Katie Update #21

It seems strange that after 2 days there wouldn't be too much to report, but it appears that this is the case. Katie continues to make significant progress in her return to consciousness. She is now following a much more regular sleep cycle. She sleeps solidly through most of the night and is awake quite frequently during the day. I spent the night with her last night, and aside from waking up with some infrequent coughing spells (which require a little bit of hand holding and some soothing words to calm her down), she slept straight through. Today she was awake from around 7:30 or so until the time that I left the hospital (around 11). She is definitely now able to see things and focus. We've taken to putting on her eyeglasses at times so that she can see a little better. She'll point at things occasionally (which I know must be hard for her since lifting her arms is a struggle) and lift her eyebrows as if asking what they are. This morning, she pointed to a couple of teddy bears that we have suspended above her bed and to a huge balloon (a Valentines gift from Katie's boyfriend, Tedd) situated on the ceiling above her bed. I explained what these were, and she smiled, which is a truly wonderful sight.

She is still intubated, meaning that a tube is still running into her mouth and down her trachea and that the ventilator is still attached and helping her breathe. She is doing most of the breathing on her own, now, but still has occasional spells where she will either forget to breathe or is too tired and the machine takes over. In the past two days, though, she's only had two of these apnea spells, which is really pretty good considering the amount of time that she spent with a machine doing all of her breathing for her. There is a bit of urgency in getting her breathing completely on her own and extubating her (i.e., removing the ventilator and the tube). Aside from the obvious discomfort that the tube is causing her, if she needs to stay connected to the ventilator for much longer, doctors are recommending performing a tracheostomy on her. Being intubated for an very long period of time has been shown to cause internal scaring which can lead to serious difficulties down the road. Putting a tube directly into her trachea (surgically inserting it into her neck) can alleviate this problem. We are not wanting to do this if at all possible because the procedure has risks in itself and will most certainly leave a little scar on her neck from the incisions. We'll do it if necessary, obviously, but we want to make sure she has the opportunity to try and breathe on her own prior to taking this step.

Her CT scan did reveal some blockage in her sinuses as well as some fluid buildup in one of her ears. Both of these may be sources of infection that are not being adequately handled by the antibiotics that she has been taking, and either could potentially explain her continued high temperatures. The ENT specialists want to drain her ears and irrigate her sinuses. Both are surgical procedures requiring general anesthesia. This surgical team is also the group that would be performing the tracheostomy, if required. We initially were scheduled for surgery for this today, but have decided to put it off for the weekend. This is so that we don't have to do two surgeries (one for the sinuses and ear and one for the tracheostomy). We'll reevaluate her situation in this regard later.

From a neurological standpoint we have a bit less news. The neurologists reattached the EEG both Wednesday afternoon and Thursday afternoon. Neither of these readings showed any seizure activity, which is great. Wednesday's reading was very good, showing nearly normal brain activity. Thursday's reading was also mostly normal, but it did reveal some abnormalities during her sleep cycles. The doctors had taken her off of one of her anti-seizure medications (Depakene, aka. Valproic Acid) in preparation for her potential surgery on Friday. The Neurologists think this may be the reason for the abnormal activity and have resumed her Depakene dosages since surgery is no longer imminent. We'll see today what effects this had on her brain activity.

Well, that is about it. I guess by the volume of writing that I just did, this was in fact quite a bit to report. We are starting to see a light at the end of this tunnel, and it is very exciting for all of us. I'll continue to be there, and I will continue to keep everyone posted. Thanks as always for your e-mails, postings, and pages. Keep 'em coming. Now that Katie's more awake, we want plenty to read to her!

Thanks and bye for now.

Paul