This is from the Mother in Law of Chris.
 
 
Gina Niemi, 541-787-2036
Henna Tattoo Artist, Face and Pregnant  Belly Painter 
_www.FantasyFacesOnline.com_ (http://www.fantasyfacesonline.com/) 


Glimmer  Body Art, Diamond FX, Mehron Paradise, Kryolan, Amerikan Body Art
_www.WOWFactorSTuff.com_ (http://www.wowfactorstuff.com/) 
Fast,  Friendly & Affordable!








  
____________________________________
 From: [email protected]
To: [email protected],  [email protected], 
[email protected], [email protected],  [email protected], 
[email protected], [email protected],  
[email protected], 
[email protected],  [email protected], [email protected], 
[email protected],  [email protected], 
[email protected],  
[email protected], [email protected],  
[email protected], [email protected], [email protected],  
[email protected], [email protected]
Sent: 4/5/2010 7:16:13  A.M. Pacific Daylight Time
Subj: Fwd: april 2




---------- Forwarded message ----------
From: Cathy Godric <[email protected]_ (mailto:[email protected]) >
Date:  Sat, Apr 3, 2010 at 12:47 AM
Subject: april 2
To: [email protected]_ (mailto:[email protected]) , 
[email protected]_ (mailto:[email protected]) , 
[email protected]_ 
(mailto:[email protected]) , [email protected]_ 
(mailto:[email protected]) , 
[email protected]_ (mailto:[email protected]) , 
[email protected]_ (mailto:[email protected]) , [email protected]_ 
(mailto:[email protected]) , [email protected]_ 
(mailto:[email protected]) 



 
 
Chris up date April 2: 
{Hi everyone.  Tuesday was a very rough day…  (Full moon, confusion, and 
well…two steps forward and one step back). } Little  did I realize…  
And then Thursday happened and it was even rougher than  Tuesday.   
We had a meeting with the primary doctors who are monitoring  Chris’s 
health.  They had asked for Neurologists to come in  and consult with them 
about 
Chris’ Diffuse Axonal Brain  Injury…DAI.   
But even before they saw Chris, a nurse came out and said that  Chris was 
going to be transferred to Kaiser…We said nooooooo…we hadn’t heard  from the 
doctors…. 
Then on Thursday we did.  Yes, on the Cat-Scan  they could see DAI as spots 
on the surface of the brain. 
SOME of the neurons have been damaged, but NOT all of  them.  No, they 
could not see Chris’s brain using the MRI  (higher resolution for a clearer 
picture) because Chris’s shoulders are 2  inches wider than the machine…  There 
was no need at this  time to do an EEG…his brain wave activity, because 
they do not think he has  had seizures.   
So…the million dollar questions…Will Chris recover from this  brain 
injury?  How severe is it?  How long  will it take? 
At this time, in Highland ICU, the doctors are getting Chris  stabilized…if 
he had continued breathing on his own without the tubes down his  throat 
and on a ventilator…he would have been stable enough to be transferred  to 
Kaiser’s ICU.  However with the diffuse axonal brain  injury, where they think 
that there was shearing of the axons on some of the  neurons, the 
neurologists are recommending that Chris goes to a facility that  has ICU as 
well as a 
department for Neurological rehabilitation that includes  physical and 
occupational therapies.    
And then, with Chris progressing we can see to what level he can  obtain.  
He is not a vegetable!  He is not  brain dead!  But we don’t (and neither do 
these specific  doctors, because they are trauma surgeons) know how much 
Chris will  recover.   
If you have done some research on the internet, you might find a  grading 
scale that helps doctors determine mild, moderate, or severe  categories…
These numbers cannot be directly correlated to the Cat-scan  pictures of the 
brain (they are like x-rays that take a picture of the brain,  like a slice of 
bread in a loaf.  Liz and I were able to see  Chris’ cat-scans).  The 
neurologists and the rehabilitation  therapists will be able to tell us more… 
And then there is the family and friend factor.   We all had a very 
emotional afternoon and numb with the prognosis…fear  and uncertainty ran 
rampant 
as we listened and heard what sounded so dire and  final.  We all needed to 
grieve a little, and face the fact  that Chris was not going to bounce back 
right away…BUT that does not mean that  he won’t ever bounce back… 
We as a family and as friends must stay positive, hopeful, and  determined 
to be there for Chris as he faces his challenges.   We heard, I wrote, that 
this will be a long process…and today is the 22  day in ICU!!!  No kidding… 
I’ve pasted in a description of what DAI is and its  repercussions.  Some 
of you may want to check out some other  websites…they  are:                  
                                      (skip to below the Brain Trauma 
article) 
#1            _http://en.wikipedia.org/wiki/Diffuse_axonal_injury_ 
(http://en.wikipedia.org/wiki/Diffuse_axonal_injury)  
#2            _http://en.wikipedia.org/wiki/Traumatic_brain_injury_ 
(http://en.wikipedia.org/wiki/Traumatic_brain_injury)  
#3            
_http://en.wikipedia.org/wiki/Primary_and_secondary_brain_injury_ 
(http://en.wikipedia.org/wiki/Primary_and_secondary_brain_injury)  
#4            _http://tbirecovery.org/Overview.html_ 
(http://tbirecovery.org/Overview.html)   (easy to read and  understand) this is 
also a website. 
#5             
     
