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Archive for the ‘DICOM’ Category

Pop!

Today I ate lunch with my manager. He likes to schedule one-on-one lunches about once month to see how we’re doing. I was under instructions from my oral surgeon to not eat anything hard.

Fish, I figured, would be okay. I will not name the name of the place I ate at, because it wasn’t there fault and the food was actually tasty.

Maybe I was stupid and didn’t realize the gravity of my situation. But I was trying to be careful and cautious. I made sure that I didn’t eat anything that was hard, because I didn’t want to break my jaw. And the coleslaw seemed pretty soft.

So were almost done and sitting around when I was eating very small bites of the coleslaw. I tried consciously chew with my right side, but maybe I messed up.
And I heard a loud pop in my jaw. The pop reverberated throughout my skull and I was absolutely horrified. I had never had anything like that happen before. It was so surreal. But it didn’t hurt, it didn’t swell and nothing seemed to happen.

Except that when I pushed in on my backmost molar, it hurt. The deep tearing pain, like when I had my biopsy. That pain was so horrible that I immediately withdrew my finger from my mouth. I was able to pull it together and get back to work, but I called my oral surgeon’s office, just in case.

And I made the appointment with the orthopedist, which I will be going to this coming Tuesday.

My oral surgeon’s office asked me where I was, then told me to come by and they’d take an X-ray. So they took a panoramic X-ray and emailed the X-ray to the on-call oral surgeon. The assistent there looked over my jaw, mouth, felt around. She told me that I was keeping the biopsy site clean and it had healed really well. That was encouraging. Then she had me close my teeth together so she could see if my molars were closing flat. I asked her why and she said that if there is a fracture, sometimes the bone snapping will tilt the teeth so that they don’t meetup evenly. She said it was like snapping a stick, then trying to bend it back to the position it was in before. With the stick being slightly askew now and non-straight.

But she didn’t find anything out of the ordinary. They apparently took bone from the bottom of my mandible, because she touched an area which hurt surprisingly more than it should have and mentioned something about the biopsy there. I’m actually not sure where they took biopsy bone from. I was numbed up, but felt sharp digging tearing pains just from my bone. Truly unpleasant, as mentioned in my earlier post.

As it turned out, the oral surgeon on-call would take 20 minutes or so to get to a place where they could look at the X-rays, so I was to wait around. Since I was already there, I thought to address the issue of why I wasn’t getting my copy of the CB CT scan data. I was promised a copy of the CD. I had already stopped by earlier on the way into work to talk to them about it, but they could get ahold of the person who did the CT scan. So I remembered while I was there and brought it up and they called over to the imaging place.

And here’s the rub. One copy was sent to the oral surgeon, one copy was sent to my dentist. I really didn’t care if my dentist received a copy, that’s fine. In fact I want him to have a copy. But the imaging people said that I had to pay $25 AND get a signed authorization from the ordering doctor.

What? This is data from my own body. Data that I actually paid for, because the imaging place doesn’t file insurance. Uggh. $25 is probably going to be a drop in the bucket compared to what this whole ordeal is going to cost me in the long run. So I bore this indignity.

I was quite happy to get my radiographic data. It made me fill like things were a little more defined.

And I saw the tumor in my jaw. Actually, it’s a CT scan, which shows bone (it uses X-rays as well). So what I really saw was the lack of bone in my jaw and how much was missing. And I even got the raw Dicom (DCM) files, which is awesome. I’ll post some of graphics from these later on.

I went back to work after that and started playing with the application they had on disc to read the DCM graphics files. I thought the UI had kind of a clunky interface, but it had quite a bit of features once you got use to it. A guy at work who actually did an internship doing volumetric rendering of DICOM files, so we talked about that quite a bit. He told me about ImageJ.

The oral surgeon’s office called me back and told me that there might have been a really tiny fracture, but that they’d give me antibiotics anyways. And DON’T CHEW. Trust me, I was more than happy to comply.

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