Doctors Hail Rep. Giffords’ Recovery as ‘Medical Miracle’

Friday, 21 Jan 2011 07:40 PM

By David A. Patten

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Well-wishers lined Rep. Gabrielle Giffords’ ambulance route to the airport Friday, cheering, waving American flags, and hoisting signs urging “Get Well Gabby!” as the congresswoman embarked on a long journey of rehabilitation already being hailed as a “medical miracle” and “divine intervention.”

It was just two weeks ago Saturday that a deranged gunman shot Giffords in the head, wounding her so severely that several major mainstream news sources initially reported she had perished. Six people died in the attack that also left 19 wounded.

A bullet penetrated Giffords’ skull and passed through her brain. Doctors report that only 5 percent of patients suffering gunshots to the head survive – and most are unresponsive and mired in deep comas.

In the hours after the shooting rampage, surgeons in Tucson temporarily removed a portion of Giffords’ skull to prevent swelling from causing further damage to her brain.

Once the risk of swelling passed, Giffords was taken off a ventilator that was helping her breathe. Her progress since then has astounded onlookers and delighted her physicians.

“I believe that Congresswoman Gabrielle Giffords’ recovery, so far, is a medical miracle,” declared Marc Siegel, an associate professor of medicine and medical director at NYU Langone Medical Center, in an article posted on FoxNews.com.

“Through it all Congresswoman Giffords continues to respond to commands,” Siegel added. “A striking and optimistic fact in and of itself … divine intervention when viewed in the larger context; a sum of all the great luck and skill she's experienced so far.”

University of Arizona Medical Center doctors accompanied Giffords’ from Tucson to her new rehabilitation facility in Houston, where she will be closer to her husband and two daughters.

The doctors reported the “heart-wrenching” experience of faintly hearing the cheers of encouragement from onlookers as the ambulance, led by a police motorcycle escort, passed the crowd lining their route.

They said Giffords responded to the cheers, “smiling and at times tearing a bit. It was very emotional.”

In a late Friday news conference doctors said the transfer to the TIRR Memorial Hermann rehab hospital in Houston “went flawlessly.” Giffords made the trip aboard a specially outfitted jet that took off from Davis-Monthan Air Force Base.

In addition to the doctors and nurses, she was accompanied by her astronaut-husband, Mark Kelly, and her mother.

Once her flight landed in Houston, the congresswoman was transferred her to a helicopter for a short flight to the hospital, where she was admitted to the ICU.

Giffords will be evaluated in ICU before being admitted to the center’s renowned rehabilitation program. It is credited with helping Buffalo Bill tight end Kevin Everett regain his ability to walk after he sustained a spinal fracture during a game in December 2007.

Sources say Giffords wasn’t the only new arrival at Memorial Hermann on Friday. Also making their presence known were members of the U.S. Capitol police force. They have established special security measures at the 119-bed facility to ensure Giffords’ safety.

Doctors said in the past 24 hours she has scrolled through an iPad, distinguished different-colored objects, and also appeared to move her lips as if she wanted to speak. She is currently unable to do so due to a breathing tube.

According to Dr. Dong Kim, the Hermann physician who greeted her, Giffords “looks spectacular.” He described her at “alert, calm, comfortable,” and say he detected “maybe some movements of her legs.”

Her Tucson physicians reported yesterday that she was able to stand on Thursday with some assistance. The bullet passed through the left side of her brain, which controls speech functions and movement on the right side of the body.

Kim said Giffords showed “very good movement on the left side of her body,” and reacted when doctors signed a bright light in her left eye. Those are all good signs for a patient in her condition, they said.

Kim added she showed “pretty good [muscle] tone in her left leg, which is “often a precursor to a more functional recovery.”

They added they did not see movement in one of her arms, however.

Doctors have been careful to emphasize that 100 percent restoration of functionality is not necessarily Giffords’ goal. Rather, the rehabilitation is designed to help her regain as much of his abilities as possible, and to help her adjust to what doctors are calling “the new normal.”

They have been careful not to predict how far her recovery could progress. Doctors have said they are worried she may not regain full motion in all of her limbs, and may also find it difficult to regain the level of eloquence she had before the shooting.

According to Siegel, a miraculous concatenation of unlikely events came together to save Giffords. Among them:
  • An intern, who had learned first aid in high school, gave her immediate assistance, keeping pressure on the wound to “keep blood (and perhaps parts of her brain)” from escaping, the doctor wrote on FoxNews.com.
  • Only 38 minutes passed between the shooting and Giffords’ arrival at the hospital.
  • The Tucson hospital she went to happened to be a “level one” trauma facility.
  • Its top surgeon, Dr. Peter Rhee, had combat experience as a Navy surgeon in the Iraq war, and had extensive experience treating head wounds. Medical experts use superlatives to describe Dr. Michael Lemole, the neurosurgeon who operated on Giffords. Siegel, for example, calls him “the great neurosurgeon.”
  • The bullet’s path was high up in the brain. It did not cross from one side of the head to the other, and missed “the so-called “eloquent” brain areas that control speech and movement.
  • Giffords’ doctors removed part of her skull to give her injured brain room to expand. But they also “ventilated her rapidly to blow off carbon dioxide,” Siegel wrote. That procedure helps keep the brain from swelling.
  • Doctors say the course of Giffords’ recovery is difficult to predict, and each patient responds differently.
Giffords’ ability to speak remains undetermined. Even after leaving the hospital, she is expected to receive up to five hours a day of various rehabilitation therapies as an outpatient.

Doctors say her ability to comeback from the devastating wound depends on “neuroplasticity” – a fascinating new branch of medical science that studies the brain’s ability to rewire itself and assign new tasks to undamaged areas.
In a Thursday afternoon news conference, Giffords’ husband expressed optimism.

“I’m extremely hopeful that Gabby’s going to make a full recovery,” said Kelly. “I’ve told her that. She recognizes it. She’s a strong person, a fighter. I mean she is a fighter like nobody else that I know.”

Kelly predicted that in a few months, Giffords would walk through the front door of the University Medical Center in Tucson to personally thank the medical workers who saved her life.

"She's scrolling through an iPad,” Dr. Lemole remarked. “These are all fantastic advancements forward. They do indicate higher cognitive function.
“But,” he added, “I do want to caution everyone that she has a long road ahead of her."



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