Life in Sioux City

I cannot believe the entire month of June flew by and I didn’t get one blog post done.  HA.  Actually, I can believe it.  The person who can’t believe how hectic/chaotic life is, is Chris.  I tried to warn him.  I tried to tell him that I was being lazy in late April and early May during my time off because I knew the minute we arrived in Sioux City until the minute our new baby was born, we were going to be running a marathon at sprint pace.  And I was right.  And Chris now understands why I tanned out on the deck and ate popsicles in Marshalltown while the kids napped instead of my usual go, go, go to get stuff done while they slept.  And I often think back to reading the book Hunger Games on the deck, taking naps if I could, long walks to the park with the kids, and basically just enjoying a lazy pace of life for a couple of weeks, because I knew what would ensue soon!

So here we are:

1. Moved into our rental house

2. Bought a dental practice

3. Getting ready for our new baby boy (5 more weeks to go!)

It doesn’t sound that complicated does it?  Ha ha.  It has been an absolute whirlwind of long stressful days at the office, long stressful evenings at the dining room table with Chris, him on the IPAD, me on the laptop working diligently until we couldn’t keep our eyes open, and then doing it all over again.  Weekends spent cleaning the office, organizing, doing home projects to get ready for the baby, and the basics of life: laundry and keeping the kids happy and occupied.  Every once in a while in the last month I thought of my camera and was just too darn exhausted to even get it.  We did manage to carve out some time for fun.  Slip n Slide at Lolli and Pop’s house, my cousin Elliott’s graduation party,  Brooklynn’s birthday party, and some wonderful family dinners. It is such a comforting feeling to go to church on the weekends and see extended family, aunts, uncles, cousins and friends.  I love going to the grocery store and bumping into friends from high school or college and catching up.  Everyone has been so welcoming, and it is exciting to be back home.  I know it sounds lame….. but I am just thrilled to be living in a town that has restaurants, some decent shopping, and overall, just fun things to do!!  The second week we were here, Mom and I drove to Target and to Kohl’s after the kids went to bed early.  We shopped and then had frozen yogurt.  I was in HEAVEN.  It was so completely FABULOUS to be with my mom, buying some cute maternity clothes at Kohl’s and fun decorative items at Target, enjoying a yummy treat, and then driving back home in the same city to go to sleep in my own bed.  I had been missing this kind of simple thing for eight long years!!  Marshalltown literally had NO shopping, including maternity clothes and very little places to choose from to eat.  I consider us AMAZING for lasting three years there.

So, some details on our house.  We are renting from a very nice family, Cathy and Marty.  Chris and I did NOT want to buy another house in a hurry.  The move to Sioux City was stressful enough just with the purchase of the practice, the sale and closing of our house, and arranging new therapy and preschool for the kids, and new doctors for me and the kids. We also feel that the next house we buy or build is going to be the one we are in for decades.  We wanted to avoid buying and selling another house, two in nine years is ENOUGH for me!  Once we decided we wanted to rent we began to look immediately.  Basically, the options in Sioux City were trailers, apartments, and about five townhomes!  Sioux City is not a college town like Iowa City where a ton of students/residents want townhouses/condos.  Sioux City offered very little in terms of houses to rent.  Most of them were older homes in not so nice parts of town.  We felt discouraged and thought our best option would be renting a three bedroom apartment in Dakota Dunes.  That was an okay option because they are nice and new, with access to an indoor/outdoor pool, workout facility, and kids play place.  The disadvantages were the lack of storage for all our furniture that didn’t fit and the short commute to the office.  Chris’ mom knew the family we are renting from and they had bought the house on the North side of Sioux City when their home flooded in the Dunes last summer.  They were going to put it on the market this summer, but were willing to rent it when Chris’ mom presented them with our situation.  It is a three bedroom, split level home with a two car garage and a fenced in back yard with a  play set.  We looked at it over Easter and thought it would be cozy for our family but thought it would work, and a much better option than an apartment in the Dunes.  It has worked out nicely.  The house has two large storage sheds on the property.  One is insulated and is more like a little house than a storage shed.  We have that shed FULL of our things that wouldn’t fit in the house that we knew we wouldn’t need immediately.  The other storage shed is more like a garage and it makes up for the third stall we used to have.  All the bikes, lawn mower and yard tools and kids stuff is out there to make room in the garage for the cars.  Thank goodness for the storage sheds or we would be paying a monthly storage fee somewhere!

