Tuesday, August 10, 2004 3:03 AM CDT

Dear Friends:

It’s late now so I hope that I will make some sort of sense, but I want to let you know that sometimes when I read a particular phrase from a card or read a message on the internet or I eat a meal and allow myself to let in the love and support that is sent to us as you nourish us and keep us strong, and I am so very grateful for the many people who know and love Pía, Pía and Kris, the family and me. I want to express that you truly are helping and supporting us to help and support Pía and we cannot, and thankfully are not doing this alone. Thank you.

I want to offer an idea or two for anyone interested or with the time to do one or both of the following, but PLEASE do not feel obligated, in anyway. See if you like the idea, and if it would be fun or something you’d like to do, then great. If not that is great as well.

As you know by now, part of Pía’s recovery at Bethesda involves an on-going stimulation program where she is exposed at various times during the day to familiar sounds. To help her with this, we’d like it if anyone is interested in using your creative energies to make a CD or audio tape that we could share with Pía. Here’s what we have in mind: We would like this to be fun and to have an upbeat tone. Although we don’t want to be too restrictive, please keep the following categories in mind in making a tape:
1) “Mellow” meaning no words, just mellow music for when Pia is resting (could be classical, jazz, acoustic, etc) just as long as it is mellow;
2) “Mellow Plus” meaning mellow music which has words (Enya, Simon and Garfunkle, e.g.)
3) “Mix it up” meaning words and also music that is more upbeat, louder, celebratory. The music can be “loud” just not too blaring or dramatic.
4) A final category could be recording sounds that have a connection to Pía such as sounds that might help to spark some memories or that you know are very familiar to Pía. One example would be for rowers to tape sounds on the water, or the clanking of the oars on the dock, etc. (Rowers, please don’t feel any pressure to do this, but it was such a clear example!:-) I’m going to get my dad and brother to sing some of the songs we sang as kids, on road trips, as another example. We encourage groups of folks who already know Pía (e.g her co-workers, rowers, neighbors), to feel free to get together and make a tape. Individuals, however, can do so as well. Consider self-organizing with others using the Caring Bridge website as a reference.

In addition to using the general music categories as a guide, please do the following with your tape or CD. At the beginning, let us know who you are and also give a BRIEF description of what you have included on the tape (e.g., this a tape of “mellow music”). Also, if you want to send greetings or messages along, please be brief and upbeat. Don’t feel any pressure to fill up the entire tape. We want this to be a fun, easy and joyful way for you to connect with and/or send positive energy to Pía.

Team Pía has asked Mary Jo Kane and Robin Berry to help us coordinate all of this. If you have any questions about how to proceed, please contact Mary Jo at 612-721-5463 or maryjo@umn.edu. Robin can be reached at 612-824-5488 or tberystudio@mn.rr.com. Please send your tape or CD to:
Mary Jo Kane
2900 E. Minnehaha PKWY
MPLS, MN 55406


Much love,
Lisa

Also--Idea #2: A while ago, we mentioned the idea of sending in your favorite story of Pía. Well, we have a site for this! If you are interested, please think of and share a story or two of Pía to:
www.teampia.org

There is marker entitled, “Keep in Touch” at the top right of the home page. Please submit your stories there. We will then print them out and read them to Pía, as part of her stimulation program. They will also be available for others to read.

Many thanks to The Design Company for all the work put in to making such a great site and for helping us to expand the options and possibilities of supporting Pía!

Thanks again for all your help, love and support. We are excited to see what wonderful, creative things you will come up with. (Apologies to my dad the grammar teacher for ending a sentence with 2 prepositions, but it’s too late and I can’t get my brain to think of another ending.)


Finally! I realize I wrote all of this without saying anything about Pia. As we all know, she is incredibly strong. She continues to do well as they wean her off the ventilator. That is, she spends more and more time doing much of the work of breathing on her own and they continue to lower the amount of support that the machine provides. That is great news and an incredible effort on her part! As with anyone in her situation, not being able to get up and move around on her own has its impacts on the body and we feel that the staff at Bethesda are keeping a vigilant watch and take necessary steps to address what might come up.

Thank you for being part of Team Pia.

Saturday, July 31, 2004 7:58 AM CDT

Good morning on this fine Saturday in July,

This is Kris and the first thing I would say is ‘thank you, so, so much.’ Your continued support and work on Pia’s behalf has brought definition to the phrase ‘Team Pia’ that goes so far beyond anything I could ever have imagined. Pia and I first starting using the phrase ‘Team Pia’ a little over a year ago, as Pia’s participation in the “Pigman 1/2 Iron Man” (a ‘mere’ 2+ mile swim, 56 mile bike ride, and 13.1 mile run) approached. We knew that it would take quite a bit to support Pia’s efforts in Iowa last August and that it would take even more to help energize Pia for the full Ironman in Madison in September of ’04. Little did we know that our vision was of a team effort that would sustain Pia as she fought to recover her body, her mind, and her spirit throughout the 2nd half of 2004, and probably through most of 2005!

