Tuesday, April 28, 2009

MRI results...

The latest word, as of 3 minutes ago...

"She is doing great! They stopped the Versed last night (Versed is the medication that keeps her sedated while on the ventilator), and... pause... pause... Fred, she just opened her eyes!!! She is moving her arms and legs and is looking around!

"Traci was in the room with him at the time. I can barely type, I am so excited for them... for all of us!!!

As for some residual medical issues...Her MRI of the brain from yesterday showed some "Right occipital lobe ischemia." The occiput (pronounced ox-a-put) is the the area of you head that contacts the pillow when you lay on your back. The occipital lobe of the brain is mostly responsible for vision and some speech functions. It is unclear at this time whether or not these areas are seriously affected. It may be unclear for a longer period of time given her young age and that she has not met many of these developmental milestones as of yet. Again, time will tell.

The MRI also showed some ligamentous injury to C1/C2. The cervical spine is numbered from the top/base of the skull to the bottom. The cervical spine has 7 vertebra and is number C1...C7, then thoracic, then lumbar, then then sacrum. C1 and C2 are unique vertebra. They are not like the others. Their function is critical to allowing you to look around, turn your head, look up/down, etc. Disruption or injury to this area can allow the cervical vertebra at that level to sublux or shift on one another. If that were to happen, then the spinal cord would be pinched and possibly severed. Any disruption of the spinal cord higher than C3, you are not able to breath without a ventilator and you would not have use of your extremities. To treat this concern for ligamentous injury/laxity she will wear a cervical spine collar for a few weeks or so. This is very similar to the cervical spine collar that Traci was required to wear after her injury just days ago. Again, Ava's young age benefits her and gives her a good chance of complete recovery from this.

As for her lungs, she continues on the antibiotics for her pneumonia and continues to be assisted by the ventilator. The ventilator assistance now is mostly being continued because of pulmonary edema (swelling of the lungs). The pulmonary edema would make it hard for her to breath on her own. The ventilator is able to generate more pressure and overcome the resistance of the pulmonary edema; therefore, push more air into her lungs. Her body should start getting rid of this on her own and will be excreted through her urine. The medical team will watch urine output closely. When she starts making more urine than fluid she is getting, then this is an indicator that the body is getting rid of the extra fluid, hence the pulmonary edema improves. They watch other things as well, but this is one of them. Hopefully tomorrow she may be extubated, but again... time will tell.

As for Ava's family. Their spirits are high and want me to convey to you how deeply indebted they feel to each of you for your persistent pray, compassion, thoughtfulness and understanding. They recognize that you have been their foundation of hope and love. Please know that you are also in their thoughts and that they feel blessed to have you as friends. Manny reiterated this point to me many times. "Please let everyone know how much we appreciate everything!!" "Yeah... I got it Manny. You're sorry you can't talk to everyone. Hugs and kisses all around... Yeah... I got it!... Yes, I am sure... I got it.... Manny sorry, buddy, but I gotta go... okay... I'll tell them..."

You get the picture.Please continue your prayers. fw.

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