Rehabilitation following traumatic brain injury is a laborious process that proceeds over a period of months, helping a brain-injured patient to relearn all basics of daily living from tying a shoe to how to eat from a spoon, experts said Friday.
Long Island doctors not connected with Rep. Gabrielle Giffords' case say the congresswoman must relearn how to take steps unaided, get dressed, speak fluidly and even to grasp the subtleties of humor.
Dr. Raphael Davis, chief of neurosurgery at Stony Brook University Medical Center, said Giffords' rehabilitation largely hinges on the path the bullet took as it passed through her brain. If it missed so-called eloquent areas of the brain - regions devoted to motor function, speech and sensation, such as senses of sight, hearing and touch - her rehabilitation will proceed at a quicker pace.
"Rehabilitation goes on for quite a period," Davis said, referring to months of occupational, speech and psychological therapies. "Whatever her deficits are now that doesn't mean she will have the same deficits six weeks or six months from now."
Dr. Eric Cruz, a specialist in brain trauma at Nassau University Medical Center, noted that rehabilitation is based on the premise of brain plasticity - the 3-pound organ's ability to adapt under extraordinary circumstances.
"The unique thing about the brain is that the parts that were not injured will rewire and take over from the damaged areas," added Cruz, who heads the medical center's brain injury program.
"What doctors will be focusing on in the next few weeks and months are gross movements - moving her hands, her arms and legs - and working with her on activities of daily living, helping her develop fine motor skills," Cruz said. "Fine motor skills include the ability to pick up a spoon and not spill the contents of the spoon, and bring it all the way to her mouth."
Giffords' rehabilitation, Cruz added, is about incremental steps - coming as close as possible to her previous abilities - and helping her avoid depression when she doesn't achieve personal goals quickly.