Day 26, 7 p.m. medical update

Greetings from Room 12.

Sage has had a day of rest and relative quiet. She had a bath, change of sheets, and her hair washed by Nurse Diane in preparation for a visit by her brother Nathan and her grandfather Pop. She continues to be weaned from her ventilator settings along with the level of sedation medication she is receiving. Her oxygen level is at 30% (the air we all breath being at 21%) and her medical team on rounds today did use the word "great" in reference to some of her numbers. 

Sage continues to have a normal white blood count and rids herself of the excess fluids she has been carrying out of necessity of these past 25 days. Even though the pneumothorax seems to have resolved itself, the chest tube will stay in place until she is off the ventilator.
Sage also started NG (nasogastric) feeds today, which is another milestone on the road to recovery. She has a fabulous protein and nutrition concoction specially formulated for her by the Nutrition team here at DHMC.
The Neurology team visited Sage today, and the most exciting part of their visit was that she moved her right leg - which is a first! Sage tracks people and voices with her eyes, continues to respond to simple commands for movement and reflexes, and holds on tight! with her left hand. She also expresses recognition and emotion, as she cried silent tears when she saw the face of her brother Nathan, and that of her grandfather and her grandmother.
The result of the MRI finds that nothing has changed, which means nothing has gotten worse - and this is considered good news. The affected area of Sage's brain is the left insular cortex and seems to be the area associated with movement on the right side - and most specifically, of her right arm. This is also what Sage is presenting clinically, as she has moved her right leg, knees and toes, yet without much movement in her right arm. This however, does not mean that she won't! - or so we say in the land of good jou-jou.
It appears that the opinion of Sage's Neurology team is that Sage's brain lesion is a result of a subacute stroke (infarct), as opposed to cerebritis. The thinking behind this is because Sage's cerebrospinal fluid (CSF) from Friday's lumbar puncture was normal and clinically her condition is not pointing toward cerebritis. The opinion seems to be that the cause of the infarct points more toward a blood clot than a lack of oxygen - out of deductive reasoning, more areas of her brain would be affected if it were the latter.
What this means in terms of prognosis is still uncertain; it is mostly a matter of waiting, weaning, moving forward with small and steady steps,  physical therapy, nutrition and rest. Sage is moving forward, in the way that is uniquely and beautifully her own - slowly, surely, steadfastly, sincerely.
For this we are thankful, and hold huge gratitude in our hearts for 'Team Sage' - the medical miracle makers, the miracle channeling team, family, friends, strangers, humanity itself.
Thanks to you, blessings and peace.