You all have been incredible, and once again sustained us through the end of a very long week. I had not been able to read messages on this site all week and when I did late last night, my energy, resolve and spirit were lifted so, so, much. It is amazing what positive energy can do for us and for Pia in this incredible journey.

And positive energy is exactly what has Pia gotten Pia through the last 10 days at Bethesda. It has been an exhausting week for Pia, yet she is hanging in there. Early this week, Pia’s schedule for her Coma Stimulation and Ventilator Weaning programs took shape. The goal is to work Pia as hard as she is able to work during scheduled ‘stimulation’ sessions, with carefully planned rest periods during which she is able get ready for the next ‘round’ of challenges. The schedule is rigorous, and the rest periods far less than Pia would seem to need (in my humble opinion,) but the name of the game is ‘PUSH.’ The well-trained and very experienced staff at Bethesda is pushing Pia to see whether she will be able to breathe without the ventilator. At the same time, Pia is being pushed in an attempt to facilitate her return to consciousness. As you can well imagine, each of these processes takes a tremendous toll on Pia, and there is a delicate balance of ‘stimulation’ and ‘rest’ that must be achieved in order to be sure that Pia is ‘pushed’ but not driven past her limits.

To give you an idea of the physical environment at Bethesda, Pia’s unit is structured much like acute care ICU units, and the hospital procedures, rules and requirements are very much like we experienced in the ICU at Regions. The treatment parameters are guided by an attempt to maximize the potential for Pia to make progress in the time allowed for each of her rehabilitation programs. There are specific requirements for Pia’s ability to continue to remain in this unit, which is another reason that all decisions that are made by the members of Pia’s health care team are made to support her success in both the vent weaning and the coma stimulation programs. This team has advised us that we won’t know for some time when it is advisable to enlarge the circle of the ‘on site Team Pia’ to include visitors, and that the highest priority right now is Pia’s participation in her therapies. However, please know that having your positive energy brought more directly to Pia is a subject that we discuss with Pia’s caregivers regularly.

We are so grateful that Pia’s vital signs remain stable, and that the injuries sustained in her limbs and other parts of her body continue to heal. And while Pia has been virtually free from fevers since her move to Bethesda, she continues to remain vulnerable to infections and other complications that can arise from being unconscious and immobile. While I just learned that Pia contracted a new infection this week, we remain confident that she will fight this infection with the same determination that she has relied on to fight so many other similar challenges over the last 6 weeks.

While Pia’s journey at Bethesda will be long and challenging (and have its ‘ups’ and downs’) we know that with your constant love and support, Pia will eventually move forward. As there are signs of this forward movement, we’ll continue to share them with you. Again, we remain so grateful to be a part of such an incredible team effort.

Take good care, Kris

Saturday, July 24, 2004 6:54 AM CDT

Good morning all,

This is Kris,and I'm writing to give you a sense of what our last couple of days have been like at Bethesda. Pia tolerated the transfer from Regions to Bethesda well, as her vital signs remained stable. She was, however, exhausted, and slept very deeply virtually the entire day on Wednesday, even prior to the move. (There are some who believe that she sensed that something 'big' was going to be happening when she awoke that day!)

Thursday was our first full day at Bethesda, and we met a number of the professionals who will be working with Pia. We are impressed by the staff that we have met thus far, and appreciate that they are trying to help us understand the differences between being in an intensive care unit and being in a rehabilitation unit. They have quite a 'team' approach, which you can imagine fits in quite nicely with the approach used by "Team Pia." We also appreciate their obvious experience in dealing with patients who have suffered traumatic brain injuries.

On Thursday and Friday, Pia's therapists conducted baseline assessments and gathered the remaining information from the staff at Regions that was necessary to create Pia's treatment plans. Early next week, we'll have a better understanding of Pia's schedule for both her respiratory program (attempts to wean from the vent) and her coma stimulation program. Both of these programs are rigorous, and will be coordinated in their approaches to exercise and stimulus, as well as creating a rigid schedule for rest and the absence of stimulus. We'll be adjusting our schedule to fit within these programs and to assist Pia in her therapies as appropriate.

We expect that in the next week or two we'll have some idea of when Pia's treatment programs will accommodate visitors, and on what schedule. We know that many of you have anxiously awaited the opportunity to bring your positive energy and strength directly to Pia, and we too are anxious to have her experience the full force of your love and support. So please know that as soon as we are able, we'll be creating a schedule for short visits with Pia and we'll let you know who the 'point person' will be for maintaining this schedule.

We continue to be lifted by your non-stop messages, assistance with meals, errands, tasks of daily living, etc. We could not be with Pia as much, or in the way that we are, without all of your help. We are still restricted from making phone calls in Pia's room so telephone communication remains a challenge for us. We will, however, try to keep you updated on Pia's progress here at Bethesda through this website.

Please know that while the progress of Pia's recovery is slow, we believe that it is steadily moving forward, and we know that it is at the pace that is right for Pia.

