In 2013, Ann Marie Woodruff was involved in a severe traffic accident that crushed her skull. Eight years later, her ongoing path of recovery took a new twist when she had a seizure and was diagnosed with epilepsy.

November is Epilepsy Awareness Month, a time to highlight the disorder that happens when the brain’s electrical activity misfires – a seizure. People with a traumatic brain injury (TBI) are at higher risk for developing epilepsy weeks or sometimes years after their brain injury, as in Ann Marie’s case. 

Ann Marie was 7 years old when she was involved in the wreck. The trauma to her brain caused serious complications:

• Removal of forehead bone, to give space for her injured brain to swell
• Reconstruction of her forehead with a titanium plate  
• Physical, speech and occupational therapy during three months of hospitalization
• Problems with reading comprehension, headaches and noise sensitivity
• Then at age 16 … the epilepsy diagnosis

Despite all those challenges, the Euless 18-year-old is now a high school graduate and a licensed driver. She’s following her dream by working at a kennel and attending dog grooming school. The anti-seizure medication she takes causes some sleepiness but has kept her epilepsy under control.  

"Epilepsy stumped us for a few months, but she is such a determined girl that she was not going to let epilepsy keep her down or define who she is or wants to be," said her mother, Carla Woodruff.

According to the Epilepsy Foundation, seizures can result from a change in the chemical environment around the brain cells after bruising/bleeding in the brain, or a skull fracture. Early treatment with medication reduces the chance of additional seizures.

Ann Marie fits the higher-risk category for developing epilepsy because she lost some tissue in the frontal lobe of her brain, said Cook Children’s neurology nurse practitioner Erin Davis, APRN, CPNP. Ann Marie sees Davis every six months to manage her epilepsy. When she meets with families in neurology, Davis uses the analogy of file cabinets to explain how the brain stores memories and other functions. 

“It’s all organized,” she said. “And when you have a traumatic brain injury, they all get knocked over. You have to spend time lifting each one back up and then putting the files back in.”  

Ann Marie has come a long way in putting those file cabinets upright thanks to perseverance, a sense of humor, and the skill of her providers at Cook Children’s. “I have spent the last 10 years doing so many things to improve myself and not just be the girl with a brain injury,” she said. “It hasn’t been easy. But I know I’m worth it.”

This is her story.

The Injury

In the second grade, Ann Marie lived in the West Texas town of Anson. She took karate class in Abilene, about 25 miles away. Her dad, Bill Woodruff, picked her up from karate on Jan. 29, 2013, and began driving home. Ann Marie sat in the back buckled into a high-back booster seat. It was dark and dusty, which reduced visibility on the highway.

Bill Woodruff didn’t see the stopped 18-wheeler that was blocking both lanes. Their crew cab truck slammed into the semi’s trailer and went under it. The impact killed Ann Marie’s dad. She took a blow above her right eye, and her skull was shattered.

Paramedics rushed Ann Marie to a hospital in Abilene. She had multiple injuries – including a liver laceration and broken leg -- but the most urgent priority was to relieve pressure from the swelling of her brain. Doctors in Abilene performed a craniectomy, removing most of her forehead bone from ear to ear. Later that night a helicopter transported Ann Marie to Cook Children’s Medical Center in Fort Worth.     

Admitted to the pediatric intensive care unit, she remained in a coma for several weeks. Therapy began once she woke up.

“She had to relearn everything … how to walk, how to talk, who she was,” Carla Woodruff said.

Ann Marie’s brain shifted as the swelling and fluid began to subside. Measurements were made via CT scan, and a manufacturer in Germany created a metal device to fit the exact size and shape of her missing bone.

In the meantime, Ann Marie wore a hardshell helmet to protect her head in case she fell or something bumped into her. The next step: Placing a titanium plate across the gap in her forehead.  

Reconstructive Surgery and Therapy

Seven weeks after the accident, Ann Marie went back into surgery for a cranioplasty, to replace the missing part of her skull. Cook Children’s neurosurgeon Richard Roberts, M.D. followed the incision made when the bone was taken out. Peeling back the skin was a slow process because her scalp was so thin.

Dr. Roberts installed a plate custom-made for Ann Marie and built from titanium, which resists infection. The plate contains hundreds of tiny holes.

“What winds up happening is tissue from underneath and tissue from the scalp can grow together through the holes and help anchor the plate,” he said.  

He described Ann Marie’s recovery as amazing given the extent of her injury.

“If you look at the original CT scan you would think it would be difficult to survive,” Dr. Roberts said. “The hard work and dedication of Ann Marie and her mom and the whole hospital laid the foundation for success.”

That hard work included speech, physical and occupational therapy during her stay at Cook Children’s. As a nurse practitioner, Davis coordinated various aspects of her care. Exercises were designed to feel like play. Those sessions aimed to repair Ann Marie’s attention span, impulse control and other thought processes. For patients with TBIs, intensive rehabilitation soon after injury can help the brain to rewire, Davis pointed out.  

Speech therapy six days a week helped Ann Marie to regain language, focus, and skills such as problem-solving. Speech pathologist Renee Lavelle, MS, CC, SLP in the Neuro Rehab Unit helped Ann Marie learn to eat, starting with liquids and moving to solid foods. “She was easy to work with. She would try anything,” Lavelle said.

Ann Marie remembers little about being hospitalized. But she does recall feeling feisty enough to warn the nurses that she knew karate.

