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

 
Contents:

THE LIVES I HAVE TOUCHED
PREVENTIVE MEASURES ARE A MUST FOR FALL AND WINTER
DIGESTIVE PROBLEMS
CONTINUING YOUR SOCIAL LIFE WITH AN OSTOMY
BAD BREATH
SENIORS WITH OSTOMIES
ILEUS — THE OTHER BLOCKAGE
FOLLICULITIS
OSTOMY FORUM

Re-Route Archive

Volume 30, Number 3  December, 2002

THE LIVES I HAVE TOUCHED
By: Ellice Feiveson, Metro Maryland
This is a milestone year for me, it has been almost 10 years since my ileostomy surgery and ten years as a volunteer for Metro Maryland Ostomy Society. I know in these past years I have touched peoples’ lives and I am proud of the work I do as a volunteer. I have spoken with and counseled women who had ostomies due to Crohn's disease, ulcerative colitis (as I had), cancer and other diseases. I feel that I give my patients hope that they will live normal lives with an ostomy. It is very rewarding for me to visit a patient at home or in the hospital knowing she may be depressed, anxious or unaccepting of her ostomy, and then weeks later, via telephone calls or extra visits , find that the patient is beginning to adjust to her new lifestyle, slowly, but surely. I must admit that volunteer work is hard, but rewarding. I must walk into that hospital room smiling, self-confident and pleasant. Whether I have numerous errands to run or appointments, it is my responsibility to give each patient my undivided attention and time, and I do. Each patient is so different. Some patients have tons of questions for me and others barely want to talk to me—perhaps they are in denial at that moment. That is okay too. I think that the trick in being a good volunteer is to be patient and understanding no matter what the circumstances. I always remember back to when I was in that bed— sick, frightened and confused. I have truly become a more compassionate and caring person in the last ten years. I have maintained friendships with some of my patients and counsel them through the long months of healing. One of my special patients is a young woman who lives in Washington State. She had a rare cancer and has an ileostomy. I visited her several times at the hospital and we truly bonded. She is a brave woman, smart and funny, and I hope I am helping her cope as she gets better. I have received notes from patients and really appreciate their kind words as to how I made a difference by visiting them and caring. I have definitely been fulfilled these last ten years. Being a volunteer and helping others is wonderful because I feel like I did make a difference. Volunteering is not for everyone. If you truly love helping others, then go for it. I know I will be continuing this work for a long time to come. Helping others is truly my passion!!

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PREVENTIVE MEASURES ARE A MUST FOR FALL AND WINTER
By: F.Y. I.. AARP Health Care Options Via: Indianapolis, IN UOA Chapter
It is extremely important to take precautions to avoid illness or injury that may result in the need for long-term care services. Pneumonia, heart attacks, and injuries resulting from falls are the most common reasons individuals need this type of care during the fall and winter months. Pneumonia— If you are older, are recovering from surgery or an illness, or have respiratory problems, you may be susceptible to infection and pneumonia. If you start getting a sore throat or do not feel well, try to avoid crowded areas such as shopping malls where germs and bacteria are prevalent. Call your doctor if you experience a persistent cough, an elevated temperature, shortness of breath, or colored mucus. In order to avoid infection, consider taking advantage of the flu and pneumonia vaccines that are available. Also, make sure you have done adequate fluid and nutritional intake. Heart Attacks— During the winter, many heart attacks are the result of exposure to the weather and overexertion. Protect yourself from the cold weather with appropriate clothing: warm coat, gloves, hat, and scarf. Breathing cold air may be too intense for your heart, so you may want to cover your face with a scarf. If you are not normally active, you should not attempt to shovel snow. If you must absolutely shovel, make sure to rest frequently. You may be having a heart attack if you are experiencing any combination of the following symptoms: a feeling of indigestion; nausea; vomiting; chest, jaw or shoulder pain; light-headedness; or sweating. Immediately contact a medical professional if you experience these symptoms. If you have a history of cardiac problems, contact your doctor before shoveling or engaging in any cardiovascular activity. Injuries— Although shoveling snow may not be recommended, it is important to make sure your driveway and walkways are cleared and well lit. Wear good soled shoes or boots that provide traction, and use the railing when climbing stairs. Following these tips will help you minimize the chance of falling during slippery winter months. It is also important to have a support system in place. For example, if you have to walk a dog or shovel your own driveway, have someone assist you. Local senior centers are a great resource, or you may find community assistance through “The Eldercare Locator.” This is a public service provided by the Administration on Aging and the U. S. Department of Health and Human Services. The number to call is 1-800-677-1116. This service will connect you with plowing services, Meals-On-Wheels, and homemaker and transportation services in your local area. Planning ahead, whether it is getting a flu shot or putting your support system in place, may help you avoid a situation that could result in the need for long-term care services. Like the old saying, an ounce of prevention is worth a pound of cure.

