Donations & Free Clinic in Orange County

Monday, August 26, 2013

After finally moving into our new facility, I compiled an inventory of dental supplies and equipment that I no longer needed. Estimated net worth of these items based off of comparative sales equates to over $4500.00. Once we were settled into our new office, I contacted Loma Linda School of Dentistry and arranged for a pick-up for my donation. For those other dentists, who do not realize, Loma Linda has international outreach missions of free clinics that are in dire need of dental equipment and supplies. Loma Linda runs these missions through NASDAD (National Association of Seventh-day Adventist Dentists) Should anyone wish to send in a donation please contact them at:  909-558-8187

The following month I was contacted by the director of the Tzu Chi Medical Foundation  about their very first free medical and dental clinic in Orange County. This organization has been operating various mobile clinics throughout Southern California and Mexico for over a decade. I immediately made arrangements so that I would be able to volunteer and donate my services.

Upon arrival on 8/25/2013 in Santa Ana, I noticed that while there were a lot of patients in the waiting area, the numbers were not anywhere near what I am used to experiencing in the free clinics in San Bernardino and Mexico. Perhaps the population in Orange County were not as financially strapped and therefore did not need as many of these free services? I was immediately ushered into the mobile unit and assigned to perform surgical extractions and fillings.

What I felt was nice, was that they assigned 1-2 assistants to help me with my dental surgeries. Normally the doctors at free clinics receive 0 – 1 assistants – so this was a pleasant surprise. These assistants were also volunteers – the lady in the photo is a retired molecular biologist, while the gentleman was an engineer. Because this was Tzu Chi’s  very first free clinic in Orange County, it took the organization almost an hour before we were able to see patients. Therefore we started around 10 am and ended at 2:30 pm. Even though the duration of this free clinic was shortened, I was still able to see about 12 patients, all with procedures such as scaling and root planning, fillings and surgical extractions. In general, I did notice that the oral health of patients here in Santa Ana were definitely in better condition than that of the patients in the San Bernardino and LA counties. However regardless of the conditions of their teeth, all these patients were in need of dental work, and all of them were very grateful that we provided them with our services.

Posted by Dr. Brien Hsu at 1:04 PM

Robbers, Free Clinics and a better Economy?

Wednesday, May 23, 2012

Recently we had a break-in at our construction site for our new facility. The burglars basically stole some materials and cut out copper piping, medical gas piping and electrical wiring in the building. When we reported the crime to the Rancho Cucamonga Sheriffs Dept, we found out that these incidents have been very common especially during these times. It’s frustrating because the amount of money the thieves made from selling the copper and metal was nothing compared to the repairs we would have to do for our office. Luckily my partners and I have insurance and most of the damages should be covered… It just puts yet another delay on our anticipated move date.

FYI : for those patients who are not aware yet, we are moving to a new dental office in the same shopping center in the next few months.

It’s interesting, the theft occurred earlier in May and I thought to myself our economy most be getting worse … if people would go that far to make a buck. Yet last week-end, I went to volunteer at another free-clinic in San Bernardino and I was prepared for a long day with long lines of patients…

I was shocked the lines were short and the work needed by many of the patients were quite minor. I saw about 16 patients and was done early in the afternoon. When I left that day, I felt great – not only because I was able to help people who cannot afford dental care, but the place being less packed translated into what I believe is a sign that the economy is getting better…which means all my patients who have suffered losses the past few years may finally be seeing the light at the end of the dark financial tunnel!

ADA Annual Session Las Vegas

In the month of October 2011, a colleague and I visited the American Dental Association Convention in Las Vegas at Mandalay Bay. It never ceases to amaze me as to how may dentists and auxiliary staff attend these annual sessions. Every year the ADA rotates the site for this convention – and this year it happens to land in Las Vegas. The typical set up of these large annual meetings are the first floor containing exhibits on new dental technology and materials and on the floors above, classes are held for dental related continuing education. This year there must have been over forty thousand attendees … perhaps many of them here because they wanted to gamble afterwards?

