Giffords back in rehab center
U.S. Rep. Gabrielle Giffords is back in a Houston rehab facility following an operation to replace part of her skull last week.
Giffords was moved Tuesday from Memorial Hermann-Texas Medical Center to the nearby rehabilitation hospital where she has been recovering after being shot in the head Jan. 8.
Doctors replaced part of the congresswoman's skull with a synthetic plate in a 3.5 hour operation last Wednesday. A portion of Giffords' skull was removed to allow her brain to swell without causing damage after she was shot through the left side of her brain at a constituent event.
"She's doing fine, great," said Giffords' spokesman, C.J. Karamargin.
Giffords had remained in the hospital where the surgery was performed until doctors were sure there were no signs of infection, Karamargin said.
Giffords was also given a permanent internal shunt, to drain excess cerebrospinal fluid, during the operation.
The surgery came as Giffords' husband, Capt. Mark Kelly, was in space commanding the shuttle Endeavour.
Giffords, who watched Kelly blast off at the Kennedy Space Center, made two trips to Florida to see the shuttle lift off after the original launch was scrubbed by NASA.
Giffords will continue her rehab in Houston once she is released from The Institute for Research and Rehabilitation (TIRR) Memorial Hermann, her husband said last week in an interview from Endeavour.
Kelly is due to return to Earth on June 1.
Giffords will turn 41 on June 8, five months after she was shot.
Doctors don't know when Giffords can be released from the hospital, or when she might be able to return to Congress, they said.
"(The surgery) was an important step in Gabby's recovery," said Dr. Dong Kim, a neurosurgeon who has been treating the congresswoman, at a press conference after the operation.
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 last Wednesday, Kim 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 last week.
"I'm optimistic that when she comes back... we're going to see a lot of positive changes," Francisco said.
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.
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, her chief of staff, Pia Carusone, said last week. 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 last 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 Wednesday for a hearing on his competency to stand trial.
Loughner is accused of killing six and shooting 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.