Although Rep. Gabrielle Giffords (D-Ariz.) was shot in the brain only two weeks ago, her recovery to date "has been nothing short of miraculous," says ABC News' Bradley Blackburn. The next stage in her healing starts today, when she moves from Tucson's University Medical Center to a rehabilitation center in Houston. Already, she's standing (with help), communicating, and scrolling through an iPad, all of which is "quite inspiring," says Giffords' husband, astronaut Mark Kelly. (Watch an ITN News report about Giffords' recovery.) But she can't speak — and may never regain that ability. Here's a look at how far the congresswoman has come, and a preview of the difficult road ahead:
What can Giffords do thus far?
After being removed from a ventilator last Saturday, Giffords is breathing on her own. On Wednesday, she stood, with the help of aides, and even took a few steps. She can see at least shapes and colors, move both hands, and scroll through an iPad, her doctors said Thursday. Her husband and doctors also wheeled her outside that day for the first time since the shooting, to the hospital's roof, "to see the mountains" and sunshine in an attempt to lift her spirits, said hospital spokeswoman Jo Marie Gellerman.
What can't she do?
Talk and swallow, due to a tracheotomy tube inserted in her throat to prevent a build up of saliva in her lungs and avoid infection. Kelly says his wife moved her lips Thursday, in an apparent effort to talk, but it remains unclear how much verbal ability, if any, Giffords can recover. Since the capacity for speech is usually rooted in the left side of the brain, through which the bullet passed, "she may not be able to speak at all, she may make nonsensical words, or she may be able to use words, but not fully or completely," says Mark Ashley, chairman emeritus of the Brain Injury Association.
Does Giffords recognize friends and family?
Her husband Kelly says she does. "She'll smile at me and will do things she'll only do around me, like pat me on the face," he says, or play with his wedding ring while holding his hand, like she did before the shooting. "I can just look in her eyes and tell. She is very aware of the situation."
Assuming she is healthy enough for the trip, Giffords will be flown to Houston Friday for intensive rehab at TIRR Memorial Hermann hospital, part of the Texas Medical Center. Kelly says his family picked TIRR Memorial Hermann for its world-class reputation and proximity to Tucson. Giffords will be close to where he is training for the final space shuttle flight in April. The choice of the Houston facility "will let me be there by her side as much as possible every single day," he says. After four to eight weeks there, Giffords will move to an outpatient facility for months, or even a year or two.
What will rehab entail?
The goal is to transition Giffords "from a heroic, high-tech fight to save her life to a long and arduous slog to help her brain rebuild itself," says David Brown in The Washington Post. Doctors will use MRI machines to better appraise the damage, then therapists will aggressively focus on helping Giffords speak, walk, and regain use of her limbs. That will involve training other parts of her brain to take over for the damaged neurons. Later Giffords will work on being able to take care of herself and perform the "activities of daily living."
What's her prognosis?
Given her ability to communicate and move, her chances of recovery are quite good, says Dr. Kester Nedd at the University of Miami medical school. "Motor function is a very strong predictor of outcome." There is reason to be "very optimistic because her recovery here was so quick," agrees Dr. Michael Lemole, Giffords' neurosurgeon at the Tucson hospital, but it's also "not uncommon for people to initially improve, then plateau." Doctors' best guesses are all we'll get for a while, says Mark Ashley. And "the closer we are to the date of the injury, the less reliable our predictions will be."
Sources: Wall Street Journal, ABC News, HealthDay/U.S. News, LA Times, USA Today, Washington Post, Reuters