Dr Anna Galazka: Commentary on lymphoedema

Hello everyone and welcome. My name is Anna Golaska and I am a lecturer in Management, Employment and Organisation at Cardiff Business School. I would like to offer a few words that summarise what I learned about specialist lymph therapy. During my PhD in 2016-2017 when I was looking at the development, nature and role of clinician-patient relationships in wound care. I interviewed a lymphoedema specialist who was collaborating very closely with wound care clinicians in clinics where I was conducting my ethnographic research. I learned quite a lot from that particular lady about what interaction with patients with lymphoedema should look like and in the short presentation I would just like to summarize those lessons learned. I learned that the most important skill for a limb therapist is the ability to be able to communicate with lots of different types of people to really understand what it is that a specialist can offer to somebody. Trying to engage with the person because it involves talking about something that is a lifelong management skill. It's about making sure that a therapist can understand what it is that really bothers the person because you can look at the person and think that their problem is the big swollen leg but it might be, as I learned, that on that big swollen leg a person has perhaps an ulcer that doesn't smell very nice and actually for that person the thing that is the most important is that ulcer, that smell, and it's that thing that needs to get fixed for them, maybe for themselves, maybe for them this seems to be the most important thing. So communication as I learned is very very important, being able to negotiate the best way forward, always taking into consideration the progressive nature of the disease that the person, the individual might not be able to understand the importance of nuanced communication about the possible outcomes if they engage with certain recommended treatment plans and management strategies but also the outcomes if they don't necessarily engage with those recommended treatment strategies so that people can understand what they are saying yes to but also so that they can understand what they are saying no to. So what I learned from that a lymphedema expert is the importance of taking care of the person, caring for the person and communicating with them about their condition, communicating with them about lymphedema that they might not necessarily know anything about, communicating with family members who might be involved in care who might not necessarily know anything about lymphedema as equally important. So communication across the board, communication about the fact that it might be a long-term condition that might require lifelong management rather than a straight-up cure. So talking about the truth, talking about the facts, but also giving that person a sense of hope that things can actually be managed well, that they will learn how to manage it, that they will get better, that it will be possible for them to have a better quality of life at some point in the future. Thank you.