Take good care today, and enjoy the weekend, Kris

Wednesday, July 21, 2004 11:26 PM CDT

Hi Everybody-

This is Pia's sister Lisa and I am writing to let you know that this afternoon, Pia was moved from Regions Hospital to Bethesda Rehabilitation Center. This is an important move on Pia's road of recovery. It appears that she tolerated the trip relatively well and her vitals remain stable and strong. (Her blood pressure is still better then mine!:-))

She begins a battery of tests and examinations in the next few days and then begins a serious rehabilitation regime focusing on getting her off of the ventilator. At the same time, she will be receiving intensive sensory stimulation. As this all happened today, we do not know what the schedule will be like, what will our role as family be in this new setting and so we ask that you continue to refrain from visiting until we better understand what this will all look like.

Thank you very much for your continued support, love and encouragement. This is an incredibly intense time and knowing that there is a larger supportive community has been and remains terribly important.

SI-C-U later!!

Love and Peace,
Lisa

Monday, July 19, 2004 8:45 PM CDT

Hi all --

Well, we're all still excited for Pia's upcoming move to Bethesda, but we want to let you know that it won't be happening tomorrow. Pia continues to fight infection and will remain in SICU a little longer. We're not completely sure of the new move timeline, but we will definitely let you know when plans are underway.

Here's a poem by Nancy Wood that we wanted to share:

My help is in the mountain
Where I take myself to heal
The earthly wounds
That people give to me.
I find a rock with sun on it
And a stream where the water runs gentle
And the trees which one by one give me company.
So must I stay for a long time
Until I have grown from the rock
And the stream is running through me
And I cannot tell myself from one tall tree.
Then I know that nothing touches me
Nor makes me run away.
My help is in the mountain
That I take away with me.

Earth cure me. Earth receive my woe. Rock
strenthen me. Rock receive my weakness. Rain
wash my sadness away. Rain receive my doubt.
Sun make sweet my song. Sun receive the anger
from my heart.

With love

Trish and Kathryn

Saturday, July 17, 2004 7:28 AM CDT

Good morning all,

As I write this message, the Lifetime Fitness Triathlon is just beginning at Lake Nokomis. Pia partipated in this triathlon last year as a 'warm-up' event for the 1/2 Ironman she completed the following August. Pia planned to do the Lifetime Triathlon this year as a part of her training for the full Ironman in September. Well, as we all know, Pia's efforts have been redirected. However, her intense training to prepare for the Ironman is serving her well as the 'warm-up' for the challenges she now faces.

Today, Pia is preparing her mind, body and spirit for her next major event-a move to Bethesda Rehab Hospital in St. Paul for respiratory rehabilitation in an attempt to wean her from her reliance on a respirator. This will require focus, determination, and great patience. However, as many of you have noted, we have seen Pia demonstrate these qualities in many aspects of her life and expect that she will bring the full force of her strength and resolve to this effort as well.

I must report that the force of the energy created by the Team Pia community is powerful and quick!! Yesterday, a number of Pia's healthcare providers (at Regions and at Bethesda) conferred and agreed that if all goes as expected, Pia will move to Bethesda on Tuesday. (It would have been Monday, but there won't be an open bed until Tuesday!!)

This is incredible news for Pia, and we are all continuing to move toward that goal with her. We are also ready to accept any delay that might occur, should that become necessary. We'll let you know how the plan for the move is progressing, and we continue to be lifted by your constant support and love.

Kris and the entire "on site" Team Pia

PS Let's have a very loud cheer for the power of this wonderful community of support, love and healing--GO TEAM PIA !!!!

PPS Some have called members of the family raising concerns about my reference to a 'procedure' being planned. I apologize for any anxiety raised by the vagueness of my reference. There is no new injury, medical issue or complication about which you need to be concerned. Pia's body is healing and her progress is slow, but steady and forward moving!!

PPPS After the move to Bethesda, we won't be discussing specific details of Pia's progress in her respiratory therapy. There are many aspects of Pia's recovery, and working on respiration is only one among them. As a team, we are attempting to be directed in our focus by Pia's own path. And while we have found that it can be tempting to focus on certain aspects of recovery as 'markers' of progress, this does not serve us, or Pia, well as we work to support her in this very long journey. We will, however, attempt to continue to give you a general sense of the path of Pia's recovery. Again, thanks sooo much for your continuing support and for the way that you have embraced this method of communication during these challenging times!!!!

Thursday, July 15, 2004 3:29 PM CDT

Good afternoon everyone,

I hope that you are having a great Thursday! I have spent a lot of time today speaking with a number of Pia's doctors, her nurses and various therapists. Everyone of these professionals agrees with the 'on site' Team Pia that it is just about time for Pia to leave Regions SICU and head to Bethesda for the next phase of her recovery. She came ooooooh sooooo close to making this move on Wednesday morning, but didn't quite make it. And as it turns out, Pia knew best (did we ever doubt it?) Pia was harboring a new infection that has just been identified, and against which the medical team is now working diligently(with Pia's able assistance!!!)

And while Wednesday wasn't the right day, we all feel that the time for this all important move is very near. In fact, I have a very strong feeling about Monday, July 19th being the right day for Pia's move. What if we were to try to harness all of the energy generated by this overwhelming community of love, support and healing and channel it toward making next Monday be THE DAY? Could it work? Well, if we all focus, and if it's right for Pia, I believe that it could happen.

