News

Earlier this year, staff from The Walton Centre visited a hospital in Nigeria during their building of a new stroke and neuroscience centre. Here is an extract from Professor Andrew Brodbelt's account of the trip.

Dr Baba Aji and I were on our way to Maiduguri, Northeastern Nigeria from Abuja, the capital. We were with Professor Ahmed Ahidjo, an interventional radiologist, and the Chief Medical Officer of a large federal hospital complex in a city of three million people. I was looking over the vast dry land, over which we were flying and reflected on the fact that Ahmed makes use of every opportunity to advance his vision of better healthcare for his city, region, and country. We had arrived the day before and had already been to the Nigerian Department of Health and met the permanent secretaries for health and procurement. Describing a plan for a collaboration between The Walton Centre (WCFT) and The University Hospital of Maiduguri (UHM), Ahmed successfully petitioned the department for funding of a CT scanner, MRI, and Angio suite for his new stroke and neuroscience centre. 

I have never been to Africa before. Walking across the tarmac, after disembarking the plane at Maiduguri airport, it was hot, sunny, dry, and dusty. The people were very friendly, and welcoming. We were greeted with a line of people from the hospital welcoming us, then though immigration, and into a waiting car. We followed our security escort, and were driven through the streets of Maiduguri, at speed at times. Vast numbers of cars, small three-wheeled taxis, and bikes were on the road. If there are traffic rules, they involve a lot of horn honking and pushing through at junctions. There were so many people. I felt we were in a living, breathing city. People were in bright colours, with long flowing clothes. There were lots of children about. 

The purpose of our journey was to visit the UHM, meet people working there, see their facilities, attend, and present at a one-day symposium, and agree how a collaboration between the two hospitals could work. There was a lot of building work going on, and we toured several of the sites during our visit. The stroke and neuroscience centre came about because Ahmed noted that stroke patients occupied many of the hospital beds. Patients tended to present late, often many days or weeks after symptom onset, with pressure sores and infections. Ahmed wanted stroke patients treated much earlier to improve their care and outcomes. He agreed funding with the federal government for the building. The stroke centre became a stroke and neuroscience centre following Dr Aji’s advice after visiting in 2023. The building is due to be completed later this year. The ground floor is occupied by an emergency stroke admitting unit, outpatient department, radiology department, and ITU with adjacent neurosurgical theatres. There is an educational centre, and 150 ward beds. 

We also toured the limb reconstruction centre. Due to the previous insurgency related to Boka Harum, there are a great number of people who have lost arms or legs. The centre provides a complete service from initial fitting, manufacturing, and education on use. There is no funded healthcare provision in Nigeria, and although there are subsidies, a minority of people in Maiduguri can afford healthcare. It costs around $200-300 US dollars (£150-£200) to buy a new leg. There are sometimes subsidies available from charitable donations from wealthy Nigerians which can help with affording costs. Incomes in this area are extremely low, even well-paid doctors will earn only £400 a month, and most people earn much less. Schooling must be paid for, and many must decide on medical care, school for the children, or the essentials for living. An additional issue for the hospital is that the electricity supply regularly cuts out. To counter this problem, Ahmed built a solar farm and has the first Linacs (radiotherapy machines) in Nigeria that run purely on solar power. 

As well as touring the facilitates, we had an eventful and busy few days. Dr Aji and I presented at the symposium, we took part in a clinical conference, meeting a patient with a brain tumour and his family, and a patient with headache and a cervical disc prolapse. We were interviewed for a TV documentary, and also by the national press, and appeared on the national news. We met the governor, Prof Babagana Umara Zulum, for dinner, and the Shehu of Borno state. The Shehu is the religious leader for Borno state, and for this last meeting I was sized up and provided with dress robes to wear. I felt this was a great honour, and due in no small part to Ahmed’s influence in the region. 

The Walton Centre is currently developing a partnership arrangement with UHM to facilitate cooperation, to include potential educational, research, estate, and clinical collaborations. At the end, we left Maiduguri with new friends and contacts, and a wish to continue to work with them in the future. 

At the age of 31, Liane Draper was working fulltime and looking after two young children, when she began to experience seizures that left her with lockjaw and black spots in her memory.

Liane felt that her busy, stressful routine with family and work may have contributed to the situation in which her Epilepsy was discovered. She said: “At the time I didn’t stop. I’d do a full day’s work, then come home, sort out the girls and then spend the whole evening cleaning the house top to bottom. Looking back now I think it’s safe to say I was struggling mental health-wise. I wanted everything to be clean and tidy, but obviously I went too far with it.”

The 44-year-old, from St Helens, was diagnosed with Epilepsy and was referred to The Walton Centre for treatment.

She said: “I’ve had lots of scans and treatment over the years to really pin down which parts of the brain my seizures are coming from. The Walton Centre has been amazing throughout. I’m able to speak to experts about my care regardless of what it is. I really appreciate their support and their ability as a team to look after me from a number of different perspectives.”

