Heidi, Lymphoedema Specialist

Heidi Allen has been a lymphoedema nurse at Katharine House for four years and is currently working from home due to the pandemic. Before working at the hospice, Heidi was a hospital based cancer nurse specialist in Macmillan roles for head and neck cancer, skin cancers and radiotherapy. Ninety percent of her lymphoedema patients have been cured of their cancer and are now living with a long-term side effect … swelling.

“I’m a mummy and so my day starts super early with a breakfast routine, school prep and a quick walk up to the primary school to drop my two children at the gate. The social scene is not quite the same these days, waving at other parents and grandparents from a distance.

Then it's back home to a rather quiet home and a pre-boiled kettle to make that cup of tea that I so enjoy first thing (but will probably only drink half of!).

I’m here to help people manage their swelling wherever that swelling may be on their body. I assess all my lymphoedema patients and referrals (I am currently working with around 100 people) and recommend the best course of management to try to reduce the swelling and make life just a little more manageable. I also offer specialist massage and bandaging techniques, but it's important that patients are empowered to self-manage from the start so that they can support themselves on a daily basis. This is vital for good outcomes.

Armed with my cup of tea, I sit at the desk with my laptop and diary, checking who has made contact via email and telephone since yesterday. I make a list about who needs that urgent contact first thing.

I’ve received a new referral for a woman struggling with swollen legs due to her cancer and cancer treatments. It’s affecting her daily living now. I’m pretty sure I have something in my ‘tool box’ that will be able to help her.

I make that phone call introducing myself and explain that in the current climate I will only be able to offer remote support rather than face to face at this time, but that I’ve had amazing results during this pandemic and I’ll work as hard as I can to help her.

Telephone calls are great but not quite the same as face to face. Getting to know that person and making a hands-on touch assessment is so needed for my work, but we have video calls, which really are the next best thing. So after the initial assessment we video call. It’s great to put a face to a name and the camera can be moved around so that I can see her legs, see how she can move them, check the skin and ask additional questions. Usually I would be using a tape measure in clinic to measure her limbs, but I can’t do that remotely and so the woman’s husband is thrilled to have a job to do this week. These measurement are important to get a baseline so we can note changes over the next few weeks and months.

We make a plan together and I let her know that I’ll send an email summarising our conversation and the agreed plan. I pop a tape measure in the post and a few samples of moisturisers to use at home. We then agree to talk again in a week but I emphasise the importance of her calling me in between times.

Mid-morning, I check on one of my patients who has had breast cancer and has a swollen arm. She has been self-managing so beautifully over the past few weeks but we need to tweak her garment now as she has had some reduction to the limb and needs a better fitting compression sleeve. She emailed through her measurements last night so I can plan her next compression garment. I make the phone call and congratulate her on her hard work.

We always have time for a little social chat (like I would do if she had attended my clinic in person). It’s all about holistic care, not just about an arm or a leg.

Then it’s on to responding to those emails. I’m fortunate that I can still order compression garments for my patients to get delivered to their home addresses, and so today I need to authorise payment of those invoices from my budget.

Then … tipping away my half-drunk cup of tea, I make a fresh one and hope I get to drink the whole cup this time round!

This afternoon is exciting. I have enrolled on a new course in Dorset, which is running via Zoom rather than face to face. It’s about a technique through movement and breath, which stimulates lymphatic flow and can be very effective for the management of swelling. It’s a two-and-a-half-hour session with me set up in my lounge with a chair to practise standing and seated techniques to music and with a yoga ball.

At the end of today and tomorrow I will have to be assessed and if all well this is a technique I can share one-to-one with my patients via video calls for now. But looking ahead when I’m back on site at the hospice my aim is to teach a class (but that will need face-to-face training in Dorset!).

It’s been a great afternoon meeting new professionals and learning new techniques. How wonderful to have another ‘tool in the box’ that may just make that difference to someone managing their swelling. I certainly feel better doing the movements as working from home sees me sitting for long periods of time.

When I’m not working, my family is my world and we enjoy the outdoors so much, even if it’s raining. Just the other day we all donned our walking boots and headed off to a local National Trust property with the camping stove in the backpack and had hotdogs on the picnic rug with toasted marshmallows. I am pleased to say I had a cup of tea and managed to drink the whole lot!

It’s the simple things I love, smelling every rose we spot, enjoying those fallen acorns, waiting in anticipation for the conkers to be big enough to collect in every pocket of Mummy and Daddy’s clothing (the joys of having young children!) and foraging for those blackberries and apples right now. Fully enjoying togetherness. What could be better than that.

Katharine House Hospice

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