So, I'm going to visualize Pia moving from Regions to Bethesda on Monday, and invite any of you who are so inclined to visualize with me. I promise to let you know how Pia's progress toward that move is going, and I also promise to visualize each and every one of you having a great July weekend!!! Much gratitude and affection, Kris

Wednesday, July 14, 2004 8:23 AM CDT

ALERT: Please see PPPS below, if you last read this page before 2:40 pm on July 14th.

Hello everyone,

This is Kris. The first thing that I must do is thank you so much for your continuing website entries. In addition to providing inspiration for Pia , your messages are oh, so important to those of us on the 'on site' team. There are times when they make it possible to do all that we need and want to do for Pia. You have heard me say this before, but I must repeat it because I have recently experienced the power of your support on a completely new level. Please bear with me as I describe how this happened.

About 10 days ago we got some devastating information about the extent of Pia's injuries. It was extremely difficult for all of us at the hospital, and it took everything we had in us to continue to bring positive energy and hopefulness into Pia's room. And as you can imagine, we were all in such pain that it was difficult to have anything left to offer to one another. After about 48 hours of pure hell, during a period in which we were asked to leave Pia's room, I went down to the computer in the hospital's medical library. It was a Saturday night, and I hadn't had a chance to read your messages since the previous Wednesday morning. I caught up on all of the new messages and I found that reading these messages completely transformed me, physically, emotionally and spiritually. By the time I finished reading the messages, and absorbing all of the love, support and hope conveyed in them, I was in a completely different place in the universe. I believe that I was able to 'be there' for Pia in the way that she needed me, and I was also able to put the information we received into a completely different context. And then, within 24 hours of my reading your messages, we received information that called into question the veracity of the devastating conclusions that had been drawn 3 days before. We were told that the news that had us reeling, might actually not have been an accurate assessment of Pia's condition.

I must tell you that while this particular experience stands out in my mind, we have all had similar ones on this journey with Pia. There are good days and bad days. Great hours and challenging hours, but Pia is hanging in there through all of it. And because of your love and support, we are all, (as are you all,) doing the best we can to hang in there with her. All of your messages and acts of kindness and support are keeping us going, and the energy travels directly back to Pia. Her strength, courage and power to heal overwhelm us everyday.

And probably not unrelated to all of the positive energy being sent to Pia, we have some encouraging news to relay today. We expect that Pia will soon be able to be released from the Surgical Intensive Care Unit at Regions Hospital. Her doctors have determined that Pia should soon be beyond needing the acute, medical intensive care offered by this unit. If things go as planned, Pia will be transferred to Bethesda Rehabilitation Hospital in St. Paul. Bethesda has excellent programs that we know will serve Pia well in the next phase of her recovery.

We're not exactly sure when this move to Bethesda will happen, but shall let you all know just as soon as it does. Pia is still fighting fevers and the other challenges faced by someone with her extensive injuries, which will impact how we are all guided in our attempts to support her continuing progress at Bethesda. However, I don't want to minimize the amazing strides that Pia has made in her recovery. Her body continues to fight and to serve her well through this struggle, we see daily the strength, determination and 'gutsiness' that you have all described so aptly in your messages to Pia and to each other on this website.

Once again, I need to thank each and every one of you for your continuing support of Pia in her recovery.

We are sending gratitude and tons of love 'back at ya' from St. Paul, Kris & Pia

PS At this point, we're not sure what our schedule will be at Bethesda, or how the move will affect the generous meal delivery system you have in place. Please know that we'll get that information to you as soon as we have it.

PPS We expect to give you more information concerning where you will be able to post your favorite picture of and/or story about Pia soon.

PPPS July 14th 2:40pm update:
Okay, so here's a little sample of the 'on again, off again' path we're on. When I wrote to you this morning, Pia was originally scheduled to be transferred to Bethesda today or tomorrow. As of 9:00 this morning, however, we're on hold again. Pia had a little complication this morning that changed the analysis, and there are tentative plans for a procedure to be done next week here at Regions. While this could all change again quickly, for now, we're at Regions, still in SICU, and plan to be here for the foreseeable future. Thanks for sticking with us!!!

Wednesday, July 7, 2004 3:34 PM CDT

Dear family and friends,

Greetings from Regions Hospital! As always, thank you for your wonderful, on-going support.

We’re writing to give you a brief update and to ask for your help, if possible, as we make some transitions in preparation for a long-term recovery process.

First and most importantly, Pía remains incredibly strong and is making steps each day towards recovery. There are many things that we celebrate each day – perhaps Pía has held a non-feverish temperature for two consecutive readings, perhaps her respirations are relaxed for a long period, perhaps she’s opened her eyes and closed them, perhaps she’s moved her eyes toward the direction of one of our voices. Pía’s recovery will be one marked by daily important steps towards recovery as well as by cycles, where some days many steps are taken and the next day we don’t really see so many of those steps. Over all, she’s maintaining strong vital signs and we feel is slowly moving on the continuum towards “awake.”

