Sue Hansard, Lymphoedema Nurse Specialist and PhysioPod UK
PhysioPod have worked with Sue Hansard, Lymphoedema Nurse Specialist of First Lymph Care for a number of years, since meeting at a BLS Conference. This is a summary of Sue's articles and case studies involving deep oscillation and other non invasive modalities in the treatment of Lymphoedema and Lipoedema. Her personal opinion pieces on careers in Lymphoedema, rethinking Lipoedema management are a must read, as are her articles on dementia and bullying. Thank you Sue, we love working with you.
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"Early one Saturday morning in 1996, I was putting my uniform on for the first time in 13 years. It was to be my first shift as a volunteer nurse in a local hospice. My first tentative step to returning to the profession I had longed to be part of since the age of seven. My stomach was turning somersaults, my mouth dry and I felt incredibly out of my comfort zone. The welcome was warm, with undertones of bemused curiosity:
"Many things have changed in the past 20 years of Lymphoedema management. I suspect that many people working within the specialism, for various reasons, are not always 'up to speed' on new thinking and new research and evidence. Possibly not able to get funding for Conference attendance, maybe not having protected time to attend virtual conferences and training, maybe having 'too much' day-to-day stuff to deal with. And then the COVID situation hasn't helped. Fewer services now I think and longer waiting lists... at least in Staffordshire.... it all means that patients are not getting a prompt, timely assessment and it would seem even when people do attend clinics, the self-management advice is lacking.
When lockdown happened back in March, I was just one week away from retiring from the best job I have ever had. I had only been with Mary Ann Evans Hospice for four years, but after twenty two years in Lymphoedema management, I now felt confident in my knowledge-base and skills. Finally, I believed in myself. That said, I have always believed in life-long learning and the specialism of Lymphoedema still excites me with research findings, new research projects and innovative approaches to help people living with lymphatic conditions.
If we are asked about BULLYING many of us will recall those kids at school who we were afraid of. The playground bully. It resonates with childhood, being childish even. But of course, bullying behaviour is not confined to the playground, to school, to children. It affects adults in every occupation, globally. It causes emotional and physical harm which one can take years to recover from. It leads to loss of productivity, effectiveness, increased sick leave, financial losses for the individual and organisation and a negative impact on the workforce.
Dementia - Finding Mum by Sue Hansard Lymphoedema Nurse Specialist, Mentor, Educator and Writer at FIRST LYMPH CARE
Sue Hansard is trying to redress the balance about living with and caring for someone with Dementia. This is written from Sue's perspective and in part, is her way of honouring her Mum and celebrating the relationship that they were able to develop and cherish, because of dementia. Sue welcomes feedback and sharing. "Two years ago my lovely, gentle Mum died. She was 85yrs old. Six months before she died, she could still touch her toes, or do high kicks when sitting in her chair! Her hearing was acute (at times) and she had excellent hand-eye co-ordination. But, she could no longer communicate verbally. She could not string words into a meaningful sentence. She didn't KNOW who I was. Though I do think she knew that I was someone familiar, with whom she felt safe.
A personal opinion piece about working together, skilling up in specific knowledge and expertise and giving Lipoedema it's own dedicated specialist nurses."I have worked for 25 years in Lymphoedema Management, treating all types and causes of Lymphoedema but also treating Lipoedema. Over that time, Lipoedema and Lymphoedema are often seen as ‘counterparts’, ‘bed- fellows’, similar diseases. In the past, many Lymphoedema services included Lipoedema in their referral criteria - but this seems to be changing.
Lymphoedema services in the UK were already stretched before the covid pandemic took hold. Now 16 months on, some suspended services are beginning to see patients again face-to-face. Others are not yet able to re-open and some have closed permanently.
Mrs B, a 68 year old woman had been diagnosed with Grade 2, oestrogen receptor positive left breast cancer at a routine mammogram in 2016. She underwent Wide Local Excision (WLE) and Axillary Node Clearance (ANC). Thirteen Lymph nodes were removed and two were positive for cancer.
Following surgery and after wound healing, she underwent fifteen fractions of radiotherapy to the chest wall and affected quadrant. She is now being treated with Letrozole (hormone therapy drug) and reviewed by her oncologist at six monthly intervals.
"I have treated patients who have had severe sclerodermatic changes due to radiotherapy which further compromises drainage. Sometimes fibrosis affects the cheeks, chin, neck and even ears. This is especially difficult to treat. I have recently found that a Deep Oscillation therapy (DOT) can significantly enhance the effects of MLD in these complex cases. I achieve faster softening of submental/submandibular oedema with Hivamat or Deep Oscillation Personal than MLD alone."
My client had undergone private surgery to repair an umbilical hernia, with muscle repair, abdominoplasty and vaser liposuction to the abdomen after the first lockdown. Unfortunately, a wound infection had led to visible keloid scarring (see image) and deeper tethering/cording mid-abdomen, this was uncomfortable and unsightly. The length of the scar was 4 cm. I recommended the lady also use Pro-Sil™ gel daily on the scar line to help smooth/softens and diminish appearance of scars.
"I first came across DEEP OSCILLATION® at BLS conference about 8yrs ago, when Mary and Julie first introduced the concept to the UK. Since then I have read research and increasing numbers of clinical accounts of its efficacy in treating lymphoedema, and the benefits to therapists in reducing RSI so often experienced by massage practitioners.
About Sue Hansard Lymphoedema Nurse Specialist
Sue Hansard gained her BA in Nursing and R.G.N Qualification in 1982. During her varied career she has worked in surgery, orthopaedics, medicine, elderly care, renal dialysis and day surgery. She moved into palliative care in 1996 and has worked in Lymphoedema management since 1998. Sue founded 'First Lymph Care' in 2003 to make Manual Lymphatic Drainage Massage available to all; especially those with Lymphoedema, or skin sensitivities, which are sometimes contraindicated for other forms of massage. Sue’s nursing knowledge and experience gives her clients confidence and assurance that treatments are always appropriate for their condition and safe. Sue is registered with the NMC and BLS and fully insured to practice independently. She always takes a thorough medical history prior to any treatment planning. Through 'First Lymph Care' Sue provides a complete holistic approach to her clients, providing general health care advice and support for people living with Lymphoedema to help them manage their condition as well as post-operative recovery. She writes and produces her own Fact Sheets, is a Peer Reviewer for L.S.N. (Lymphoedema Support Network) and B.M.J (British Medical Journal) and freelance medical writer. Raising awareness of the many benefits for all, of Manual Lymphatic Drainage and managing Lymphoedema specifically is a key purpose of 'First Lymph Care’. In the past Sue has delivered training on Lymphoedema and its management to small groups of Allied Health professionals in the UK and Bulgaria.