When she was discharged three months after arriving at Cook Children’s, Ann Marie could walk with assistance, feed and dress herself, and respond to simple questions. She continued speech therapy on an outpatient basis and returned to Cook Children’s for annual checkups.

“Over the years every time I see her, she’s better and better,” Davis said. 

Adapting and Achievements

The mental fog continued to lift after Ann Marie left the hospital. But reading comprehension remained a particular struggle. She eventually enrolled in Novus Academy in Grapevine, which serves students with learning differences. She made good grades and thrived in the alternative setting, graduating in May 2023.

It takes a little longer for the pathways of Ann Marie’s brain to process information.

“When asked a question, I usually can’t just answer. I must think about it and see if my brain has stored it somewhere,” she said. “It isn’t always there.”

But she has found new tricks for learning, especially through touch and music. She took up the piano, guitar and trombone. She also loves caring for animals. Her mom describes Ann Marie as kindhearted and hardworking. And she’s resilient when challenges arise, like the news that she needed medication for epilepsy.  

As Ann Marie puts it … Being stubborn comes in handy. Don’t let hurdles stop you from pursuing your goals, she advises. She hopes to someday work at a zoo or wildlife refuge.

“Sometimes it takes a little more grit, but you can do it,” she said. “Don’t give up on your dreams just because something is hard. It is worth everything you must put into it.”

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In June 2018, Payton Singh arrived via ambulance to Cook Children’s Emergency Department in a barrage of flashing lights and sirens. She was just 12 years old and decided to end her short life while her parents were away from home.

Payton and her family returned to Cook Children’s this week to reunite with her medical care team who saved her on her darkest day.

“I can’t even explain the emotion and the panic that sets in as a parent,” said Brandy Lumbert, Payton’s mother. “After getting the call, I remember running into the emergency room - they knew exactly who I was. And then she flat-lined right in front of me. As a parent, you want to jump in and tell the doctors and nurses to move faster, but you’re just standing there, helpless.”

Payton and the Lumberts also shared their story on the latest episode of our Raising Joy podcast.

Payton’s brother, Kegan, found her unconscious in her room and took action well beyond his years. Though he was just 8 years old, he had the wherewithal to call 911, put the family’s dogs outside and notify his parents that help was on the way.

 When officers arrived at the Lumbert’s home in Keller, Texas, they believed Payton had been without oxygen for 12 minutes.

 “Doctors told us, ‘She’s alive but she’s not showing any brain activity,” said Nick Lumbert, Payton’s stepfather.

 The medical team was able to stabilize Payton and moved her to the pediatric intensive care unit (PICU).

 “Every day in the ICU, we’d stare at the breathing machine to see how many breaths she was taking on her own,” said Nick. “It was very hard to go through that.”

Soon after being admitted to the hospital, Payton’s neurologist pulled the Lumberts aside to show them the scans of her brain. They revealed four small spots, an encouraging sign that the damage wasn’t as dire as it could have been. Still, it was unknown if she’d ever walk or talk again.  

On day five in the PICU, something unexpected happened.

“I remember walking through the doors and we hear all of the alarms going off and we take off running to her room,” said Brandy. “She had stood up next to the bed and was ripping everything off. She looked right at us and I was flabbergasted!”

And just like that, hope began to shine on the Lumbert family.

Soon after, Payton was transferred to Cook Children’s rehabilitation unit where she embarked on the long road to recovery. Over the next six months, she underwent treatment at three different hospitals across Texas.

Now, four years later, she is returning to Cook Children’s to say ‘thank you’ to the people who saved her life.

 On Thursday, September 1, 2022, Payton and her family were reunited with the doctors, nurses, and care team members who cared for her at Cook Children’s. This emotional reunion was requested by Payton, who is now a 17-year-old high school senior. She has a job, drives a car and is planning to pursue a career as a veterinarian.

The Lumberts recently shared their story on the Raising Joy podcast in hopes of encouraging other families who may find themselves in a similar situation.

 When asked what message she has for kids and teens who are struggling with their mental health, Payton said “Get help.”

 Their episode is now available on all major podcast platforms including Apple, Google and Spotify.

 September is Suicide Prevention Awareness Month.

 Here are some signs to be aware of – though not every suicide attempt will display signs. This is why it’s important to talk to children and teens about suicide, whether you suspect they are suicidal or not. 

1. Preoccupied with death (writing, drawings)
2. Talking about feelings of hopelessness
3. Talking about being a burden to others
4. Telling loved ones goodbye
5. Decline in performance
6. Giving prized possessions away
7. Isolating and withdrawing
8. Acting highly anxious or agitated
9. Acting reckless and taking risks
10. Rages
11. Changes in sleeping and/or eating
12. Use of alcohol/drugs
13. Dramatic changes in personality and/or appearance

If you feel your child needs help, please click here to find a Cook Children's Behavioral Health location near you. You can also address your concerns with your child’s pediatrician, psychologist or therapist.

The 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) offers 24/7 call, text and chat access to trained crisis counselors who can help people experiencing suicidal, substance use, and/or mental health crisis, or any other kind of emotional distress. People can also dial 988 if they are worried about a loved one who may need crisis support.

Raising Joy is part of Cook Children’s Health Care System’s Joy Campaign, a communications initiative aimed at preventing youth suicides. For more information about the Joy Campaign, visit cookchildrens.org/joy.

New episodes of the Raising Joy podcast will be available each Tuesday. It is currently available on all major streaming platforms including Apple, Spotify and Google Podcasts.