The one problem with the house was that a week and a half before we were to move in, the family told us the house wouldn’t be ready in time.  Uggggghhhhh.  We were pretty stressed about what to do.  They were concerned about the master bedroom and a funny smell they detected.  The couple is very nice and were worried something was wrong and didn’t want anyone to move into the house with small children unless everything was safe.  Basically, they had every expert you could possibly think of come to the house and tell them nothing was wrong. Electricians, plumbers, animal control, duct cleaners, mold experts, carpet cleaners, even an environmental expert, etc.  I cannot even imagine how much money they spent trying to figure out what “smelled” in the master bedroom when no one else  could really even smell it.  Chris’ mom even offered to meet Cathy at the house.  She couldn’t smell a thing.  But they persisted and didn’t want us to move in until they tore out the insulation in the bedroom and in the garage below to see if there was something wrong.  They didn’t want us to move in until after everything was done.  That meant a delay of about two weeks.  Chris was freaking out.  He was so worried we would have to move everything into storage and then have to move it all again to the house, renting a second moving truck and having to pay for storage for a few weeks.  It meant living with one of our parents for a few weeks during the crazy time of figuring out everything with the close of the practice.  Finally, I decided that the women needed to take charge.  Chris and Marty had been communicating about all this, and no offense to men, but they just don’t talk the way women do.  I called Cathy and explained the situation.  I reassured her that we were not worried about the funny smell.  She is an extremely conscientious person who worried about a pregnant woman moving into their home if there was a potential health concern. They have three small children and they lived in the house for seven months and everything was fine.  I offered the solution of us moving in and staying out of the master bedroom and second stall of the garage so they could have the work finished.  She agreed that was fine, but said they needed one more week without us moved in.  She did say we could move in our things, just not stay there for one week.  I agreed that would be fine.  It was an acceptable solution but Chris and I were a bit frustrated since the problem seemed to be an imaginary one to us.  We did appreciate their diligence and concern for our safety.  In the end, we stayed at my mom’s for four days and then were able to move into the house.  We did have to wait for another week to move into the master bedroom so Chris and I slept on a mattress on the floor with all our furniture and the baby furniture all crammed into the second bedroom.  Rolling out of bed was not fun for that week!  Once the sheetrock, insulation, and painting was done in the master bedroom we got to move into it.  It was such a relief to finally get those two rooms organized.  Never once have we noticed a funny smell or noticed any problem. 

The house is working out but I realized how spoiled we were in Marshalltown with our huge master bedroom and big walk in closet.  Now, if the kids are in our bedroom and I am trying to make the bed, it is seriously impossible to not knock over a little body.  I am always shooing them out of there because there is just no space.  The closet situation is also a disaster, but whatever, I keep reminding myself this is temporary.  And we really don’t even have that many clothes.  I just don’t understand how a couple used to share these small closets in older homes.  The master bath is tiny as well, no space for a second person to be in there at all.  And the two car garage is so small that I get out of the Yukon before Chris even pulls in because it is such a tight squeeze.  But, we are grateful that we found this house, and it will just take some adjusting. 

We are all unpacked and the house is decorated, with exception for the baby’s room.  It had very ugly brown and navy wallpaper.  They said we could strip and paint the room it if we wanted to.  So Chris has been working on that.  Stripping wallpaper is a lot of work but we have the walls taped and paint picked out and waiting so hopefully that project will be done soon.  There is also an older border in the kids bathroom that I would like to remove as well.  Chris knows that is next.  I picked out paint that would match the kids’ bathroom décor so  hopefully there will be enough left after the nursery is done. I can’t wait until it is complete because it is going to be so bright and fun and colorful.  Just the way I like things for a baby’s room.  We are ordering his chair in Omaha tomorrow.  We are going there for the fourth of July (TODAY!) and there is no place to order one in Sioux City.  Jack and Savvy’s chairs were ordered at the baby boutique in Coralville but that store has since closed.  And you can’t order online.  What a pain.  The company wants to be sure that you have felt and seen the material in person before you order it.  The bedding is here and I love it!  Pictures to come. 

Enough with the house, onto the practice.  (The only reason I am documenting this is because I want to remember this process and because I might have one or two dentist friends who might be interested!) I really don’t know where to begin.  I would love to write up the WHOLE process so I can look back and laugh….or cry…..or just remember how much work it was and feel proud of how far we have come.  I guess the only thing I know for sure is that I am so happy I have had my husband with me every step of the way.  Chris has been absolutely amazing and utterly NEEDED for every bit of this process.  He has helped make every decision and has guided me through this whole process.  He is so good at looking at big picture while still focusing on the details and how to accomplish the goal.  His business background and smart financial sense has made feel calm in the chaos.  I don’t know how anyone does this alone.  There is no way possible I could take on all the tasks that are necessary to run this practice.  Chris is definitely handling the business, I am focusing on the dentistry. 