At the beginning of 2022, Liane had a procedure where telemetric sensors were inserted into her brain, to further study the origins of her seizures. Then, in December that year, Liane underwent brain surgery, after which she is yet to experience another seizure.

Liane continued: “It was a long surgery, and I’m still on anti-epilepsy medication, but to be so far seizure-free is incredible, and I cannot thank The Walton Centre enough. The hospital is like my security blanket. Particularly Professor Tony Marson and the team, they are focused, empathetic and incredibly compassionate.” 

The Walton Centre hosts one of the largest Epilepsy services in the UK. The specialist Trust offers multidisciplinary care, from the first seizure through to complex epilepsy and brain surgery. The hospital has recently been announced as one of only two centres for Laser Interstitial Thermal Therapy, a cutting-edge procedure for patients with Epilepsy that is not easily controlled with medication.

For more information on our Epilepsy services at The Walton Centre, head to our website: Epilepsy

What is your job role?

Lead for Speech and Language Therapy within The Walton Centre.

What made you choose to do the job you are in now?

My mum was a nurse, so I knew from an early age that I wanted to go into something health care related. Having a chat and a cup of coffee is massively important to me so when I found out there was a job to help others with that - I knew it was the one for me!

Favourite part of your job?

So many to choose from, its hard to pick! It is such a varied job and no two days are the same, but the best part of the job is getting to know people and their stories. When we first give people the ability to communicate, for example patients with tracheostomies on ITU, it can be very emotional for all involved! I also love when we can get people eating or drinking again and finding out what the 'first tastes' are that they would go for. 

I’m also lucky enough to have been able to set up an Multi Disciplinary Team secretion management clinic for some of our Motor Neurone Disease patients – drooling is so socially stigmatized that it often causes people to become socially isolated and being able to address that and give people confidence to spend time with family and friends again is a real privilege. 

Tell me about the most rewarding experience you have had in your role.

I’m lucky that I love most things about my job but there will always be the patients that stick with you. I think when we’ve worked really hard with someone to get their swallow going – often from the very early stages on Intensive Care Unit when they can’t even manage their own saliva and have to have a tracheostomy and the distress that causes. We support them all through their journey – getting them communicating again, rehabilitating the swallow so we can get the tracheostomy out alongside the Multi Disciplinary Team and then carrying on with our input until we manage to get them eating and drinking again. Making them that first cup of coffee or getting them that first bar of chocolate always makes it all worth it. 

What's the best advice you've received at work?

You can always add something positive to someone’s day – even if it doesn’t feel like it in the moment! The gains we make might seem small at the time but they can all add up to be a big thing.

What/who is your biggest motivator at work?

It sounds really obvious but the patients are definitely the biggest motivator – even when we don’t manage to get the outcomes we all wanted, knowing that we’ve done everything we can, that we’ve used the most up-to-date evidence and therapy and there really is nothing else we could have tried makes it a bit easier, for us as well as the patients. Being able to reassure the Speech and Language Therapy team of that as well goes a long way towards keeping morale high in tough times and in keeping the team motivated. 

What is on your bucket list for this year?

Work wise, becoming one of the first Speech and Language Therapists in the country to be able to offer botulinum toxin injections for saliva control and trying out new developments such as Biozoon (flavoured air) with our nil by mouth patients and evaluating the impact of this.  Outside of work I’d like to finally take the trip to Iceland (the country!) I was supposed to do in 2000.

Since 2007, Emily Lloyd has been treated at The Walton Centre to manage her epilepsy. As a teenager in 2002, Emily experienced her first seizure and was cared for by Alder Hey Children’s Hospital. Transitioning to The Walton Centre, Emily was able to work with her clinicians on the best treatments and innovations possible to live with her condition.

Making her way through different medications to control her seizures, Emily found the rate of instances was unreliable and hard to manage.

She said: “I had both absence and tonic-clonic seizures and they were happening very frequently - my body was not getting time to recover before the next instance. I was constantly exhausted and also it was getting dangerous. One time I had a seizure while straightening my hair, burning my face, and another time I collapsed waiting for a train, falling onto the tracks. I was also struggling to think clearly, and my memory was extremely poor. I went back to Professor Tony Marson and the team at The Walton Centre for a better solution.”

Tonic-clonic seizures involve both tonic (stiffening) and clonic (twitching or jerking) phases of muscle activity, a serious disruption to people who experience them. During ongoing treatment and investigations, the specialist epilepsy service at the Trust recommended that Emily consider a Vagal Nerve Stimulator. A stimulator such as this is considered for patients where a specific area of the brain causing seizures cannot be identified. The device detects a seizure forming, and disrupts the episode with an electric signal, essentially stalling the seizure. Emily underwent the pathway in 2018.