Brain Trauma - Axonal Shear Injury

 (http://catalog.nucleusinc.com/enlargemonographimage.php?ID=7663)  
(http://catalog.nucleusinc.com/enlargemonographimage.php?ID=7663) Contrecoup, 
an 
injury to the brain often seen in car  accidents after high-speed stops, 
results from the brain bouncing  violently against the wall of the skull. This 
event can cause diffuse  axonal injury, also referred to as axonal shearing. 
This  injury involves damage to individual nerve cells (neurons) and loss of  
connections among neurons which can lead to a breakdown of overall  
communication among neurons in the brain.

 (http://catalog.nucleusinc.com/enlargemonographimage.php?ID=4039)  
(http://catalog.nucleusinc.com/enlargemonographimage.php?ID=4039) The neuron is 
the 
main functional cell of the brain and  nervous system, consisting of a cell 
body (soma), a tail or  long nerve fiber (axon), and projections of the 
cell body called  dendrites. The axons travel in tracts or clusters throughout 
the  brain, providing extensive interconnections between brain  areas.

Mechanism of Injury
This damage causes a series  of reactions that eventually lead to swelling 
of the axon and  disconnection from the cell body of the neuron. In 
addition, the part of  the neuron that communicates with other neurons 
degenerates 
and releases  toxic levels of chemical messengers called neurotransmitters 
into  the synapse or space between neurons, damaging neighboring neurons  
through a secondary neuroexcitatory cascade. Therefore, neurons that  were 
unharmed from the primary trauma suffer damage from this secondary  insult. 
Many 
of these cells cannot survive the toxicity of the chemical  onslaught and 
initiate programmed cell death, or apoptosis. This  process usually takes 
place within the first 24 to 48 hours after the  initial injury, but can be 
prolonged.

 (http://catalog.nucleusinc.com/enlargemonographimage.php?ID=1870)  
(http://catalog.nucleusinc.com/enlargemonographimage.php?ID=1870) One area of 
research that shows promise is the study of  the role of calcium ion influx 
into 
the damaged neuron as a cause of  cell death and general brain tissue 
swelling. Calcium enters nerve cells  through damaged channels in the axon's 
membrane. The excess calcium  inside the cell causes the axon to swell and also 
activates chemicals,  called proteases, that break down proteins. One family 
of proteases, the  calpains, are especially damaging to nerve cells because 
they break down  proteins that maintain the structure of the axon. Excess 
calcium within  the cell is also destructive to the cell's mitochondria, 
structures that  produce the cell's energy. Mitochondria soak up excess calcium 
until  they swell and stop functioning. If enough mitochondria are damaged, 
the  nerve cell degenerates. Calcium influx has other damaging effects: it  
activates destructive enzymes, such as caspases that damage the DNA in  the 
cell and trigger programmed cell death, and it damages sodium  channels in 
the cell membrane, allowing sodium ions to flood the cell as  well. Sodium 
influx exacerbates swelling of the cell body and  axon.

National Institute of Neurological Disorders and Stroke  researchers have 
shown, in both cell and animal studies, that giving  specialized chemicals 
can reduce cell death caused by calcium ion  influx. Other researchers have 
shown that the use of cyclosporin A,  which blocks mitochondrial membrane 
permeability, protects axons from  calcium influx. Another avenue of 
therapeutic 
intervention is the use of  hypothermia (an induced state of low body 
temperature) to slow the  progression of cell death and axon swelling.

