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Molars on the run


Perhaps, one of the more neglected and ignored part of the body, the tooth could easily end up last in a runner’s priority list where a well-toned musculature, a robust heart and formidable legs take center stage.  But the little devil once left untreated and rotting can easily make its presence felt during the most unexpected moment, especially during those crucial periods in a race when one’s resistance and strength are already compromised and waning.

Imagine one appropriately trained, properly nourished and well prepared participant in a trail race that took a year to manage, finance, and map out suddenly experiencing one of life’s most excruciatingly painful episodes – the toothache.  And bam! All those months of blood, sweat, mud and tears suddenly vaporizing into thin air due to one missed dental appointment.  But Mr. Badass soldiers on, having survived a plethora of generalized pain, cramping, fatigue, and sleeplessness in all its degree and variety.  But the most dramatic discomfort coming from a sore molar easily beats ‘em all in a kaleidoscope of physical agony.

While many of these trials and tribulations most runners had the chance to experience, embrace and adapt to during training days and lesser races, this rare yet unbearable episode was something unfamiliar and seemed impossible to remedy immediately. At the third aid station, Mr. not-so-bad Ass gulps a strong analgesic to ease the discomfort but an hour later, the gremlin is back with a throbbing vengeance.

Alpha male finds various ways to mask the awful experience as he nears the last aid station. He puts pressure on the cheek area, places some ice to numb them and even pinches it once in a while.  Marshalls at the last aid station are baffled to encounter one bruised runner with half of his face swollen.  The expression on his face was a mixture of relief, nervousness, and frustration.

Relief from the next pain reliever is finally coming down as two emotions surface: nervousness since time is ticking away and this thorn by his side has dramatically slowed him down, and frustration for delaying his dental appointment for weeks.  An hour after leaving the last aid station, the rest of his niggling discomfort in the muscles, the mind and the joints conspire with the odontalgic main man.  Together they collaborate to make Mr. Poor Ass one broken, pained, and wandering zombie runner.

He still makes it within the cutoff time but so do the rest of the participants who were mostly high spirited and vibrant at the finish line.  Meanwhile, our Mr. Thrashed runner is looking lost and out of synch.  In one of nature’s cruelest joke, once he completed the final kilometer of the race, all of his suffering disappears like it never happened at all.

And so he survives this one but now he has learned his lesson.  Or so we thought.  He still foregoes his dental appointment but instead arms himself with sheets of narcotic analgesics.  It works like magic, of course.  Now all the savings he made foregoing his dental visits can go to registration fees for more races to come.  After all, once all his teeth start to rot and thaw, new dentures await.  So from Mr. Badass he has completed his transformation to Mr. Toothless.  And yes, he bites more than he can chew.

Your nigging tooth, if left untreated can result to more than sleepless, lancinating nights.  Let’s look at the other possible complications:  dental abcess, difficulty in breathing (once infection crosses the midline), difficulty in mouth opening (trismus), facial swelling (cellulitis), bone loss, teeth loss, including medical problems such as heart disease and diabetes.

Jose Lorenzo Mina Jr has been practicing dentistry for the last 27 years and has been witness to the Filipino patient’s evolving attitude and knowledge in dentistry.  While many patients are now armed with various knowledge (some bogus and highly questionable c/o of Mr. Goggle) in dentistry and dental care, a considerable number of patients still want to hold on more to their fancy cellphones and flashy gadgets than their good ole chompers.

Special thanks to Glairold Recella for Van’s picture after ascending Mt. Ayaas last May 27, 2018 during the Outrun your Dreams trail race.

 

 

 

 

 

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Frontrunner Article #4: The Great Disconnect


to run or to treat...?

to run or to treat…?

‘Doc, was that you we saw running the other day?’ queried my patient.  It’s been a question I get a lot since doing my training runs on weekdays.  Whence before I dreaded being sighted on the road dripping in sweat in very skimpy outfits by patients and friends, today I wear my running badge with pride and some confidence.  If before I led a double life of runner and dentist, today, I eagerly share my ultra trail and road adventures with gusto and gratification.

