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Jun 12, 2011 1:34 PM by Nichole Larkey & AP

First photos of Giffords released since shooting

HOUSTON (AP) - Images of a smiling Rep. Gabrielle Giffords were
posted Sunday on her Facebook page, two photos that show her with
shorter, darker hair but few signs that she suffered a gunshot
wound to the head.
The photos were taken May 17 outside the Houston rehabilitation
facility where Giffords has been undergoing treatment since she was
wounded five months ago at a meet-and-greet event with
constituents. Six people died and a dozen others were hurt in the
Jan. 8 attack in Tucson, Ariz.
Since then, access to the Arizona congresswoman has been tightly
controlled. Until Sunday, no clear images had been released.
The only recent sign of Giffords came in late April, when grainy
television footage showed her slowly ascending a flight of steps to
a NASA plane that took her to Florida to watch her astronaut
husband rocket into space. The image was so blurry that it was
impossible to confirm it was Giffords until doctors did so at a
news conference in mid-May.
Giffords spokesman C.J. Karamargin said staff members released
the photos Sunday to help satisfy "intense interest in the
congresswoman's appearance."
The timing coincides with plans to release Giffords from the
hospital later this month or in early July. Her staff hopes the
images will help curb unwanted photography when she begins visiting
an outpatient clinic in a more public setting.
"What we wanted to avoid was a paparazzi-like frenzy,"
Karamargin said.
The professionally shot pictures were taken before Giffords
underwent surgery to replace a piece of her skull that had been
removed shortly after the shooting to allow her brain to swell. The
images suggest the congresswoman is returning to her former
appearance - though she still looks slightly different than before.
But the photos give little indication of Giffords' cognitive
abilities - what, for example, her speech is like after being shot
in the left side of the head, which controls communication. The
images also provide no hints as to when, or if, she will be able to
resume her job.
"There's nothing that unique about the outer presentation,"
said Jordan Grafman, director of the Traumatic Brain Injury
Research Laboratory at the Kessler Foundation Research Center in
West Orange, N.J., explaining that many brain injury patients look
good within months of being hurt.
"But the image doesn't tell us the inner mental state or the
brain itself, how it's functioning," said Grafman, who has not
treated Giffords. "What's their social skills? Do they have a
nuanced sense of humor? Can they participate in activities? All
that is what's important."
Pia Carusone, Giffords' chief of staff, has indicated that while
the congresswoman is able to speak and walk, she remains a shadow
of her former self.
Karamargin said Giffords' left eye appears smaller in one of the
photos because part of her skull was missing when it was taken.
That has since been repaired. He also said her hair is shorter now
because it was shaved for the surgery that repaired her skull.
The photos capture Giffords' ecstatic mood following her
husband's space shuttle launch.
"She got to see her husband successfully ride a rocket into
space," Karamargin said. "So who wouldn't be pleased?"
He added: "I think this photo speaks volumes about the
congresswoman's resilience and recovery. It shows someone in very
good spirits, someone who is happy, someone who has a very positive
attitude."
Of the two pictures, one is more clearly posed, that of a
smiling Giffords looking directly at the camera. The left side of
her head appears slightly distorted and swollen. A second photo
shows Giffords in a more casual light - smiling while sitting
alongside her mother, Gloria Giffords, with the hospital's greenery
evident behind them.
The pictures were taken by Tucson photographer P.K. Weis.
Carusone told the Associated Press late Saturday that doctors
and family were considering "many factors" while weighing when to
release Giffords from the hospital. She did not elaborate.
"We're looking at before the end of the month. We're looking at
early July," Carusone said. "We don't have a date."
In an interview published Thursday in the Arizona Republic,
Carusone said Giffords can express her basic wants and needs, but
has difficulty stringing together sentences to verbalize more
complex thoughts and feelings. Giffords, she said, relies on hand
gestures and facial expressions.
"She is borrowing upon other ways of communicating. Her words
are back more and more now, but she's still using facial
expressions as a way to express. Pointing. Gesturing," Carusone
said.
The description matches what experts expect from someone who has
suffered a traumatic brain injury. Often, they can be easily
disoriented, have trouble prioritizing, suffer from some memory
loss and could have difficulty recognizing people. Some have
difficulty doing several tasks at the same time.
Most cognitive recovery occurs in the first six months to a year
after an injury, though it becomes less noticeable as time
progresses. In the second year, progress sharply drops.
Carusone said if Giffords' recovery were to plateau now, "it
would not be nearly the quality of life she had before."
"All that we can hope for is that she won't plateau today and
that she'll keep going and that when she does plateau, it will be
at a place far away from here," she said.
While Giffords' release from the hospital will mark a crucial
step in her recovery, she still must undergo months of outpatient
rehabilitation that will include speech, occupational and physical
therapy.
The release of the photos seemed to please the public and her
admirers.
On Facebook, the photos immediately generated conversations and
comments, with dozens blessing Giffords and her family,
complimenting her for her perseverance and courage and her ability
to overcome the odds.
Some mentioned Jared Lee Loughner, 22, the shooting suspect who
has pleaded not guilty to charges stemming from the shooting and is
being held at a Missouri facility. A judge declared him incompetent
to stand trial, but prosecutors hope his competency can be restored
so he can be put on trial.
Still, others wondered about how far Giffords has progressed.
"It would be nice to get a truly honest assessment of her
internal cognitive experience," Alex Hakkinen, who told the AP he
works with brain injury patients at a rehab center in
Lawrenceville, N.J.
Hakkinen said Giffords' staff has an obligation to bring her out
in public at some point so constituents can assess her abilities,
maybe in a "fireside chat" of sorts. Or they should acknowledge
that she's incapable of doing so right now, he said.
State Sen. Linda Lopez said Giffords looks beautiful.
"Wow! I saw her at the very end of March, and even then, Gabby
was all there, her smile, her personality," Lopez commented on
Facebook. "And she looks even better now."

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