Giffords major leap in recovery USA TODAY

Doctors: Giffords' moving of legs is major leap in recovery

Doctors say the Ariz. congresswoman is making a miraculous recovery after being shot in the head in an assasination attempt that killed six and left 13 others wounded last Saturday in Tucson.

Affirming that "miracles" do happen, neurosurgeon Michael Lemole said Thursday that Rep. Gabrielle Giffords is yawning, rubbing her eyes and showing clear signs that she's awakening and "starting to become aware of her surroundings."
Five days after emergency surgery for a gunshot wound to the brain, doctors have begun physical therapy, dangling Giffords' legs off the bed and asking her to lift them.

"She's able to move her legs on command," said Lemole, of University Medical Center in Tucson. "That's huge. She's moving both her legs."

Although her condition is still critical, doctors say her progress bodes well for her long-term recovery, though they say it's too early to tell how she'll progress.

During Saturday's shooting, a bullet plowed through the left side of her brain, home to nerves controlling language and vision. That region also governs the movement on the right side of Giffords' body, which is why her doctors say her leg movements are such a good sign.

"She may not have permanent paralysis," said Keith Black, head of neurosurgery at Cedars-Sinai Medical Center in Los Angeles.

Giffords startled her husband, her doctors and a roomful of friends from the House and Senate on Wednesday by opening her left eye, moments after another visitor, President Obama, stepped out into the hallway.

During a memorial service that evening, the president described the moment, saying, "Gabby opened her eyes for the first time. She knows we're here."

In a briefing Thursday, Lemole said he was at her bedside at the time. He said the presence of visitors who were talking to her and holding her hand prompted her to try to "raise her head and look around."

Later on, he said, she tried to open her eyes to watch the TV in her room. When her friends addressed her, they asked her "very specific things, and she used her hands to communicate with them," Lemole said.

Although he describes himself as a "cautious neurosurgeon," Lemole acknowledges that "a lot of medicine is out of our control" and that "miracles happen every day."

Doctors won't be able to assess Giffords' ability to speak until doctors remove the ventilator tube that snakes through her vocal cords into her lungs, making speech impossible.

"The breathing tube is the next major milestone," said Peter Rhee, chief of the Tucson hospital's trauma service.

He said she's still on the ventilator to reduce the risk of pneumonia, but he's hoping to remove the tube in the next few days, because Giffords is breathing on her own. Keeping her on the ventilator too long could increase the risk of infection or blood clots, so doctors prefer to remove the tube as quickly as possible, says neurosurgeon Alex Valadka, of the Seton Brain & Spine Institute in Austin.

All things considered, Black says, "the fact that she's beginning to wake up, open her eyes and follow some commands suggests that she's out of the critical period" and that her brain swelling has passed its peak