

She came for the first visit and it went well. I told her I would see her in a couple of weeks for the second appointment to do the second two pulpectomies.
The second day she came in with a bit of an edge. No big deal - I had work to do.

We started the second two pulps (the second one being a retreat). I want to preface this next part with some philosophy. Lower anteriors are usually easy to get an endo access. But when they have crowns it is a bigger deal to me. I try to make the access very small and I want to make sure I have proper perspective when doing so. This being said, I don't routinely put a rubber damn on for my accesses. I usually gain access, then put the rubber damn on. (You now know where this is going.)

I got access, no problem, in the normal tooth. It was the re-treatment tooth that was giving me trouble. The access was fine but I couldn't get a file down the tooth. The number 8 file kind of hit something and bent and didn't get down. It was the hitting and bending that would lead to what happened next.

The file bounced out of my hand and landed on her tongue. No big deal. I was going to pick it up and before I could move to get it she shot up in the chair. I thought she overreacted a bit, but she spit it out and gave it to me. She laid back down and we went on. I finished both procedures without further incident.

Two weeks later she was supposed to come back to finish the root canals on the first two. She calls 15 minutes before the procedure and says, "I am not coming back and you know why."

This was coming out of left field to me. She claims that she left a message on the machine here at work. I never got it. It seems that what she said on the machine was that that night after the last procedure she had to go to the emergency room. She claims that when she jumped up to remove the file from her mouth that she hurt her back and when she turned sideways she hurt her neck. And then she said she was calling me today to ask me what I planned to do about it.

She said that all this happened at my office and as a result of me dropping a file.
She said, "I don't have medical insurance and I have all these hospital bills that are piling up and I don't know what to do."

I just sat there on the phone and didn't say anything. I couldn't believe this was happening. It was stunned silence. All these things are running through my head. She is crazy. She is some woman that doesn't have insurance and is looking for a big pay out. And she kept asking me what I was going to do about it.

I told her I wasn't going to do anything. She, of course, says something like, "I am not that kind of person that sues people." Then went on to say, "If you don't do anything, I might have to get other people involved."

I said, "Do you what you have to do." I told her that I would get some council on this matter and get back with her.

I've had time to think about it, and I have to tell you, it STINKS. I mean, it really stinks. Yes, I dropped a file in her mouth. Yes, she jumped up. But I think it would be the same if someone slipped and fell in the reception room. I know what you are going to say about the file and a rubber damn but...

I really care about the fact that she got hurt here. I wish it didn't happen. Should I feel responsible?

But I just didn't get the best vibe from her and there are a few reasons why. She came in for her first appointment with her "husband" and he did all the talking. She came to the second appointment by herself and I asked her where her husband was. She said that they are divorced but still living together, and the reason they got divorced is that he beats her. I was starting to put all the pieces together. Now I am in the middle of this thing.

I called my insurance and they are as much help as you guys would be if I asked you.
They said, "If you can find out how much they want and just settle amongst the two of you then we don't have to get involved but if you decide you want to get us involved we will start crawling all over everyone."

So it is going to come down to: how much will it cost me to make this thing go away? I do want to stand behind principle. "You are crazy, and if you want any money from me then you are going to have to go through my people."

I called her back and have left 4 messages on her home voicemail. Her ex-husband finally answered the phone yesterday and said, "She is in bed. She has been in so much pain that she hasn't really gotten out of bed in the last three weeks."

COME ON. Really? He and I went back and forth and he promised to send me all the bills from their hospital visit. I told him that I would look at them and then we would talk.

Apparently when it rains, it pours, and my friends, at my office it is pouring. I am in a bad mood and it doesn't look like it is going to get any better any time soon.

Have a good weekend. If you can encourage me with a nice comment that would really help.

I am going to drink... a lot (the AGD doesn't condone drinking to deal with your problems, but I think it may help).

Thanks.
john

The times... they are a-changin'

Hey all,

My mood hasn't changed since Friday so. It is supposed to be 92 degrees here today, this could be one of the reasons.

We have this nice (but old) building that was built in the late 70s. If you don't remember, we have 3600 square feet here. Well, air conditioning must be different now than it was 35 years ago. We have 5 (yes, I said Five) air conditioner units. Yesterday, one of the units stopped working. I swear I had sweat dripping down my back and my gloves were sticking to my hands. My assistants were grouchy yesterday because of tough working conditions. It sucks when you get up and you have pits.

I saw the Time Travelers Wife this weekend. YYYYYAAAAAWWWWNNN!!! I woke up half an hour later, looked over and my wife wass crying like a little girl. I leaned over and whispered, "I love you that much, too," and then went back to sleep. Hey, you have to take advantage of vulnerable moments like that.

I wanted to talk about... what else?... the economy. No, I am not going to talk about Obama; I am going to talk about how it is effecting the way we practice dentistry.

I want to give you a perfect example of what happens at my office. Three years ago, the dentist ruled the doctor/patient relationship. There were rules and policies in place that the dentist wanted. For instance, here we do a new patient exam. This is a 90-minute appointment that a new patient gets with me. We do X-rays, an interview with me, then data collection (cancer screening, bite, teeth and cavity check, TMJ, and perio).

We USED to be adament about not having the patient get a cleaning on the same day as the exam. This was a hygiene-driven rule. Looking back on it, it was kind of a stupid policy. The mindset behind the rule was that we needed to know the patient before we started treating them. We needed to know their dental health before treating them.