The last 23 years I’ve been in the practice of dentistry, friends and patients have always pictured me as the mild mannered guy whose idea of fun involved prying out tooth fragments and draining pus on swollen faces in the comforts of my sterile clinical existence.  It was a cocooned existence where the action was confined inside the hallowed caverns of the oral cavity, the valleys of the periodontal pockets, the uphill cusps of molars and darkened tunnels of root canals.  It was a safe, predictable, staid and boring lifestyle which little by little took a toll on the shoulders and back.

welcome to my cubicle!

welcome to my cubicle!

While I never looked better then, replete with well formed arms and chest (I was a gym buff), I had zero cardio-vascular workout and was easily fatigued and burnt out.  Plus the blood pressure went out of control.   Time for a game change…

i miss my rippling triceps...but then.

i miss my rippling triceps…but then.

Back in 2003, I loved posing, ala-Gardo Versoza.  This one was taken by Taal lake...

Back in 2003, I loved posing, ala-Gardo Versoza. This one was taken by Taal lake…

4 years ago when I stumbled into the world of running, I started donning the skimpiest of apparels and exposing myself into the ever-changing elements of extreme heat, rain and all sort of flotsam in the choking  world of Metro Manila roads.  So imagine one moment I’m pounding the pavement under the sweltering heat, dripping in sweat and all sort of bountiful slime and dirt.  And an hour later, I’m in the safety of my operatory attending to patients’ needs as peppermint oil wafts across Sitti’s cooing voice.

Back to my simple controlled life...

Back to my simple controlled life…

The great disparity was simply jarring that the first impulse was to conceal it from my patients.  The thought of them seeing me oozing with sweat and grime was just too much to take.  So this is my double life – one is controlled, organized and serene while the other is unpredictable, chaotic and full of surprises.  While I hardly break a sweat inside the clinic, the other is about dirt, sweat and I just love it.

We want our dentists well groomed, smelling sweet and uttering the wittiest statements & dishing out the most helpful of tips, don’t we?  And not cursing the wind and the race director (where the hell is the finish of this %$@* race?).  Now who would want to see his dentist slugging it out in muddy trails and treacherous mountain tracks?  I can just read their thought bubbles:  “Now isn’t that going to weaken his dexterity and clinical skill in handling my dental cases?” or “So how can he still take care of me when he’s always up there in the mountains, caked in mud and being feasted upon by jiggling leeches (eeew…)?

having a blast in the real world...

having a blast in the real world…

Now, let me run through all these misimpressions.  Oh yes, I am exposed to all sort of inconveniences (torture, if you may) in an environment teeming with dirt and grime an ordinary sheltered individual won’t be able to stomach.  But after each adventure, I’d bathe and scrub myself clean to the bone and I’d like to believe we observe aseptic techniques in our practice once ensconced in our four-walled, environmentally controlled clinic.  And yes, after years of hitting the road and trail, I can still take out an impacted molar or negotiate some shrunken root canals.

life is a series of movements whether it's macro or micro...you just learn to adjust to the situation.

life is a series of movements whether it’s macro or micro…you just learn to adjust to the situation.

And I still haven’t thrown my clinic sked into chaos in favor of the outdoors.  I can’t keep hiking if I don’t have the funds to sustain it so the most I’d take out in my work week is 1-2 days.  Basically, I still have 5 full days to see patients – yes, even if I’m a bit burned and limping.  Fact is, I look forward to be back to my air-conditioned environment after days to being exposed to inclement weather.  It balances things out without feeling burned out on either side of my polarized universe.

Without a doubt, running, besides stabilizing my fluctuating blood pressure and lulling me to long peaceful slumbers (didn’t know that Sleepasil has been routine to some colleagues), had strengthened me, physically and skillfully.  I can take hours of continuous dental procedures without complaining and feeling wasted – always keeping in mind that the finish line is coming round the bend.  Or during those toxic stressful clinic moments where I’ve learned to handle the situation the way I’ve battled injuries and submission during a race.

i run. i treat. i am rundmd.

i run. i treat. i am rundmd.

