GUILTY AZ - Six killed, 13 injured in shooting at Gabrielle Giffords event, 8 Jan 2011 - #1

[mankato64]

Woman Grabbed Loaded Magazine From Gunman
Patricia Maisch Being Called A Hero

sorry article won't link

www.kpho.com, just saw the interview on the news, fantastic and courageous people during the chaos

 

[Herding Cats]

I thought shunts were used to relieve pressure ... I had no idea they would remove part of a skull!

Depends on what they're expecting. Shunts are used when there is a buildup of ventricular fluid - they drop a drain into the ventricles, and can "drain" out the fluid that way.

But swelling is not the same thing as ventricular fluid accumulation. There is not likely to be one spot where the fluid is accumulating; more likely, the insulted tissue is swelling. The cells are holding onto fluid, the body's inflammatory cascade has been activated by the trauma, and it's the brain tissue itself which is expanding.

They are likely maintaining her on an IV of hypertonic fluids. That will help draw fluid from the cells back into the vascular space, and thus eventually out through the kidneys. Hypertonic fluid is fluid where the ratio of "stuff" (usually sugar and/or salt) to water is higher than the 0.9 of normal blood. They'd use this because, as the saying is, "where salt goes, water flows." Diffusion through the porous cell wall into the "drier" fluid outside it and then out through the vascular system will bring the swelling down - it would "dry out" the brain. In this case, we want the brain 'drier', because the swelling can cut off blood supply, which means no oxygen can get there, and cell death follows. If that can be prevented, her prognosis is good to survive.

Right now, it's all about the swelling...and preventing it if possible.

Best-
Herding Cats

 

[Nancy2441]

Woman Grabbed Loaded Magazine From Gunman
Patricia Maisch Being Called A Hero

sorry article won't link

www.kpho.com, just saw the interview on the news, fantastic and courageous people during the chaos

Here's the link:

http://www.kpho.com/news/26420808/detail.html

 

[Missizzy]

A few questions--

Does anyone know just why Loughner took four years of ASL (American Sign Language)?

Given that he is described, over and over, as a loner and one who did not connect, is there anything out there about him receiving special education (what an irony as Gabby was extremely anti-"No Child Left Behind"), or possibly being a special needs adopted child?

And what does everyone make of this statement:

http://www.foxnews.com/us/2011/01/09/arizona-suspected-gunman-no-stranger-to-trouble/#ixzz1AbYyyhQm

"...the suspect's mother, who works for the Pima County Board of Supervisors and notes that Loughner has multiple arrests but no criminal record...."

I'm confused. Who has had multiple arrests? The son or the mother and why no record?

 

[mankato64]

Just said on the local CBS news that the intern Hernandez, who helped Giffords by applying pressure to wounds, will be honored on the floor of the State House of Reps tomorrow.

Wow, what a neat human being.

 

[Steely Dan]

I thought shunts were used to relieve pressure ... I had no idea they would remove part of a skull!

Depends on what they're expecting. Shunts are used when there is a buildup of ventricular fluid - they drop a drain into the ventricles, and can "drain" out the fluid that way.

But swelling is not the same thing as ventricular fluid accumulation. There is not likely to be one spot where the fluid is accumulating; more likely, the insulted tissue is swelling. The cells are holding onto fluid, the body's inflammatory cascade has been activated by the trauma, and it's the brain tissue itself which is expanding.

They are likely maintaining her on an IV of hypertonic fluids. That will help draw fluid from the cells back into the vascular space, and thus eventually out through the kidneys. Hypertonic fluid is fluid where the ratio of "stuff" (usually sugar and/or salt) to water is higher than the 0.9 of normal blood. They'd use this because, as the saying is, "where salt goes, water flows." Diffusion through the porous cell wall into the "drier" fluid outside it and then out through the vascular system will bring the swelling down - it would "dry out" the brain. In this case, we want the brain 'drier', because the swelling can cut off blood supply, which means no oxygen can get there, and cell death follows. If that can be prevented, her prognosis is good to survive.

Right now, it's all about the swelling...and preventing it if possible.

Best-
Herding Cats

When I was seven or eight years old (approx.1971ish) I was having a backup of fluid in my skull causing me great headaches. They gave me a series of spinal taps over several months and finally admitted me to the Children's Hospital of Philadelphia. We were living near there at the time. The final spinal tap they took on me showed my spinal cord pressure at double what it should be.

When they admitted me they told me it was just a precaution but they ended up doing surgery on me anyway. Since I was about 7 or 8ish I'm going to go by what I was told by my father. (The surgery was done by Dr. Spitz who was Mark Spitz's uncle and the inventor of the Spitz shunt.)

The problem was that my brain was growing faster than the spinal cord opening and causing a backup of fluid. (This may be hard to follow I usually draw a picture to show people so I'm trying with just words here.) They didn't shunt me, instead they cut a round piece from the top of my head. They then cut ring out of that piece. They took the ring and cut it up into equal pieces and used them to prop up the center piece. The empty spaces between the skull eventually grew back in.

Curiously, I have a ridge on my head that drops off like a cliff. I don't understand how that could be if they were trying to create more skull room. They put me on an ice bed for awhile I can't remember how long but it seemed a lot longer than it probably actually was. This was to keep the swelling down. (The next post I'm writing is about Kevin Everett and how they used cold therapy on him and until now I've never made a connection to their use on him and how they used a different technique on me.)

Anyway, it appears to have helped.

 

[Steely Dan]

Just said on the local CBS news that the intern Hernandez, who helped Giffords by applying pressure to wounds, will be honored on the floor of the State House of Reps tomorrow.

Wow, what a neat human being.

Wow! I bet Clarence will never have to show him what the world would be like without him.

 

[Steely Dan]

Kevin Everett's story isn't about being shot but it does involve spinal cord injury and potential paralysis and how quick thinking doctors gave him back the ability to walk again. It's not what Ms. Gifford is going through but it's an inspirational story. Hopefully her story will end as well.

http://en.wikipedia.org/wiki/Kevin_Everett

Not everything below is in the Wiki page. However, on this subject I trust my memory more because it was three years ago and I read his book and followed the news reports of his treatments religiously.

Kevin Everett was a tight end for the Buffalo Bills. In a game in September 2007 he was playing on special teams and in something that can only be called a one in a billion perfect alignment happened when he collided with Domenick Hixon and fell to the ground barely able to move with a broken neck.

(Hixon was then with the Broncos, BTW it was not an illegal hit. Both guys were textbook tackling it's just freaky. Domenick Hixon felt horrible about the whole thing and during the season he became a NYG and they played Buffalo in the final game of the year for the Bills and he was able to talk to Kevin who was attending the game and feel better.)

[ame]http://www.youtube.com/watch?v=9SoDPFhT-u8[/ame]

The NFL had been funding a study in cold therapy up until that year when they decided to stop funding the study. IIRC, it was being done at the University of Miami. Ralph Wilson, owner of the Bills, had continued to help fund the study giving $1 million after the NFL cut off funding. Because of this the Bills doctor and training staff were very well versed in the application of this theory. At the time the Bills were one of a handful of teams that kept chilled IV fluids on the ambulances at the stadium. Now I believe they all do.

When I saw the hit Everett was on the ground convulsing and I thought it was no more than him getting the wind knocked out of him, but when they came back from commercial it was evident this was darn serious.

Aboard the ambulance they started administering the cold IV fluids to bring his temperature down. Doctor Cappuccino who was on the ambulance told the ambulance drivers to go to a more distant hospital than the one the Bills typically used.

Miraculously, a week or two before a child had been injured during his son's little league game and needed an MRI. He learned that the hospital closest to the Bills didn't have a 24 hour MRI staff and that it would probably be two to three hours before they could administer an MRI. The hospital he told them to go to had a 24 hour MRI staff and was able to do the MRI immediately. The extra few minutes of travel time saved hours for the doctors and in one of those odd coincidences he wouldn't have known that three weeks before.

They performed surgery on him and things didn't seem to be getting much better. Back then cold therapy was a hotly contested, and maybe still is, theory for treating spinal injuries. I believe the idea is to bring the body temperature down to just above hypothermia which keeps the tissues from swelling and causing further damage. Faced with the negative evidence Dr. Cappuccino and the surgeons debated the cold therapy with Cappuccino being the strongest advocate. Eventually he won and they used the technique. Soon Kevin could wiggle his toes but Cappuccino was highly doubtful he would walk again. Today he is walking around and married to his longtime girlfriend. He proposed to her while still unable to move his limbs and she said yes. If she ever left his side for a moment he'd get upset.

Proudly the Bills fans and just citizens of Buffalo made sure that his family had everything they needed. Evidently the wives of the Bills do some charity works and made sure that there was always somebody with a family member in the waiting room and that the room was stocked with food and/or anything else the family wanted or needed.

When the doctors cleared him they moved him to a hospital in Houston which was closer to his home and they did all the physical therapy there.

A side note; The doctor conducting the study at the University of Miami was being interviewed and when asked about Wilson's continued support of the program he said; "What comes around, goes around."

Some more stuff;

This has interviews with Kevin and Dr. Cappuccino; http://www.wgrz.com/news/local/story.aspx?storyid=62299

http://video.buffalonews.com/player/?id=167&category=Buffalo Bills

http://sportsillustrated.cnn.com/2007/writers/tim_layden/12/14/everett/

http://abcnews.go.com/Health/story?id=4216671&page=1

May your story be as inspirational someday Gabby. Like I did for Kevin, I'm praying for you.

 

[alwayslooking]

Hi Nancy, Last night I watched this coverage for hours and think Dr Baden's replies were more informative than Dr Gupta's {sp}. I was left with a question tho as at first we learned the bullet entered her temple and only went a short distance thru the bone and brain, exiting thru her forehead. A straight shot thru and thru.

Then last night Dr Gupta mentioned it entered the temple and went a short distance, exiting out the back of her head.

I'm wondering if anyone else heard this about the back of the head? I guess it depends on if he approached her from the front or the back.

Interesting, as I also learned there are parts of the brain that are not used and will adapt to compensate for losses in other parts of the brain.

My husband was shot in the head, left side front to back. I don't believe anyone knows what will happen, the brain is so unique. My husband was in out patient rehab for a year and a half, it has been 9 years and he has a personal trainer, massage therapist, and a team of doctors. He had to learn to walk and talk again, he will never drive, he still falls down!

Now the good news, he is always happy never mad, his grandchildren adore him, his short term memory is terrible, but long term is perfect. He is a pleasure to be around and loved by everyone he meets!

 

[Steely Dan]

My husband was shot in the head, left side front to back. I don't believe anyone knows what will happen, the brain is so unique. My husband was in out patient rehab for a year and a half, it has been 9 years and he has a personal trainer, massage therapist, and a team of doctors. He had to learn to walk and talk again, he will never drive, he still falls down!

Now the good news, he is always happy never mad, his grandchildren adore him, his short term memory is terrible, but long term is perfect. He is a pleasure to be around and loved by everyone he meets!

That's awesome. The grandkids got to keep grandpa around. It sounds like a relatively small price to pay for such a horrific event. :blowkiss:

The link below also has a video of Dr. Gupta describing her injury.

http://pagingdrgupta.blogs.cnn.com/...ffords-survived-bullet-to-the-brain/?iref=NS1

...Neurosurgeons will want to know if the bullet passed across the midline of the brain. If it does, there is a much poorer likelihood of survival. In Giffords' case, it did not. Other positive factors: Her blood pressure didn't drop as a result of the bleeding, and the oxygen supply in her body was maintained, according to her doctors that I interviewed.

Finally, the fact Giffords was “following commands” even before she had an operation was a very positive sign.

To follow commands signifies a higher level of brain function than simple reflexive movement. It indicates that she was able to hear the command. She was able to process the meaning of that command, and finally, she was able to execute the command. I spoke to Dr. Randall Friese, the trauma surgeon who examined Giffords when she arrived at the hospital. He told me she was clearly able to understand him, and squeezed his hand when asked to do so. And, after the operation, Giffords was still able to follow commands....

 

[Cypros]

One thing that I hope results from this tragedy is a change in the college classrooms. I just saw an interview with Linda Sorensen, who was a classmate of Jared's this last summer. She was frightened of him from day one and sat by a window with her purse in her hand ready to escape if he became a threat and she has emails to friends describing her fear that he would show up with a gun and kill everybody. Jared was kicked out of class on the first day but returned for a couple more weeks before he was finally removed permanently from the class. I know from another interview on CNN.com that he was able to return again in the Fall and disrupt more classes before he was finally expelled with a requirement that he get counseling.

