United Ostomy Association, Inc.
Evansville, Indiana Chapter
Re-Route

 
Contents:

HOW DOES AN OSTOMATE LOSE WEIGHT SAFELY
COLOSTOMY BOWEL CONTROL
THAT'S HARD TO SWALLOW
SELECTING UROSTOMY EQUIPMENT
CARTOONSVILLE

Re-Route Archive

Volume 26, Number 3  December, 1998

HOW DOES AN OSTOMATE LOSE WEIGHT SAFELY
Via: Kankakee Ostomy Association
NO, NOT BY MAGIC, but no one should be overweight, especially an ostomate. Besides the usual medical, surgical, psychological, social, and economic problems, obesity presents prosthesis management problems for the ostomate. Whether a diet is unsafe depends upon each person's specific medical condition or body need. There is no guarantee of safety with individualized trial and error and evaluation, and then it is only 99% safe, and even this can change with time. The safest course to follow is to consult with your physician for metabolic study. Discover if your overweight problem is medical, psychological, incorrect eating habits, etc. Educate yourself regarding vitamins, minerals, proteins, carbohydrates, calories, nutrition, absorption, allergies, side effects, etc. These data can be obtained from books, at health food stores, and from dieticians, or nutritionists. Eat balanced meals. Seek quality, not quantity. Stay away from junk foods. Diet through natural means by forming healthy nutritional habits and not using medication as a crutch. Exercise actively. 

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COLOSTOMY BOWEL CONTROL
Via:  S.NV.'s Town Karaka 
Patient's with a right sided colostomy do not have as much remaining colon as those with a left sided colostomy. Because of this there is usually too little colon left to absorb enough water to make a solid stool. This type cannot be controlled by irrigation, but instead behaves very much like an ileostomy with a fairly continuous discharge. The left sided colostomy is often described as a "dry colostomy" because it discharges formed stool. One has the choice of attempting to manage this type either by trained control or irrigation control. Only one-third of the people who attempt to train themselves to control the colostomy without irrigation are successful in doing so. This type of training relies very heavily on diet and medication to achieve regularity. Many physicians in this country feel that control is more easily and satisfactorily achieved by irrigation. However, there are some patients who can't achieve irrigation control, because they have an "irritable bowel." This problem has nothing to do with the colostomy. It is just part of some people's makeup. Some people, even before they have their colostomy, may have had very irregular bowel habits. They retain these habits after the colostomy is performed so that regular irrigation does not assure them of regularity. When this condition exists, the physician will sometimes suggest that the patient dispense with irrigation, since it will not produce the desired regular pattern, and the person may become frustrated trying to achieve this. In this case, once again, the colostomy is treated much like an ileostomy with the wearing of an appliance all of the time. 