But eventually, like some illicit love affair, one tries to inevitably merge both lives.  I soon realized that running would play a greater part for the rest of my earthly life so I might as well wear it like a proud badge.  Soon enough, I was opening up to my patients on my exploits on the road and trail.  And what do you know, they were piqued curious (perhaps, by that BDM trophy resting at the reception area) and fascinated by my ‘secret life’.  I was no longer the guy who was buffed, clean and whole some, I had become the gaunt dark warrior – looking burnt and hardened but brimming with eagerness and perseverance and ready to take on any challenge, whether at the dental operatory or the road…


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A Series of Unfortunate Injuries on the Trail to Dahilayan


The CDO Connection

The first time I saw the CDO-Dahilayan Trail Run pop on my FB page, I knew I was going to be part of Mindanao’s first Ultramarathon.  You see, my ties with CDO go a long way back to 1990 when I was part of UP-PGH’s Dental Externship Program.  When you spend 24 hours at the emergency room and 8-hour duties at the Out-Patient Department for 5 days together every week, you’re bound to get close with fellow dental externs, some coming from Cebu, Davao and Cagayan de Oro.

PGH wonder years...

Beyond the confines of our dental cubicles, our 2 batches (the seniors & the juniors) were never short of get-togethers, outings and a lot of bonding.  Even when the program ended, the excursions continued.  In CDO alone, we’ve visited Drs. Johnny Lu (my cubicle buddy) and Danny Antolin 3x since.  This year was my fourth.

White Island, Camiguin (2007)

Cris, Malou, Johnny, Danny

Pre-Run Rituals

We touched down at the CDO airport last Thursday afternoon and were promptly whisked off by Danny to the Dynasty Court Hotel, 30 minutes into Michelle Estuar’s seminar.  The place was packed and we met up with Francis Velasquez (the race director), Johnny and the rest of the organizing group for this ultrarun.  Jonel & Francis gave the final instructions to many of the participants who were feasting on the delicacies for the carbo-loading party, including a roasted pig, stuffed with lemon grass.  I know – 2 days to a long trail run, one should be stuffing on pasta and sweet potatoes but what’s a guy to do when faced with that crackling brown lechon skin but dig in…yum.

final words from Francis and Jonel...

The next day I was supposed to be relaxing and investing on some sleep but Danny had other plans in mind.  He toured us around city into the soon-to-open CDO international airport.  And finally settling at their family beach house where we took off from the beach paddling into the middle part of the sea to swim and snorkel.  The corals, starfishes and marine life are still intact and quite thriving. It was an fun-filled, invigorating morning, as expected from a CDO jaunt.

Danny, the coco juice extractor

Idyllic relaxation before the battle...

We met up with Johnny at Candy’s (owned by his sister in-law at Limketkai) for our late lunch.  We devoured the delectable salad, spinach pizza and pasta and the to-die-for (I  know, very Alicia Silverstone) desserts, with me finishing off all the leftovers.  I was the only one running in a few hours, right?  We split up at around 4 pm with Dan, Malou & Cris travelling ahead into Dahilayan with Johnny driving me to the hotel where Boring Team mates Doc Topher, Bong & Juvy are already comfortably ensconced.

Last decent (and unforgettable) meal at CANDY'S

An hour of preparations and final arrangements and I plopped myself on my foamed bed.  At 10:30 pm, I was hoping I had dozed off even for a few minutes after hours of lying down and writhing around.  At 12 midnight, everybody gets up to go down and search for some meal along the street.  I stayed along and partook of my inasal chicken we earlier purchased at Steve’s.  Still tasty.

Good Borning, CDO!

And it all began…

BoRiNg time...

baby, you're a firework!

At 2:45 am, we were in front of the CDO city hall – Doc T, Bong, Juvy, Doc Art & I in our Team Boring shirts.  The atmosphere was buzzing with excitement and electricity (and some trepidation for me).  Of the 172 runners, 30 are from Metro Manila.  Sparks and fireworks fly from the starting line as runners shoot out to the city streets at 3 am.  Soon enough, the road ascends in long distances.  My plan was to finish the first 27.5 kms in 4 hours so I could just walk the final kilometers.

smile though the legs are struggling..

