Ever since she began the long and often painful process of recovering from a gunshot to the head, Rep. Gabrielle Giffords has been focused on one thing — getting well enough to watch her husband, Capt. Mark Kelly, launch into space on Friday.
On April 25, the team overseeing Giffords’ recovery at the Institute for Rehabilitation and Research (TIRR) at Memorial Hermann Hospital in Houston greenlighted her trip to Cape Canaveral to attend the liftoff of the space shuttle Endeavor. On Wednesday, she boarded an airplane headed for Florida, according to The Associated Press. Kelly will pilot the spacecraft on the next-to-last mission of the shuttle program.
“Her attending the launch is a goal that we were working toward, and we have achieved that end. She has made remarkable progress in her rehabilitation, and we saw no reason why she could not travel safely to Florida,” said Dr. Gerard Francisco, the lead physician on Giffords’ brain injury rehabilitation team, in a statement released by TIRR.
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Another one of her physicians, Dr. Dong Kim, chair of the department of neuroscience at University of Texas Health Science Center, added that Giffords, who still has a piece of her skull missing, is medically well enough to make the trip and would likely not need an ambulance transport.
But the thousands of well-wishers hoping to get a glimpse of the injured Congresswoman’s progress on Friday may be disappointed. For privacy reasons, Giffords’ family and friends say they will keep her away from the cameras so that she can watch her husband’s launch without being disturbed.
Based on the few details released by Giffords’ office, experts in rehabilitation medicine say that she appears to be progressing as well as can be expected. Four months after her injury, according to interviews her physicians have given, Giffords is establishing a “new normal,” which includes small triumphs such as learning how to speak again. Today she speaks mostly in single words and short phrases, but she is working toward stringing together longer phrases or even whole sentences. Giffords’ speech therapy involves focusing on singing simple tunes first, which speech therapists say can help reorganize language circuits that have been jumbled by injury; singing provides a rhythm and cadence on which patients like Giffords can train their attention.
The doctor overseeing Giffords’ rehabilitation puts her in the top 5% of patients recuperating from similar injury. Still, recovery from traumatic brain injuries “isn’t measured in days or weeks, but in months and often years. Her recovery is not over, and even though she is able to attend the launch, she has lots of rehab in front of her,” says Dr. Steven Flanagan, chairman of rehabilitation medicine at the Rusk Institute of NYU Langone Medical Center.
The fact that she is speaking, even if not in full sentences yet, is a good sign. Upon hearing that she was cleared to go to Cape Canaveral, Giffords said, “Awesome,” and pumped her fist, Kelly said in an interview with CBS’ Katie Couric.
Patients like Gifford often suffer from depression or personality changes. The Congresswoman appears not to be affected, her doctors have said. She laughs and jokes, plays board games with her husband, and is reported to have forged strong relationships with her caregivers. She is the same outspoken, determined woman she always was. “She shows a lot more independence right now — that’s what’s emerging,” Dr. Francisco told the Arizona Republic recently. “She’s her own person.”
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According to staffers, Giffords has also regained full motion on one side of her body. “Her left side is perfect. She can do whatever you can do,” Pia Carusone, her chief of staff, also told the Republic. To improve motion in her right side — which is affected because she was shot in the left side of the brain — therapists are helping her walk with the aid of parallel bars, and practice balance and coordination by playing bowling and indoor golf games. Physical therapy also involves lifting weights and swimming.
“The faster the paralysis resolves, overall the better function we can expect,” says Flanagan. “In general, if a patient is recovering actively within the first few months after a traumatic brain injury, that’s a good sign.”
But rehabilitation is not an exact science, and it’s not clear whether Giffords will be able to recover completely from her paralysis. There is no cutoff beyond which doctors can say with assurance that a patient’s recovery is complete, says Flanagan. That’s especially true of cognitive abilities, such as speech, language, communication and memory. Restoring mental skills is often the longest, most involved part of rehabilitation, since re-learning problem solving and concentration can frequently take years.
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But setting goals, such as Giffords did to attend her husband’s launch, is a good way to make step-by-step progress in regaining what was lost.
At the Kessler Institute for Rehabilitation in New Jersey, patients undergo the same type of intensive therapy as Giffords. Watch below: