Katie Update #19

Friends and Family,

Okay, I'm back from my brief hiatus to Athens. This is my first e-mail since Wednesday, though many of you probably saw that I posted an update (#18) on the web site on Friday. I may start posting exclusively to the web site more often, as e-mailing everyone is not possible unless I'm at my parents' computer, so to remind you, the web site address is http://katieyork.blogspot.com.

Apparently, Katie had a pretty rough night Saturday (well, Sunday AM to be precise), with lots of coughing and seemingly spasmodic body movements, but aside from this things have been pretty stable with her. She is still having occasional seizures, though, which is certainly far from desirable. They have upped her dosage of Phenobarbital, which they hope will help combat this. Her seizure free times seem to correspond to when her Phenobarbital levels are highest, so this continues to give us hope that some combination of drugs at a high enough dosage will eventually allow her to be both conscious and seizure-free. Whether she will need to stay on high-doses or whether her brain will eventually heal to the point that the drugs are not necessary is something we likely will not know for months.

She is continuing to regain consciousness, though in fits and spells. She is now completely off of all intravenous medications. I returned from Athens to the pleasant surprise of seeing two of her three IV pumps missing and the third turned off. The only major things now sticking out of her are her NG/OG (nasogastric/orogastric) tubes used for feeding and her ventilator. She is making good progress in weaning herself off of the ventilator. Since she's been on the device so long, her diaphragm muscles have atrophied along with the rest of her once Zena-like physique (those who haven't seen her since the onset of her condition would be truly shocked by how frail she looks now). It will take a little more time--probably a couple of days--for her diaphragm to build back up to the level that it can support her breathing without some degree of support from the ventilator. Once this happens, we are hopeful that they can remove this device as well. She is also moving quite a bit more. As of this evening, she can move most of her limbs at least marginally on command. She stays conscious with her eyes open for a few minutes at a time, but it doesn't appear that she is focusing on anything (my amateur attempts to test this by having her follow my finger have yielded no eye movement whatsoever). I don't know if this means that she can't yet see anything or that she simply hasn't yet regained control over her eye muscles. Sadly, she is now crying quite a lot. Of course we aren't sure if she is in pain, though doubtless she is experiencing a lot of discomfort and most certainly she is scared and confused. Crying, though, means that she is at least somewhat aware of her surroundings and has control over at least this emotion, so even this is a positive sign.

Monday or Tuesday she will get another MRI. At this point we are doubtful that there will be any signs of further damage. We are most hopeful now that the lesions on her brain are showing some additional signs of healing. My understanding is that the most prominent lesions appear on both the left and right temporal lobes of her brain (among other things, these control emotion, which is why I'm somewhat relieved to see her crying). On the last MRI, we saw some shrinkage in lesions in other parts of her brain, but the ones on her temporal lobes have thus far remained consistent since her first MRI. Obviously any shrinkage in these lesions, along with continued healing elsewhere, would be a very positive (if not miraculous) finding.

Things have changed so quickly with her condition that it has been hard at times to "see the forest for the trees," but we are all remaining strong through this and are still confident in Katie's eventual recovery. Regardless of how quickly she gets off of the ventilator and of how quickly the doctors can determine the magical mix of drugs required to keep her brain stabilized, her recovery is going to be a long and arduous process for all involved. I know you all will be here for us and most importantly for Katie, and we are all very grateful to be heartened by this knowledge.

Thank you!!
Paul