Hope for Getting Back: Our Friend’s Falling Accident

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Back on November 6th, 2023, our friend Irakli had a very unfortunate accident on one of his work trips to Kakheti region of Georgia. He fell from the second story balcony and fell on concrete pavement. As a result, he sustained multiple lacerations, broken ankle and wrist, punctured left lung (pneumothorax), but the most serious were his head injuries. His skull was fractured in four places, which lead to development of two intracranial (inside the head) hemorrhages - epidural and subdural. These caused significant ischemic (caused by a lack of oxygen) injuries to some of his brain areas, notably the right cerebellum and also caused significant brain swelling. This happened around 11:00pm and what's especially bad is that he was in a rather desolate area at the time. He was found some 30 minutes after the injury, ambulance arrived in an hour and took an hour to get to the regional hospital. He was taken to Telavi Referral Hospital (an hour away in the same region) and was operated on by the on-call neurosurgeon some 3 hours after the incident.


The surgery (craniotomy with dual hemorrhage evacuation) was a success and without it he wouldn't be with us, but the time period without medical assistance nevertheless made his prognosis and recovery worse. He was intubated (breathing tube) and placed in intensive care and remained comatose for a significant amount of time, approximately a month. During this time he did not elicit significant reflexes and his Glasgow coma score (international coma assessment guideline) was significantly low 4-6/15 (8/15 is enough to take the person off mechanical ventilation and 3/15 for a significant time is classified as clinical brain death).

During his time he was also "hemodynamically unstable" (his heart could not pump blood at enough pressure, it was critically low) even with necessary medications, therefore initially they could not move him freely to do CT scans to check progress. Significant brain inflammation set in shortly after the surgery, which put him in a coma, and there was no recovery prognosis as the inflammation was seemingly immune to bombardment with corticosteroids and hypertonic saline to “quiet it” and “suck it out”. At some point there was a concern that Irakli had developed sepsis and was in shock, but thankfully the marker (CRP) came back negative and it was ruled out. In 3 weeks his condition improved a little and they were able to do the scans and minor necessary manipulations, but Irakli's overall health remained in a disastrous shape - he still required maximal infusion of medications to keep his brain perfused with blood, again due to very low pressures and they could not transport him to Tbilisi (the capital of Georgia) to a better clinic. Irakli's family would have no problem with him staying in Telavi for treatment, but the clinic and staff there, as heroic and always attentive as they were, were very limited due to being underfunded. The regional clinic simply lacked basic facilities, tech and conditions to support a person as badly injured as our friend was.

Fast forward to mid-December, we could finally transport my friend to Tbilisi, his pressures had remained low, but good enough according to physicians to take the risk and put him in the ambulance car. I met the team at the clinic in Tbilisi and helped the ambulance team take him up to the 6th floor, to the neuro-rehabilitation wards, he looked terrible, honestly. Still with a tracheotomy tube in his throat, multiple tubes for feeding/drinking and gastric cleansing, indwelling urinary catheter, and skin over the head pushed down as there was a piece of bone missing underneath it from the surgery a month ago. Nevertheless, we thought we were in the clear finally, seeing as we had arrived at a better funded, private, modern clinic, but that’s where we were wrong. In short, to this day there has been little to help from the staff, which are overworked, underpaid and inattentive to a patient that’s not on the brink of death anymore. Irakli’s condition, despite having gained back consciousness and restored normal blood pressure, remains very poor. He has control over his limbs but he cannot move them due to ossified joints (“contractures”) from lying flat for almost 3 months now and he cannot see from his right eye. Especially bad is how the hospital cannot address his breathing issue without use of a tracheotomy tube, which has caused two bouts of hospital-acquired pneumonia and possibly cystitis (possibly of Klebsiella Pneumoniae etiology). Currently he cannot talk either, because of the said tracheotomy tube. Physical therapy is also very poor, with barely 15-20 minutes of assisted workouts per day. In short there is very little progress, if any by the merit of the medical staff, especially considering the timeframe.

Talking to the leading neurologists in the country, Irakli’s family was advised to move him to Germany, where he can undergo holistic treatment: full neurologic and physical rehabilitation. They said Georgian hospitals are just too incompetent and ill-equipped to deal with such difficult issues, and that staying here, while likely will not kill him, will not heal him either. In short, they said “do not expect things to get better here”. If anything, things might get worse, as remaining tied to the hospital bed does pose significant risk of further complications (such as hospital-acquired illnesses) and losing mobility (not due to neurologic impairment, but due to muscular atrophy and joint ossification). These leading neurologists, who are not his attending doctors told Irakli’s family that there are specialized centers in Germany which could deal with these issues and put him “back on his feet” in 2-3 months’ time. This treatment is associated with significant costs though – approximately 90,000 Euro for the full treatment, seeing as how it costs anywhere from 800 to 1000 euro per day and that Georgians are not EU citizens and therefore not entitled to socialized healthcare in EU. So far, us friends have chipped in and collected some 7 thousand euros to alleviate the burden of our friend’s healthcare costs on the family, which, in full honesty is not affluent. His initial treatment costs were covered by the Georgian governmental health insurance under “emergency procedures”, but his rehabilitation at this private clinic has cost 18,643 GEL (equivalent to 6,500 Euro), so the money we collected is almost fully spent.

I humbly beg anybody who is willing to spare some money to donate. Irakli has the potential to get back to his normal self, this is something that the doctors are sure of, his neurological state is promising and this is precisely the reason why they recommended his family to take him to Germany. It’s just that Georgia simply lacks the medical know-how and the facilities to bring our friend back to his former self, otherwise we would all prefer for him to stay with us and to be with him in his recovery journey. I believe that there is no reason for anybody to remain at their lowest, physically, mentally, spiritually, socially, economically, or otherwise, especially when they have the potential to gain their life back. Therefore, I beg you to help Irakli out. No amount is too little, be it 1 euro or 50, every little thing helps and every little thing is appreciated. Please help us get our buddy back.

With respect and gratitude
- Yours truly, Irakli’s family and friends

Organizer

  • Teimuraz Grigalashvili

Donors

  • Maia Aleksishvili
  • Donated on Feb 25, 2024
€10.00
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2 donors
  • Maia Aleksishvili
  • Donated on Feb 25, 2024
€10.00
€1.00

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