The 35-year-old from Liverpool said: “After it had been turned on and calibrated, the rate of seizures dropped dramatically. I’ve gone from weekly instances, to approximately two tonic-clonic seizures a month. Having the rate decrease like this has meant I can notice how other environmental factors such as stress and sleep influence my epilepsy. I can also see a huge change in thinking and memory due to the reduction in absence seizures.

“I can only thank the team at The Walton Centre for the incredible support they have given me over the years. With their help I’ve been able to take control of my condition as much as possible, and therefore improve my quality of life.

“The team are so supportive, especially the Epilepsy Specialist Nurses – they’ve been invaluable. They’ve helped me to incorporate seizure awareness into my workplace and now they’re supporting me in managing my condition in conjunction with starting a family. I’ve also been able to take part in research which will hopefully help improve services for other patients.”

The Walton Centre hosts one of the largest Epilepsy services in the UK. The specialist Trust offers multidisciplinary care, from the first seizure through to complex epilepsy and brain surgery. The hospital has recently been announced as one of only two centres for Laser Interstitial Thermal Therapy, a cutting-edge procedure for patients with Epilepsy that is not easily controlled with medication.

More information here: Epilepsy

Have you or a member of your family had a brain tumour diagnosis or brain tumour surgery in the last year? 

We are holding two patient events called 'Coping Better Together' to help give you extra information and extra support. The events will be held on Friday 20 September 2024 and Friday 14 March 2025.

You can register for the event or alternatively, leave the team a voice mail on 0151 556 3778 and state your name, date of birth, telephone number, which date you wish to attend and whether you will be attending face to face or on Microsoft Teams.

In October 2022, retired police officer Dave Smith was treated at The Walton Centre for a ruptured brain aneurysm. Dave, aged 56 at the time, was out with friends on a Saturday afternoon watching a live rugby match on the touchline when he suddenly developed double vision and slight unsteadiness on his feet.

Dave said, “I was chatting with pals about the match, when suddenly I felt as though I was looking through a kaleidoscope. The club doctor had a look at me and called for an ambulance.”

Dave was rushed to A&E in a friend’s car, where the team there suspected a stroke. However, after further testing and a scan, they found a ruptured aneurysm and he was transferred to The Walton Centre.

Dave said, “They told me I would need emergency surgery, to deal with the bleed. I had a procedure where the aneurysm was ‘coiled’ – everything was explained to me in a calm and reassuring manner which put me at ease".

Endovascular coiling is when tiny platinum coils are placed inside the vessel in the brain causing the bleed. This then prevents the vessel from growing or rupturing further.  

When Dave woke up from his procedure, he said he felt surprisingly good. He had no head pain or sickness after the treatment but was experiencing fatigue and sight problems.

Dave said “I felt brilliant after the procedure. The only thing I was left with though was double vision, this worried me as I didn’t know whether I would be able to be as active. There was no guarantee that the double vision would correct itself, so that was my only concern.”

Thankfully, the double vision began to disappear. Dave explained “Before the aneurysm, I was cycling 200 miles per week and I’m an avid walker and hill climber. My biggest fear was that I would not be able to return to this level of fitness. It’s been an interesting year and a half, but I am finally back to the level I was before the aneurysm. I couldn’t be happier.”

Dave, now 58, will continue to have yearly check-ups and scans at The Walton Centre to monitor his progress.

Dave expressed his gratitude to The Walton Centre saying “I have nothing but praise for the people in the NHS. I honestly couldn’t be more thankful for the amazing staff at the hospital for their exceptional care.”

Greener Allied Health Professional awareness week is between Monday 22 April and Friday 26 April. Greener AHP week is a chance to raise awareness of how the Trust is becoming more sustainable and how we are committing to NHS net zero.

At the Trust we have been making a conscious effort to be more sustainable as a team. An example of this is our AHPs encouraging patients to return their walking aids that they are no longer using. This has led to us reducing waste and also reducing purchasing costs for the Trust.

Our AHPs have also been involved in things such as our feed bottles recycling project. Denise O’Dwyer, an Advanced Dietician at The Walton Centre said: “This was a project that was identified by the dietetic team at The Walton Centre through patient feedback when a patient highlighted concerns about how much plastic waste was generated when patients were reliant on Enteral feeding (single use syringes, multiple feed bottles daily, sterile water bottles, giving sets).

“It was something I was passionate to take forward with the aim to minimise plastic waste in this patient group. We have recently changed our patient feed bottles (2,220 per annum) from going in clinical waste to mixed plastics recycling."

This project was piloted on Horsley ICU, Denise said "Bottles were previously discarded into clinical waste, but by simply washing them out, they could be put into mixed plastics recycling. Across the Trust, this will save us 60kgCo2E which is the equivalent of driving from The Walton Centre to Portsmouth in a family car."

“The project was supported by the Facilities and Sustainability teams to help implement it on ICU. It’s a project that required a collaborative approach with the MDT to ensure its success. An aspiration going forward would be to implement this across all clinical areas within the trust and to consider recycling of nutritional supplement bottles.”