Let's say we scheduled the 90 minutes with me and then a cleaning afterwards and they needed premedication before a cleaning because of a hip replacement. Or they were going to be referred, because of major perio, directly to the periodontist. Then you have a hygiene spot going unused. Or what if they didn't show? Then you are screwed twice instead of once. Who cares if it was convenient for the patient? We had a policy and it wasn't going to be broken.

Now, if the patient wants to get their teeth cleaned on the day of the new patient exam, NO PROBLEM. I recognize there were some legitimate reasons for having those policies, but, we've relented.

A couple of other things come to my mind. The cosmetic guys really have been hit really hard in this economy. So the guys that shrunk their practice to veneers and full mouth reconstructions have either changed their hours to 10am-1pm three days a week or they are opening up their repertoire.

Ten years ago, a friend told me he didn't see kids. I was shocked. Kids are a huge part of my practice. Not the restorative part, but the cleaning of their teeth and seeing the whole family, from kid to great grandma. I wonder if he is reconsidering.

I have heard through conversations at study clubs that people that haven't been doing root canals for years are now picking the gutta percha back up. I am thinking this is a little bit dangerous.

I have tried to not get into doing things that won't be A+ stuff. For example, if I don't normally do root canal retreatments, I am not going to go out and buy chloroform (that is what they still use, isn't it?) and start that because my day is slow.

Okay, I know I tried to extract that #18 when I had no business doing so; I am chalking that up to a brain fart. But, I have definitely loosened up the reigns a little bit on my policies. It is not full-on "Whatever you want" policy, but it is getting close. If it is within reason, we are doing it. If it doesn't compromise A+ work, we are doing it. And you know what? I think the patients are really appreciating it. SERVICE. I keep preaching it and I hope we are doing it.

How are you practicing different? Have you loosened the reigns? Did you have stupid policies? Are you doing different procedures? How is it going?

Let me know. Don't tell me I am alone on this one.

Have a great Wednesday,
john

She makes how much?!?!

Hey all,

Hope everyone is having a good week. I had been having a really good week - until yesterday. It was a tough day. You know, you try to be good at what you do, you try to treat everyone nicely, you try to treat your employees well, and you feel like if you do all of that you might be able to make a pretty good career out of it.

Why does it seem so hard to do this sometimes? And what’s really hard is getting them all going at the same time. You could be doing awesome dentistry, but no one is coming in. Or lots of people are coming in but you just don't feel awesome about it. One day, your staff lounge is filled with gifts that patients baked for you; the next day someone says they were hurt at your office. Sometimes you can be looking at the new BMWs and thinking you would look good in that car (with your new Prada shades on) and then the next week you don't have the money to cover all the bills.

You have to be tough in this business. Just remember the higher you get the farther the fall is. The bigger you are the harder you fall (and I am getting huge in Europe!).

Now you know why some people will sell their practices to a management company because they don't want it anymore. "Take it and I will be an employee. That’s got to be easier than all this S@%T!" Okay, I am done with my pity party.

I have never talked about this, but it is something we all have to deal with. We have eight employees right now, and it has been as high as 11. Everyone that you have hired was been hired at a different time. Someone who is an assistant might have been hired when there were no assistants around. When you put out an ad to hire an assistant and you get four people applicants, it is very different than now, when if you put an ad out there, now you might get 50 applicants to choose from. When there is that much competition for a spot, you have bargaining power. When you have one good assistant and she has 4 offices to choose from you have to open up the wallet.

Now, my staff is pretty solid. I think things got a little crazy with babies and the economy, but I can't see me changing anything for a long time. I think everyone likes me and my style and is "picking up what I am laying down." (I don't know why but I like that saying, so you might hear it a lot). Sometimes staff encounter hardships, so I might give in to them a little more. You know, we’ve become a family and I want to help my family.

Now the real issue comes when they are friends. Because friends talk.

Pause for effect [go on, I’ll wait]…

You all know what I am saying. The assistant who has been at your office for 4 years is making the same as the assistant who has been there for 8 years. Before I go any further, all scenarios I use are totally fabricated. Fiction based on actual events, if you will.

So the two of them get together start drinking and of course start talking about work. They talk about their money issues at home and then it comes out. "Well, how much do you make?" Then everyone knows what everyone else is making. You, as a boss, are screwed.

They would never blame each other but they come to you. "I know it is slow but I have been here much longer then she has and I know I am more important." Translation: I am not going to ask for a raise now but it is coming.

I have a dentist friend that tells his staff that if they ever tell anyone how much they are being paid they will be FIRED. He tells them on the first day of work that the amount I pay you stays with you and never should get out. I am starting to agree with him. It would alleviate any pay issues.

This scenario used to be okay because of bonuses. In my office, the person that has been here the longest gets the best bonus. But now that there is no bonus, it is coming down to getting respect. And I get that.

I don't really think it is the money. I don't think that 50 cents an hour (a whopping $24 a week) is going to change someone's life, but it is the principle. And as much as I understand this, I don't know what to do.

I can give her $2 more an hour, but who gets a $2 an hour raise? And then you are talking about making her the highest-paid assistant in the Southeast. Who is she - Darrelle Revis (the best cornerback in the NFL, who decided he wasn't going to play until the Jets upped his contract to $20 million a year)? And quite frankly the assistant she is comparing herself to is pretty awesome too.

