HOUSTON (AP) — Images of a smiling Rep. Gabrielle Giffords were posted early Sunday on her Facebook page, two photos that show her with shorter hair but few other signs of the gunshot wound to the head that she suffered five months ago.
The photos were taken May 17 outside TIRR Memorial Hermann in Houston, the rehabilitation facility where Giffords has undergone intensive rehabilitation since late January, weeks after the shooting at a meet-and-greet with constituents in Tucson, Ariz. Six people died and a dozen others were wounded in the Jan. 8 attack.
Media and the public's access to the Arizona congresswoman have been tightly controlled while she recovers and, until Sunday, no clear images of her had been released. In late April, grainy television footage showed her slowly ascending a flight of steps to a NASA plane that took her to Florida to watch her astronaut husband rocket into space. The image was so blurry that it was impossible to confirm it was Giffords until doctors did so at a news conference in mid-May.
The professionally shot pictures released Sunday were taken before Giffords underwent surgery to replace a piece of her skull removed shortly after the shooting to allow her brain to swell. They appear to indicate the congresswoman is physically returning to her former self — though her appearance, including darker hair color, is slightly different than from before the shooting.
The photos also give little indication of Giffords' cognitive progress — what, for example, her speech is like after being shot in the left side of the head that controls communication. The images also provide no hints as to when, or if, she will be able to resume her job in Congress.
Pia Carusone, her chief of staff, has indicated that while Giffords is able to speak and walk, she remains a shadow of her former self.
Of the two pictures, one is more clearly posed, of a smiling Giffords looking directly at the camera; the left side of her head appears slightly distorted and swollen, though it is not clear that is from a gunshot wound. A second photo shows Giffords in a more casual light — smiling while sitting alongside her mother, Gloria Giffords, with the hospital's greenery evident behind them.
The pictures, taken by Tucson photographer P.K. Weis, were posted on Facebook amid the possibility that Giffords could be released from the hospital in the coming weeks.
Carusone told the Associated Press late Saturday that doctors and family are considering "many factors" while making the critical next-step decision to release Giffords from the hospital. She did not elaborate.
"We're looking at before the end of the month. We're looking at early July," Carusone said. "We don't have a date."
In an interview published Thursday in the Arizona Republic, Carusone said Giffords can express her basic wants and needs, but has difficulty stringing together sentences to verbalize more complex thoughts and feelings. Giffords, she said, relies on hand gestures and facial expressions.
"She is borrowing upon other ways of communicating. Her words are back more and more now, but she's still using facial expressions as a way to express. Pointing. Gesturing," Carusone said.
The description matches what experts expect from someone who has suffered a traumatic brain injury. Often, they can be easily disoriented, have trouble prioritizing, suffer from some memory loss and could have difficulty recognizing people. Some have difficulty doing several tasks at the same time.
Most cognitive recovery occurs in the first six months to a year after an injury, though it becomes less noticeable as time progresses. In the second year, progress sharply drops.
Carusone said if Giffords' recovery were to plateau now, "it would not be nearly the quality of life she had before."
"All that we can hope for is that she won't plateau today and that she'll keep going and that when she does plateau, it will be at a place far away from here," she said.
While Giffords' release from the hospital will mark a crucial step in her recovery, she still must undergo months of outpatient rehabilitation that will include speech, occupational and physical therapy.
Still, the release of the photos seemed to please the public and her admirers.
On Facebook, the photos immediately generated conversations and comments, with dozens blessing Giffords and her family, complimenting her for her perseverance and courage and her ability to overcome the odds.
Some mentioned Jared Lee Loughner, 22, the shooting suspect who has pleaded not guilty to charges stemming from the shooting and is being held at a Missouri facility. A judge declared him incompetent to stand trial, but prosecutors hope his competency can be restored so he can be put on trial.
Still, others wondered about how far Giffords has progressed.
"It would be nice to get a truly honest assessment of her internal cognitive experience," Alex Hakkinen, who told the AP he works with brain injury patients at a rehabilitation hospital, commented under the photo.
State Sen. Linda Lopez said Giffords looks beautiful.
"Wow! I saw her at the very end of March, and even then, Gabby was all there, her smile, her personality. And she looks even better now," Lopez commented on Facebook.
"I think people are going to be very happy to see how great she looks. For someone who's undergone what she's endured, it's really something. I feel relieved. She looks beautiful," Lopez added.
Associated Press Writer Bob Seavey contributed to this report from Phoenix.