'No change is good,' docs say: Giffords critical but stable

For an update on Giffords' condition Thursday, and a report on her opening her eyes spontaneously for the first time following the shooting, see Giffords opens eye for first time after Obama visit.

Rep. Gabrielle Giffords remains in critical condition after she was shot in the head while meeting with constituents Saturday.

Seven others remain hospitalized at University Medical Center in Tucson, doctors said Monday morning.

Six were killed and 13 others were shot, authorities said.

Giffords brain remains swollen, but the pressure isn't increasing, doctors said.

Her condition is stable, neurosurgeon Dr. G. Michael Lemole Jr. said.

"No change is good, and there is no change," said Lemole.

"That's why we are much more optimistic and we can breathe a collective sigh of relief after about the third day," he said.

Giffords' family is with her constantly, said Dr. Peter Rhee, medical director of UMC's trauma center. Her husband, Navy Capt. Mark Kelly, is at her side, he said.

It's hard to observe if Giffords can recognize anyone, Lemole said. She is on a ventilator, which covers much of her face.

Giffords is following basic commands. Lemole said such commands can include moving fingers and wiggling toes, but wouldn't discuss specifics about what commands the congresswoman is following.

"Not only are those centers of the brain working but they're communicating with one another," another promising sign, Lemole said.

Recovery after a gunshot wound to the head can take weeks or months, doctors said.

"As far as a functional assessment, we're not in a position to do that at this time," Lemole said.

The bullet that hit Giffords traveled the length of the left side of her brain. It entered the back of her skull and exited above her left eye, doctors said.

Sunday, Lemole described the wound as "very devastating."

"The higher the trajectory, the better the hope of recovery," Lemole said at Monday's briefing. He explained that wounds close to the base of the brain can affect basic body functions.

Swelling of the brain is the most serious threat now that her condition is stable. Surgeons removed the left half of her skull to allow her brain to expand without bruising, Lemole said.

The bone removed can be implanted once the swelling subsides.

"We not going to speculate" about her recovery, Lemole said. "I've seen the full range of possibilities."

Giffords was able to respond to simple commands when she came to the emergency room shortly after 10:30 a.m. Saturday but couldn't speak and remains unable to. 

"She did not say any words," said Rhee.

When paramedics brought Giffords to the medical center barely half an hour after the shooting, she was whisked to surgery where doctors removed portion of skull covering the left side of her brain to relieve pressure from swelling. The bone was preserved and can be replaced after the threat of swelling passes, Rhee said Sunday.

The surgery included removal of some "devitalized brain," Lemole told reporters Sunday.

"Fortunately we didn't have to do a lot of that," he said.

The bullet passed through the entire length of her brain but missed some critical areas that would have made recovery much more difficult.

The projectile did not cross the central dividing line between her brain's hemispheres, which would have been a much worse injury. Recovery from injuries such as this are often measured in years, Lemole said.

Giffords is in a drug-induced coma in intensive care. Doctors frequently awaken her to check her responsiveness, and she could open her eyes and respond to simple commands Sunday - an encouraging sign, said Rhee said at Monday's briefing.

Giffords cannot speak because she is on a ventilator, and cannot see because of the area of her injury and the surgery requires her eyes be kept closed, the doctors said Monday.

Other patients

Of the 7 other patients who remain in the hospital, 5 are in serious condition, and 2 are in good condition, said Rhee. One remains in intensive care.

The other patients have had operations on their abdomens, surgery for vascular issues, and extremity issues, Rhee said.

Six surgeries were performed on victims, Rhee said. "It was a combat, trauma type of scenario," he said Sunday.

"Many of them will have further surgeries," said Rhee at Monday's press conference.

Some have severe injuries to the torso, he said. Doctors wouldn't give much information on the other patients, citing confidentiality laws.

A memorial to the shooting victims outside UMC and contributions from the community "speak to the way (Tucson) is coming together and trying to heal," said Lemole.

The incident and it's aftermath aren't burdening UMC financially, said Dr. Rainer Gruessner, head of the surgery department. He said he couldn't provide a cost estimate for treating the victims.

"We're seeing the best of what our community can offer," he said, citing donations of food and work done by volunteers.

The doctors plan to hold another press conference Wednesday morning.

Loughner charged

Mountain View High School graduate and former Pima Community College student Jared Lee Loughner, 22, was charged Monday in the rampage that killed six people and left Giffords and 13 others wounded.

Loughner faces five federal charges, with additional federal and state charges likely.