Ostomy Association
of Southwestern Indiana
Re-Route

 
Contents:

SKIN ATTENTION
TAKING CARE OF YOUR SKIN
A LITTLE OSTOMY TEST
CAN TAKING VITAMINS BE DANGEROUS?
NAMING YOUR STOMA
WASH THOSE HANDS
TRUE OR FALSE!
WHAT YOU SHOULD KNOW ABOUT GENERIC DRUGS
TAKING CARE OF YOUR STOMA AND YOUR SKIN
OSTOMY PEN PALS

Re-Route Archive

Volume 34, Number 7  April, 2007

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TAKING CARE OF YOUR SKIN
Via: Metro MD & Hemet -San Jacinto, CA
Many people with ostomies experience some degree of skin irritation from time to time. The most common causes are leakage of effluent (active digestive enzymes or urine) onto the skin, allergic reactions to the adhesive material in a skin barrier, or improper hygiene. A few simple, preventive measures will help to keep your skin free from irritation. Cleanse, rinse, and pat your skin dry between pouch changes. Avoid using an oily soap, which can leave a film that interferes with proper adhesion of the skin barrier. Choose a skin barrier that is unlikely to cause skin irritation or cause an allergic reaction. Make sure that your skin barrier is correctly applied to prevent leakage. If your skin is uneven due to scarring, etc. such depressions may be filled with a paste. Despite your best efforts, however, skin irritation may occur. If there is redness around the stoma—If your skin is not blistered, broken or bleeding, the redness is usually due to pressure from the skin barrier. No treatment is needed. If there is a redness, blistering or weepy skin—This is usually caused by leakage. Leakage may also cause burning, itching, or discomfort around the stoma. Remove the skin barrier, wash the area well, and put on a clean pouch, paying particular attention to the seal between skin and skin barrier. Stomahesive Paste or Powder may be used to fill the crevices around the stoma to give added protection. If there is reddened skin with a pinpointed rash—This usually indicates Monilia, or yeast infection, similar to “diaper rash”. Contact your physician for the proper medication. Following these tips will help; Do not “air the skin.” Discharge from the stoma may further damage the skin, so keep your pouch on. Avoid skin creams and ointments—They can interfere with proper adhesion of the skin barrier. Do not use a heat lamp to “dry” a rash—This may burn the stoma. If your pouch is not comfortable, free from leakage, skin-friendly, odor-free, secure, longwearing, and inconspicuous—Keep looking and consult your ET nurse.

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A LITTLE OSTOMY TEST
Via: Hemet –San Jacinto & Cleveland Ostomy Association
1. Your appliance has been on for 2 days and you experience a burning, uncomfortable sensation around your stoma. You:
     a. Ignore it. It seems to come and go anyway.
     b. Wait until the designated day to change your appliance.
     c. Take a cool bath.
     d. Change your appliance immediately.
The answer is d. Ideally, your appliance may stay on for five to seven days. However, if you experience burning or itchiness around the stoma, discomfort or pain around the stoma or discoloration of the adhesive, change your appliance regardless of the day. These signs usually indicate leakage. Stool or urine on the skin is very irritating. In addition, itching or irritation under the pouch can be due to dehydration. If you are pretty sure the appliance is not leaking and there is nothing externally wrong with it, try drinking a few glasses of water instead of removing the appliance. Don’t be a hero. When it bothers you, change.
2. When you remove your appliance, you notice the skin around the stoma is reddened. To treat it, you:
     a. Apply cool compresses for a short period of time before reapplying your appliance.
     b. Apply a protective powder such as Stomahesive or Karaya to reddened skin areas, remove any excess, and      continue with reapplying your appliance.
     c. Apply a soothing cream or ointment to the reddened skin areas.
     d. Use an alcohol wipe on your peristomal skin.
The answer is b. It is important to observe the skin around the stoma. Use a mirror to help observe the skin and stoma. If the skin appears reddened, irritated or weepy, you may require a protective powder. You may need to change your appliance every two or three days until the skin heals. While creams and ointments may be a reasonable solution for skin irritation in other areas of your body, they may not be useful around your stoma because your appliance will not adhere to moist or oily skin. Cool compresses may be soothing but cannot heal the skin. Alcohol will dry the skin which may cause it to itch.
3. Your neighbors invite you to a pool party. You:
     a. Decline the invitation since you cannot swim with an ostomy.
     b. Limit your fluid and food intake for 12 hours prior to the party so your stoma is not active.
     c. Accept the invitation.
The answer is c. If you enjoyed swimming before the operation, continue to swim after. For extra security while swimming, you may want to picture-frame the adhesive part of your appliance with paper or waterproof tape or apply a skin sealant, for example—Sween prep, directly over the adhesive. Printed rather than solid colored bathing suits help to camouflage the outline of the appliance. Some women prefer bathing suits with skirts and some men prefer boxer-style trunks, but snug fitting suits may be worn to hold the appliance firmly in place. If you have an ileostomy, limiting food and drink will not stop your ostomy from functioning. When the stomach is empty, the discharge is liquid, highly acidic and gassy. Skipping meals or limiting fluid intake leads to dehydration and/or electrolyte imbalance.

