Giffords 'recovering very nicely' after skull surgery

U.S. Rep. Gabrielle Giffords is recovering well after having a skull implant and shunt placed in her brain Wednesday, her doctors said.

A plastic implant was placed over the left side of her skull, where surgeons removed a section of bone to relieve swelling after the congresswoman was shot Jan. 8.

Giffords will no longer have to wear a protective helmet, doctors said.

"She hates the helmet, she tells us about it every day," said her chief of staff, Pia Carusone.

"She's very excited" about the surgery, Carusone said. Giffords has "been looking forward to this for a while."

Doctors don't know when Giffords can be released from the hospital, or when she might be able to return to Congress, they said.

"Yesterday was an important step in Gabby's recovery," said Dr. Dong Kim, a neurosurgeon at TIRR Memorial Hermann hospital in Houston, where Giffords has been undergoing rehabilitation.

Doctors checked the results of the surgery on a CT scan and "everything looks great," he said at a Thursday morning press conference.

Giffords' own skull could not be replaced because it was contaminated by the gunshot, so an implant was used instead.

Surgeons performed the cranioplasty and placed a shunt to drain excess cerebrospinal fluid during a 3.5 hour operation Wednesday, he said.

"The shunt is a permanent, completely internalized system," he said, noting that it cannot be seen and that some patients forget they have one placed. The shunt drains excess fluid not absorbed by the brain into the abdomen.

"You can have it for the rest of your life, it doesn't impede anything," Kim said.

Giffords was "initially in some pain" and had some nausea following the surgery, he said.

Giffords is resuming bedside rehabilitation Thursday, said Dr. Gerard Francisco. She is expected to return to the inpatient rehab center at the Houston facility next week.

"I'm optimistic that when she comes back next week, we're going to see a lot of positive changes," Francisco said.

Giffords is a "great team player" while performing rehab, Kim said.

Kelly interview

Giffords' husband, Capt. Mark Kelly, discussed her condition Thursday morning from the space shuttle.

"I had a chance at the end of the day to call her mom and her chief of staff and my brother periodically ... as the surgery was going on and she's doing really well," he said. "Everything went as planned and her neurosurgeons are very happy."

"She's recuperating and she's actually getting back to therapy today," Kelly said in an interview from aboard shuttle Endeavour.

"Obviously, this has been a long road since Jan. 8 for us. Her having surgery yesterday was not planned all along, but she was ready and the doctors wanted to do it then. It didn't make sense to wait a couple of weeks until I got back," he said.

Kelly said Giffords will receive outpatient treatment in Houston once she is released from the hospital.

"I started calling her Gorgeous Gabby today," Kim said, saying Giffords is "cute" with her hair shaved for the surgery.

"She hasn't looked in a mirror yet (after the surgery), but as soon as she does, she'll be very pleased," he said.

"She does not need to wear the helmet anymore," he said.

Some bullet fragments remain in Giffords' brain, doctors said.

"It's common after a gunshot wound for little fragments to remain," Kim said.

Removing the fragments could cause more injury, he said.

Release date unknown

Doctors haven't determined when Giffords can be released from the hospital, they said.

"Your guess is as good as mine," Kim said.

"We can't predict how much progress she'll make. We can't predict when she'll return to work," Kim said.

Giffords is "recovering very nicely," Francisco said.

Her cognition has "improved very significantly," he said, noting that "we're having meaningful, fun conversation—she's cracked me up."

"It's difficult at this juncture to make any guesses about when she'll go back to work," he said.

While doctors said they have a tentative schedule for Giffords' rehab and release, they declined to give specifics about dates.

Keeping up with the news

Giffords is "interested, absolutely curious and interested" about current events, Carusone said. Her staff reads her news reports and she keeps up with politics, she said.

The congresswoman's rehabilitation is "certainly a slow process," Carusone said at a press conference Monday, following the launch of the space shuttle. "It requires a lot of patience, and understanding that recovering from being shot point-blank in the head takes time."

Giffords "understands, if not everything, close to everything" when presented with complex concepts, Carusone said.

"She understands sarcastic humor," she said.

"Her voice sounds very normal, it sounds as it did before the shooting," she said.

"She's able to fluctuate her volume level" and express being light-hearted or serious with the quality of her voice, Carusone said.

"Her speech is getting better with the constant therapy she's doing."

Loughner competency hearing

The man accused in the Jan. 8 attack, 22-year-old Jared Lee Loughner, will be in court next week for a hearing on his competency to stand trial.

Loughner is accused of killing six and shooting U.S. Rep. Gabrielle Giffords in the head in what authorities charge was an assassination attempt.

He also is charged with wounding 12 others at a "Congress On Your Corner" meet and greet with constituents.

In March, Loughner was charged with 49 federal counts in the attack. Not guilty pleas were entered on his behalf by the court.

Fourteen of the charges Loughner faces could result in the death penalty, if the prosecution seeks it. No decision of whether to ask for capital punishment has been made, authorities have said.

Loughner likely will face local charges in the shooting incident, authorities have said.