Hydrate or you might *want* to die

Hydrate or die has been an ad slogan of Camelbak for some time now. However, I might suggest that the slogan hydrate or you will wish you *could* die might be more appropriate. Why is this you might ask? To which I would immediately answer “extreme pain”. In this case, the cause of the exquisite pain a couple of months ago at the end of 2006 was a kidney stone, likely a vestige of my trip to Argentina. It was of course my fault as I deliberately made sure to dehydrate myself so as to not have to get up and down on the aircraft for 12-18 hours of traveling to the foot of the Andes. On top of that, there was surprisingly low humidity there and my diet was one of meat, cheese and local wild mushrooms with more alcohol consumed than usual for almost two weeks straight. On top of that, exercise was limited to short hikes and not enough running or any biking and again, little to no hydration on top of the small amount of liquid I was consuming with meals, i.e. most excellent Malbec wine.

I have to say that over the years, although I have broken bones, broken my nose, torn ligaments, opened wounds large and small through a variety of activities, this was the absolute, most stunningly painful experience of my life. Never before have I been incapacitated by pain, but this almost brought me to my knees. When the pain started, H and I were standing in the post office mailing packages and letters prior to Christmas and I suddenly had to grab the counter. H looked at me in surprise and asked if I was OK. I simply responded “Ow…..”, to which she became even more alarmed as she had never seen me like this. Relating that I was in great pain, we decided to leave for home. I thought I could drive home, which was silly in retrospect as we had to pull over just a couple of blocks away and I climbed into the back seat in an agonizing attempt to find a position that mitigated the pain. After having completed the first two years of medical school before finishing my PhD curriculum, I thought I knew what was happening to me and just wanted to get home as there really is nothing one can do for a kidney stone initially. Granted, it could have been a number of things, but going to an ER would have done nothing for me as they would have had to schedule a CT or MRI anyway and this was obviously not emergent, despite the incredible pain. So, I just about crawled back into the house and made an appointment with the doc to have it looked at and while this was not an emergency per se, it did hurt bad enough to make me want to get a scan locally rather than drive the 300 or so miles away to my parents business where I could have used one of the most advanced MRIs in the state. Nevertheless, whether my faculty status had anything to do with it or not, I was able to schedule a CT scan tout de suite locally here in SLC at the Utah Center for Advanced Imaging Research which indeed confirmed the presence of a kidney stone. I’ll spare you the details of kidney stones as you can look them up in a variety of places including Wikipedia in the link at the top of this entry, but I will use the topic of kidney stones as a segue to discussing some of the coolest software out there in any space, much less freeware.

The destination of this segue and interesting aspect of this experience, aside from learning about a new personal apogee in pain, was not only the availability of my data, but the existence of a freeware software suite designed to allow me to explore the data from my CT scan and render it in a number of forms and weightings. After getting the scan, I asked for my data and was pleasantly surprised when the University of Utah Radiology Department said “sure, CD O.K.?”. They burned a CD for me on the spot and eagerly took it home, remembering my meeting with Joël Spaltenstein, one of the programmers involved in the creation of this application suite, OsiriX. OsiriX is an open source PACS workstation DICOM viewer designed to explore radiology data (you will need a Macintosh to run it). In addition to providing tools to explore DICOM data, OsiriX can generate beautiful animations and images, other examples of which can be seen here, here and here. It is an impressive piece of software, and I would encourage anyone who has access to their/others data (no, you can’t have mine so don’t ask) to spend some time with this code to not only get to know yourself or family members a bit better and certainly more intimately (which brings to mind the lyrics of The Vapors “love song”, Turning Japanese “I want a doctor to take your picture, so I can look at you from inside as well”). Seriously though, this is not only a tool for the researcher, or clinician, but OsiriX is also a tool that can be used for education or simply to take charge of your own healthcare.

Oh, yeah….. The moral of this story is as the title of this entry says. Hydrate or you might very well want to die.

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