In total I spent 2 days at this convention – which I felt was not enough. Visiting the many booths help me upgrade all my necessary dental materials such as my dental composite materials and prepared me with a list of many other dental upgrades to come in our new office that was currently under construction. The classes I took up on the 2nd and 3rd floor, as always, were helpful in broadening and improving my knowledge on my dental surgery skills and education.

Posted by Dr. Brien Hsu at 9:13 PM

November 30th Wind Storm

Saturday, December 17, 2011
I was in the middle of writing my blog on November 30th, when the power went out in our house. Looking outside my window, I noticed the power was out on many other houses. I could hear the sound of the winds blowing outside and could see the trees swaying on the sidewalk. I figured it was just a regular wind storm and went to bed. Little did I know that the winds hit as high as 97mph and that the power was out for over two hundred thousand people. When I woke up in the morning to head out to work, I could see the damage done to our city:
              
Driving by the devestation throughout our city, I was called by one of my office staff. She basically told me that our new office construction was “blown down.” I hastily told her I would be there as soon as I had things wrapped up at home. I drove to the construction site to find this:
I just stood there in silence trying absorb everything. All this damage would set me back some … it would also delay our anticipated move from our “older office” to this “new office.” The next few days would be quite difficult – the power remained out at my residence and area for 6 long nights, where temperatures indoors would hit as low as 38 degrees…

Dangers of Whitening Toothpaste

A patient came in about a month or so ago, having sensitivity to cold on several upper and lower teeth.  The symptoms started roughly about one year ago. One dentist had recommended doing fillings on several teeth, while another even recommended a root canal and replacing several fillings. Looking for a third and final opinion the patient sought out my services. After x-rays and several tests, I determined that no fillings or root canals were necessary. I advised the patient to stop using any form of whitening toothpaste and prescribed a medicated paste to apply daily for a few weeks. On their follow-up appointment, the patient no longer had any more symptoms of sensitivity. They were thankful that I had saved them a lot of money by not doing any fillings. My response was, “Money you can always replace, but tooth structure cannot be replaced once they have been drilled on. While I’m happy you saved some money, I feel even better that you were able to save your tooth structure.”

So how was I able to determine that there was no need for fillings or even a root canal? The tests and x-rays did not show decay or faulty fillings and after conversing with the patient, I discovered that they had been using a new whitening toothpaste for about one and a half years. I could not be certain that this was the main cause of the patient’s problems, but from my past experience with many other patients having similar symptoms, I decided to proceed with stopping the usage of all whitening products and to prescribe the medicated paste. And just like many of my other patients the problem was solved.

I find that, with the on-going trend of desiring whiter teeth, a craze for whitening products is developing – everything from over the counter take home kits to special whitening toothpastes. Many patients have been experiencing sensitivity to cold after using these products. Most of these patients have less dense or thinner enamel and the chemicals that manufacturers use to whiten teeth are in essence damaging the tooth structure. These same chemicals have been modified by various companies and are now being used in all whitening toothpastes. Luckily if caught in time, these symptoms are reversible by following some simple protocols. It makes me wonder sometimes, what will happen in the future as more and more of these cases become more prevalent? Slowly I am seeing the number of whitening toothpastes increase in the market, while the number of regular toothpastes diminish.

Pre-labor Surprise, Entry # 1

*Please note that newer entries for my personal blog are published in reverse order (newer posts are published at a later date), so that the true story of my family can be told in chronological order. The real date of this post is July 20th, 2011*

On  Tuesday, January 19th, 2010 sometime in the morning, I was working on a patient, when my staff informed me that my wife was on the line with some urgent news. I quickly excused myself to answer her call. My wife, who was 9 months pregnant, told me she was at her obgyn and was having strong contractions. Her doctor advised that she go over to the hospital immediately. Because the hospital was about 8 miles away from the obgyn, my wife said she would drive herself. I didn’t’ feel comfortable about her driving, so I told her to wait for me. However because I was over 50 minutes away, the doctor said she should not wait that long and that she would be fine to drive herself. My wife also said, it’s possible that this might be another false alarm and did not want me to inconvenient my patients for that day.  Knowing that it would probably take too long to get to her and not wanting to argue with my wife during her contractions, I grumbled and helplessly agreed. If there’s one thing I learned from all those Lamaze classes – never argue with your wife when she’s about to go into labor.

