Doctors: Giffords faces a long, rocky road to recovery
Houston - In the days and weeks ahead, Rep. Gabrielle Giffords recovery "of a gunshot wound to the head will be a marathon, not a sprint, doctors say.
Nearly three weeks after his brain injury, several acute medical problems in question, according to doctors who are not involved in your care.
It can take months - or more - to get her back if it was torn before the bullet in his brain.
An immediate concern is an infection in his brain, said Dr. Greg Zorman, chief of neurosurgery at Memorial Healthcare System in South Florida.
The second concern is the construction of fluid in the brain. Gifford had hydrocephalus after she was shot, a condition where an excess of cerebrospinal fluid puts pressure on the brain.
Arizona surgeons implanted a drain to remove the fluid, and on Monday, Dr. Dong Kim, a neurosurgeon Giffords in Houston, the flight took off, saying he no longer needed.
Zorman said doctors will be closely monitored to ensure that excess fluid does not return Giffords.
Giffords Wednesday left the intensive care unit at the Institute for Rehabilitation and Research (TIRR) at Memorial Hermann in Houston, where he will undergo physical therapy, occupational therapy and speech therapy to try to get your brain where a once was.
"It 's just a few weeks since it happened and was tolerated aggressive treatment program," Dr. Gerard Francisco, the chief medical Tirri Memorial Hermann told CNN American Morning. "
This program started as soon as Gifford arrived in Houston after being moved from Tucson, Arizona University Medical Center, he said, and has been upgraded.
The team of neurosurgeons Giffords' describe the situation of fluid from the brain as "stable," said Francisco, "but we will control that. "
"Recovery is fast neural and wait situation," said Zorman. "A recovery for the injury only takes time."
One of the first things that doctors want to do is try to get Gifford return to a normal schedule, said Dr. Alan Novick, medical director of rehabilitation for Memorial Healthcare System. "In the ICU, patients are the days and nights mixed up."
Giffords rehabilitation doctors give a series of tests to assess their physical and cognitive abilities, "he said.
For example, they ask him to draw a clock.
"It sounds simple, but sometimes they put the wrong numbers, or put all the numbers on the right," he said. "That 's what he shows us a part of the brain problems."
Another area doctors will examine is called the "executive power", or the ability to incorporate many ideas at the same time.
"In our daily lives, there are fragments of the news coming all at once, and we can integrate several things happening at the same time," said Dr. Ross Zafonte, chairman of the Department of Physical Medicine and Rehabilitation, Faculty of Medicine Harvard.
"Obviously, it was very good at it, and I hope it will again," he said.
With brain damage can operate according to the area of the brain has been damaged, "said Francisco. Doctors see Gifford function "closely and change the therapy program" to address individual impairments or losses, "he said.
But Francis said he remains surprised by the speed of recovery Giffords. "When I see her every day, something new," he said. It was a challenge to his medical team, but provides them with opportunities to challenge her too, "he said.
Trying to become the person that was once possible to be very trying, the doctors said.
"Emotionally, this type of recovery can be very difficult," Zafonte said. "Rates of depression in this situation are more than 50%."
Some brain injuries not only affect the emotional state of the patient, but their basic personality.
"They may have different behaviors," said Novick. "The spouses and family members must cope with a person who was not necessarily the same person they knew before the injury."
All this requires the patience of patients and their families.
"People like (Giffords) often have a difficult road," Zafonte said. "But often in places that surprise us, and surprise."