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CAN TAKING VITAMINS BE DANGEROUS?
By Joy Bauer. Today Show Nutritionist
A new study raises questions about taking antioxidant supplements.
How can people make sense of this disturbing new information?
First — it’s not actually new information; this was a meta-analysis, so it combined the results of several already-published studies (68 studies were included in this review). The objective of this study was to assess the effect of beta-carotene, selenium, and vitamins A, C, and E on mortality, i.e., whether these antioxidants help you live longer. And in terms of the outcome,… to quote the conclusions from the actual study…. it says: “Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. The potential roles of vitamin C and selenium on mortality need further study.” These results certainly sound disturbing, but keep in mind many health experts have criticized this study for the following reasons. One big issue concerns the diverse nature of the pooled studies. Critics say that the ones included were too different in terms of dosage, duration, populations studied, and nutrients tested to be able to draw a meaningful conclusion. They also question why two large studies from China and Italy which showed a lowered risk of mortality among antioxidant supplement users were excluded. Another criticism is that the studies only looked at how these nutrients worked in unhealthy people, not in how they might prevent illness in the first place. Finally, there’s the issue of amounts. Many of the people included in the studies were taking very high doses of antioxidants — much higher than the RDA, and much, MUCH higher than the levels found in a typical serving of fruit or vegetables.
What are we supposed to do? Who do we believe?
Remember that the study examined supplements, not food. No one is disputing the health benefits of fruits and vegetables, which are super-rich in antioxidants, as well as other nutrients you just can’t find in a pill. Furthermore, these naturally-occurring nutrients interact in ways we haven’t figured out yet. That being said, I say people should stop taking MEGA-doses of antioxidants unless there's a real reason for taking them…. and that’s something to work out with your personal doctor. On the other hand, I do think most people will benefit from a basic multivitamin to fill in any potential nutrient gaps in their diets (most importantly you’ll get 100% daily value for Vitamin D —an important vitamin that most people do not get enough of). Think of it as an “insurance policy.” I’m also a fan of calcium supplements (with additional Vitamin D3) for women who don’t get enough from food. Make sure it’s D-3 (cholecalciferol), which is more bioavailable than D-2. Finally —I really like omega-3 fish oil supplements because they’re so good for overall heart health. If you don’t eat enough omega-3-rich fish — like salmon and sardines — you may want to consider a supplement. Always speak with your physician first. That’s about it for the general population. People with health problems may need to take extra supplements, of course, but they should get expert advice before they hit the vitamin store.
If you do decide to take supplements, make sure they are SAFE.
Your best bets are to buy products that display the “USP verified” logo on the label; it means the supplement has been tested and verified for the following:
1: What’s on the label is in the bottle -- no more, no less.
2: It doesn’t contain harmful levels of contaminants.
3: It will break down properly in your body.
4: It has been made under good manufacturing processes.
You can also subscribe to “Consumerlab.com”. This company reviews a broad range of dietary supplements, and then tests popular brands for identity, potency, purity, bioavailability, and consistency — much like USP verified products. I really like Consumerlab.com because it gives you so many brands to choose from, and their reviews are very educational.

