CAPE CANAVERAL, Fla. - She's seen her husband launch into space, and now U.S. Rep. Gabrielle Giffords is looking to the next step in her recovery - surgery to replace bone in her skull.
Giffords returned to Houston from Florida Monday after seeing her husband, Capt. Mark Kelly, roar into space on schedule at 5:56 a.m. Tucson time. Kelly is commander of the shuttle Endeavour, which is on a 16-day mission to the International Space Station.
Giffords, 40, is recovering from being shot through the brain in an assassination attempt Jan. 8 in Tucson. Her next major step will be surgery to fill in a piece of skull that was removed to allow for brain swelling, her staff said Monday. The congresswoman has had to wear a helmet to protect her brain.
Giffords' own skull, which had been preserved from surgery the day of the shooting, will not be used to replace the missing bone, her staff said Monday. Doctors will instead give her a fabricated piece of skull. The surgery is expected to take place in Houston, but no date has been set. The congresswoman's chief of staff, Pia Carusone, said she expected it to be soon.
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"That surgery needs to happen; that is the next step we're looking at," she said.
Carusone fielded questions about Giffords from reporters at the Kennedy Space Center Monday. Giffords did not make any statements. She has not made a public appearance since the Tucson shooting spree.
Giffords is talking, can understand complicated concepts and is able to recognize subtleties in conversation, including sarcastic humor, Carusone said. She understands when people speak to her in Spanish, Carusone said. Giffords was bilingual before the shooting. Giffords' voice is the same as it was before the shooting, her staff says.
"She understands, if not everything, close to everything," Carusone said. "For people who know her, she's a very determined person."
The hope is that Giffords can return to her life both personally and professionally as soon as possible, Carusone said. But there's no timeline, she stressed.
Carusone urged patience, noting that Giffords was "shot point blank in the head," and that her recovery is a slow process.
"Every patient is different with brain injuries," she said.
Giffords was shot clear through the left side of the brain. The left side controls right-side strength, sensation and speech.
As a result, Giffords is learning to do more tasks with her left hand. Though she was right-handed before she was shot, she wrote a note to Kelly with her left hand and sent it into space on Endeavour Monday morning. Carusone, who watched the launch with Giffords, did not know the content of the letter.
About a half million people lined the space coast to watch as the shuttle fired up and shot straight into the air, creating a bright yellow-orange plume that lit up the cloudy morning sky. Due to low clouds, the shuttle was visible for only about 30 seconds after liftoff.
"This is one of the quickest disappearances of the shuttle I've ever seen," Endeavour launch director Mike Leinbach said.
Viewers had to stand at least three miles away for takeoff. At the Kennedy Space Center's countdown area, which is 3.1 miles from the launch pad, the ground shook from the blast.
Giffords watched the launch while seated in a wheelchair on the roof of the launch command center. After the shuttle lifted off, Giffords turned to Carusone and said, "Good stuff," Carusone said. Giffords does not always need a wheelchair to get around, but Carusone said it was more comfortable for her to view the launch that way.
"We were cheering, clapping, taking time to absorb what we were seeing," Carusone said. "We were looking up at the clouds, wondering if it was going to be scrubbed. . . . She got very excited that this was a go."
Also with Giffords was her mother, Gloria. And Gloria Giffords played a role in the mission - an artist, she designed the Endeavour mission's logo, which incorporates all six crew members' names.
Carusone said Giffords is wearing Kelly's wedding ring on a chain around her neck. Kelly took Giffords' wedding ring into space with him. The two spent a little more than two hours together at an astronaut cottage Sunday afternoon. Giffords stayed at a nearby hotel.
The shuttle is scheduled to return to Earth on June 1.
The Endeavour crew's mission is to deliver a $2 billion device to the International Space Station called an Alpha Magnetic Spectrometer, which is designed to search for unusual matter by measuring cosmic rays. The Endeavour crew is also delivering supplies to the space station, NASA officials said
Giffords arrived in Florida shortly after 9 a.m. Tucson time on Sunday. She flew from Houston with the family of Endeavour astronaut Greg H. Johnson.
Giffords has been in Houston since late January, when she was transferred there from Tucson in critical condition. She is recovering from her brain injury at TIRR Memorial Hermann rehabilitation hospital.
Her staff says the trip Giffords made to Florida for the April 29 scheduled launch marked a milestone in her recovery. When that launch was scrubbed because of technical problems, they say Giffords was "insistent" that she return for Monday's liftoff.
"It was a great day. We've been looking forward to this for a long time," Carusone said. "She was very proud."
Kelly's twin brother, Scott, delivered red roses from his brother to Giffords, and to Mark Kelly's daughters, Claire and Claudia, at the launch viewing.
Shuttle mission manager Mike Moses said Giffords and Kelly serve as reminders that the shuttle launches are about whole families, not just the astronauts.
"We are very happy to have her here," Moses said of Giffords. "It's a pretty remarkable testament to human will and recovery that she would travel here twice and see her husband launch into space."
Giffords' staffers were not sure whether the congresswoman will attend Endeavour's landing.
A small contingent of Tucsonans, including survivors of the the Jan. 8 shootings, was also on hand for the launch. Retired Army National Guard Col. Bill Badger, who helped tackle Jan. 8 gunman Jared Lee Loughner, attended with Roger Salzgeber and Patricia Maisch. Salzgeber and Maisch have also been credited with helping to prevent Loughner from reloading his gun that day.
"None of us knew each other beforehand. Now we are friends," Badger said. "The last launch didn't get off. With a tragic event like what Mark and Gabby went through, you like to see this happen and go without a glitch. It was exciting to watch and to hear it rumble as it went out of sight. It was just spectacular."
Giffords' staffer Mark Kimble attended and had a chance to see Giffords for the first time since Jan. 8. Kimble was there that morning when Giffords was among 13 people wounded in a spray of gunfire. Six people were killed.
"It was a very emotional moment to see Gabby for the first time but also extremely inspirational," Kimble said. "We've heard such good reports of her recovery, but to see her and talk with her, it was a very moving experience."
Contact reporter Stephanie Innes at sinnes@azstarnet.com or 573-4134.