As a professor, I find that our colleges/universities are increasingly held prisoner by students with mental health problems. Here is a recent article that describes the issue:
http://www.myfoxphilly.com/dpps/hea...h-college-students-dpgoh-20101221-fc_11160158 excerpt:
But 44 percent in (college) counseling have severe psychological disorders, up from 16 percent in 2000, and 24 percent are on psychiatric medication, up from 17 percent a decade ago.
The most common disorders today: depression, anxiety, suicidal thoughts, alcohol abuse, attention disorders, self-injury and eating disorders, the study reported.

Every college professor that I know has stories about students who are disruptive in class and have no business being there. Many professors have been threatened and intimidated. Many college students have stories about classmates who frighten them. The college's have their hands ties because the student has paid for the courses and, therefore, has the right to attend. Even if the student is failing the class and has no chance to pass, I cannot prevent him/her from continuing to attend.

I commend Pima College for acting relatively quickly (it could have been faster) and for requiring Loughner to get counseling and demonstrate his mental health competence before returning to their campus. All colleges should follow suit.

 

[strawberry]

As soon as I saw this guy's Youtube ramblings, I immediately thought, this kid has schizophrenia. I'm not a psychiatrist but I have taken psych classes and he is at the age where it usually hits. His thoughts are disorganized. Most schizophrenics are not violent but the ones who are usually are following commands of auditory hallucinations. Maybe he is just an angry irrational guy but my gut says schizophrenia. I wonder if his parents sought help for him? It must have been obvious to them...I know a wonderful family whose son became schizophrenic very early, in his middle teens. When he was 23 he hanged himself...suicide is usually a result of commands as well. So so sad.

 

[Steely Dan]

This page has a lot of CNN videos on the subject; http://www.cnn.com/2011/CRIME/01/10/arizona.shooting.investigation/index.html?hpt=T1

It's taking awhile to load. I'm guessing it's from heavy traffic.

 

[alwayslooking]

I hope I don't come across cold, BUT............I don't care if he is mentally ill, all I care about is making him stand trail and then execute him. All killer's have something wrong with them. In a perfect world, he would have taken his own life, sparing the victim's a trial!

 

[Steely Dan]

I hope I don't come across cold, BUT............I don't care if he is mentally ill, all I care about is making him stand trail and then execute him. All killer's have something wrong with them. In a perfect world, he would have taken his own life, sparing the victim's a trial!

If he's actually involved with a supremacist group it's probably better he survived. He may eventually crack.



Here's an interview with her intern;

http://www.cnn.com/2011/CRIME/01/10/arizona.shooting.intern/index.html

 

[strawberry]

I didn't realize the little girl was the granddaughter of former Phillies manager Dallas Green. She's the part of this story that makes me the angriest.

http://www.dailylocal.com/articles/2011/01/10/news/doc4d2a6439c9cf0926183235.txt

 

[Velouria]

And if he is p'schizo, and fixated on Giffords in '07, I am left wondering where his parents were in all of this...

respectfully snipped and BBM

That's what I'd like to know, Herding Cats.

The suspect had multiple arrests and STILL managed to pass an FBI background check. WTF? Seems that if the parents had indeed sought psychiatric help for him there would be some sort of red flag preventing a firearm purchase. The fact that this obviously disturbed young man was able to legally buy a gun scares the bejeebers out of me.

 

[Gozgals]

I hope I don't come across cold, BUT............I don't care if he is mentally ill, all I care about is making him stand trail and then execute him. All killer's have something wrong with them. In a perfect world, he would have taken his own life, sparing the victim's a trial!

Well put, thanks for taking the words out of my mouth.

Goz

 

[Gozgals]

Rest in Peace Christina.

Thank you for this thread.
Been crying reading about her. What a beautiful little girl.
Blessings to her family and all the victims.

Goz

 

[Trino]

http://news.yahoo.com/s/ap/20110110/ap_on_he_me/us_med_congresswoman_brain_injury

Doctors are optimistic for survival, but recovery could take months/years.

Can she still represent her Congressional district?