I run along Bad Boy Bong (Bernadez) who was also pacing Berns Ong who was eyeing a podium finish.  Their tempo even on the uphills was quite brisk so I let them go at around 15 kms., after many a chases.

mistaken identity (people along the road mistook Berns to be Sen. Cayetano): thus the cheering, Pia, Pia!

one of the many awe-inspiring views...

Jacob: Dawn Runner

As we left the city, the roads give in to verdant mountains and fields and trees.  With the sun finally creeping out of the clouds, the runners take a respite from the numerous ascents to enjoy the stunning scenes.  I would run along 2 new friends along the road – Fred Casino (works in Ortigas but CDO in origin) and Jacob Mendoza (Zamboanga-based) who would beam me out of my monotonous running stupor.  We would zip in and out of each other’s zone until finally, the descents came in and I was riding like the wind.

with Fred before another ascent...

running down a dream....

I finally caught up with Bong & Berns along with our designated support jeepney.  I changed to my long sleeve running shirt just in time for the entry of the blazing morning sun.  At 7:09 am, I finally reached the halfway point (27.5 kms.), still on fresh legs though hints of cramping on the left knee, right calf and quadriceps were bubbling up.

Now if only all roads were like this...

Let the sunshine…

A few kilometers into Camp Philips, Del Monte area, the road would suddenly angle up so steeply, forcing us to hike up as the air becomes thinner and the muscles more fatigued.  American in planning and lay-out, Camp Philips was such a refreshing sight for the weary runners with its enormous trees, open gardens and friendly neighborhood, offering pineapples, bananas & juice drinks at its many stations.

a banquet of delight

Alas, the cool breeze gave in to hectares upon hectares of pineapple plantations.  And I welcome the heat and the endless, lonely walks but not for long.  I was getting giddy.  This is where my feet start to give in.  Blisters from the Nuvali trail run start to surface so every step on the angular pebbles can be a real ordeal.  Mr. Right foot produces an island of blister while Mr. Lefty is showing signs of an impending plantar fasciitis.

cue in: Zephyr in the skyyyyy....

To make matters worse, my MP3 player which has been pushing me to glide on many portions of the race finally conked up in the middle of the pineapple wilderness.   Roads that were paved for most of the way had transformed into uneven pointy rocks.  So what’s a guy to do 15 kms. into the finish line?

a)            Attempt to pop up the frigging blister.  It almost happened when one of the guys at the water station suddenly brandished a Swiss knife.  Close call.

b)            Attach a protective foam around le blister.  Simple eh?  But what if the foam is just ¼ inch in diameter and the wound is 2-inch wide?

c)            Keep moving and offer every excruciating step to family and loved ones.  That’s what I did – all my wishes and hopes for them.  Plus I offered the run to my brother Fred and my close friend Dr. Maricel Vinluan, both July 9 birthday celebrants.  It was also a time to pray.

a view to a kill....

Many ultrarunners know about this – when the body can no longer go on, you let the mind take over.  It worked for me at the Nuvali Trail Run & the BDM 102, so it should work now.  Unexpectedly, during BDM 102, I battled with fatigue, sleepiness and the heat.  There were no real physical injuries I needed to delete from my system.  At both trail runs, it was blister galores at every step of the last kilometers.  Soon enough, I learned to wrestle with that beast (instead of ignoring it) every time it comes around – I face it, do something about it and continue with my journey.  As in real life…

Soon enough, signages of the Dahilayan Adventure Park start popping up.  My road to Golgotha turns out to be 2 kilometers of further ascents through muddy trails.  As I cross the finish line, the rains welcome my arrival.  It was exhilarating and refreshing. Race Director Francis and Christine (Johnny’s wife) were on hand to welcome me 8 hours and 40 minutes after I had left Cagayan de Oro City.

the moment!

my preciooouusssss!

