Physicians at University Medical Center may try to remove Rep. Gabrielle Giffords’ breathing tube on Saturday, the next major hurdle in her recovery, Dr. Peter Rhee said Friday morning in Tucson.
Doing so will finally allow them to assess how well she is able to talk after being shot in the head last Saturday morning in the mass shooting outside a Safeway.
Her recovery continues to amaze the doctors who have been treating her.
“We couldn’t have hoped for any better improvement than we are seeing now given the severity of her injury,” said Dr. Michael Lemole, a neurosurgeon who has been a key member of the team treating her.
During the week, Giffords has passed a number of milestones, including moving her hands and arms, opening her eyes, responding to commands, sitting up in bed and lifting her legs. The medical team stopped placing her in the medically induced coma on Thursday and planned to have her start sitting in a chair for brief periods on Friday.
“At every point in the reported evolution of this, what we’ve heard has been on the favorable side,” said Dr. Neil Martin, chair of neurosurgery at UCLA’s Reagan Medical Center. “Two good things happened. She had great, very rapid medical care. And she was fortunate that the bullet did not take a pathway that was more damaging.”
Giffords has also been breathing on her own, but the team left the breathing tube in to prevent the buildup of fluids in her lungs that could lead to pneumonia. If doctors remove the tube, she can be released from the intensive care unit to a normal hospital ward and her condition will be downgraded from critical to serious and the focus will shift to the rehabilitation process.
In the very best of circumstances, if she can stand up, maintain her balance and has minimal speech deficits, she could probably go home in a few days and have outpatient physical and speech therapy.
More likely, however, if she is having some difficulties, has some risk of falls, substantial impairment of the use of her arms and hands, and problems with her speech, she would go to an acute rehabilitation facility for at least a couple of weeks and perhaps longer.
There, she would be seen by a physical therapist, an occupational therapist (who would work with her on swallowing and coordination of her hands) and a speech therapist.
“Recovery after a brain injury hits several levels,” Martin said. “The first hurdle is survival. It looks like that is going to happen. The next level is reasonable neurological function, walking and talking. The odds of that are also very good.
“Next is reasonable function, at least to an observer. But real recovery also requires that a patient’s co-workers and family thinks the patient is functioning well. That’s a higher bar. Even in that circumstance, the patient often knows there are things they can’t do. The final threshold is when the patient thinks they’ve made a good recovery. That takes a number of months or a couple of years to figure out.”