Please know that “awake” in this type of recovery is a process. We’ve learned that it doesn’t happen all at once, but that different parts of Pía’s body, mind and soul wake up, try things out, take a break, try again, etc. over time. That’s what we’re on the look out for in our stimulation efforts and we feel that she is on this path. This is great news!

As we all make longer-term plans, there are some transition details that we are beginning to figure out and ask for your help in this. Howard, Lisa and Kathryn currently do not live in the Twin Cities and are looking for a short-term housing option as we make the transition. A couple things that would be very helpful if anyone has a lead on them include:
~A small or “mother-in-law” type apartment that would take a dog and a cat. Howard, Lisa and Kathryn are looking for such a place together in the Twin Cities for a few months until we can figure out what a more permanent solution will be. Many of you have so generously offered us a place in your house which we truly appreciate. Between Kathryn and Lisa’s dog and cat, crazy hours at the hospital with comings and goings at all hours, the need to focus on Pía, and so as to not disrupt your already established family life, we feel that a separate entrance/kitchen/etc. makes most sense.

~A laptop computer – anyone know of one that isn’t being used currently or know of a good deal? Lisa and Kathryn are reconfiguring their current work situations to make the hospital a work home base and this would be helpful to them and to Kris who is managing household, medical research and legal issues out of Regions.

Now we’re going to ask you to do something else—this is a bit more fun. Please begin to think about your favorite stories about Pía. We’re in the process of figuring out how to best collect these stories, but in the not too distant future, we hope to read stories to Pía about her life, friends and wonderful community. We think that by next week we will let you know where to post these.

Again, thank you all so much. ¡Siempre adelante!

Howard and Lisa (Pia's dad and sister)

Saturday, July 3, 2004 4:14 PM CDT

Good afternoon to this amazing group of Pía friends, supporters, family, loved ones. We’re on a two-hour mandatory break from the SICU and are taking this opportunity to write a brief update.

Part of the difficult and painful process that we all share as committed members of Team Pía is the long-term waiting, hoping, praying, loving and strength that this recovery requires. Because of the nature of a slow recovery process, there really isn’t that much new information that we have to share each day.

Pía continues to have steady vital signs and continues to struggle with daily health challenges and infections in the SICU. She is so incredibly strong and continues to inspire me with her pure athleticism, strength, will and determination. She is engaging in a combination of intentional stimulation and intentional rest, monitored and implemented by the excellent team of medical professionals that surround her and coordinate her care.

We are just beginning to explore options for the places where the next stages of Pía’s recovery might happen. We will definitely keep you updated as these plans become more concrete.

I want to express my sincere gratitude to all of you who have been involved in bringing us food here at the hospital and who have called to be involved in on-going meal deliveries. The food calendar is set up and is full (!) because of your generosity and commitment to this recovery. Thank you so much. The food provides us with much needed nourishment and, perhaps most importantly, allows us to keep eating and healthy during periods when it is just not possible to leave the floor or area because of our need to have a medical consult, wait to sign a form or participate in daily activities related to Pía’s recovery.

Also, we were able to find a wonderful July 4th week home for Sadee with lots of back up options, too. Again, thank you.

Your messages, care and on-going communication are providing so much strength to this recovery. The guestbook serves as such an inspiring place of hope and love for members of ‘on-site’ Team Pía. Your messages are also being read to Pía as part of her stimulation, so please know that your communication with us via the web is playing a very active role in the healing and recovery.

I firmly believe in the strength and power that this community offers to Pía’s healing, in the power of the many, many prayers heading this way and in Pía’s sheer strength and determination.

Takk takk takk takk takk...on and on...(Norwegian for thank you ~ the more takks the more thanks),

Kathryn
Pía’s sister-in-law

Tuesday, June 29, 2004 11:08 AM CDT

Good morning everyone from Kris,

I am at Regions Hospital with Pia, Lisa, Howard and Kathryn and we would like to give you an update with respect to Pia's condition. We would also like to discuss the ways in which we can all support Pia during this phase of her recovery.

For now, the four of us are continuing to try to assist Pia's incredible medical team in providing an environment in which Pia's body, mind and spirit can heal. We are doing that by being sure that one of us is in Pia's room with her during all times permitted, so that she knows that she's not alone in her journey and so that one of us is with her should she regain consciousness. We are also with Pia and in constant contact with her health care providers so that we are able to learn all that we need to know about Pia's injuries, her treatment and the parameters for her recovery. This education enables us to make educated decisions on Pia's behalf when the need arises and has also enabled us to be able to know that we are assisting Pia, as opposed to impeding her, in her healing process.

As many of you have acknowledged in your messages to us over the past 12 days, our work with and for Pia is exhausting and takes just about every ounce of physical and emotional strength that we can maintain. Please know that we realize that our work on Pia's behalf would not be possible without the loving support and acts of kindness and generosity that so many of you have provided since June 18th. So actually, we are ALL working to provide the space in which Pia is able to devote all of her energy to healing.

As you know from past messages, the number of people permitted in Pia's room (and in the hospital) has been greatly restricted and we expect this restriction to remain in place for some time. We know that not being able to see Pia has been, and will continue to be, difficult for those of you who so desperately want to be at her side and to deliver positive energy, strength, and prayers to in a way that feels more direct. It is for this reason that I believe that it is time to discuss Pia's challenges in a little greater detail so that you are able to understand, as we do, what will help Pia in this stage of her recovery, and what will not.

