How do I get an appointment?
You can be referred to our service by your GP, hospital doctor or another healthcare professional.
Before your appointment
Please bring a list of medication and any other relevant medical information or letters, particularly if you have received treatment at another hospital or clinic.
If you have already been issued with compression garments by another service, please bring these with you.
If you have been given a "health needs assessment" form by your oncology clinic or clinical nurse specialist, please bring this with you.
You may find it helpful to wear loose fitting clothing that can easily be removed, as examination may include measuring the area affected by swelling.
What to expect at your appointment
You may be invited to attend a small group teaching session (this sometimes takes place before you have your first assessment with a specialist).
The teaching session forms part of your management programme and lasts about two hours, it covers information about the lymphatic system and how to manage lymphoedema.
If there are specific reasons why you are unable to attend a group teaching session, your specialist will ensure you are provided with the information you need.
You will be seen by a physiotherapist or nurse who are specialists in the management of lymphoedema.
Your first appointment will last between 60 and 90 minutes. A follow-up appointment is then normally arranged within six to twelve weeks. Following this, reviews are usually at three to six months intervals.
Your specialist will take a full medical and social history and carry out a physical examination, including:
- assessment of your skin and underlying tissues
- assessment of function and movement
- measurement of your affected limb in cases of arm and leg swelling.
Your specialist will confirm if you have lymphoedema and work out a plan of care with you. You will be given advice and written information about how to manage your lymphoedema.
You may be fitted with compression garments depending upon which part of your body is swollen.
Your progress will be monitored and if necessary, changes will be made to your plan of care to help you achieve better control of your lymphoedema.
Other healthcare professionals may attend the clinic to observe patients being assessed and treated for lymphoedema, they will only enter the room if you agree to this.
After your appointment
Following your initial appointment, your GP and consultant will be sent a letter about the outcome of your assessment. You will also receive a copy of this letter unless you confirm you do not wish to receive this information.
If it is recommended that you are seen within six weeks, your next appointment will be booked before you leave the hospital. If your next appointment is not due for more than six weeks ahead, you will be sent a letter nearer the time confirming the date and time of your appointment.
Your specialist will advise when you should come back to the clinic for review of your lymphoedema. If you do not receive an appointment letter from the clinic by the time you expected to be seen, you should contact the clinic by telephone on 020 7188 4749.
When your swelling is stable, you feel confident with self management and can obtain compression garments on GP prescription (where this is appropriate), you will be discharged back to the care of your GP.
If the garments we have fitted you with are available through your GP we will provide you with information on how to obtain this on prescription. From April 2009, patients under 60 years of age who develop lymphoedema due to cancer treatment have been eligible for free prescriptions for compression garments. Please note, to ensure you do not pay for compression garments, you will need to obtain a prescription exemption certificate from your GP or oncology clinic.
If you have any problems or questions about the management of your lymphoedema you should ring the clinic and ask to speak to a specialist. If they are not available at the time please leave a message. You should expect the specialist to return your call within 24 to 48 hours.
If you have symptoms of cellulitis (infection):
- increased redness and swelling in the affected area
- skin feels hot or warm to touch
- the area is more tender or painful than normal
- there is a burning sensation in the tissues
- you have a raised temperature with flu-like symptoms
You should arrange to see your GP immediately or, if the surgery is closed, you should attend your nearest Accident and Emergency Unit as cellulitis needs to be treated using appropriate antibiotics.