Ali Batchelor is St. Margaret’s Lead Lymphoedema Nurse Specialist. In this blog, she talks about her role in the hospice and explains what lymphoedema is…

“I started in the hospice as a Bank Nurse on the In-patient Unit in 2001 and then applied for the lymphoedema post in 2002 when the existing nurse left. Although I had very little experience in lymphoedema, the hospice sent me on a specialist course in Glasgow and I also learnt “on the job”, with good support from other services in the South West.  

I had 200 patients on the caseload then, so the service has grown, as has the team – we now look after 1600 patients with oedema across Somerset. 

Lymphoedema occurs when the lymph system is damaged or blocked; fluid builds up in soft body tissues and causes swelling. It can be caused by cancer and its treatment, such as having your lymph nodes removed. Other causes can include orthopaedic surgery, burns, problems with veins in your legs or it can be hereditary. Lymphoedema usually affects an arm or leg, but it can also affect other parts of the body. 

Treatments for lymphoedema include skin care, a form of lymphatic massage, compression hosiery and exercise. At St. Margaret’s we run an exercise class at both our Taunton and Yeovil hospices, and a swimming group in Taunton which our patients can access. We hold daily clinics in both hospices and regular clinics in Community Hospitals, while aiming to provide psychological support to our patients. We also provide teaching sessions on the recognition and management of lymphoedema to other healthcare professionals and work closely with specialist nurses in hospitals and with community nurses.

As well as this, we also monitor patients at risk of developing lymphoedema after breast cancer surgery, using a special machine that identifies extra fluid in the tissues before it is visible. We can then treat it at a very early stage, improving the outcome.

While lymphoedema is not curable, it can be managed using these treatments. Correct treatment improves mobility, reduces the risk of infections and aims to prevent the condition becoming worse. Patients can be referred to the St. Margaret's Lymphoedema Clinic by any healthcare professional.

Even though our service is very different from other services in the hospice as many of our patients do not have a life-limiting illness, in the Lymphoedema Team we feel very much a part of the hospice team and work closely with our colleagues on the In-patient Unit and in the community.

It is lovely to be able to work 1:1 with our patients and, as lymphoedema is a chronic condition, they often stay with us for years, allowing us to build a good relationship. It is hugely satisfying to see the results of our treatments and how they can improve our patients’ quality of life. ”