It’s a tough one. Any thoughts? What do you do? I am looking forward to hearing what you have to say.

The Gators have a bye week, thank fully. Have a great weekend.

john

Weekend from H!@#$ll

Hey all,

I haven't talked about movies in a long time, so hear goes....
The Losers....very good.
Robin Hood....very good.
From Paris with Love....good.
I took the kids to the $1 theater to see Despicable Me and planned to sleep through the whole thing. I have to tell you that this movie was very good. I laughed like crazy and at the end I was crying (literally). This is the animated movie with the very scary looking villain and cute little minions.

I have to tell you about this weekend.
It is not anything dental but I think it will be a good read.
Friday night....6 and under soccer game. Noah scored 3-4 goals. There is a bit of a nip in the air here in Florida. I was wearing my brand new Chicago Marathon fleece (I wasn't cold, but I wanted everyone to see my new fleece). And all the parents are sitting next to each other cheering on their kids. One of the mothers (my mom would call this woman "heavy set") said she was cold. I said, "Do you want to use my fleece, I am not even cold (and this is where I think I went wrong) and this fleece is an extra large."
Now, I don't know why I said that. Stupid, stupid, stupid.
I had good intentions, I think I was trying to let her know that it would fit her.
But I have to tell you that I felt so bad. All weekend and even now I feel bad.
If it was dude I wouldn't have thought twice about saying this. But as much as I was trying to be nice I think I might have hurt her feelings.
Now the question is do I say something to her the next time I see her. I think I am going to let this one die.
And my weekend only got better.

Saturday morning I ran (8 miles and feeling great).
Then it was breakfast and then go cross town to my daughters swim meet.
Now, I don't know if you have ever swam in a meet or anything so I will try to explain it to you. Back in the day when I was doing this, a swim meet took a whole weekend.
Now they have express meets. That is, when an event is going on the next swimmers are ready to go. So much so that when the previous event finishes the kids stay in the water and the next swimmer starts by jumping over the previous swimmer. Then when the next event starts the previous swimmers exit the pool.
Now a whole meet will take about 3 and a half hours.
My daughter was in 6 events.
The pool was organized chaos. There were people everywhere and getting from one side of the pool to the other was an adventure.
So Madison was in the very first event, so we sung the Star Spangled Banner and Madison was already at her spot.
Now after her first event (which was event #30) is when the meet started to really get going.
She came back from her event and sat at our seats. She said she was going to go see a friend. I said no problem (her second event was like #37). Then David, the baby, needed to be changed so Hilda went inside to deal with David.
Now there is a PA system at the pool and they are announcing what event # is going on and who is in the pool. They announced that this was event #36.
WHAT???!!! Already, damn that was like 12 minutes.
I jumped up and started to look for Madison and like I said before the place was a zoo.
I realized there is no way I am going to find her in this mess.
Then the starting gun goes off and event #37 is starting and they are announcing who is swimming in each lane and Madison is not in her lane swimming.
Then half way through the event I see her at the starting block. She had missed her event.
Hilda comes out of the building with David and I tell her that Madison had missed her event.
Now we are both church going Christian people but between the two of we dropped about 14 F-bombs in about a five minute yelling session.
It was hot, we were out of our element, we felt helpless (because the coaches weren't much help either), it was chaos and now Madison had to pay for our disorganization.
All you can do is drop the F-bomb and you couldn't even yell it because there are so many people there. You had to say it between your teeth.
So Madison is hysterical and both her parents are pissed as s!@#$%t.
But we sat her down and told her she has to let it go (I mean she still had 4 events left).
I told her it was my fault because this was all so new to me. I told her I was sorry and it wouldn't happen again.
It took a couple of minutes but we all got over it.
Once she swam again the event she missed was forgotten about.
So all this before 1pm on Saturday. Still got lots of stories to tell.
Before I tell the next story I have to preface it.
Our church had 5 interns that worked at our church for the summer.
My family really took to them. We had them over for dinner. We had them over for World Cup games. So when they went back to college I told one of them the next time he is back in town I would try to get him up to a Gator Game.
Well, last week he called and told me he was going to be in town. I asked my wife it would be okay if I took Luke (my 11 year old son) and Joe (college guy) to this weeks Gator Game.
We got the green light.
It was a 7pm game. Great, I could go to Madison's swim meet come home at noon (we originally had the times wrong) and get picked up to go at 3pm (see I usually go with another friend and he graciously volunteered to drive).
Well, I purchased the tickets and had them at home.