Besides my wife did tell me that she would call me as soon as she got to the hospital. When I didn’t get a call from her half an hour later, I got concerned. Right after I finished treating my patient, I got on the phone and gave my wife a call. She answered her phone and calmly told me that her water broke.  I got extremely anxious and asked how – what – when?!

Apparently when she parked her car at the hospital, her water broke. She was complaining about how she was upset because she had just washed the interior of her car. I could still remember the wonderful details about how amniotic fluid stuck on the carpet of her car and dripped all over the concrete…leading a nice trail up to the five star Huntingtong Memorial Hospital doors… Somehow she ended up in the hospital cafeteria … When I asked why she wasn’t getting admitted into the hospital, she said, “Don’t you remember in labor class, they said once your water breaks, the hospital will not let you eat anything solid until you give birth. And I didn’t want to be hungry!” Imagine that … my wife, 9 months pregnant, standing there in the middle of the hospital cafeteria, scarfing down a cup of split pea soup, wearing her nice work pants – completely drenched and dripping with uterus fluid…

* Too be continued on the next post titled “Rough Night at the Hospital” *

San Bernardino Free Outreach Clinic

On August 14th, 2011, I spent my Sunday morning and afternoon donating my dental services at an outreach clinic for underprivileged families in San Bernardino. In total I saw 18 patients. As a dentist, I always try and salvage a patient’s teeth. So it pains me to see that the majority of my patients seen on that day, needed extractions. Some of these teeth were so badly damaged and infested with infection that there was no chance of saving them. There was one patient in particular that I remember. She had an upper left wisdom tooth that was fractured and abscessed. The tooth was diagnosed for a surgical extraction -preferable by an oral surgeon specialist. None of the other doctors at the free clinic felt they had the experience or the tools to perform the surgery. I could see that the patient was in terrible pain and was afraid she would not be seen. I did not want to see the patient go home in discomfort, so I stepped in to perform the surgery. The majority of the patients who need surgical wisdom teeth extractions in my practice are referred to our oral surgeon in order to facilitate treatment. However because of my extensive past experience in oral surgery, I was still able to extract the tooth in less than 20 minutes, even though the free clinic was not properly equipped to manage these types of surgeries.

I wonder sometimes, what would happen to these patients were I not present at these clinics. It seems that at every free clinic that I volunteer for, not only am I always the youngest doctor there, but I’m always taking on the more complicated cases and taking care of the most number of patients. However, I am still very thankful that there are other doctors who volunteer their time. Without the extra help, it would not be possible for these free clinics to exist. I regret that I have not been able to donate my services as often this past year. My baby girl, Hanna was born with a severe heart defect last year and twice she would not have made it, if it were not for the modern day advances in infant heart surgery. Needless to say, I have spent many days and nights at the hospital and at home cherishing every moment I have with her. However, I feel that my sick daughter is still not an excuse for not focusing some of my time towards charity.

In summary, the condition of the mouths that I saw that day at the San Bernardino Outreach Clinic were a lot worse than the previous times that I have volunteered. In addition it was odd that the number of adult patients far exceeded the number of children patients. And this is comparing patients seen over the 12 years that I have volunteered my dental services. I suspect, that the deteriorating economy played a large factor in this phenomenon. Regardless, it always warms my heart, when I can see the thanks in the smiles and eyes of the many patients that I helped that day. Giving back to the community always feels right especially during these times of economic instability. It is also during these times that I truly feel fortunate to have a thriving practice with patients who take pride in maintaining their oral health.

Rough Night at the Hospital, Entry # 2

*Please note that newer entries for my personal blog are published in reverse order (newer posts are published at a later date), so that the true story of my family can be told in chronological order. The real date of this post is August 16th, 2011*

After getting off the phone with my wife, I had my patients cancelled for the rest of that Tuesday and all of the next day, Wednesday. I let my office manager know to keep the Thursday scheduled for our patients in order to offset for the other closed days. I then headed straight home to pick up the over-night hospital bags for my wife and myself.