While Pia tolerated the procedure on her head and neck well, she continues to face daily struggles on her path to wellness. One of the greatest threats to Pia's continuing health is the threat posed by infection. Pia has continued to fight at least one infection for most of her stay in the Surgical Intensive Care Unit, and is fighting this battle even as I write to you. And while this is not uncommon for a patient in an intensive care unit, it is critical that exposure to additional sources of infection be managed carefully.

The other reason for the restriction on the number of people in the room with her (in addition to the careful management of the behavior by those in the room,) is the extraordinary amount of rest that Pia requires right now. As you might imagine given the nature of harm she suffered, Pia sustained injuries throughout her body. We have not even discussed many of these injuries, as they pale in comparison to Pia's head and neck injury and other more pressing physical obstacles. However, the amount of healing that is required of Pia on an hourly basis is overwhelming for those of us with her to even try to visualize. However, we must focus on this, and we must continue to be guided by what is best for Pia's body, given the extreme demands she faces.

We feel that at this point, it is also important to discuss the amount of healing that is required within Pia's brain. We have no indication at this point of the long term impact of the damage to Pia's brain sustained during the head and neck injury. However, we know that even under the best of circumstances, Pia's recovery in this regard will take at least many months, and possibly years. The primary concern at this point is supporting her overall health, and being patient with the time that it takes for brain cells to regenerate and for the body to accept such an extraordinary trauma. For this reason, we are not now even focusing on whether or when Pia 'wakes up.' Instead, we are focusing on continuing to be able to maintain an environment in which every part of body and mind can recover from this trauma.

The information about Pia's recovery may also be helpful in understanding what will assist us, as we work to support Pia. As I mentioned, we are being sustained in our efforts on Pia's behalf by your continuing acts of kindness. You have all done so many things that have been critical to our being able to maintain our focus and our fortitude. Your willingness to take on so many tasks (we've come to call them 'do outs,' a term given to us by Trish!) permit us to focus all of our time and energy on Pia. Please know that we are all sooooo grateful for all of your help, and that our immediate needs remain the same. It is such a gift to be able to eat the wonderful food that is provided and/or purchased through your continuing generosity. We also appreciate your understanding in accepting that we right now we have virtually no time for visiting with you or making phone calls with updates. We'll continue to post messages to you with updates on Pia's condition. However, we have been advised to expect changes to occur very slowly from this point forward.

We would also like to discuss the status of visits to the hospital. We are challenged as members of "Team Pia" in finding ways to meet Pia's needs, and getting the support that we need without violating hospital rules. The hospital is discouraging (they might actually say 'forbidding') visitors to the hospital and remain concerned that Pia and her family have used a disproportionate share of resources that are available to all families of patients in the Surgical Intensive Care Unit. We must insist, therefore, that you continue to refrain from attempting to visit us or Pia while we are in SICU at Regions. We understand how difficult this is for many of you, and will advise you immediately should this situation change.

Please know that as the demands of meeting Pia's needs change, our needs will change as well. As we face the coming weeks and months, we'll need to continue to call upon you, and we'll be asking for different kinds of support. There will be times when we will be able to and will need to talk, to visit with you and to have contact outside of the hospital. We remain hopeful that there will also be times when Pia will need to talk to you, to visit with you, and to have contact outside of a hospital setting. Your presence and loving suppport will be critical at that point, as our needs will be great. Your continuing messages on this website let us know that you're in this fight with Pia for the long haul, and we intend to be sure to find ways to include you in every step of the challenging recovery process she faces!!!

After Pia's acute health issues subside, we expect that her long term care will begin at a facility outside of the hospital setting. We don't know about the timetable for this transition right now, but please know that we'll let you know when this transition occurs. Please also know that just as soon as we (as the 'on site' Team Pia) would be lifted by your visits, we'll tell you. And of course you'll all know when Pia herself is able to have you visit with her!!!!

For now, please know that your loving support is what is keeping us all going each and every day. We hear you, we need you, and we are sending love back to each and every one of you. Kris and Pia and the entire 'on site' Team.

PS Kathryn tells me that there are a couple of short term needs that have been identified:

1. We have not yet found a long term foster care placement for Sadee and are in serious need of dog care from Friday July 2nd through Sunday July 11th. If you are able to provide this care, please contact Dana via email at d.silkensen@att.net or on her cell phone at 612-743-6624. Please be sure to contact Dana again about this specific request, even if you have been in communication more generally with her about providing "Sadee care."

2. If you are interested in being on the 'food calendar,' and have not yet been contacted, please call Kathryn at 507-363-9239. (feel free to leave a message on Kathryn's voicemail if you don't reach her.) We are in the process of forming 'food teams' and Kathryn can talk with you about how others are choosing to work together in this way.

3. Keep up your spirits, positive energy and prayers as they are sustaining those of us at the hospital as well as those reading the postings on the website!!!