We are at the meet and realizing there is no way we are getting out of here by 12:30.
So I started thinking of plan B. See we are about 35 minutes from home but directly on the way to Gainesville.
Now it is 1pm and I am starting to panic. I still have to go home and get dressed and get the tickets and get Joe and leave by 3pm.
Well that ain't happening. So I came up with this elaborate scheme. I would go home get everything I need. I would change, get drinks and snacks, get the tickets and meet my friend at my house and we would leave together.
We would go by the pool, drop off the van for Hilda and jump in my friends car.
Well, what do you know everything worked.
The last event was just finishing when I pulled up the pool. I put everything in the van and met my friend at the gas station.
I kissed everyone goodbye and we went to the game.
We got there in just enough time to sit and have a beer and a cigar while the kids threw the football. It was great.
We left the car about 50 minutes before the game so we could show Joe the campus.
See Joe goes to a college with about 3000 students max. See the University of Florida has about 58,000 students. The campus is HUGE and there is a lot to see.
We went around to the main drinking strip and saw all the crazies. I showed him a bunch of dorms and educational buildings.
Okay lets start making our way to the stadium. We got close to the stadium and we split up from our friends and agreed to meet back at the car after the game.
We were very close to the gate and I realized I forgot the tickets in the car.
Now this isn't like grocery store where you just turn around and go back out to the parking lot and get to your car.
No, the car is very very far away. So I called Rich, my friend with the car and he didn't answer his phone. Cell phone coverage is very spotty there because so many people are on the phone at once and it is so loud a lot of the time you just don't hear it.
Calm down, John.
So I see a guy holding one ticket in the air (the universal sign for I am trying to sell this puppy). I run up to him knowing it is 10 minutes before the game and he has long passed the area where people are buying tickets. I went up to him and gave him my story and said, "and yes this is my 11 year old son that you would be helping out." He gave me the ticket.
Okay, stay calm you are 33% there.
10 seconds later another guy has 2 tickets in the air. I went up to him. I gave him my story and he said, "how much will you give me for them?" I really didn't want to give him anything but I realized he paid $90 for them. I said, "how about $20?" He was thrilled.
He probably would have given them to me but what the heck.
So I paid $110 for 6 tickets. Three I would never use.
We went to the game and had a blast. I don't want to talk about the outcome but we had a great time.
And got home at 1:15am.
Up for church bright and early the next morning.

WOW!!! That was about 30 hours of my life. Crazy.
I thought it would be fun to talk easy stuff today after Friday's blog.
The crazy life of John Gammichia. Stick around, there will be more.
Hope you are having a great week,
I will talk to you on Friday,
john

Failure 101

Hi all,

It's Friday. What can I say? My life is just getting back to normal.

I forgot something in Wednesday's blog - the signs. As I was running ,thinking things were going fairly smoothly and that I might not have anything to write about, I started to memorized some of the crazy signs that people were holding up. It seemed that I had a bunch of them memorized but after my "passing out" episode, it seems they all didn't stay in my brain. Here are a few that I can remember.

"It takes an idiot to run, but it takes a special idiot to run a marathon."

"You are doing fine; your nipples aren't bleeding yet."

"Your legs will forgive you... eventually."

"Mortuary ahead... look alive."

Then I saw this shirt that said, "Dear God, let someone be slower than me so they can read this shirt." I'm looking down at my toes and one of my toenails is coming off because of this run.

Okay now that you are awake...

I started this blog almost three years ago to try to make people feel less alone in this crazy thing they call dentistry. I use to read the magazines and feel so insecure because I wasn't producing $4,000,000 in a three-day week. I used to go to the annual meetings and talk to my lying friends about how it was going and apparently I was the only one that didn't have it all together.

It appears to me that I have done the same thing to you guys. I talk about things that go wrong in the office but I rarely talk about things that go wrong in the operatory, and there are reasons for that.

First, it doesn't happen very often. I am talking about catastrophic failures. Sure, I get the marginal ridges chipping off one of my fillings or a two year old filling that looks like crap, But on this one I am talking about the "Oh S!#t, I have to tell the patient something went wrong."

Second, I don't like to talk about it. I think this is definitely a problem. I want you to think that I have it all together. I want you to like me and think I am funny. If you think I am great at teeth and you like me and think I am funny then I am in blogger's utopia. But we all know there are cracks in this armor. Or maybe you don't, because I haven't told you.

About two years back, I wrote a blog telling you how I pulled the wrong tooth but I quickly took it down after about 4 hours. I was embarrassed. It was a kid. The script from the orthodontist said to take all of her laterals out except one (so I didn't really take out the wrong tooth, just one I wasn't supposed to). See, she was born without #10 and the orthodontist was going to save #G through the first phase of ortho. Not after I got ahold of her.

I didn't read the script right; simple as that. But does anyone really like to to just admit they screwed up? Would that make me less credible? In a place where there are a lot of your dentist friends around and you tell that story, do they understand where you are coming from or do they start to distance themselves from you? I have got to think the latter.

Well, last Friday I did it again. Twice in three years, that's not too bad right? Are you distancing yourself from me yet?

My father sees this patient for the first time. He has two teeth broken down to the gum line that are unrestorable. #18 is a long tooth. It has post endo of 40 years (with silver points in the mesial roots). You know what that means - that tooth is not coming out easily. Even my oral surgeon told me that teeth like this break like a cracker.

To all you non-dental people, let me explain. After a tooth has a root canal it loses its vitality and becomes more brittle, and because it has no life in it, something happens to the tooth bone interaction. The tooth starts to become one with the bone over time. So you have to cut the bone away from the tooth sometimes to loosen it up.

I talked to the patient at length about how this tooth was going to break. And we would do our best to get it all out. There was a good chance this tooth was going to break and we were going to have to make a decision on whether to go after a root tip or not.