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NAMING YOUR STOMA
By Debbie Florio Via: Hemet San-Jacinto
Have you ever seen the movie Castaways, with Tom Hanks? He found a package, containing a volleyball, on the island upon which he was marooned. He named the ball “Wilson”. He talked through all his problems, plans, and experiences with Wilson. Wilson really saved his sanity. Being able to talk to something, even if it doesn’t talk back, can really be a release. Lots of people name their cars, and beg it to start on a cold day, or thank it for getting them home safely during a storm. I knew I was going to need a way to release my new feelings after my ostomy surgery. I spent my week before surgery trying to come up with a name for my future stoma. I thought a name would help me get more familiar with it. I knew I wanted a female name. I could not imagine my stoma being male. My surgery was May 17, 2001. I kept myself busy coming up with the perfect name. It had to be no more than two syllables and had to flow with the word stoma. I was so caught up in my search that I forgot to worry about the surgery. Sally and I had a rough start but we make a good team. It helps me during unpleasant times to talk to Sally. I scold her when she makes a mess and I praise her when she holds a seal tight. Being able to speak to her during changes makes things easier. I thought sharing this with individuals with ostomies of all ages might help. If you can release your feelings, nothing stays pent up inside you. I even take it one-step further. At those embarrassing moments when your stoma needs to release gas, rather than getting flustered, I tell her to quiet down. The moment passes and it makes the people around me a little more comfortable.  Just remember, you can always officially Register your stoma's name at the following location: Stoma name Registry.

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WASH THOSE HANDS
Via: M.A.O.G. Memphis, TN. & Hamilton/Fairfield, OH Chapter
We were taught that infectious agents (bacteria, etc.) were primarily carried through the air. We know that direct contact with infected materials, particularly from our hands, is the number one transmitter. The hand that covers a sneeze, removes a soaked bandage or scrubs a bathroom, carries microorganisms on its surface and in skin crevices, including the fingernails. If this same hand, unwashed, goes on to handle food, dress a baby or bandage a cut, or change an ostomate’s pouch, it can spread “bugs” most effectively. Frequently hand washing is the most important activity we can perform to prevent infections to others and ourselves. But thorough washing requires effort beyond a mere quick rinse: at least 20 seconds of vigorous friction with soap is the minimum. As this relates to ostomy care, it means washing before and after emptying.

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TRUE OR FALSE!
Via: The Ostomatic News, Dallas Area Chapter
Researchers have only recently begun to understand the many, often complex, diseases that affect the digestive system. Accordingly, people are gradually replacing folklore, old wives' tales, and rumors about the causes and treatments of digestive diseases with accurate, up-to-date information. But misunderstanding still exists, and while some folklore is harmless, some can be dangerous if it keeps a person from correctly preventing or treating an illness. Listed below are some common misconceptions (fallacies), about digestive diseases, followed by the facts, as professionals understand them today. Ulcers—Spicy food and stress cause stomach ulcers. True or False? FALSE. The truth is almost all stomach ulcers are caused either by infection with a bacterium called Helicobacter pylori (H. pylori) or by use of pain medications such as aspirin, ibuprofen, or naproxen, the so-called non-steroidal anti-inflammatory drugs (NSAIDs). Most H, pylori-related ulcers can be cured with antibiotics. NSAID-induced ulcers can be cured with time, stomach-protective medications, antacids, and avoidance of NSAIDs. Spicy food and stress may aggravate ulcer symptoms in some people, but they do not cause ulcers. Heartburn — Smoking a cigarette helps relieve heartburn. True or False? FALSE. Actually, cigarette smoking contributes to heartburn. Heartburn occurs when the lower esophageal sphincter (LES)- a muscle between the esophagus and stomach —relaxes, allowing the acidic contents of the stomach to splash back into the esophagus. Cigarette smoking causes the LES to relax. Bowel Regularity —Bowel regularity means a bowel movement every day. True or False? FALSE. The frequency of bowel movements among normal, healthy people varies from three a day to three a week, and perfectly healthy people may fall outside both ends of this range. Constipation— Habitual use of enemas to treat constipation is harmless in Non-ostomates. True or False? FALSE. The truth is habitual use of enemas is not harmless. Over time, enemas can impair the natural muscle action of the intestines, leaving them unable to function normally. An ongoing need for enemas is not normal; you should see a doctor if you find yourself relying on them or any other medication to have a bowel movement. Irritable Bowel Syndrome —Irritable Bowel Syndrome is a disease. True or False? FALSE. Irritable bowel syndrome is not a disease. It is a functional disorder, which means that there is a problem in how the muscles in the intestines work. Irritable bowel syndrome is characterized by gas, abdominal pain, and diarrhea or constipation or both. Although the syndrome can cause considerable pain and discomfort, it does not damage the digestive tract as diseases do. Also, irritable bowel syndrome does not lead to more serious digestive diseases later. Celiac Disease—Celiac Disease is a rare childhood disease. True or False? FALSE. Celiac disease affects children and adults. At least 1 in 1000 people and, in some populations, 1 in 200 people have celiac disease. Most often, celiac disease first causes symptoms during childhood, usually diarrhea, growth failure, and failure to thrive. But the disease can also first cause symptoms in adults. These symptoms may be vague and therefore attributed to other conditions. Symptoms can include bloating, diarrhea, abdominal pain, skin rash, anemia, and thinning of the bones (osteoporosis). Celiac disease may cause such non-specific symptoms for several years before being correctly diagnosed and treated. People with celiac disease should not eat any foods containing gluten, a protein in wheat, rye, barley, and possibly oats, regardless of whether or not they have symptoms. In these people, gluten destroys part of the lining of the small intestine, which interferes with the absorption of nutrients. The damage can occur from even a small amount of gluten, and not everyone has symptoms of damage.

