MONDAY, Jan. 17 (HealthDay News) -- Arizona Congresswoman Gabrielle Giffords continues her remarkable recovery after she was gravely wounded by an assassin's bullet to her brain nine days ago: On Sunday, her doctors upgraded her condition from critical to serious.
Giffords underwent surgery Saturday to replace a breathing tube that had been in place since she was shot in the attack in Tucson that left six people dead.
The 40-year-old Giffords had been breathing on her own, but the breathing tube had been left in place as a precaution. In its place, surgeons inserted a tracheotomy tube in her windpipe, protecting her airway and allowing her to be disconnected from a ventilator, according to officials at University Medical Center in Tucson, where Giffords is being treated.
Doctors also inserted a feeding tube. Both procedures, according to the hospital, are common in people hospitalized with brain injuries.
The hospital issued a statement saying that Giffords' "recovery continues as planned."
Her doctors said earlier that, once the breathing tube was removed, they would be able to assess whether she could speak.
On Friday, doctors said Giffords was "continuing to make all the right moves in all the right directions" toward recovery. The Wall Street Journal reported that she has defied the odds and continues to show improved function day by day.
"She is beginning to carry out more complex sequences [of movement] in response to our commands, and even spontaneously," said Dr. Michael Lemole Jr., neurosurgery chief at University Medical Center. "We couldn't have hoped for any better improvement than we're seeing now."
Giffords' doctors said she has been opening her eyes more often since she first did so Wednesday. That was the day she also touched the wedding ring worn by her husband, astronaut Mark Kelly, after being asked by him to do so.
On Thursday morning, doctors said Giffords was able to keep her eyes open for up to 15 minutes at a time and could move her legs and one of her hands, The New York Times reported.
"She is doing some fairly specific things with her left hand," Dr. Peter Rhee, the hospital's chief of trauma, said at the time. "She is yawning. She is starting to rub her eyes."
Lemole also noted that Giffords could "move both of her legs to command," the newspaper reported.
Doctors want to ensure that Giffords doesn't regress and are watching for pneumonia and blood clots, the Associated Press reported.
Experts said that, despite her remarkable progress, Giffords may have suffered some permanent damage, but it's not yet clear how extensive that damage might be.
Giffords was gravely injured, 13 others were wounded, and six people, including a 9-year-old girl, were killed in the Jan. 8 shooting spree that took place in front of a Safeway supermarket in Tucson, where Giffords was meeting with constituents. Jared Loughner, 22, faces multiple murder and attempted murder charges in the shootings.
Giffords, a Democrat, was first elected to the House of Representatives in 2006.
The fact that Giffords is alive is a bit of a miracle.
According to Dr. David Langer, director of cerebrovascular research at the Cushing Neuroscience Institutes, part of North Shore/Long Island Jewish Medical Center in Great Neck, N.Y., 90 percent of people with gunshot wounds to the head die.
The U.S. National Institutes of Health has more on traumatic brain injury.
SOURCES: David Langer, M.D., director, cerebrovascular research, Cushing Institutes of Neuroscience, North Shore/Long Island Jewish Medical Center, Great Neck, N.Y.; The New York Times; Wall Street Journal; Associated Press
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