A researcher studies  an image generated by an immunofluorescent microscope 
to understand cell  death in the hippocampus, the section of the brain that 
controls memory.  The hippocampus is frequently affected in traumatic brain 
injury  patients. This technology allows the researchers to study what 
happens  to injured cells at the molecular level, and to look for ways to  
interrupt the chain of chemical events that causes permanent brain  damage 
after 
a severe head injury. 
(http://catalog.nucleusinc.com/enlargemonographimage.php?ID=4053)    
(http://catalog.nucleusinc.com/enlargemonographimage.php?ID=4053) 

In the healthy brain, the chemical glutamate functions as  a 
neurotransmitter, but an excess amount of glutamate in the brain  causes 
neurons to 
quickly overload from too much excitation, releasing  toxic chemicals. These 
substances poison the chemical environment of  surrounding cells, initiating 
degeneration and programmed cell death.  Studies have shown that a group of 
enzymes called matrix  metalloproteinases contribute to the toxicity by 
breaking 
down proteins  that maintain the structure and order of the extracellular 
environment.  Other research shows that glutamate reacts with calcium and 
sodium ion  channels on the cell membrane, leading to an influx of calcium and  
sodium ions into the cell. Investigators are looking for ways to  decrease 
the toxic effects of glutamate and other excitatory  neurotransmitters.

The brain attempts to repair itself after a  trauma, and is more successful 
after mild to moderate injury than after  severe injury. Scientists have 
shown that after diffuse axonal injury  neurons can spontaneously adapt and 
recover by sprouting some of the  remaining healthy fibers of the neuron into 
the spaces once occupied by  the degenerated axon. These fibers can develop 
in such a way that the  neuron can resume communication with neighboring 
neurons. This is a very  delicate process and can be disrupted by any of a 
number of factors,  such as neuroexcitation, hypoxia (low oxygen levels), and 
hypotension  (low blood flow). Following trauma, excessive neuroexcitation, 
that is  the electrical activation of nerve cells or fibers, especially 
disrupts  this natural recovery process and can cause sprouting fibers to lose  
direction and connect with the wrong terminals.

Scientists  suspect that these misconnections may contribute to some 
long-term  disabilities, such as pain, spasticity, seizures, and memory 
problems.  
NINDS researchers are trying to learn more about the brain's natural  
recovery process and what factors or triggers control it. They hope that  
through 
manipulation of these triggers they can increase repair while  decreasing 
misconnections.

Source: National Institute of  Neurological Disorders and Stroke
Last Reviewed: October  2002 
_Medical/Legal Disclaimer_ (http://catalog.nucleusinc.com/disclaimer.php) 
Copyright © 2003 Nucleus Medical Art, Inc. All Rights  Reserved.   


Chris’ left chest tube was removed today.  He  practiced breathing a little 
on his own without the ventilator breathing for  him… (Spontaneous) but 
still had the tubes in.  It’s the  weekend, so they will be keeping him quiet, 
not cat-scans, moving on off his  bed.  He will still be suctioned out every 
two hours by the  therapists or the nurses to remove the sticky secretions 
that are inside his  lungs.  Perhaps on Tuesday or so, they may schedule 
Chris  for a tracheoscopy.  This is not a backwards step but more  of a 
sideways step.  The doctors have tried to not involve  Chris with another 
surgery, 
but the Trach will help him breath on the  ventilator, while at the same 
time, allow for him to practice more frequently  off the ventilator without 
having to put the darn tubes down his throat over  and over again.  He will 
need to be fed directly to his  stomach because he won’t be able to eat 
normally and have the trach…but it  allows him to start communicating with us 
by 
talking.    
He was responsive to Judy, and Gene, and Liz and Vic and  Darlene…I got no 
reaction, till I rubbed the frown off of Chris’s forehead,  and then he 
squeezed my hand.  ( he has been a very  frustrated patient today…his heart 
rate, and blood pressure were high, the  fever to 103 came back but Vic, 
Darlene, Judy, Gene and I got to work real  quick with ice cold wash cloths and 
putting them on his body while waiting for  the water blanket to be ordered and 
delivered.    
Liz came in this evening, and was in a much more positive spirit  today 
than yesterday.  She has also been on the Internet,  and found a success story 
involving a person that had survived defuse axonal  brain injury…I believe 
she has posted it on facebook on the Chris and Savannah  update page.   We 
are staying positive and  hopeful, with love and perserverence we can all help 
Chris get through  this.   
Thank you for being there for us. 
Cathy



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