PPS From Kris again: What's going on at Wimbledon? Are the Williams sisters still in it? Any major surprises? I'll pass on the news to Pia!!!

Sunday, June 27, 2004 3:05 PM CDT

Hi all --

I am extremely happy to report that Pia's first surgery, addressing her most serious injuries, went extremely well this morning and she is now back resting in her room. Her vital signs remained strong throughout the procedure -- she's a fighter!

Thank you all for your thoughts and prayers and good wishes -- I know that Pia was drawing on all of that energy this morning during the surgery and will continue to do so as she fights to recover.

We have been told that Pia's recovery will be a long process marked by little victories along the way. Today we can all celebrate one of those victories.

Trish

Saturday, June 26, 2004 10:16 PM CDT

Dear Family and Friends,
It is Saturday evening and we just got word that, barring any scheduling changes, Pia's surgery is scheduled for tomarrow, Sunday, June 27. This will be a long procedure--estimated to take at least eight hours.

Please note that the SICU (Surgical Intensive Care Unit) is still limiting visitors as Pia remains in critical condition.

We are writing to ask that you take a moment, say a prayer, make a toast or somehow send your love to Pia during the day on Sunday. She needs lots of strength especially tomarrow.

We will update the website as soon as we are able tomarrow evening.

Peace

Friday, June 25, 2004 3:39 PM CDT

Team Pia --

Pia is continuing to hold her own, her vitals are strong. We are hopeful that she will have a first surgery within the next few days. We will let you know when we have a definite time for the surgery. Please know that the scheduling of the surgery is dependent upon things besides Pia's status (e.g., the doctors' schedule, other trauma patients).

Also please know that your messages continue to support us as we work to support Pia. Many people have told us that your messages have helped them tremendously through this difficult time. We're glad this space is able to do this.

-kris, howard, lisa, tom, kathryn, louanne, trish, and jason

P.S. rrrank rrru rrrery much ruff!!! - Sadee

P.P.S. Obviously we are all a little punchy right now.

Thursday, June 24, 2004 1:53 PM CDT

Dear Family & Friends:

I have had the incredible privilege of knowing Pia for the past seven years. From the first time my sister Kris brought Pia to Illinois to "meet the family", we knew there was something unique and special about her.

Pia continues to hold tough and amaze the doctors with her strength and determination. Since Saturday, I have been able to talk with so many of you who have played a large part in making Pia who she is today. Kris & Pia are truly blessed to have all of you in their lives. I am in awe of the love and commitment from all her family, including cousins, aunts and uncles. Your love and warmth are testimonies to your family, and Pia has showered that same love on all of us who have been blessed to be touched by her - as evidenced by all the notes of love and encouragement.

I would like to take this opportunity to let you know how Kris is doing. As others have told you, this battle is going to be long and hard, and I know we are all concerned for Kris' wellbeing as well. Kris is eating well, thanks to many of you who continue to care for all of us. We are so grateful for your show of love in this way. Kris is also sleeping pretty well. She remains at the hospital, but some of us are sitting with Pia during the night, so Kris can get larger periods of rest to keep her strong. Kris continues to express her gratitude to all of you for your support, and your understanding why she can't talk with each of you personally. She does, however, feel your love, well wishes and prayers. These continue to sustain her and help her to face each day.

Since I live in Iowa and don't personally know a lot of you, it has been amazing to see the community of people in Kris' and Pia's lives, who continue to step up with prayer and support in so many ways. God is good to have put so many of you in their lives. I am sure this committed group will be there for the long haul. Everyone should be so blessed to have such wonderful friends and family to stand by us during those difficult times in our life.

I would like to share from my heart, and let you know ways I have found peace during this time. This past week I have turned to God's word to help comfort me, and one passage that I keep going back to is Isaiah 40:29,31 - "He gives strength to the weary and increases the power of the weak. . . . but those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, and they will walk and not be faint." It's been evident that the Lord has been with Pia since the first person found her, and helping to get her to this point. My prayer continues to be for strength and healing for Pia, as well as comfort and peace for all of us who love her so very much.

May the Lord continue to be with each of you and help you in your grief and sorrow. May you gain strength through Him, and may He continue to guide the doctors and give them wisdom and knowledge on the best care possible for our Pia.

Louanne Neville
Pia's sister-in-law

Wednesday, June 23, 2004 9:44 PM CDT

Hi all-
This is Lisa. I am Pia's sister and I would like to thank everyone for such amazing support and positive energy. I believe that this is and will continue to be important in Pia's recovery. I sincerely thank you.

My sister, as so many of you know, is an amazing person--talented, funny, strong, loving, cranky, generous, determined, smart, gleeful and so much more. These days now are very difficult for all of us knowing her and loving her in such a tough spot. I, like you, await her smile, wit, laughter and in general, to have her here again with us.

Here is a poem that we have over her bed, which I read often and it helps me focus. Perhaps it will serve you as well:

May the long time sun shine on you
All love surround you
And the pure light within you
Guide your way


Many thanks and blessings to each and every one~

Lisa

Wednesday, June 23, 2004 12:08 AM CDT

Dear Friends and Family,

We continue to thank you for your generous thoughts, messages, cards and phone calls. We feel your energy and love and are deeply grateful.