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THAT'S HARD TO SWALLOW
Via: Fall 1998, "From Your Shoulders UP" published by:  Midwest Otolaryngology
Sometimes we hear something we don't believe, and we call it "hard to swallow." There are also those of us who experience this in a literal way in other words, we actually have a hard time with the act of swallowing. What does it mean? Dysphagia, as it is called, refers to the feeling of difficulty passing food or liquid from the mouth to the stomach. It may be caused by a number of factors, most of which are temporary in nature. About 15 million Americans find swallowing difficult, and older people are often the ones having these bouts of discomfort. Even the simple act of downing a cold drink can cause severe coughing and choking, and, in some cases, this can be a life-threatening event. If you have trouble swallowing, see an otalaryngologist. When a swallowing problem fails to improve after a few weeks, it's especially important to seek medical attention because this is sometimes indicative of a serious disease, such as a tumor or a progressive neurological disorder. Swallowing involves four stages: oral preparation (food is chewed, liquids are manipulated); oral stage (tongue propels food or liquid to the back of the mouth, which starts the swallowing process); pharyngeal stage (quick passage of food and liquid through the pharynx into the esophagus); esophageal. stage (food and liquid pass through the esophagus into the stomach). The first and second have some voluntary control, but stages three and four occur naturally. So, how can you have problems with a process that seems so simple? Something interrupts the cycle, and this interruption can be caused by easily resolvable problems such as poor teeth, ill-fitting dentures, or a cold. But, one of the most common causes is gastro esophageal reflux, which occurs when stomach acid moves up the esophagus to the pharynx, causing discomfort. Common symptoms are heartburn, indigestion, and sore throat, often aggravated by lying down, especially following eating. Treating reflux involves changing dietary habits. You may be asked to eat low-fat food and small meals; also, you should avoid bedtime snacks, caffeine, alcohol, tobacco, and spicy foods. You can prevent high acidity with prescription or over-the-counter medicines or antacids. Some people have trouble swallowing because tension or stress has triggered throat muscle spasms, which have resulted in a "lump" sensation. Frequent throat clearing, which usually produces little or no mucus, can make the problem worse by increasing irritation. Other causes of swallowing troubles are stroke, progressive neurological disorders, presence of a tracheotomy tube, a paralyzed or unmoving vocal cord, a tumor in the mouth, throat, or esophagus, or previous surgery in the head, neck or esophageal areas. Symptoms of swallowing difficulty can include a feeling that your food or drink is sticking in your throat; discomfort in the throat or chest; a "lump" in the throat; weight loss; coughing or choking caused by food, liquid, or salvia being aspirated into the windpipe and lungs. The time to worry is when food really doesn't go down normally. Coughing and chronically experiencing "food going down the wrong pipe" are good reasons to seek medical attention. Examining the mouth and throat can be done with mirrors or a small tube (flexible laryngoscope), which allows an otolaryngologist to see the back of the tongue, throat, and voice box. If necessary, your doctor may examine the esophagus, stomach, and upper small intestine and may order special X rays. If you're a heavy smoker or drinker, a tumor or cancer might be the cause of a swallowing problem, and immediate medical attention is required, with a thorough head and neck evaluation. Remember this rule of thumb: if it feels like something is stuck 'in your throat, and the feeling lasts for several weeks, you should see a doctor. In most cases, a swallowing problem is not serious, and it's usually easily resolved. 

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SELECTING UROSTOMY EQIPMENT
Via: The Osto-Mee News, Hamilton, OH 
Generally, your appliance should stick to your body for at least three days and three nights. Some urostomates prefer to change daily. Your appliance should be easily concealed under normal clothing and be comfortable in any position, despite the stress you place on it in your daily activities. There are one-piece, and custom-designed appliances. Appliances are made of various types of vinyl, plastic, and rubber. In hospitals where there are ET nurses, your personal needs will be evaluated and your appliance will be ordered for you. For some, this appliance is the style worn for a lifetime; for others, weight gain, normal growth, and other factors may later on require a new or different style appliance. Don't continue using a recommended appliance if it is not satisfactory. Try different types until you find one that is both comfortable and convenient to use. Sometimes a one-piece appliance might work better than a two-piece unit when. The patient's eyesight is poor or if their hands are shaky. The patient is a youngster who is just learning to care for himself or herself. The new patient is depressed or uninterested and clearly will not be bothered with assembling anything. The stoma is flush with the skin and a particular one-piece appliance offers the proper convexity in the face plate for obtaining the best seal. Sometimes a two-piece appliance may be better when. The patients want to put the face plate over the stoma first, which allows them to be sure that the stoma is correctly centered . (This is particularly helpful when the stoma is irregular in shape and the face plate opening has been tailored to fit.) It is necessary to provide a very small face plate to avoid contours such as scarring, depressions, or high spots on or near the surrounding area. There are manufacturer's who make appliances to meet those needs as well. A two-piece system may work better when you or the doctor want the pouch to be changed daily for cleaning, With a two-piece, this can be accomplished with ease, while the flange remains securely in place. The need to keep your equipment spotlessly clean cannot be stressed too much. Bacteria will multiply rapidly even in the tiniest droplet of urine. The bacteria may travel up through the ureters and cause a kidney infection, or the bacteria can cause odor by acting on the urine. There are special products to clean and disinfect the equipment. It is important to empty your appliance at regular intervals. If you drink a lot of fluids, of course, you will need to empty the appliance more frequently.

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