So we began and it went about as expected. I would get a purchase point and it would break. Things were not very stressful because it was going about as we expected. It got so far down that I asked my assistant if we had any longer burs. This was my mistake. I never use the longer carbide burs and I don't have a real good feel for how they cut (I usually use a diamond to cut through bone). I started blasting away and got a little farther down and the root broke again. It was at this point, I told him that we were going to stop because I didn't want to cut anymore. I thought we got enough of the tooth out that it wasn't going to cause any issues. He was fine with it.

I suggested that we take an X-ray to see how much was left. I told him that if there was too much tooth left he was going to have to see an oral surgeon. Very clear lines of communication at this point.

I stepped out of the room as my assistant took a quick picture of the tooth.
I came back in and this is what I saw:

(marinate on that for a second)

Are you thinking of distancing yourself from me? Am I losing my credibility with you?

Okay, so I knew the next couple of minutes with this patient would be crucial. We were looking at this X-ray together and full disclosure is a MUST (at least it is to me).

I told him what appeared to have happened. I told him that I must have angled the bur the wrong way and clipped the adjacent tooth. I told him it was on me, that if he ever had any issues with this tooth that I would take care of it. I told him that in two weeks I was going to bring him back and see what I can do about filling in the hole that I created. I told him that I thought it was going to be okay and if it isn't I would take care of it.

I said it very casually so as not to get his hear rate up, even though I had some pretty good butt sweat going. He was totally okay. I, on the other hand, was a basket case. I hate this. I like sharing successes with people. I don't like having to disclose things like this to people. It ruined my day. I haven't stopped thinking about it since. But I guess it is supposed to feel like this. It is supposed to hurt because that is how you learn.

I hope this is going to make me more careful in the future. This is going to make me sharper because it will be in the back of my mind every time I pick up a bur during an oral surgery appointment.

I screwed up and I am going to learn from it. I still want you to like me. I still want you to think I am a good dentist. This is why people don't share in magazines or at a dental conference. It isn't easy, and it isn't fun. It kind of burns. Know that if you screw up, you are not alone, but it is going to burn. And if it doesn't burn then you need to look at yourself in the mirror and ask yourself why it isn't burning.

Sorry so heavy on a Friday.

Have a great weekend,
john

The Chicago Marathon

Hi all,

On Friday, I told you I was going to write about how I screwed this tooth up, but I thought, while it is fresh, I would tell you about my marathon. I will tell you about the screw up on Friday. [This is kind of like a blog cliff-hanger.]

The run was on Sunday. We were to arrive in Chicago at 1pm on Saturday. Everything seemed fine when we made the flight. But as the day went on, it seemed like we might be getting tight on time. See, if you are in a HUGE marathon like this one, you need to pick up your race number, your race packet and T-shirt the day before at the Expo. And this Expo closed at 6pm.

Still seemed okay. But we didn't want to get in to Midway, go to the hotel, check in, then go to the Expo. This was too scary of a time crunch for us. So we went straight from the airport to the Expo, and the Expo was an absolute madhouse.

(outside the Expo Center...very cool)

(inside the Expo Center)

It was very well-run and picking up your stuff was pretty easy and efficient, but there were so many people there. And we were doing all this with our luggage in tow.
No big deal. We made it out of there alive. We made it to our hotel and settled. We went out for some Chicago-style pizza for our pre-race meal.

The excitement was building. We were to meet at 6am for a 7:30 race start. My friend and I stuck together. We were going to try to meet with a bunch of others but it was just so crazy.

We had planned on checking our gear (wallet, cell phone, extra clothes) in my friend's tent. He had raised money for the American Cancer Society, and they have a hospitality tent where all their participants can sit, check bags, get drinks and such. But this tent was one of the farthest tents away. So we met at 6am and didn't get to his tent until 7. That means we walked for an hour - not really the calm morning we were looking for. We made it to our corral and had about 10 minutes to spare before the race started.

The place was a mob scene. Even getting into your corral (they place you in the starting line according to your best time) was crazy. We finally got in and there were about 20 port-o-jons lined up with about 20 people in line for each. Apparently that wasn't enough, because people were just peeing everywhere. Girls were actually squatting along a fence. I have never seen anything like it. (I know it is probably TMI, but I wanted you to see what I saw.) And I guess, once you start and the urge comes on... if you got to go you got to go. There again, girls literally just pulling off to the side and squatting. All in the first mile. I guess men have it a bit easier this way.

As you might imagine, the start and beginning were a bit of a fog for me. Runners everywhere and the crowd was 6 deep. It was awesome. You were running down the city, huge buildings on both sides of you and people cheering and screaming everywhere. It was incredible.

Everything was going so smoothly. We passed the halfway point at 2:08. I felt just okay. Nothing great. I was just trying to chug along and make it to the end. I wanted to make it to 20 miles to then just gut it out. Everything was fine and I even thought to myself that things were going so fine that I wouldn't have anything to write about in the blog.

(Feeling sporty at about mile 10)

Well, that didn't last long. At mile 16 my legs, more like my calves, started to cramp. At first it was a tightness and a little walk relaxed it a bit. But then it turned into a full on "I am going to clench into a ball and not relent" kind of cramp. Nothing would relax this thing. No amount of walking, no amount of stretching. I was in pain and I still had 8.5 miles to go.

To his credit, my friend stuck with me. "I am not leaving you. We are in this together." So now, not only am I frustrated with my body because I wanted to run, but my legs would not cooperate, but I had the guilt of ruining his race. I tried my best to work it out. I would say, "Okay, let's run and see what happens," and we would go literally 20 yards before they would freeze up.

