- Associated Press - Monday, January 10, 2011

TUCSON, ARIZ. (AP) - Doctors said Monday that Arizona Rep. Gabrielle Giffords‘ had given a thumbs up sign and tried to grab her breathing tube _ heartening developments two days after surgery for a gunshot wound to the head.

Dr. Peter Rhee said surgeons had seen many encouraging signs. On Sunday and Monday, Giffords was able to respond to a verbal command by raising two fingers with her left hand.

“When she did that, we were having a party in there,” Rhee said. And even while sedated, she has reached for her breathing tube. “That’s a purposeful movement. That’s a great thing. She’s always grabbing for the tube,” Rhee said.

Also, while her brain remains swollen, the pressure isn’t increasing _ a good sign for the congresswoman’s recovery.


Neurosurgeon Dr. Michael Lemole of Tucson’s University Medical Center said swelling from such an injury typically peaks around the third day, so doctors “can breathe a collective sigh of relief” after reaching that point on Tuesday.

In addition, Rhee said that two specialists from the Washington, D.C., area are being brought in. Col. Geoffrey Ling and Dr. James Ecklund have experience in treating combat wounds.

Recovering from a gunshot wound to the head depends on the bullet’s path, and while doctors are optimistic Giffords‘ odds, it can take weeks to months to tell the damage.

Doctors say the bullet traveled the length of the left side of the Arizona congresswoman’s brain, entering the back of the skull and exiting the front.

Fortunately, it stayed on one side of her brain, not hitting the so-called “eloquent areas” in the brain’s center where such wounds almost always prove fatal.

Importantly, Giffords was responding nonverbally Sunday to simple commands in the emergency room _ things like “squeeze my hand.”

That implies “a very high level of functioning in the brain,” Lemole said.

Now, her biggest threat is brain swelling. Surgeons removed half of her skull to give the tissues room to expand without additional bruising, Lemole said.

That bone is being preserved and can be reimplanted once the swelling abates, a technique the military uses with war injuries, said Rhee, Lemole’s colleague and a trauma surgeon.

Adding to Giffords‘ good prospects is that paramedics got her to the operating room in 38 minutes, her doctors said. Now she is being kept in a medically induced coma, deep sedation that rests her brain. It requires a ventilator, meaning she cannot speak. Doctors periodically lift her sedation to do tests and said she continues to respond well to commands.

The brain’s left side does control speech abilities and the movement and sensation of the body’s right side, Lemole noted. But he wouldn’t speculate on lasting damage, saying, “we’ve seen the full gamut” in such trauma.

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