Giffords opens eyes, begins physical therapy

Rep. Gabrielle Giffords spontaneously opened her eyes on Wednesday night while surrounded by friends and continues to show encouraging signs of recovery. She remains in critical condition in the ICU at University Medical Center, where four other patients injured in the Jan. 8 shooting remain in fair condition.

Dr. Peter Rhee, medical director of University Medical Center's Trauma and Critical Care and professor of surgery at the University of Arizona College of Medicine Department of Surgery, said of the four patients who remain in fair condition at UMC, one will undergo a planned surgery today, and another will be discharged.

"Everybody is making fantastic forward progress," said Rhee.

Though still listed in critical condition, Giffords also is making major progress.

"As you heard from the president yesterday, it is true, she did have spontaneous eye opening yesterday ,and she's becoming more and more alert at this time," Rhee said.

Dr. G. Michael Lemole Jr., section chief of neurosurgery at the UA department of surgery, was in the room when Giffords opened her eyes while surrounded by friends from the U.S. Congress. He said it was a combination of the unexpected but familiar that may have prompted her to open her eyes and look around.

"That's important from a scientific or neurosurgical perspective, because it implies that not just those parts of the brain that process commands are there, but the parts of the brain that let us awake from sleeping, our arousal center, those are starting to work spontaneously," Lemole said. "She's starting to become aware of her surroundings and the appropriate context of family and friends. That's a very important step on her next move forward."

Lemole said she continues to spontaneously open her eyes, and that they are just beginning to focus and track.

"We're just starting to see the signs of her trying to track her gaze to wherever she wants to look," Lemole said. "That's very, very encouraging and reflects on a level of alertness. This is all very encouraging that she continues to do this consistently. One of the most important things in neurological recovery is consistency. We want to see people repeat things over and over again."

Giffords began aggressive physical therapy today. While sitting supported on the side of the bed with her legs dangling over the edge, she was able to move both legs on command.

"I have to say this is a major leap forward," Lemole said. "This is a major milestone for her. We're hoping she crosses through many more."

Brain swelling is becoming less of a concern at this point, Lemole said, but he continues to be vigilant about that as well as pneumonia and blood clots – issues any ICU patient could face. Rhee said Giffords' breathing tube will need to be removed in the next several days, and he and Lemole will determine whether she's strong enough to breathe on her own or whether a tracheostomy will improve her comfort and care.

"In the assessment, we look at whether or not someone is able to move when we ask them to, we look at whether or not they open their eyes spontaneously and the last piece is what is their verbalization," Lemole said. "We can't assess that with a breathing tube in."

Provided by University of Arizona