We are writing with some additional information on Pia's progress and on our understanding of the marathon process that this will be.

As most of you know, Pia has been in a near fatal accident and suffered a severe head and neck injury. Her basic vital signs are stable, however we feel it is important to stress how intensely long and slow this recovery process will be. To give you an idea, we would expect Pia to be in the Intensive Care Unit (ICU) for months. Her overall recovery will probably take a year (We are always hoping to be wrong - for this to be shorter!).

Because of the long-term nature of this incredible recovery, we truly will need to call on you over time and over the next year. Right now, the best and most critically important thing that you can do for Pia is to send your energies, your thoughts and your prayers of love, healing and recovery. Visiting is impossible right now during this first critically ill stage. Our goals are to make sure that Pia has as much time to rest as possible, that Kris, Lisa and Howard have as much time in her room as possible (without disturbing her), that we develop a long-term recovery and support plan that can be sustained over this time, and that we send important messages of love and recovery to her as much as possible.


We have had a large number of visitors to the hospital and are extremely grateful for your support. Unfortunately, the ICU cannot continue to handle the volume of visitors that are coming to share thier concern for Pia and the family. The ICU staff have expressed concern about their abilities to do their work with all of the visitors and phone calls and the space that is needed on the ICU floor for other families dealing with similar extremely difficult times.

Because of this, we are asking from you a very difficult thing right now - and that is to hold off on visiting the hospital during this stage of recovery. It is very important to Pia and to her family to not lose the right to be with her during the evening, and if we push the ICU rules too much, we could lose that possibility. Also, the ICU staff have told us that we cannot have food on the floor. We can eat the meals that are brought, but we need to eat them quickly and then get rid of excess food. We really appreciate the people that are bringing meals and will call to arrange that with the people that have volunteered. If you would like to bring a meal, we've got a calendar going, so please sign up in the guestbook and we'll be in touch as the need arises.

More than anything, we are trying to respect the needs of the ICU and the important needs of Pia during each stage of recovery. This is difficult but tremendously important and we appreciate your understanding so much.

There will be so many ways for you to help in the different states of Pia's recovery. We know that we will need to call on each and every one of you in the long-term.

The best that you all can do right now is to continue to send your thoughts, your energy and your prayers. We are logging everyone's contact information and offers from the website.

Love,

Trish and Kathryn

Tuesday, June 22, 2004 12:26 AM CDT

Hello dear friends,

This is Kris. I want you to know just how much Pia and I appreciate all that you have done to show your love and support at this difficult time. Your generous calls, voicemails, email messages, postings on this website, visits, cards and gifts, deliveries of food and help with life's day to day task have been truly overwhelming.

I regret that Pia and I have not been able to personally visit with each of you who has come to the hospital or called over the last 3 days. Please know that your messages of love and support have been delivered to us and have been critically important to all of us working to support Pia's recovery. As you know, we are working with Pia's medical team to create an environment in which she can heal and fight the daily challenges that arise. Pia is working extremely hard, every minute of every day, to reclaim her body and her life. As we all know, this is only possible because of Pia's incredible spirit and determination. However, she can't do this alone, and we all realize how incredibly important all of your love, positive energy and prayers have been and will continue to be.

Before I close, I would like to give you an update on Pia's condition. Her vital signs remain strong and her overall condition remains the same. Given the circumstances, this is very, very positive. Pia's medical team has been relentless in anticipating and addressing every challenge that might arise. The team has kept all of us, including Pia, well informed and very involved in her care. These individuals, to a person, are superb practioners and supportive and respectful caregivers. We could not ask for better care. The primary goal remains securing Pia's comfort and providing an environment in which she is able to get complete rest prior to her upcoming surgery.

In closing, please know that we feel your love and support and depend on it every minute of the day. All our love, Kris and Pia

PS Pictures of Pia have been placed in the photo album of this webpage. Please feel free to email any pictures that you would like to have added to the album to: teampia2004@yahoo.com Thanks.

Monday, June 21, 2004 12:32 AM CDT

It is anticipated that Pia will have a procedure in 7-10 days. In preparation, she needs as much rest as possible. During this second stage of recovery, the entire focus needs to be Pia's need for profound rest. Please note that ICU visiting hours are limited to immediate family. We'll let you know as soon as that changes.

There are things in the next few days or weeks that we might need help on such as bringing food, Sadie care, errands, etc. If you would like to help on any of these, please leave a note in the guest book with your phone number and the days and times that generally work best for you. We will call you as we need to. Thank you so much for your generosity.

Monday, June 21, 2004 10:27 AM CDT

On Friday, June 18, in the early afternoon, Pia was completing a long bike ride in Wisconsin and was in a hit and run accident. There were several caring, generous people that had the presence of mind and spirit to care for Pia until she was transported to Regions Hospital in St. Paul. They were instrumental in her safe journey to an excellent trauma center, for which we are very grateful.

Pia was seriously injured and is in critical condition in the ICU. She is receiving top notch care and her awesome strength is helping her make it through this difficult time.

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