Finally, at mile 22, he told me, "My legs are freezing up with all this stopping and going. I am going to have to leave you." He ran off, and I was left to my own misery. I finally walked/crawled/ran through the finish line at 4:48. I was so glad it was over. It was misery for about 2 hours. I didn't feel that bad because I had to walk so much. I didn't really feel that spent.

I found my friend (he finished about 8 minutes before me) sitting on the ground waiting for me. I sat down with him. I ate a couple of cookies to try to get my blood sugar up. At this time the event people asked us to move so we got up - and this is where things started to get interesting.

I said to my friend, "Now I don't feel so good. Let's just stand here for a second."
We stood there and I put my head on his shoulders.

"Are you ready to go?"

"Yes."

He took a step forward and I took a step sideward and that is the last thing I remember. He told me I was out for about 10 seconds. He grabbed my arm and I started to go down. He pulled me to him and then grabbed me around my waist. (Now, I am not a small man and he said his legs were fine after the race but he did strain his side trying to hold me up.)

The next thing I know is that I hear a woman in a very strong voice, "LAY HIM DOWN, LAY HIM DOWN!" I came to and I was being laid flat on the ground. They put me in a wheelchair and rolled me over to the Medical tent. Inside this area was like a M*A*S*H unit. There were very chipper people asking you how you were doing. I told them that after I got in the wheelchair, not only did I feel like a wussy, I felt alot better. I was put in the "not going to die" area and they waited on me for a couple of minutes. They got me a cold towel and a Gatorade. In about 5 minutes I let myself out. I met everyone else back at the hospitality tent. And that was my marathon experience.

(After the medical tent. This is my friend who saved me from breaking my teeth.)
Easy, right?

The Gators lost (I don't want to talk about it). I was disappointed in my run, but I FINISHED and I didn't have to go to the hospital. We took a taxi back to our hotel and I got in a shower and some rest. I couldn't nap because I was really hurting.
But after some rest and football-watching, we were looking forward to a nice dinner out. We all knew we were going to splurge so we didn't even think about it.

We went to a place called Hugo's Frog Bar and Fish House and it was AWESOME. I had some beer and a big fat steak. The food and the company. The race, the pain, the triumph, the friends, the sharing.... All of this is why I love running.

The next day, we got up and had about 5 hours before we had to go to the airport.
So it was off to breakfast first. I was still full from the night before, but we had heard a lot about this place called Bongo's. You know how much fun it is to go out to see a new city and eat or shop at places you don't get in your town. Bongo's was worth it. A small place with about 20 tables, packed to the brim for breakfast. Take a look at the photos and you will see why. It was only time I have paid $14 for pancakes but...

(Breakfast at Bongo's... these are the $14 pancakes. Are you kidding me? Check out the $14 French toast.)



Then it was off to shop. American Girl Place was our first stop. Then my camera battery went out and I didn't bring a charger.



Shopping was fun because a lot of people were out and wearing their medals. They were easy to spot. They were the ones that needed help lifting their legs to get up a curb. They were the ones that couldn't bend their ankles, walking with their toes up in the air. Hilarious.

Nike is the official apparel for the Chicago Marathon, so it is the only place you can buy racewear. The Nike store in Chicago is a five story building that you couldn't even walk in because there were so many people. There were people everywhere buying everything in the store. If they didn't do a million dollars in sales that day I would be shocked. There were lines at cashiers on every floor. Huge crowds was definitely the theme for the weekend.

Chicago... an absolute fantastic city. I love it every time I go. It has awesome stores and restaurants. Great arts, great parks, easy transportation. Great people. One of our cab drivers was telling us how much he loved America and what an awesome country it was (he was from Nigeria).

The Marathon was great, but I don't think I will do it again. I think I am not a fan of crowds. I am actually not a fan of people cheering me on, as weird as that sounds. I just wanted to be by myself, in my struggle and in my pain. I guess I am weird that way.

Have a great Wednesday,
john

ps. I am done with the blog. Uh oh!! I guess that means I have to get up from this chair. Small things like this are very difficult when your calf muscles hurt at every move. Advil is my friend.

Friday before the Marathon

[This was supposed to be published last Friday; my apologies.]

Hey all,

Gonna be a short one today. I am off to Chicago tomorrow morning, and I have a very busy day today. I have to tell you - I am kind of nervous. I don't know why. I think because it is out of town and I don't want to forget anything. We are getting in at about 1pm tomorrow, and the Expo where I have to pick up my number and stuff closes at 5pm. This is kind of tight for my liking, but it is what it is.

I have to remember my watch, my Ipod, the chargers, my shoes, and appropriate clothing. I have to remember my camera for my wife to take photos of me winning 1st prize (or just finishing). I have to remember my computer so I can watch DVDs on the plane. I have to go to the store today to by earphones and running stuff before I go. I am just kind of stressed out and, oh yeah, I have to run 26.2 miles on Sunday.

So before I forget, my website for the smiley silly wristbands is up and running. Very basic but it gets the job done. The order is in and for the first 400; we are going to lose money but I want to see how it goes.