We dug in right away the first week we were in Sioux City.  I spent time observing at the office, watching to see how they schedule patients, how Dr. T runs the practice, and how the staff interacts with each other.  I looked through dental supplies and tried to familiarize myself with his equipment.  I was very naïve to think that working in a community health center you work with the basics and bare minimum since the budget is king.  I was so wrong.  I mean, I truly thought that since I didn’t have a touch n heat, EPT, a laser, or other certain dental materials and instruments I would have liked to try that I was working with the bare essentials.  WRONG, WRONG.  I was working in a community health center with new chairs, digital radiography, electronic records, and basically everything that I needed to do dentistry well.  The extras I would have liked would be considered luxuries in a lot of private practices and I kind of thought those things were standard in private practice. 

I have learned that Dr. T is a dentist who works with bare essentials.  And his equipment is OLD.  And I mean OLD. And that is okay, I understand why he wouldn’t update his equipment because it worked for him and it would be a huge investment towards the end of his career.  It would not have made financial sense for him. It has not been easy for me to adjust though.  The chairs are so loud I was afraid they were breaking as I reclined my first few patients. Certain drawers do not stay shut in the ops, certain water lines haven’t been run in decades.  I found out the hard way squirting brown water out in front of the patient to rinse a denture.  Yikes.  The light shines through the cloudy foggy plastic.  He does not own a slow speed handpiece.  I HAVE TO HAVE a slow speed handpiece.  The burs at the office are ones I am not familiar with and wasn’t even sure what to use them for.  I am used to using an operative cassette with an operative bur block.  Same with fixed pros, containing everything I would need.  They have no cassettes and no bur blocks.  Oral surgery forceps are rusted in their sterilization pouches, likely 4-5+ decades old.  I think they belonged to the dentist Dr. T used to work with when he first started.  Several packages of materials are expired. Like in 2000 or 1995.  Hahaha.  I just have to laugh at some of this because it is funny but brought me near tears a couple of time.  He uses a spitoon and does not use water with his highspeeds.  Those lines had to all be cleaned and readied for me, who never even knew that it was possible to do a crown prep without water coolant. The dental assistant had to be trained to use the high evacuation suction since he never used water.  Infection control protocols at the office are interesting.  I am still figuring out what to do about that.  The office has three part time hygienists that equal two full time.  The staff has been with him for decades.  Having someone new and young like me has been a tough adjustment for them.  I can understand that.  They are very accustomed to how he practices dentistry. 

Dr. T has been so wonderful to me.  He is so encouraging and laid back and did offer to purchase anything that I needed to get started.  The list would have been so long that I opted to not divulge the things I knew I would need and do the best I could with what he had for as long as I could.  I made it two weeks.  It is so hard to do dentistry when what is in your hands is so unfamiliar.  You make a fool of yourself in front of the patient trying to figure out how a particular material or instrument works, while trying to prove to them that though you are young, that you are a competent dentist.  It was very exhausting to try so hard to acclimate myself to their system.  The way they are used to scheduling is also so foreign to me.  The provide a lot of same day treatment to patients who call in with a  problem.  So instead of scheduling off of a treatment plan, patients are given a time slot, the problem is discussed, exam completed, radiographs made to diagnose the problem, and the work is started once the room is properly set up for the procedure.  It is a bit backwards to me and doesn’t seem to be efficient.  I am slowly trying to change the way we schedule the patients.  I have put in MASSIVE orders for the equipment and supplies that I need to be able to work in the way I am comfortable.   I am trying to not stress out about the mountain of debt we are in.  Haha.  I am failing at this task. 

Chris and I worked together to secure a good accountant.  He is a family friend and his firm has been great to us.  They worked with us to obtain a tax ID number and our lawyer, Greg, got us set up as an S-corp in the state of Iowa.  We are now formally Lohr Family Dentistry P.C, doing business as named with his name included. We signed a five year lease after some negotiation with the landlord at the current practice location.  All of these three things sound simple enough….but they were overwhelming too.  All of this business stuff was just difficult for me to understand.  We established business bank accounts and Chris has taken care of all of the banking needs for the practice.  He has worked with the accounting firm to set up direct deposit and payroll. Eventually Chris is going to do payroll himself but for now they are going to do it for us until we are settled in.  Direct deposit set up has been challenging.  With employees having five or six different banks, everything takes longer than you would guess. 

The installation of the hardware took place the second week of ownership.  The schedule was lightened to accommodate the install.  Reading paper charts and trying to figure out what treatment was necessary was difficult because the analog films are not mounted,, most of the viewboxes are broken, and there are about 12 envelops on average in a paper chart that have to be gone through to find the most recent radiographs.  The hardware install went well, but of course there were structural problems with the building such as concrete behind the sheetrock instead of wood framing.  The electrician quotes and cabling quotes were more expensive that we thought.  The hygienists were used to tvs in their operatories.  The electrician told me that we were in violation of code for the way Dr. T had run the cable and the electrical to the tvs and that we were at risk of a fire if it wasn’t remedied.  So of course, I had to be the bad guy who gave the bad news that the tvs had to go.  Chris took them down and cleaned up all the cabling in the ceiling. 