Subplots:

a.       I missed out on the Dahilayan Zip Line (Asia’s longest) but swear to be back and enjoy a full day of its many rides and amenities.  But maybe I should watch ‘Forever & a Day’ before that.

b.      The reason we had to leave Dahilayan early was to attend a dinner tendered by Johnny for us.  And I had my fill of all the lechon skin I could munch on.  I have suddenly become a fan of roasted pork.

a fitting climax of the CDO adventure...

c.       I never got to eat my food implements for this race.  The reason – besides having a well-stocked water/food station, barrios in many areas prepared sabas, camotes and boiled eggs, handing them out to famished participants.  Plus more food coming from co-runners.  It’s a wonder my tummy didn’t act up.

Thanks to Marge Auyong-Velasquez, Runner’s Circle, & Dr. Emmanuel Tiburcio for the great pictures!

Postscript:  Cris and I left for Manila Sunday morning arriving at 7:30 just in time for my induction as active member of the Endodontic Society of the Philippines.  I was still limping from that blister and dozed off many times during the whole day seminar.  Something’s gotta give…

I zzzzzzzolemnly swear....


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OUR ONDOY EXPERIENCE


OUR ONDOY EXPERIENCE

As in most places in Marikina last September 26, 2009,our poor clinic was one of the casualties of storm Ondoy bringing in 5 feet floods with mud.  We were fortunate to be around when the waters started rushing in the clinic (we even treated 2 patients that September 26th morn).  At first we tried warding off the rising waters by sealing the glass doors with dental wax, glue gun or whatever material we thought would prevent water from seeping in.  But when the deluge was too much, we knew our space would be underwater in no time.

So acting as one unit, we started bringing up all our delicate stuffs – the small dental machines, the paper documents, the drawers containing the dental instruments and whatever we could fill the upper space with.  We were fortunate to have built an attic (as extra storage area) because we just couldn’t imagine where to bring all our delicate items.  We left when the waters were waist deep and most of the things were brought up to safety except for the dental chair (too heavy) and the x-ray (mounted on the wall).  It was like in a Titanic movie when it took us time to open, close then lock the metal and glass doors.  All the while, my car was sinking from the deeper waters outside by the parking area.  We ventured out as waters continued to rise, settling in one of covered areas.

By late afternoon, with the continuing rains, I braved the floods and knocked on a high school classmate’s condominium room on the 8th floor after searching for his name on the now wet records.  He and his wifey warmly welcomed me in and later my 2 assistants.  As the night settled in, we continued to observe the worsening conditions – the floods, the rushing trash, the people clambering on building roofs, wet and hungry.  And of course, our clinic and my car – by now a rectangular island of blue metal in a sea of brown.

There was no electricity.  Most of the communications were by mobile phone which by now was at risk of running out of power.  We subsisted on canned foods with gloomy thoughts and restless energy looming through the night.  By 11 pm, we noticed the waters finally settling to a certain level then eventually going down.  By 5 am, water has completely disappeared in front of our clinic.  And so we ventured to check the extent of the damage.  By 9 am, an army of cleaners was summoned by my family, hosing and eliminating every trace of mud from the insides of our clinic space.  Before night fall, mydentalspace is free of any trace from the storm.  Or so I thought…

It would take another 10 days before the major dental appliances (dental chair/x-ray/compressor) all submerged to dry up, be cleaned up and brought to normal working condition.  We started treating patients on the second week after the storm but a month later we had a 4-day break for minor repairs and repainting of the clinic walls.  1.5 months after Ondoy, our clinic is back to normal operations and my car is running again.

Despite everything, we are still very thankful to the Lord as the damage/trials we experienced was not that permanent and we were able to rise out of the problems faster than some.  And we learned a lot from this tempest – no problem that comes along is too difficult to hurdle, family and relations matter more over material possessions and always build an attic which is accessible and useful.

Anyway, you have a detailed rundown of my Ondoy experience.  2009 is one of the most trying year I believe on my 44 years of existence, but the Lord has prepared me for a predicament of this magnitude and I thank Him for giving me strength, fortitude and hope.