I am still in a quandry over the price. It is a packet of 5 dental-related plastic wristbands. What would you sell it for? Or, better yet, what price would you buy it for? $1? $1.50? Would you pay $2? Think about it, and at the end of the blog, I will tell you how much 2,000 bands cost to have made.

Today I am going to tell you about one of my successes and Wednesday I am going to show you how I messed up one tooth. We have been blogging together but we haven't really talked about screwing things up. I think in the three years I have been blogging, I haven't really done anything that was terrible... until today. I am embarrassed to show you, but I think if I show you all my successes it is only fair that I show you when things don't go all that well.

Success
I don't know if we have ever talked about it, but I do root canals. I don't have a problem with doing molars; in fact, I like doing molars. I have been doing root canals since I got out of school. I went to a bunch of hands-on courss after I graduated and felt really confident in my ability (and since then, I feel like I have really improved). I took a Steve Buchanan course and it changed my life. He taught me rotary instrumentation and warm gutta percha obturation. The thing is, I have been doing my root canals the same way for about 12 years.

I have looked at periodicals and they still are teaching the same technique.
I have called my old dental school professor (I know what you are thinking, "Oh, yeah, dental school is where to get cutting-edge dentistry."), and he says that it is still the technique that I am using. Well, the other day I got into this lateral and I soon found out that it was pretty curved.

I thought about closing it up and sending to an endodontist, but I figured, as long as I am here, I might as well see this through. I got to tell you that I didn't think it was going to come out this well. I thought I would be a millimeter short but, man, did it come out well. Here is the final x-ray:



This is a success. Now, before you go thinking about how awesome I am, I just put in a call to my oral surgeon to see how he is going get me out of this doozy that I did today. I will tell you all about it on Wednesday.

Have a great weekend,
John

P.S. Ok, how much would you spend on 5 smiley bands? What if you are a pediatric dentist and you are going to buy 100 packets? How much would you spend for each pack?

Thanks for your help.

Watch a lecture in your underwear

It is with much sadness that I report to you that Dr. Crowder is no longer writing for us on Mondays. As you all know, he is a young dentist, a husband, a father, and a tireless volunteer for the AGD, and it can get to be too much. [I can totally relate.]

I want to personally thank him for a lot of insight and even more laughs. His entries will be missed.

Thank you, Dr. Ric.

This weekend was packed full of stuff. My last run before the marathon. Ten miles? Piece of cake. Soccer games. School party. But Sunday was the highlight of it all. David turned ONE on Sunday. Can you believe it? Remember, when my wife had the swine flu and there was practically a HazMat team walking around our room? Anyway, the party was great (just family). We got a separate cake that David could smash up. And he really did smash it up - he was taking big clumps of it and squishing it and it was coming out of his clenched fingers. It was awesome.

And I am out of books. I would like some advice on my next book to read. I would like fiction, and I want it to one of your favorites. A can't-miss.

I watched the movie Simon Birch last night with the kids. This movie is so awesome. If you haven't seen it, it is a must-see. It is very sad but very redemptive. Bring the tissues.

And now for today's topic...

I went to a lecture and the lecturer kept referring to a new website called Dental XP.
If you are member (the basic membership is free), you have all dental articles at your finger tips. You have lectures at your disposal (usually bits of lectures, about 10-15 minutes). You have technique videos at your disposal.

And because I am a member I get emails periodically announcing a webinar. Have you ever done a webinar? A webinar is just like it sounds. You have a speaker who is in a one-inch box at the top left corner of the screen (usually sitting at his desk) and your full screen is his PowerPoint presentation.

The lecturer has a pointer and you can see what he is pointing at on your screen.
This was a lecturer named Nassib Fares, DDS, and he was giving his lecture from his office in LEBANON. I was very intrigued because he was giving a one hour lecture on Posterior Composites.

But he advertised his lecture with this picture.

Are you kidding me?

This guy puts me to shame. Here I am thinking I am the finest dentist in the Southeast, and here is a guy in Lebanon who is laughing at my work. I had to see him.

The webinar was scheduled for 1pm on Friday. I booked an hour off my schedule and couldn't wait. So there he was, in a one-inch box on the top left-hand part of the screen. In a separate box under him was the lecturer I saw at that course (he was hosting). Under the videos of the lecturer and the host, was a box for questions.
There was a button I could press to raise my hand. I was in heaven.

There was a bit of a language barrier, but it wasn't really an issue. I really wanted to see his pictures. And let me tell you, they didn't disappoint. He put up pictures that were even better than the one above. He put up pictures that made me shake my head. This guy is an AWESOME clinician. I asked questions in the little box and it was like it was me and him.

He spoke of fillings like I would. He spoke of his passion, and how composite restorations are making a comeback. The bar has been raised for me.

The funny thing is that the host/presenter was sitting in his office in Atlanta watching the lecture as well. He introduced the lecturer and then just sat there for the entire hour and forty-five minutes (yes, it went over 45 minutes and actually they had to tell him to stop because he was so far over the time, a big lecture no-no).

All in all, I thought the webinar was good. I can watch a dental lecture in the comfort of my own comfy chair. I did go to Dental XP and found some articles and did watch more lectures on video. They weren't interactive, but still I could turn the volume down if the speaker;s voice was annoying me. Isn't technology grand?

Then I thought maybe the AGD should get into this type of CE. I talked to the IT department and their stance at the present time is they "are working on it."
But a shameless plug is their CE Database to find some Continuing Education options.

