Outside the Beltway

The news about Congresswoman movement to a rehabilitation center is great news. Considering that she was shot in the head just two weeks ago, the fact that she is able to leave the hospital is near miraculous.

I have heard reports of her using an iPad to pick out colors, responding to commands, and even standing and walking by herself (exact;y how unaided in unclear). However, the one thing that is always glaringly absent (to me, anyway) is any mention in stories about her recovery of her speaking (or, for that matter initiating communication in any way).

Has anyone heard any reports of her speaking?

While I am not trying to throw a wet blanket on the good news concerning her recovery to date, I also wondering as to her exact state, so I am wondering if there is further information that I have missed. However, I fear that all the lack of talk about talking may indicate that she is still a long way from full recovery (even though I have heard references to that possibility).

Congress, US Politics

14 responses to “A Question About Giffords”

Maggie

January 22, 2011 at 3:05 pm

Re: “Giffords speaking”

Unless I am mistaken, I believe I heard the doctors at the first hospital had removed the tube down her throat several days ago for a direct tracheal intubation into her neck??? This obstructs the ability for air to pass the larynx and speech to happen … I did hear if she tries to speak it is no more than a soft whisper.

Perhaps someone has heard a more recent medical report on her than last I heard?
Steven L. Taylor

January 22, 2011 at 3:08 pm

Maggie,

Good point about the tube and such.

I had not every heard anything about whispers or attempts to speak.
Maggie

January 22, 2011 at 3:17 pm

Steven –

The head trauma is dangerous mostly in the fact that an infection in the brain tissue could result in increased swelling of the brain. The intubation, while slightly and seemingly more invasive than the tube down the throat, also frees her up to move from her bed better and participate in physical therapy, while insuring an open air passage should her condition worsen suddenly. It’s sorta kinda like a picc line or catheter already in place. I don’t know that she would currently be hooked-up to O2 (doesn’t sound like it) but it’s in place if suddenly needed. Sometimes “tubing” someone down the throat in an emergency situation might be near impossible.
Steven L. Taylor

January 22, 2011 at 3:20 pm

All of which makes sense. Mostly, I am trying to reconcile reports that make it sounds as if she will make a full recovery square with the fact that a lot of what has been reported sounds like a person who, while doing marvelously given the situation, may still end up not fully recovering,
Neil Hudelson

January 22, 2011 at 3:35 pm

Steven,

I can’t find the article anymore, but earlier today I read that she was able to form shapes with her mouth. If that’s true, I think it indicates that perhaps speech is a possibility in the future.

Does anyone have information on how recovery in these types of injuries occurs? I think speech may be complicated enough physically that it may take more time to rehab than walking or hand eye coordination.
Maggie

January 22, 2011 at 3:42 pm

Steven –

My daughter is an RN. She spent a couple years in a hospital neuro-surgical ICU. The ‘oral intubation’ is generally used when a patient is unconscious (which they at first had her in a drug-induced medical coma). When they weaned Giffords off the medication so that she could regain alertness and mobility they replaced the oral tube with the neck fixture. This also might mean they still want to hook her up to O2 periodically during the day if they think she’s not drawing in enough while breathing on her own (blood gasses, etc.)

That said, but both manners of intubation, if used over a long period, might/could result in affecting her speech ability in the future. A speech pathologist would then work with her on trying to resolve that issue in the future, should it be one for the lady.

From what I have heard in the hospital reports and the family pressers/remarks on her interactions, actions and reactions to them, Rep. Giffords’ cognitive abilities seem very good.

She has a major task ahead of her, to be sure, but it all sounds very promising for as full of a recovery as hoped for, and then some.

The frontal and temporal lobes of the brain are involved in speech. The wound being a “through and through” is good in that the bullet didn’t (hopefully) leave behind fragments to continue tissue damage, although I am to understand there was follow-up surgery to remove skull debris that was there.

It’s complicated, and it all depends on the individual, as always. She’s young, healthy and strong. Good starting point, I think.
Maggie

January 22, 2011 at 5:48 pm

Just a footnote here:

I, in no way, have any inside information on Rep. Giffords’ condition or current medical protocol or prognosis outside what I have gleaned from the news reports.

I was just tossing in my pedestrian knowledge of what ‘might’ be the answer to the query and concern posed about her possibly not speaking.

