February 18th, 2011
12:13 PM ET

Inside Giffords' rehab: Hard work, hard questions

When I walked into TIRR Memorial Hermann hospital, I had a few things on my mind. I would get to see firsthand the type of therapy Congresswoman Gabby Giffords was receiving after being shot in the head in early January. I also realized that, despite sending hundreds of my own neurosurgery patients for rehabilitation, I had not spent extended time learning all the various therapies currently available and how they work together to restore function. Finally, I reflected on a conversation I had with T. Christian Miller from ProPublica, about TriCare (the Pentagon’s health plan for the armed forces) and how it won’t pay to cover cognitive therapy for brain injured soldiers.

Gifford’s doctor, Gerard Francisco, greeted me and showed me a white board of a therapy schedule he tailored for me. On this day, I was playing the patient. An intensive, exhaustive seven-hour schedule was presented, full of physical therapy, speech, recreational, occupational and my personal favorite – music therapy.

The mantra of Julie Welch, my physical therapist, was “do not neglect your weak side.” While some patients may be inclined to overcompensate with the left side of the body if the right side is weak – my therapy focused on just the opposite. Giffords was shot in the left brain, and it would be her right side of the body that would be affected. Electrodes were hooked up to the muscles on my right leg, and then I was asked to ride a stationary bike. If my right leg wasn’t performing as well, small shocks stimulated the appropriate muscle during my pedaling, and also sent a message to the brain that this muscle was being ignored or neglected. Francisco explained that “it was part of the re-wiring process that takes place.” We know the brain can tell a muscle what to do – such as lift your right leg. With these stimulations, the muscle is now also telling the brain what to do.

During speech therapy, my therapist, Shap Shadravan worked on what she called apraxia of speech. This is the difficulty to say words correctly and consistently. It is not due to weakness of speech muscles, or discoordination, but rather caused specifically by an injury to the brain. Think of it as saying “len” whenever you wanted to say “when.”  We practiced making movements with my lips and tongue and re-learning sounds made at the front, middle and rear of the mouth. Given the congresswoman’s tracheotomy, we also learned how to speak with this tube in your throat, using a special valve to force air over the vocal cords.

Near the end of the day, I sat with Maegan Morrow, my music therapist, and filled in words to well-known songs. Everything from "Twinkle, Twinkle, Little Star" to "Maneater" by Hall and Oates. While it may have looked like simple and fun singing, Megan was constantly using strategies to externally cue me. I realized through music, she was working on developing my attention, memory and overall executive function.

In fact, most of the therapy I received at TIRR overlapped, and so much of it focused on cognition.  Francisco is convinced this type of approach rapidly expedites a brain-injured person’s recovery, and he has plenty of evidence to back him up. Certainly spending a day going through the therapy as I did allowed me to see that evidence for myself.

All of this, of course, got me thinking about T. Christian Miller, his report about TriCare, and the more than 200,000 service members that have suffered a brain injury since 2000.

Giffords is currently receiving proven and effective therapy at one of the premier rehabilitation centers in the country – and, very deservedly so. Question is: After considering all of this, why don’t tens of thousands of brain-injured troops have that same care available to them?

soundoff (357 Responses)
  1. ZisseVed

    cialis online with no prescription how to buy cialis online from canada cvs cialis coupon

    June 3, 2021 at 19:48 | Report abuse | Reply
  2. cialis online

    tadalafil bph mechanism cialis tablets buy tadalafil powder

    June 4, 2021 at 00:54 | Report abuse | Reply
  3. CrulkAsd

    is there a legal generic cialis made in the united states buy generic cialis generic cialis lowest prices

    June 4, 2021 at 04:03 | Report abuse | Reply
  4. ZisseVed

    is there a generic cialis available how to take cialis for best results how to get cialis online

    June 4, 2021 at 08:09 | Report abuse | Reply
  5. EncoxHtf

    cialis lower back pain buy generic cialis online cheap cialis generique

    June 4, 2021 at 13:37 | Report abuse | Reply
  6. EncoxDev

    can you buy prescription drugs online legally most reliable canadian pharmacies good pill pharmacy

    June 4, 2021 at 17:27 | Report abuse | Reply
  7. EncoxGtv

    Vermox canadian online pharmacies that do not require a prescription pharmacy discount card rx relief

