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Volume 27, Number 3 December, 1999
DO IT YOURSELF THERAPY Via: OAB and
Gettysburg, PA and Indianapolis, IN
For most people, the mental affliction any handicap causes can be much harder to overcome than the physical disability itself.
Some strong-willed persons adjust readily, but even they had to exercise self-control and positive thinking to achieve their good attitude. If you meet someone who is apparently carefree, you can be sure it is not because his problem is lesser. Chances are he has
won and will continue to win his mental battles with depression and pessimism.
The world sees us as we see ourselves. If someone with a problem feels embarrassed, the problem may not show, but the embarrassment
will and others will feel embarrassed for him. If you are happy and cheerful and respect yourself, the people you meet will respond to your mood. Your stoma does not make you; it does not show. An attitude of withdrawal turns people off. The solution: forget yourself and be completely interested in the other person. You may find that person has greater problems than you do, and you will be so intent on helping that you will forget your own problems.
URINARY CRYSTALS By.. Terry Lowry, ET,
reprinted from the Erie, PA, Semi-Colon News, Via So NV Town Karaya
A chronic problem that occasionally occurs with urostomies is the accumulation of urine crystals on the stoma or skin. These urine crystals (amorphous ammonium phosphate) are associated with alkaline urine and
are common when one is using reusable equipment. The crystals appear as white, gritty particles and may lead to
STOMAL irritation and / or bleeding of the stoma. The peristomal skin may be emaciated and the crystals can be felt on the skin.
How can one avoid this problem? Urinary crystals can be prevented by proper cleansing of reusable pouches, maintaining acidic urine, carefully fitting the
STOMAL opening in the appliance. If urinary crystals are present, mix equal parts of water and white vinegar to make a solution to coat the stoma and the pouch. Vinegar compresses may be applied to the stoma when the pouch is changed. Remember to drink 2-3 quarts of fluid daily. You may need to ask your doctor about taking something to help maintain acid urine.
KEEPING WEIGHT DOWN Via: Ostomy News Review, Green Bay, WI
Keeping weight down is especially important for ostomates. Even a few extra pounds can affect the fit of our appliance and cause the stoma to recess. For new ostomates, extra weight may put pressure on healing tissues. Here are a few ways to drop or maintain weight.
Eat your biggest meal at noon and then have a very light dinner by 6 p.m.
Eat an apple, or two bread slices, or other fiber-type food 20-30 minutes before dinner. It will help curb your appetite at the table. These foods, combined with a glass of water, will expand in your stomach and reduce your capacity to eat. Chew well and eat slowly. It takes up to 20 minutes for the brain to receive the messages of fullness from the stomach.
Don't eat after 6 p.m. Resist snacking late at night, and your body will reward you with more restful sleep and lots more energy in the morning. Food eaten in late hours will generally go directly into fat production because the body's energy needs are low at night.
Remember that vegetables are considered free of calories when not covered with dip, butter, or other extras - so you can have these healthier snacks without guilt.
Finally, instead of plunking down in front of the TV until bedtime, how about a relaxing evening stroll? You'll sleep better and feel better in the morning.
MEDICAL ASPECTS OF AN ILEOSTOMY
Dr. R.B. Kelleck, Great Britain, Via Snohomish Insights
The new ileostomate may find it difficult to believe that life without a colon can be completely healthy. To understand this, one needs to know what is the normal function of the colon or large bowel which has been removed.
This organ is only found in land animals and its major function is to absorb water from the food residue. When animals first moved from the sea to the land they moved from a world where water was plentiful to one where it might be very scarce and they adapted to this by developing
the colon as one means of avoiding dehydration.
The only other substance that is absorbed from the colon is salt. All the other things we get from our food and which we need for energy and health are absorbed from the small intestine which is unaffected by the usual operations for ulcerative colitis.
People with an ileostomy get just as much food - whether carbohydrates, fats or proteins - as anyone else. The other function of the colon is to act as a reservoir for the waste products of the body until there is a convenient moment for disposing of them. This function is simply taken over by the pouch whether external or internal.
COLOSTOMY CONCERNS Via: Side Exit, Santa Barbara, CA
The most common problem after colostomy surgery is skin irritation. Herniation around the colostomy may also occur. This is manifested as a bulge in the skin around the stoma, difficulty irrigating , partial obstruction, and occasionally prolapse of the colon at the colostomy (the bowel pushes itself through the stoma).
Many of these problems can be avoided if the stoma site is marked before the surgery at a place that lies within the rectus abdominus muscle near midline. The ET nurse can be of great help in this. The ET nurse is also helpful in managing complications should they arise.
You should call the doctor when you have: cramps lasting more than two to three hours; severe unusual odor lasting more than a week; unusual change in stoma size and appearance; obstruction at the stoma and / or prolapse; excessive
bleeding from the stoma opening or a moderate amount in the pouch in several emptying
(eating beets will lead to some red discoloration); injury to the stoma; a cut in the stoma; continuous bleeding at the junction between the stoma and skin, severe watery discharge lasting more than five to six hours; and any other unusual occurrences regarding the ostomy.
A stoma can become narrowed (stenotic) over the years. This may reflect continued injury
from irrigation or a temporary poor blood supply immediately after surgery. This can usually be corrected with a small operation if the condition is significant.
With the introduction of irrigation cones, rupture or perforation of the colon is rarely seen. This may happen when an irrigation catheter is used if care is not used when introducing the catheter into the stoma.
QUESTIONS AND ANSWERS Via Ostomatic News, Dallas, TX
Should I expect my family to help with the care of my ostomy?
Not if you are able to care for yourself I am sure any normal, healthy person will not ask a member of the family to accompany them into the bathroom to help with the elimination process. Why should you? Unless, of course, you are not physically able to care for yourself. Too many ostomates use the well known crutch of I can't do it myself', and have someone do a task of personal hygiene that could have been done themselves. This person is handicapped indeed - mentally - not
physically.
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