University Hospital Southampton NHS Foundation Trust

Meet the patients: Lizzie Rodway

lizzie RodwayThree-year-old Lizzie Rodway’s parents feared they could lose their precious daughter after she was horrifically injured in a car crash, but now she is back at pre-school and caring for her favourite toy bunny.

Though it could have been so different for mum Karen and dad Adrian following the accident on their way home from a family holiday at Longleat, which left Lizzie with life-threatening head injuries. While her parents were taken by ambulance to Salisbury District Hospital and given the all-clear soon afterwards, Lizzie was flown in by air ambulance as her condition was rapidly deteriorating.

A call was made to Southampton General Hospital’s specialist paediatric intensive care unit (PICU) and a team led by Dr Iain Macintosh arrived in their dedicated PICU ambulance to collect her. Lizzie’s injuries included a significant skull fracture and multiple facial fractures. In addition, the damage to her head was complicated by poor blood flow to the brain.

“We arrived at Southampton dazed and confused,” said Karen, of Ilton in Somerset. “Our clothes were in tatters, having been cut in hospital, and then we were faced with the prospect of thinking we were going to lose our daughter.” Although given some initial hope five days later when Lizzie was deemed stable enough to be moved out of PICU, she took a turn for the worse and was rushed for surgery to remove part of her skull due to dangerous levels of brain swelling.

“Lizzie came to us with an array of complex injuries, but the addition of severe brain swelling created further concerns,” said consultant neurosurgeon Dorothy Lang. “It was vital we were able to remove part of her skull so quickly, as swelling in any patient, let alone a very young child, causes pressure inside the head to become critically elevated, denying the brain of the sufficient oxygen and nutrients it needs to survive.”

As a result of having a section of skull removed, Lizzie was fitted with a protective helmet to cover the vulnerable area until the swelling had subsided enough to have a metal plate replace her missing bone.

The helmet became a symbol of her recovery for Karen and Adrian, both 30. After a further three days in intensive care following surgery, Lizzie was moved to the paediatric high dependency unit and then the paediatric medical unit, where she spent the next 11 weeks recovering and undergoing rehabilitation.

Given the nature of Lizzie’s head injuries and her age, not only did she require the services of the neurosurgeons, but also early intervention by consultant paediatric neurologist Professor Colin Kennedy and his specialist team to manage repair of her brain function. “We have to take advantage of every opportunity that arises in the natural course of brain healing to capitalise on the flickers of function that first appear to engage the recovering parts of the brain in useful activity – this can begin even as early as on PICU,” he said.

“This reinforces their ability to function which, in turn, increases the amount of recovery that can be achieved.” When the physiotherapy team began their work in the early days of admission, Lizzie was unable to even lift her head or sit up.

Damage to her brain from the crash in affected her functional ability, meaning she suffered problems sending messages to the left side of her body from her head down. Karen explained: “Lizzie was receiving physio twice a day and occupational therapy twice a week. This proved to be as tough a time for us as the worst early days when we thought we would lose her, as we were faced with not knowing if she would walk again, have any use of her left arm or sight in her right eye.”

But, two and half months after the accident, Lizzie was fit enough to move across to Southampton University Hospitals NHS Trust’s specialist rehabilitation centre, Bursledon House, where staff accommodated Karen in a family room with her daughter. During her time at the centre, Lizzie made good physical progress and began to regain the ability to walk, talk, play and laugh.

“Bursledon House will always be a special place, as it is where we saw Lizzie take her first independent steps again and then become more and more confident on her feet – it is also where she spent most time with her protective helmet, which became an iconic symbol of her journey,” said Karen. As her stay in Southampton neared five months, the swelling on her brain had reduced and her therapy was producing good results, so Lizzie underwent surgery to replace the missing bone in her skull with a custom-made titanium plate created on-site.

Jenni Palmer, paediatric neurology physiotherapist, said: “After intense work, Lizzie has made an excellent physical recovery here and is now able to stand independently, walk independently while wearing a splint on her left foot to aid balance and is starting to incorporate the use of her left arm into day to day activities and play, which is fantastic.”

A week after having her plate fitted, Lizzie was back at home and has since been receiving weekly physiotherapy and occupational therapy in Somerset. Karen, who has now taken a career break from her job as a senior audiologist to care for Lizzie, added: “We’re all finding it a little strange settling into our new normal life back at home, but Lizzie is coping well with her continuing therapy.

“We just feel so indebted to all of the staff. If there was not such a wonderful team, I really think we would not have our beautiful daughter here with us today.” Karen and Adrian are now raising funds for the paediatric medical unit and paediatric physiotherapy team through Southampton Hospital Charity.

This story was first published in Connect magazine.


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