    June 5, 2021 at 05:49 | Report abuse | Reply
  8. tadalafil goodrx

    tadalis sx buy cialis tadalafil 5mg tab

    June 5, 2021 at 21:40 | Report abuse | Reply
  9. hydroxychloroquine sulfate corona

    hydroclorizine chlorochin hydroxychloroquine 200 mg twice a day

    June 7, 2021 at 02:55 | Report abuse | Reply
  10. hcos

    chloroquine natural sources azathioprine chloroquinolone

    June 7, 2021 at 05:25 | Report abuse | Reply
  11. MileSwa

    cialis dosage recommend [url=https://ckacialis.com/ ]cialis onlilne[/url] cialis international

    June 7, 2021 at 09:51 | Report abuse | Reply
  12. Zisseloh

    how much cialis is too much does cialis work immediately when does cialis become generic

    June 8, 2021 at 02:03 | Report abuse | Reply
  13. MileSwa

    viagra or cialis levitra cialis cialis no consultation

    June 8, 2021 at 16:17 | Report abuse | Reply
  14. EncoxAni

    london drugs canada marks marine pharmacy in canada canadian compounding pharmacy

    June 9, 2021 at 02:14 | Report abuse | Reply
  15. EncoxAni

    canadian pharmacies viagra the cns depressants include various prescription drugs referred to as walgreens pharmacy refill online

    June 9, 2021 at 02:27 | Report abuse | Reply
  16. EncoxGtv

    quality rx pharmacy Biaxin cialis super active

    June 9, 2021 at 09:58 | Report abuse | Reply
  17. EncoxDev

    canadian pharmacy 24 rx pharmacy india boots pharmacy canada

    June 9, 2021 at 13:46 | Report abuse | Reply
  18. Zisseloh

    what is cialis black viagra cialis enzyte research chemicals cialis

    June 9, 2021 at 14:11 | Report abuse | Reply
  19. EncoxHtf

    buy some cialis cialis adderall cialis free trial 2018

    June 9, 2021 at 23:16 | Report abuse | Reply
  20. ZisseVed

    generic drug for cialis what to do if viagra and cialis dont work generic cialis in usa

    June 12, 2021 at 12:38 | Report abuse | Reply
  21. ZisseVed

    cialis stroke cialis tips fast delivery cialis super active

    June 12, 2021 at 23:59 | Report abuse | Reply
  22. EncoxHtf

    brand cialis us cialis for sale nz cialis 20 mg canada

    June 13, 2021 at 02:59 | Report abuse | Reply
  23. CrulkAsd

    cialis samples online cheap cialis cialis pills australia

    June 13, 2021 at 03:50 | Report abuse | Reply
  24. EncoxDev

    legal canadian online pharmacies pharmacy rx one viagra international pharmacy

    June 13, 2021 at 08:26 | Report abuse | Reply
  25. CrulkAsd

    cialis generic best price that accepts mastercard 36 hour cialis mg cialis without prescribtion

    June 13, 2021 at 13:09 | Report abuse | Reply
  26. EncoxGtv

    legit online canadian pharmacy pharmacy technician salary canada ontario canadian pharmacy xarelto

    June 13, 2021 at 18:11 | Report abuse | Reply
  27. MileSwa

    generic cialis site:.au cialis usa cialis windsor canada

    June 14, 2021 at 05:41 | Report abuse | Reply
  28. www.pharmaceptica.com

    hydroxychoroquin https://pharmaceptica.com/

    June 19, 2021 at 13:08 | Report abuse | Reply
  29. pharmacepticacom

    tadalafil cvs https://pharmaceptica.com/

    June 21, 2021 at 05:56 | Report abuse | Reply
  30. www.pharmaceptica.com

    tadalafil peptide https://pharmaceptica.com/

    June 24, 2021 at 00:55 | Report abuse | Reply
  31. www.pharmaceptica.com

    chloroquin side effects https://pharmaceptica.com/

    June 25, 2021 at 17:06 | Report abuse | Reply
  32. pharmaceptica

    erectile male enhancement https://pharmaceptica.com/

    June 28, 2021 at 13:25 | Report abuse | Reply
  33. www.pharmaceptica.com

    chloroquine tablets https://pharmaceptica.com/

    June 29, 2021 at 04:59 | Report abuse | Reply
  34. pharmaceptica

    tadalafil without a doctor prescription https://pharmaceptica.com/

    June 30, 2021 at 11:15 | Report abuse | Reply
1 2 3 4 5 6 7

Leave a Reply to MileSwa


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.