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WHAT YOU SHOULD KNOW ABOUT GENERIC DRUGS
By Sharon Williams, RNET, Via: The Triangle, Abilene TX & GB News Review
In recent years, generic drugs have become increasingly popular within the $30 billion US prescription drug market. In fact, generic drugs now account for approximately one-third of prescriptions. So why are generic drugs becoming so popular? For one reason, in 1984, federal legislation made generic drug approval easier Plus, patients for many of the most frequently prescribed drugs have expired, allowing for generic competition. Perhaps the biggest reason for the generic drug boom is economic. According to the FDA, generic drugs generally cost 30 to 40 percent less, and often as much as 80 percent less, than their name-brand counterparts. Usually, generics are exactly the same as their brand-name equivalents. However, some name brand manufacturers my correctly claim their products are better absorbed within the body than their generic competition-leading to quicker relief. This is particularly true with antibiotics, antihistamines and analgesics. If you’re thinking about changing from a brand-name to a generic product, don’t do it on your own. Some substitutions can be inappropriate. Consult your doctor for a generic equivalent. Or, tell your pharmacist you want the generic version, and ask him or her to call your doctor for approval.

TAKING CARE OF YOUR STOMA AND YOUR SKIN
Ostomates, thank goodness for stomas! Where would you be without one? For the new ostomate, the first look at the “stoma” can be a frightening experience. It takes a while to get used to it, but when all is well, life goes on, and the ostomate learns to cope and return to normal life. There are a few “rules” the ostomate should remember: Protect your stoma from direct blows. Wear clothing that is comfortable and is not too tight. When you change pouches, check your stoma for color, swelling and narrowing. Check your stoma for cuts. Stomas have no feeling and can be cut without knowing it. For an ostomate it is important to take care of your skin: Skin should be totally dry and free of oily products when you apply your pouch. Bring your problems and questions to chapter meetings and don’t be embarrassed to ask questions. Stomas shrink in the first few months after having ostomy surgery. So measure your stoma periodically to make sure your appliance opening fits properly. Gas—After surgery, it probably seems like you have gas all the time. As swelling goes down gas will appear less. The noises seem louder to the ostomate. If you feel gas coming on, fold your arm across the abdomen over your stoma and this will muffle the noise. Don’t waste your time worrying about ostomy accidents that may never happen. When one does happen don’t panic. Clean up and figure out what happened. Need to see underneath the stoma? Use a hand mirror. Don’t let your pouch get too full. Empty it if it is over half full.