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Giffords leaves Tucson hospital for arduous rehabilitation at Houston facility

Sandhya Somashekar and David Nakamura Washington Post Staff Writer

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At 11:22 Eastern time (9:22 a.m. in Tucson), an ambulance carrying Giffords left the hospital with a police escort and wound through the streets of Tucson to Davis-Monthan Air Force Base, where she was expected to board a plane headed for Texas.

Eight military veterans from the local chapter of Veterans of Foreign Wars rode their motorcycles ahead of the green-and-white ambulance in a symbolic honor guard. Hundreds of Arizonans lined the route, holding American flags and alternately clapping, waving or clasping their hands in prayer.

Once the plane carrying Giffords lands at Houston's William Hobby Airport, likely about 2:15 p.m. Eastern time, she will be transported via helicopter to TIRR Memorial Hermann hospital. There, she will begin a rigorous rehabilitation program aimed at restoring her, as much as possible, to her former self.

Giffords's office said the congresswoman, 40, is being accompanied by her husband, astronaut Mark Kelly, who lives and trains at Houston's Johnson Space Center; her mother; her Tucson trauma surgeon, Peter Rhee; a nurse and two aides.

Upon arrival, Giffords will undergo a checkup at the TIRR trauma center to assure she remained strong during transit. After that, she will check in to the rehabilitation center.

Giffords will be assigned to the most private wing of the hospital, and U.S. Capitol Police will provide added security. But that's about the only special treatment doctors said they are planning for the most famous of their 119 patients.

"We don't have VIP here," Gerard Francisco, the rehabilitation center's chief medical officer, said after providing a tour to reporters Thursday.

The Arizona Democrat will get "a standard room-a hospital bed, a bathroom. It's very Spartan," Francisco said. "We don't plan to treat her any differently than we treat someone with a similar injury. It's business as usual. It's the rehabilitation program that we would provide anyone with this type of impairment."

That program will be the start of a long road back to health for Giffords, who has been at the Tucson University Medical Center since being shot in the face in the Jan. 8 rampage that left six dead and injured 13.

TIRR is a highly renowned rehabilitation center, ranked No. 5 in the nation last year by U.S. News & World Report. Its 200 staffers treat 119 inpatients and make 46,000 outpatient visits per year, according to information provided by the hospital.

Kelly said he and Giffords's family chose TIRR over facilities in Washington, New York and Chicago in part because of its proximity to his work and family. Carl Josehart, TIRR's chief executive, said families are encouraged to participate actively in the recovery process because they will be expected to provide care at home once the patient is released.

"Nurses train family to provide care from home," Josehart said. "If a patient needs help walking, needs to take medicine, nurses help train families how to do that safely."

On Thursday, the TIRR hospital staff was busy shepherding curious reporters around the facility, which is located on a crowded campus of medical centers across the street from Rice University, just southwest of downtown Houston.

Like her fellow patients, Giffords will spend the better part of her days working out in one of the rehabilitation center's half-dozen gymnasiums. Each is equipped with what Francisco fondly referred to as his "toys"-a bevy of high-tech exercise equipment, muscle stimulators and robotic devices designed to help patients regain muscle control, coordination and cognition.

As reporters looked on Thursday, brain injury patients were busy on the equipment. Save for the wheel chairs and protective helmets worn by several of them, the atmosphere was not unlike that of a typical neighborhood health club.

Josehart showed off the therapeutic pool, which includes a hydraulic lift to help injured patients into the water. There is a body-weight treadmill, on which patients are strapped to a harness that supports them while they walk (hospital staffers also provide assistance). There are special recumbent stationary bikes that pulse electrodes into patients to stimulate muscles. And there is a tilting table, to which patients who have trouble standing are strapped so they can slowly be adjusted into a standing position.

In addition to physical therapy, staff members will help Giffords with speech and language, her cognitive ability and the skills needed to perform daily activities such as brushing her teeth and getting dressed on her own, Francisco said.

The facility has a special kitchen and a washer and dryer - spaces and equipment where patients can practice basic household chores which help assess their readiness to reenter ordinary life.

As patients grow stronger and regain more skills, their treatment eventually includes excursions beyond the hospital grounds. "We have field trips to restaurants, museums," Francisco said. "Our goal is to simulate the real world. There's no better way than to get out in the real world."

Francisco - who received his medical degree from the University of the Philippines and completed a post-doctoral fellowship in brain injury rehabilitation at Baylor College of Medicine - has worked at TIRR since 1997. He is the chairman of and a clinical professor in the department of physical medicine and rehabilitation at the University of Texas medical school at Houston.

Though experts predict that Giffords could need up to three months of inpatient care, Francisco said the average stay for patients at TIRR is less than a month. He declined to estimate how long he expected Giffords to remain in the facility.

Francisco acknowledged that there is no guarantee that Giffords, or any patient who has suffered severe brain injuries, will return to full health.

"It's a function of what part of brain is damaged and the extent of the injury," he said. "Some with brain injury like this lose the ability to speak, lose the ability to understand. Their personality changes, they have problems with memory, it changes how they relate to people."

Nakamura reported from Houston.


Jan. 21, 2011