I will keep this on my radar. Check it out if you get a second, and tell me what you think.

Have a great Wednesday.
john

P.S. I talked to a good friend of mine and he is an avid reader. He is the reader that doesn't read for a month and then sits and reads them all. He says ALL of the blogs are resonating with him. He is going through all the same things I am and it makes him feel less alone. I really hope this is true with most of you. Keep reading because I am going to keep writing. I hope you like it. If you have any ideas, let me know. I am at Jgammichia@aol.com

I got a ticket and I am fuming!

It's Friday - not even this blog can get me down.

Final football game last night. Hip hip hooray. And we went out with a bang! A 28-20 win. 1-4 ain't half bad. The other team had only 18 players. But that is not a stat. The only thing that matters is the "W."

Oh my gosh, it was a long season. It was an 8 week season that felt like a year and a half. I think it was long for Luke too. I mean, school, practice, shower, eat, homework, bed. That is what he did every night for 8 weeks. It gets old, especially when you are getting crushed every game.

Slow dental week so you are going to hear about my life instead.

I got a ticket last week. I have been trying to rectify it in my mind all week. I didn't get a ticket for speeding. I didn't get a ticket for running a stop sign. I didn't get a ticket for making an illegal u-turn. I got a ticket crossing a double yellow line. Let me explain.

I was driving home and to take a left into my neighborhood there is a turning lane. Before the turning lane is something called a "yellow line island." This is the buffer zone between a center lane and a turn lane. I turned into this "island" to roll into the turning lane. THIS IS WHAT I GOT A TICKET FOR.

I was so angry I couldn't sleep for two days. Look, I know I actually violate the law, on purpose, about 10 times a day. But this ticket was so stupid. There was no reason for it. I was not endangering anyone. I feel like a grave injustice has been done. I mean, police officers are here to protect and serve us no one there needed serving or protecting. I think he just wanted to give me a ticket. He just wanted my $189 and to give me 3 points on my license.

This, officer, maybe all of 24 yeard old, came up to my car and asked me if I knew why he was pulling me over. I knew what I had done, but I didn't think in a million years this would be worth his time to give me a ticket.

I had to eat my anger and say, "Sir, I think it might have been because I drove into the yellow line island."

Then we had a discussion about why I thought doing this was in no way a ticketable offense, all while holding back the, "Listen, kid, I have been driving longer than you have been alive. Why are you wasting time and resources pulling me over for this ridiculous thing?"

Because at this point he's got me by the...well, you know. If I tick him off before he goes back to his car he could throw the book at me. He could give me a ticket for bald tires, endangering the lives of other drivers, driving into oncoming traffic, a bumper that is too low, and whatever other laws that he could say I was breaking. He could easily make this $189 ticket $500 in a swipe of a pen.

So I got the ticket. Then all the thinking began. I should have talked to him before he went back to his car. I should have told him my church cooks breakfast for all first responders on Thanksgiving morning. I should have told him I was a dentist (I have heard some cops don't give tickets to doctors or dentists). I should have told him I was friends with 2 cops on his force, "See I have their numbers on my phone."

But all this happened so fast and he went back to his car so fast that there wasn't that much time to think. AND I really didn't think he was going to give me a ticket even after he went back to his car. So there I was, with the ticket in hand, and there was no sense in my telling him to bug off.

Even after he told me to have a nice day, I was so angry I didn't know what to say. I figured my mouth was going to get me in trouble so I didn't say anything. But I regret not getting my whits about me and just telling him how I felt without being incensed.

I could have asked him, "How are you protecting and serving anyone right now?" I know police are always trying to build relationships with the people that they are serving. How was he doing this? By hanging out in front of the upper middle class neighborhood (the people that pay more than 90% of his salary....wow, I am bitter) and making sure people don't drive over a double yellow at 4 mph?

So now what do I do? Well, I go into damage control mode. I call one of my patients that is higher up on this particular force, and I sing him my blues. He tells me he wishes he could do something, but second in command just got fired for getting people out of tickets. But he made me feel good when he said the guy was just being a jerk by writing me that ticket.

My assistant's husband is a past chief of police and knows the chief of this force.
I thought about calling him, but decided against it. I thought about going to court and just hoping he doesn't show up. But what am I going to say to the judge, "I think this guy was being a meanie." I mean I did it, as ridiculous as the ticket is, I still did it.

Now, my last thing is I am looking into an attorney "to make this go away," Doesn't that sound so Sapranos? I don't know how they do this, but I have heard of them. I don't think it is dirty or anything but I don't want this police officer to have the satisfaction (it's not like he ever thought of me again). It is just the principle.

But basically, I am all out of options. I am probably going to have to pay the stupid ticket. I did something wrong and I got a ticket for it. But I don't know why I'm so angry. I think I am entitled to NOT get tickets. I am a good driver. I have never been in an accident. Before this one, I have received one ticket in 17 years (and that one I deserved).

I pay my taxes and I am happy to do it. I appreciate police officers and what they do for me and my family. I know they have a hard job and I sure as heck wouldn't want to do it. I just don't want to get tickets - because it sucks. Is that too much to ask?

"Have a great day and drive carefully out there." (Oooh, that ticks me off just writing it.)
john

Marathon in 9 days. I guess it is too late to start training hard.