An Un-Expected Medical Experience in Georgia!
By: Catherine Lawrence, G14 -- Peace Corps Volunteer/Georgia (1/29/15)
Until recently, I had no idea how many ribs I had. Seriously, I've never paid attention to parts of the body I cannot see. As long as everything was working; well, no need to think about stuff like that. This all changed when I was recently told, by my doctor here in Georgia, that I had a linear fracture of my 9th rib on the right hand side.[Tbilisi]
Here is some background information on ribs!
The ribcage consists of 24 curved ribs arranged in 12 pairs. Each pair is attached to a vertebra in the spine. At the front of the body, the first seven pairs of ribs are attached directly to the sternum (breastbone) by cartilage known as costal cartilage. These ribs are often called 'true ribs'.
The next three pairs of ribs aren't connected to the sternum. Instead, costal cartilage attaches these 'false ribs' to the last pair of true ribs. The remaining two pairs aren't attached at the front of the body at all and are known as 'floating ribs'.
So, I bet you are wondering "How did something like that happen?" and then the follow-up question "How am I dealing with this medical experience while I am here in Georgia?" During my time here in Georgia I have been concerned about falling and breaking something familiar, like an arm, hand or leg; but, a rib never crossed my mind. I've often written in my blog that Georgia is like a "mine field" to me as there as many areas where I walk that don't have paved sidewalks (there are lots of rocks and potholes to trip on). Also, many of the homes have at the entrance to their rooms a lip at the bottom of the door frame that you need to step over to gain entrance. I have to ever be mindful of where I am walking. So with all my worry about getting hurt in Georgia; it is ironic that I ended up getting hurt in Turkey.
To begin my story - the good news is that the area of my fractured rib didn't impact anything of vital importance. As I found out that my rib injury was in the "false ribs" section; but even still, this was something that I needed to deal with as I was in some pain.
So, how did it happen?
In a nutshell, during my adventure in Istanbul I wanted to take some pictures outside of the hotel I was staying in. I was so excited to be (unexpectedly) in Istanbul and wanted to document my being in Turkey for the first time. I was walking across the entrance in the front of the hotel and thought that the area I was walking on was a solid platform; however, as I found out it was not solid. There was an incline of sorts (or a step) that I didn't see as the entire area was the same color marble. There was nothing marking the step (not that it would have mattered.) I was not paying attention to where I was walking; I was thinking about taking pictures. As I placed my foot, on what I thought was solid ground, I felt my foot grab air and found myself falling forward. In a blink of an eye I realized what was happening and tried to break my fall by grabbing onto a near-by handle. In so doing, I twisted my body around to grab hold and did manage to catch the handle. I landed on my derriere but I was twisted around and that is when I believe I hurt my rib. Acrobatics come to mind with my actions!
Of course, everyone from the hotel came running out to see if they could help me. I did get up (un-assisted), brushed myself off and thought nothing more of it. I just felt really dumb. I went on my way to the airport for my flight home. While on the plane (many hours later) I started to realize that my mid-section was hurting when I coughed. I started to think that maybe I pulled a muscle doing my acrobatic act while falling; and again, dismissed it. As the days went on and I realized that the pain was not going away and that it even hurt when I was laughing and getting up and down from the bed or a chair. After five days, I called my Peace Corps doctor and told her what was going on. She immediately said to come into the office the next day and that she would schedule some x-rays. I really thought this was over-kill; but, better to be safe than sorry (my motto). Also, in the Peace Corps the "doctor" is the law.
The next day I saw the doctor in the office. After an extensive conversation and examination in the Peace Corps Office, she connected me with another Peace Corps Physician (on staff) and away we went to the private clinic to have x-rays and a consultation with an Orthopedic Specialist (this was all arranged prior to my coming to the private clinic by the Peace Corps Doctors). Being in the clinic here in Georgia was very much like being in the clinic in America. There are lots of people waiting to be registered and then waiting for whatever medical service they were there for. The difference is that everyone spoke Georgian, and I really don't have the language skills; but, my Peace Corps Physician (and guide) navigated me through the hoops that one must go through to gain service. I was totally in her hands and felt so taken care of.
Our turn came and I went in for x-rays. They took lots of x-rays from many different vantage points. When the results were presented that I did in fact have a linear fracture of the 9th rib, my jaw dropped. I had many questions, but everyone was speaking in Georgian (heavens, why don't I understand more Georgian). At that point we went then to the Orthopedist Specialist (office was next door) to have the official reading of the x-rays (and consultation with my doctors) and for my data to be officially placed in the clinic record system (of course we were carrying the x-rays with us) -- just like in America! The specialist spoke in Georgian and my Peace Corps doctor was translating into English what I should do in order to advance the healing process.
First, I should sleep on an incline (or sitting up). Well, I had already figured that out because laying flat on my back hurt too much. I also should put my hands on my hips and breathe deeply. Another suggestion was to breathe into a balloon or into a rubber glove to strengthen the rib healing process. The final piece of advice was to sing. Sing, I said -- really? Ok, I will sing if you all sign a voucher for me to recover in the Bahamas! Well, they all laughed; however, laughing still hurt too much -- so, I thought I would just stick with the rubber glove therapy. Of course, there was additional help given by means of medication to help me with the pain!
All-in-all, what could have been a really difficult experience; that is, navigating the medical system here in Georgia, was made as effortless as possible with the support of the Peace Corps. I was not surprised that it was a professional experience from start to finish, both by what is established medically here in Georgia and with the Peace Corps. I can now laugh without pain and my rubber glove and I cannot be separated. I continue to recover and have every reason to believe that my rib will heal nicely. My fears of what happens if I need medical help here in Georgia (other than a head cold, etc.) have dissipated - I know that I am in good hands!