December 2009


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Editorial: Weathering our Storms


Editorial:  Weathering our Storms

Life often catches us when we are most vulnerable and unsuspecting.  The day typhoon Ondoy struck Metro Manila, we were busy treating 2 patients at our dental office, unmindful of the voluminous water dropping from the gray clouds.  We could have treated more patients that Saturday morning where it not for the murky waters which started invading our reception area.

That’s when we realized that this was no ordinary calamity.  We started hoarding all our equipments, papers and small appliances up into our small loft.  The dinky space was full to the brim in a matter of 30 minutes.  The big furnitures, dental chairs and x-ray machine were left to soak in the raging waters which had reached waist deep when we left the clinic.

Outside the endless rainfall has rendered the parking lot, roads and cars underwater in few hours – along with it, my own car.  I gathered my assistants and we stayed in a condo unit of a high school classmate for the night, unknowing of the catastrophe that was devastating the whole Metro.  Gloom enveloped Marikina City as I gazed at it 9 stories above the rising, running flood waters.

We woke up (we hardly slept that night) to learn the devastation and death Ondoy brought on areas as far as Laguna and Bulacan.  Inside 17 medical/dental, muddy waters have entered every corner of our clinic and caused some damage and havoc which would take weeks to undo.  With a lot of help from well-meaning family and friends, we never ceased cleaning, repairing, replacing and painting until we were ready to treat our patients in 2 weeks.  A few more renovations later and the clinic never looked better for Christmas 2009.

It’s been 9 months since Ondoy and its traces can still be felt every now and then (a hard starting car engine or the peeling paint on one wall).  And rightly so.  They’re there to remind us of what we’ve gone through and how we were able to rise above these adversities.  They are a testament of how much strength and fortitude human nature can take and overcome them.

May  2010


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Editorial: (almost) 20 years


Editorial:  (almost) 20 years

Come 2010, I will be commemorating 20 years of rendering dental service to patients of every age and case.  How I have survived through two decades without losing interest or hope in a profession which challenges and discourages is beyond me.  I opened my first clinic in our house garage months after I finished an intensive extership training in Oral Surgery at the Philippine General Hospital.

Anyway, the first clinic catered to mostly neighbors, friends and relatives’ dental requirements for two years before moving to the Kabuhat Polyclinic (A. Fernando Ave. cor Marcos highway).  For 17 years, the practice would grow and flourish, surviving brownouts and the Asian crisis while improving on its dental equipments and appliances.  Case in point:  we started reminding patients of their appointments via our neighbor’s phone landline moving to our pocket pager into our own landline (a precious commodity that time) to our multiple cellular phones (courtesy of Sun).  Along the way, I would undergo training in Prosthodontics (3 years) and Orthodontics (1 year).

Finally on July 7, 2007, we got our own 36 (m)2 unit at the Marquinton Residences with a plush reception and its own restroom plus a new medical space.  It’s been an eventful journey from our simple beginnings.  With the recent renovations we just did, I can say that we have finally found a home.  We invite you to enter our new space, you won’t regret it.

2008


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EDITORIAL: Are you prepared for the rush?


EDITORIAL

Are you prepared for the rush?

Practicing dentistry is nothing short of taking one long roller coaster ride.  One moment you’re in a quiet solitude waiting for patients who never show up.  The next time you’re in a frenzy battle with a wailing pedo. patient, or wrestling with a persistent apical third or even searching for a severed artery from a patient spitting pools of blood.  The ride can be fulfilling as one successfully delivers a well made complete denture or it can be dangerous as one tries to stabilize a fainting patient’s vital signs.  How about retrieving a swallowed reamer or a broken needle?

With its expected tumbles and turns, twists and falls, a dentist should always be at the helm of every emergency (or ordinary) situation within the clinic.  Unexpected turns may catch the complacent dentist in the most uncompromising and frantic moments.  One should, therefore, be ready to contend with it, with enough artillery of knowledge, skill and guts and a lot of luck.  Only then, can one survive the ride.

1997