Giffords discharged from hospital, begins outpatient therapy
U.S. Rep. Gabrielle Giffords was "absolutely elated" to be discharged from a Houston hospital Wednesday, and will continue to recover from a shot to the head on an outpatient basis.
In what her office called a "major milestone," the congresswoman left TIRR Memorial Hermann, where she will continue her rehabilitation after her release.
Giffords is "absolutely elated," said her spokesman, C.J. Karamargin.
Giffords is happy "to finally be able to leave the hospital," he said.
"The congresswoman and (her husband) Mark have been looking forward to this for some time."
"I don't think anyone could have been able to predict, in those heart-breaking and chaotic days after Jan. 8, the she would be able to, in less than 6 months, be discharged," Karamargin said.
While no plans for a return to Tucson have been made, "her hometown continues to be a source of strength," Karamargin said.
"Hopefully she can come home soon," he said.
Doctors said Giffords' cognitive abilities and physical strength have improved to the point where she no longer needs to remain a patient in the hospital, said Karamargin.
Giffords, who was shot in the head on Jan. 8, will move into the home of her husband, Navy Capt. Mark Kelly, in League City, Texas.
"Gabby gives her all to everything she does and that's exactly what she's been doing at TIRR since Jan. 26," said Kelly in a statement released by Giffords' office.
"The remarkable progress she has made since then is a testament to both her single-minded determination to get better and the team of medical professionals overseeing her care," Kelly said.
At Kelly's home, Giffords will be assisted by a 24-hour home health provider.
"Anyone who knows Gabby knows that she loves being outside," Kelly said. "Living and working in a rehab facility for five months straight has been especially challenging for her. She will still go to TIRR each day but from now on, when she finishes rehab, she will be with her family
"Congresswoman Giffords has shown clear, continuous improvement from the moment she arrived at TIRR five months ago," said Dr. Gerard Francisco, the Houston hospital's chief medical officer.
"We are very excited that she has reached the next phase of her rehabilitation and can begin outpatient treatment. We have no doubt that she will continue to make significant strides in her recovery," Francisco said.
As an outpatient, Giffords' therapy program will not change. She will continue to work with the same rehab team, and her care will continue to be overseen by Francisco, who also serves as the chairman of the department of Physical Medicine and Rehabilitation at the University of Texas Health Science Center in Houston.
On May 18, Giffords underwent a cranioplasty procedure to replace a portion of her skull that had been removed to relieve the pressure of swelling on her brain. The cranioplasty replaced the missing skull fragment with a ceramic implant, around which bone cells will grow in time.
A permanent shunt was also implanted to drain fluids into her abdominal cavity via a plastic tube. Both procedures were successful. Doctors removed the stitches from the cranioplasty two weeks ago, a final step in the healing process
"Gabby has recovered well from the surgery," said Dr. Dong Kim, director of Mischer Neuroscience Institute at Memorial Hermann. "Her wounds have healed, she has resumed full physical therapy without a helmet, and I am comfortable that she can be discharged."
Giffords had been undergoing rehab at TIRR since Jan. 21, when she was flown to Houston from Tucson.
Five months after she was shot through the brain, U.S. Rep. Gabrielle Giffords struggles to communicate, an aide told a columnist for the Arizona Republic.
Giffords searches for words and has trouble putting sentences together, said the congresswoman's chief of staff, Pia Carusone, in a piece by E.J. Montini last Thursday.
Speaking directly about Giffords' condition and when she might make a public appearance for the first time since the Jan. 8 shooting that claimed the lives of six others, Carusone said Giffords' "communication skills have been impacted the most."
"If you think of it as someone who is able to communicate with you clearly, it is easy to test them. You can ask them a series of questions and you can get clear answers back. Where as with Gabby what we've been able to infer and what we believe is that her comprehension is very good. I don't know about percentage-wise or not, but it's close to normal if not normal."
Giffords is relying on expressions and gestures, rather than speaking, to completely convey her thoughts, Carusone said.
"She is borrowing upon other ways of communicating. Her words are back more and more now, but she's still using facial expressions as a way to express. Pointing. Gesturing. Add it all together and she's able to express the basics of what she wants or needs. But when it comes to a bigger and more complex thought that requires words, that's where she's had the trouble."
After an operation on her skull last month, Carusone told reporters that Giffords' speech was improving, and that she understood abstract concepts.
Giffords "understands, if not everything, close to everything" when presented with complex concepts, Carusone said in May. Giffords is "absolutely curious" about current events, she 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."
Giffords was shot through the left side of her brain, which controls speech and language, at a "Congress On Your Corner" meet-and-greet with constituents.
Continuing in office
As I reported on her birthday last week, Giffords' staffers have been relunctant to comment on her plans to continue in office, or run again. Carusone didn't stray much beyond the party line.
"The only firm timetable is the timetable and that is May of 2012, when petitions are due for reelection," Carusone told the Republic. "That's a firm timetable."
"Short of that, we'd love to know today what her life will be, what her quality of life will be, which will determine whether she'll be able to run for office and all sorts of other things involving her life. But we just don't know yet…We're about halfway through the process that is the most important time for recovery. Patients recover for the rest of their lives but it's the first 12 to 14 months that you make the biggest jumps… In the doctors minds it's not even close to when you begin to make the final prognosis for the quality of her life."
While doctors have called Giffords' recovery "miraculous," Carusone said she has a long way to go.
"She's living. She's alive. But if she were to plateau today, and this was as far as she gets, it would not be nearly the quality of life she had before. There's no comparison. All that we can hope for is that she won't plateau today and that she'll keep going and that when she does plateau it will be at a place far away from here."
While some have called upon Giffords to resign her seat, there's been little indication that she will do so any time soon.
Beginning just days after the shooting, others have explored declaring her seat vacant. A state law on vacant offices doesn't apply to federal representatives, and an online petition asking Gov. Jan Brewer to declare a special election has attracted few signatures.
According to the Constitution, members of the House of Representatives can only be forced out of office by a vote by the House. Federal courts have found that states are powerless to set limits on those serving in federal office above those found in the Constitution and federal law.
Accused shooter found incompetent to stand trial
Jared Lee Loughner is accused of killing six and shooting Giffords in the head in what authorities charge was an assassination attempt.
Among those killed were a nine-year-old girl and Arizona's presiding federal judge.
He also is charged with wounding 12 others at the "Congress On Your Corner" meet and greet with constituents at a Northwest Side grocery store on the morning of Jan. 8.
He was found incompetent to stand trial last month, and was sent to a federal facility in Missouri for treatment to restore his ability to understand the charges against him and participate in his defense.
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, but only after the federal case is resolved.