Katie Update #22

Good news continues to flow in quickly. The really big news today is that Katie has been extubated. She is now breathing on her own--no tube, no ventilator, just a loosely attached mask to provide her with a little extra oxygen. This was a really huge step for her. She was on the ventilator for almost 34 days without reprieve. The staff at MCG have been preparing her for extubation for the past few days, reducing the amount of work done by the ventilator and increasing the amount of work that she has had to do. Today, she had two successful trials of 40 and 45 minutes of breathing without any pressure support from the ventilator. At 5 PM, the doctors decided that it was time to let her try to breathe on her own, and they asked Katie if she was ready. She actually gave a little "thumbs-up" sign, which everyone enjoyed thoroughly. It was painful to watch the process because she was coughing a lot and threw up a little bit, but overall, the extubation went extremely well. At last report (just a few minutes ago), she was sleeping soundly and her vital signs were all normal (even a bit improved over earlier today). There is still some chance that she will have to be re-intubated, but the longer she goes without the tube, the less likely this becomes.

She still hasn't spoken, and it is likely to take a little while for her to do so because her vocal cords have been occluded by the tube for so long. We still have no idea what her mental status is at this point, and won't for some time to come as the drugs wear off and her mental pathways reconnect. However, we are all extremely pleased with her awareness and her reactiveness thus far. It is very apparent that she is ready to start the rehabilitation process. Every time she wakes up, she wants to exercise. She kicks her legs and moves her arms about with fervor. There is no question that she is dramatically weaker than before this incident, but she still amazes us with how strong she still is in certain areas. To date, her body and neck movements have been very limited, but we're hoping that this will change soon as she regains strength and no longer has the discomfort of the tube down her throat.

The neurologists decided to keep the EEG disconnected for the weekend. Her scan on Friday afternoon looked so good that they don't feel that there is a real need for constant monitoring anymore. They will likely hook it up again for a while on Monday to make sure that things haven't changed, but we feel like we're now controlling her seizures well using her cocktail of anti-seizure medications. There are four total medications now being administered regularly. I assume that the next step for the neurologists will be to start to lower her dosages of these medications to see which are truly required and at what level.

We haven't really discussed her surgery for her sinus and ear problems. We postponed the surgery on Friday, but we didn't reschedule it definitively. Her fever has been relatively benign for the past 24 hours, so perhaps this will correct itself as she begins to move around more and is able to sit up and let things drain normally. Note, though, that this is simply my pondering. We've had no specific discussions with the doctors along these lines. I assume this will come back up soon as she becomes a bit more stable in her breathing.

Tuesday we are scheduled for an informal consultation with a representative from the Children's Healthcare of Atlanta (CHOA) regarding rehabilitation, both physical and neuropsychological. A few days ago, we received a visit from the Hill family who recommended this facility to us. Phillip Hill, you may recall, suffered severe brain trauma from head injuries received during a Greenbrier high school football game in 2003. His treatment at MCG was similar to Katie's, and of course we would like to see Katie's rehabilitation go as well as his did. It was wonderful getting to meet Phillip and his family. They provided us with strong inspiration as well as good advice. We look forward to this next stage of Katie's recovery with great hope.

Okay, I'll stop here for now. These past few days have been really exciting for all of us. We know that there will be challenges ahead, likely very difficult ones, but simply to be able to face these challenges is such a blessing. Thanks as always for your continued prayers and your incredible support. I will certainly do my best to try and repay this somewhat by keeping you all informed of Katie's progress.

Sincerely,
Paul