That late afternoon on Tuesday, I was finally at my wife’s bedside. I remember stepping into her labor room for the first time and seeing her in her light blue hospital nighty sitting on her bed wrapped in a blanket, watching TV. Something about that moment still sticks with me. Her skin had a golden shine and face was beaming – delighted that I was finally here. I felt relieved and happy that she was doing “okay” and that we were finally getting ready for that big day at the hospital. I walked over to her bed gave her a light kiss on the cheek and sat next to her.

After about 14 hours of labor, my wife was still only 3 centimeters dilated. Her doctor informed us, that it would be at least another 9 hours before she would be dilated enough to give birth. Because of the pain from her contractions, my wife asked for an epidural so that she could get some rest. I could still remember the hospital recliner that I was trying to sleep/rest in next to my wife. You would think that for $10,000 a night, such a highly rated five star hospital  would be able to provide more comfortable accommodations. Let’s just say I think I’ve slept better in my college years on the floor of the bathroom next to a toilet after a USC party.

I think my wife could hear me tossing and turning. At around 3:30 am, I remember her opening her tired eyes and telling me to just go home for a few hours to get some rest so that I could be back bright and early. Knowing that I would need my strength and not really wanting to argue with my wife, I somehow made it back home around 4 a.m. As soon as I got home, I hit the shower and fell flat on my bed asleep.

I woke up around 6:30 a.m. to the sounds of my dog barking. Mochi, my shit-poo dog (Shihtzu/Poodle) was pretty angry because I had forgot to feed and give her water the night before. Somehow that didn’t stop her from laying a nice large dark pickle in the hallway. I quickly cleaned up her mess and gave her enough food and liquids to last the next few days. Moments later, I rushed back to the hospital.

When I arrived at the Huntington Memorial Hospital, my wife didn’t look so great, She looked very pale and her eyes were blood shot – yet she still managed a weak smile as I entered her room. The pitocin didn’t seem to be helping her dilate – she was at around 5 centimeters dilated after about 21 hours of labor. In order to try to induce the dilation further we walked around the hospital so many times, that I became an expert at counting the number of dings and cracks on the hallway walls – 92 not including the dark scuff marks which would put it at 112.

After about 25 hours of labor, our doctor informed us that my wife was still only 5 centimeters dilated and would therefore have to go through a caesarean. At that point my wife received her 2nd epidural in preparation for surgery. Just as we finished packing up our things and was ready to check-into the surgery room, the head nurse came in and said all the surgery rooms were full and that we would have to wait till one was available. Two hours later, we were informed again that a room was still not available. To this day I’m not sure why they didn’t let us know earlier, so that my wife could at least rest on her hospital bed. My nine months pregnant wife was about to burst and basically had to stand around or sit on the edge of the chair because we had to be ready at the snap of the fingers, to admit her into surgery. I kept thinking in my head at that time that we had done our research and Huntington Memorial was one of the highest rated hospitals in our area – it was hard to imagine how it could have been worse at any other hospital. My train of thought was broken when the nurse finally came in and said a surgery suite was available … my wife had suffered another 3 hours of labor waiting for that room, putting the grand total at 28 hours of labor.

* Too be continued on the next post titled “The Happiest and Saddest Day of our Lives” *

The Happiest and Saddest Day of our Lives, Entry # 3

*Please note that newer entries for my personal blog are published in reverse order (newer posts are published at a later date), so that the true story of my family can be told in chronological order. The real date of this post is September 25th, 2011*

I was lead to a hallway area near the surgical room to wait, while my wife was being prepped for surgery. Sitting there, I could feel excitement of welcoming a new family member into our world and at the same time a sense of relief that my wife’s pregnancy and long labor will soon finally be over. After about 15 minutes, the nurse escorted me into the surgical suite. My wife was on the table in her hospital gown. They sat me next to my wife on the right side near her head and allowed me to hold her hand.

I could not see what was happening because they had her mid section covered by a barrier – I’m sure this was to protect the eyes of the average husband. I’ve heard of grown men vomiting all over their wife or even passing out on the floor from watching this type of surgery.