Not a doc, just play one on the blogs. My daughters are the RN and future doc. A little ‘osmosis’ in-play here.

Yes, holiday dinners around our table are usually interesting … and graphic.
Janis Gore

January 22, 2011 at 5:50 pm

I see this article:
http://www.chron.com/disp/story.mpl/metropolitan/7392480.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+houstonchronicle%2Fmetro+%28chron.com+-+Houston+%26+Texas%29

Another:
http://www.chron.com/disp/story.mpl/ap/top/all/7393026.html

The Houston Chronicle is the logical go-to source for a while. There are some other articles there on topic.
sam

January 22, 2011 at 11:43 pm

Another layman here who has been doing a lot of research on the topic as well as following all the news and reports.

Informative video
http://www.cbsnews.com/video/watch/?id=7273151n

BTW the doctors in Arizona had said that they had moved ahead on tracheostomy faster than usual in order – to enable moving faster to the rehab phase. Also she still has a portion of her skull out. I researched this and found that typically tracheostomy is done about 10 days into one being on the mechanical breathing apparatus. I am glad she is breathing on her own now and the tracheostomy is only a precautionary measure.

Today she is reportedly mouthing words.

Daniel who had first put pressure on her wound at the site of the tragedy had indicated that she was making grunting noises.

Between the above two factors, in combination with the fact that brain has plasticity and rewires and relearns — I am finding the situation promising.

To me what is worrisome now is the drainage from her brain. Thankfully the cap enables them to do the needful. Once that heals, she is in a safer place, I feel.

Again, another layman doing a lot of research and following Gabby’s status and wishing her the very best as I am sure all of us here are.

Keep praying. And, always keep it civil. From all I have read, Rep.Gabby Giffords would expect that of us.
Suzan

January 23, 2011 at 1:15 pm

I’m also concerned about the reports of fluid buildup and wonder if the plane flight might have contributed. Apparently the medical staff decided not to report that immediately, which also concerns me.

BTW, I moderate a large political forum and we’ve been tracking her progress in this thread:

http://www.commongroundpolitics.net/discussion/showthread.php?t=61282
Lgbpop

January 27, 2011 at 8:55 am

She is one of the first beneficiaries of Obamacare, right? As a dutiful Democrat I’m sure she wouldn’t feel right about getting all kinds of special treatment just because she’s a Congressman. I’m also sure those evil private insurance companies wouldn’t be paying for any of this incredible medical care she’s been getting. This must be Obamacare in action!
Steven L. Taylor

January 27, 2011 at 9:10 am

@Lgbpop:

You demonstrate that you really do not understand what the PPACA (aka, “Obamacare”) is and how it works.
Lgbpop

January 27, 2011 at 9:26 am

The above remark was tongue-in-cheek. Give me a break, and get a sense of humor. All I did was toss Democrat rationalizing out into the public for its share of deserved ridicule. I hardly expected any intelligent person to take it seriously.
Maggie

January 27, 2011 at 11:18 am

@Lgbpop

I got your ‘tongue-in-cheek’ tone. Fact is, democrats always … always, cite how ObamaCare would have ‘prevented’ a situation, even the mental case of Giffords’ attempted assassin mass murderer Jared Laughner. And in remarking the other day on the GOP’s planned budget cuts Rep. Debbie Wasserman-Schultz implied people were going to die from cancer (or something) should the GOP successfully manage to get these budget cuts accomplished. I constantly hear this irresponsible and sophomoric rhetoric … from the mild off the cuff to the extreme (see: Alan Grayson “Die quickly!”) IF the government wonks really did want to do something to make certain everyone had proper healthcare it would not have been passing over 2000 pages of primarily nothing to do with actual patient healthcare.

With all the talk about toning down the rhetoric since the AZ. shootings I have yet to see/hear such from the democrats and their voices in the MSM. I am not throwing in my 2 cents on ObamaCare (I’m not in the mood to ‘go there’ in yet another lousy snow storm brought on by global warming), you got a penny’s worth above in the end of the first paragraph, but ObamaCare, for the left/liberals, is yet another chapter in triangulation by abstractly blaming one thing on the presence or lack of something basically unrelated. And when someone contrary to the other side does a ‘tongue-in-cheek’ to stealthly display this inane practice people take exception. Can we spread the outrage around in this era of social(izing) justice to the democrats practicing medicine without benefit of schooling or license … or even evidence?