The software training and digital radiography install (Planmeca Promax) took place the third week of ownership.  Wow…..talk about stress.  It is a very user friendly system, XL Dent, but some of the ladies have never really used computers much for anything, let alone dentistry.  I felt obligated to be the calm, reassuring, encouraging one to the staff.  Because….I am the boss.  Yikes.  It has been really hard because they all come to me for an answer, to fix their problem, and to explain things I don’t even understand yet.  Phone calls to tech support, problems with the new radiology equipment settings that were modified by the trainer yielding undiagnostic images, and frustrated staff have led me to still be at the office until 7:00 on some nights.  Uggghhhhh… but deep down I knew it would be like this.  I just keep smiling, praising the efforts of everyone, promising that the kinks will get worked out and keep MAKING LISTS!!  Just as I cross off one thing, ten more things are added!!  I keep asking God for patience, strength and wisdom to make the right decisions and to avoid the all encompassing feeling of DROWNING.  Haha.  I feel like I get a gulp of air, and then back down to hold my breath until my lungs explode.  But I know we can do this… and we are.  I feel like last week, each day got a little bit better.  The ladies are becoming accustomed to how I like to work, and the front desk manager/scheduler is learning how I like to have appointments scheduled. 

The staff has had a ton of questions for me.  Vacation time, salary, worries about production and if we are going to track that, paid holidays and on and on and on.  I don’t know the answers to most of these questions.  Most of my responses have been, “Everything will stay the same as you had with Dr. T until we have the time to come up with employee policies, perhaps in a few months. “  Unfortunately, what they had with Dr. T was made up as they went along and there are definite disagreements as to what is fair between the staff.  I am trying to ignore these issues for right now since they are complicated and I just cannot worry about them for right now. 

Some patients are responding really well to me.  Others, definitely are questioning me when I recommend a crown on a premolar with an MODL alloy with recurrent distal decay.  Seriously, there is a TON of dentistry to be done on these patients.  An intraoral camera is going to be needed soon, once we pay all the other bills.  I am trying to ease my way into getting work done on some of these patients who have been dictating care for themselves the last twenty plus years.  They seem to think all dental treatment is elective and that WATCHING decay progress is a good option.  I am very careful about my wording and incredibly gentle when they resist my efforts to improve their oral health.  I consider myself a conservative dentist, recommending treatment only when truly necessary, not pushing esthetic work on teeth that are healthy and functioning.  Unfortunately, lately, I am feeling more like someone who is trying to sell dentistry to people even though they desperately need it. 

The cleaning lady quit when she found out the practice had been sold.  She was a friend of Dr. T’s wife and I think she was doing it as a bit of a favor even though they did pay her.  Everyone’s idea of cleanliness is different. Lets just say that Chris and I were planning on walking through the office with her and discussing areas that could be improved.  It was one less thing to do but now since she quit,  guess who is cleaning??  Yep, you got it, weekends Chris and I are going at it with the vacuum, swiffers, mops, and bathroom cleaning supplies.  It is a joy.    Good thing we are great cleaners. 

Bulletin boards and a white board has been hung in the break room.  The two ops that were used as a dental museum have been cleaned out and the dumpster in the parking lot was filled with old, dusty, outdated dental equipment and expired dental supplies.  The two mini fridges have been scrubbed cleaned and defrosted.  We have made progress in decluttering and organizing the office.  The office now has internet access!!  Yay, hello 21st century!  The new fax/copier/scanner replaced the TYPEWRITER and broken fax and copier that sat in its place.  One day at a time we are becoming more efficient and utilizing technology to improve diagnostic techniques and patient care.  Air water syringes are now disposable and being replaced in between each patient, and we have head rest covers!!!  Infection control is being improved one small step at a time. 

The floors of all the ops desperately need to be replaced.  The landlord has agreed to replace the floors.  Apparently, he said they were going to replace them EIGHT years ago.  Haha.  I just have to chuckle sometimes at all this.  They brought me floor samples.  The signage outside the building and in the Plaza Professional Center directory has all been changed with our DBA and my name had been added.  The entry way floor has been redone and the walls painted.  It looks MUCH better. 

I want to take BEFORE photos of the office so that someday we can look back and see how far we have come.  I have not gotten there yet. 

Most of all, I feel so happy to be in Sioux City.  I am very grateful for the opportunity to work with the nicest, most genuine caring dentist that I have ever met.  I am thankful for the ability to be a practice owner and I am glad I can slowly mold the practice to fit me, instead of trying to make myself fit into a practice that has protocols already well established.  I know this will be an uphill run for now, but once I get to the top of the hill, I am going to savor the easy jog of the downhill.