I nearly jumped out of my chair as the terrifying screams of my wife interrupted my muse. A few minutes into the surgery had passed and my wife was screaming as if she was being butchered alive. Her face turned a ghastly white and her body was jolting in pain. Her right hand was squeezing the life out of my hand; the deathly grip was so intense, that I thought the bones in my hands would break. The nurses ran to her side in preparation to hold her down and I tried my best to console her. Apparently the epidural and anesthetic was not working, most likely because the length of her labor had lasted too long and her body was building a resistance to the medicine. So she could feel everything during he caesarian. At this point they could do nothing but press on with the torturous surgery…

A few minutes seemed to last a life time as the cries of agony from my wife filled the room.  Moments later our baby girl was born and the screaming from my wife settled. Our baby girl, Hanna weighed a whopping 9 pounds and 2 ounces and was 23.25 inches tall.  Please keep in mind that my wife is by no means heavy set – at least for now! Prior to her pregnancy, she was 112 lbs. The average baby weight in the United States is usually 6-7 lbs. After I cut the umbillical cord and Hanna was cleaned up, I brought her over to my wife. The touch of her baby seemed to calm my wife down some more and she managed a faint smile.

After they closed up my wife she was carted away and I was brought into a room, while they checked the condition of our baby girl. A feeling of happiness rushed through me as I was holding baby Hanna, I still could not believe I was finally a proud father. When everything finally checked out, they told me I would have to release our baby to the neonatal nursery so that they could continue her care while I visited my wife.  I watched from the nursery window as our daughter laid in her hospital crib. She was the biggest baby in that nursery. Next to her, the other newborn babies seemed like little dwarfs. Seeing that Hanna would be okay, I went to see my wife in her recovery room. My wife, Cisca was laying in the hospital bed with an IV flushing fluid and pain-killers through her sore body. I went over and gave her a kiss on her forehead and gave her an update about our beautiful baby. An hour passed and I asked the nurse when our baby would be able to join us in our room. She said it should be soon. Another hour passed and my mother and sisters met with my wife and I. At this point, I got up and went over to the neonatal nursery to see how our baby was doing. When I got to the nursery window, Hanna was nowhere to be found. I started conversing with some people next to me by the window overlooking the nursery. They were visiting and watching their newborn grandchild. When I asked if they saw a large Asian baby in the crib near the corner, they informed me that not too long ago there were about 4 doctors and a group of nurses hovering over our baby. Moments later they said Hanna was carted away.

Something did not feel right. I quickly tracked down a nurse and asked where my daughter was. They directed me to the neonatal emergency center. I immediately rushed into that department to talk with one of the doctors. One of the specialists explained that our daughter had a problem with her heart.  When, I asked if it was a heart murmur or a hole in the heart, they said no it wasn’t, but that someone would explain everything to my wife and I in a few moments. I tried to squeeze more information out of them, but they just brushed me off, and told me it would be better if I waited for a pediatric cardiologist to go over the information with us.

About another hour passed before a doctor came into our room to talk with my wife and I. Our daughter was diagnosed with a rare congenital heart disease, Hypoplastic Right Ventricle, Tricuspid Valve Dysplasia with Pulmonary Atresia. Basically the right side of our daughter’s heart did not develop properly and she was not getting oxygen delivered to her body. They informed us that Hanna would have to be immediately transported to Children’s Hospital Los Angeles for her survival and proper care. We were also informed that there were surgeries that could be preformed to prolong the life of our child. They would not be too specific about the surgeries or her long term outcome. We asked if we could at least see our daughter one last time before she was transported away. They said time was of essence, but that they would allow us to see our baby.  Minutes later, Hanna was carted into our room trapped in a clear polycarbonate enclosure with tubes and wires inserted all over her innocent little body. The sight of our beautiful baby in that condition brought an overwhelming sense of helpless despair and heavy sadness in the bleak hospital room. I could not help but think how this might be the last time we saw our precious baby. My mother and sisters broke down into tears. Cisca, my wife, who had just lost a lot of blood from a dreadful caesarian seemed like she was dazed in perhaps the worst nightmare of her life. We were able to put our fingers through a small hole in the enclosure to touch Hanna’s little hands. My wife offered some words of comfort to our baby and told Hanna to be strong. I wanted to show confidence in the survival of our baby and so it took every ounce of energy to hold  back the tears welling up in the back of my eyes as we watched our first and only baby transported away.

* Too be continued *

Children’s Hospital Los Angeles CTICU, Entry #4

*Please note that newer entries for my personal blog are published in reverse order (newer posts are published at a later date), so that the true story of my family can be told in chronological order. The real date of this post is October 31th, 2011*

To no surprise, I did not sleep well that night … it didn’t seem to help the fact that I had to go to work on that next day. I remember going through the motions of my daily routine and going to the office. Everything felt so surreal almost like I was living a really bad dream. Walking around like a zombie with a numbness crawling up my brain and down my fingertips. Just waiting … or rather, hoping for someone – anyone to pinch me and wake me up.  All I could think of was getting through the day so that I could go over to Children’s Hospital after work to see my baby girl.

By the time I got out, it was a little past 7 o’clock. My wife had called me; she was in pain from her cesarean and wanted me to come see her at Huntington Memorial. So I quickly jumped into the car and drove straight to the hospital. I arrived to see my wife in bed, looking very haggardly – I’m sure my tired body didn’t look much better. She was in pain and had a hard time trying to do daily activities. The nurses at this so called 5 star hospital were of little help – they would make my wife try and do things on her own, even though every step she took her stitches would open and fluid would hemorrhage out of her incision. I remember my wife looking at me- we were both really tired, I was torn between leaving my wife alone here and running off to see my sick daughter. I could tell my wife was concerned with how tired I was and afraid that I would fall asleep and get in a car accident on the way to see my daughter. I called the cardiothoracic intensive care unit and children’s hospital in Los Angeles.  The nurse there said Hanna was stable and that my sisters and mother had visited her that day. I think the nurse could tell how tired I was; she recommended that perhaps it would be better that I came early in the morning since it was already getting late. I finally succumbed to my weariness and the advice of my wife and the nurse, I would get some rest that evening and head out early morning to see Hanna.

I was up early the next day. Had some breakfast at the hospital, made sure my wife was okay and was off to Children’s Hospital LA. Upon arriving at the hospital, I checked in at the front and had them look up where my daughter was. The receptionist said she was in CTICU and made a call up there to verify that I was authorized to go up. Apparently they only allow 2 people up in that unit. Once I got the okay, I walked through and up the elevator. The place was rather large, lots of signs and different departments. There were many pictures on the wall with children experiencing various congenital heart problems. They had their birth dates … and their demise date. Some only lived a few weeks, many only a few years and others passed away at their teenage years. I could feel a pit starting to form in my stomach and refused to read any further. I immediately went up to the cardiology department counter and asked to see my daughter. They asked me to wait in the waiting area because one of the cardiology specialists wanted to speak with me.

Fifteen minutes later, I was escorted into one of the exam rooms to the side and met with Dr. Ahdoot. He was very patient with my flurry of questions. Currently Hanna was on PGE1 to keep her PDA open and she was on back up life support. Normally he would not have gone into so much detail because most parents would not understand the extensiveness of the surgeries and or the complications of my daughter’s heart condition: http://www.thic.com/hyporight.htm

Once I understood the severity and risks of my daughters defect, everything that I experienced from the past few days finally crushed me like a ton of bricks. I could not bear the weight and ramifications of my daughter’s condition … of the fact that our daughter may not live past her first surgery … and that IF she survived the first, there would be many more major surgeries to follow … after which I feared she would never be that healthy, bright and happy girl that I had always imagined. I kept thinking how it was so terribly unfair for a parent to out live their child. Unable to hold back the wave of emotions, I crumbled down, a flood of tears washed down my face as I somberly cried for perhaps the first time in 18 years.

Dr. Ahdoot handed me some tissue and offered some words of encouragement. He told me a story about a good friend of his, who was also a pediatric cardiologist. That doctor was born with a similar congenital heart defect. His friend was in his late forties and continues to treat children with similar congenital heart defects like Hanna’s. He also pulled out a picture in his email, showing a family who moved up North, who had a daughter also with a similar heart defect. She was currently doing well at the age of seven. More importantly he showed me that the couple had three other healthy children in their family. I realized that life still goes on and that there was still hope for my daughter.

After my meeting with Dr. Ahdoot, I was then escorted to CTICU to the room where Hanna was resting …

* Too be continued *

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