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DIGESTIVE PROBLEMS
By: Milly Johns, North Wind News Anchorage, Alaska
Enteric coated capsules can cause heartburn and reflux when eaten with meals, as they are released into the stomach. They should be taken on an empty stomach where they will go on past the stomach and into the intestines where their helpful actions take place. Chronic digestive problems may be brought on by allergies, or food intolerances. Get checked out by an allergist. With an allergy, you sometimes see some kind of reaction. For instance, one of my sons breaks out in hives if he eats strawberries and watermelon together. When I eat anything that has milk in it or a milk product is one of the first few things on a label, I get cramping, bloating, and diarrhea. That’s lactose intolerance. Many older people have outgrown their ability to digest milk products. As a general rule, it slowly starts leaving by school age. But there are infants born with it. They do OK with soy products, or goat milk. If you want ice cream, try the kind called Mocha Mix, which is made with soy milk. Why they call it Mocha Mix, I don’t know, because it isn’t coffee ice cream. They used to have a variety of flavors in the stores but now I just find vanilla, if any. It tastes better than regular ice cream to me. Try popsicles or fruit juice popsicles containing no milk and see if it makes a difference. Fruit smoothies can be made without cows milk or ice cream and sorbets are also good.

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CONTINUING YOUR SOCIAL LIFE WITH AN OSTOMY
Via: Tacoma, WA & GB News Review
Your social life can be as active as it was before surgery. You can enjoy all activities: meeting people, attending concerts, sporting events, civic and social club meetings, parties religious occasions or whatever you enjoyed before. The first time you go out of the house after surgery, you may feel as if everyone is staring at your appliance, even though it is not visible under your clothing. You can feel your appliance on your body, but no one can see it. Keep those questions in mind— Did you know what an ostomy was or where a stoma was located, or what it looked like before you had surgery? You may also worry about your pouch filling with gas and sticking out under your clothing. A quick trip to the restroom can take care of this problem. If you are worried about your pouch filling up immediately after eating at a social event, remember, people without ostomies often need to go to the restroom after eating and nobody will think it is unusual if you do the same! You will probably find that you need to empty your pouch less often than you need to urinate. Friendship and love- You may be wondering about your relationship with others. Now that you have an ostomy, you may feel that it will change your present relationships and decrease new opportunities for friendship and love. True friendships and deep relationships on any level are built on trust and mutual understanding. These qualities depend on you and other persons. You have the same qualities you had before surgery and your ability to develop friendships is unchanged. If you care about yourself, others will feel your strength and will not be deterred. If your ostomy does cause a break in friendship, a sexual alliance or even marriage, this relationship was not built upon trust and mutual respect and probably would have crumbled sometime in the future anyway.

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BAD BREATH
Via: Twin Tier Ostomy Group & Southern Maryland Counties Chapter
Most people think that bad breath comes only from bad oral hygiene That is not the case. However, it can be from bacteria from decaying food particles which can be prevented by brushing twice daily and flossing once a day. Other things that might help are cleaning the tongue by brushing it, if you can (some people gag from the process). Sucking on a lemon or a piece of sugar free candy sometimes helps. Other causes of bad breath are diabetes, kidney or liver disease, dry mouth, smoking or chewing tobacco, dieting, snoring, stress, age and hormonal changes. Post-nasal drip can cause odor to come from the back of the mouth. This nasal drip can be caused by sinus infection, allergies and head colds. Some of these problems are with us always. Spicy foods may stay on your breath for up to 72 hours. Garlic and onions are absorbed by the stomach and excreted through the lungs. Don’t be too quick to put someone down for bad breath. We all have it from time to time and it can be an on-going problem—considering the cause.

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SENIORS WITH OSTOMIES
Via: Indian River, FL, Ostomy Association
As baby boomers age, there are a greater number of illnesses just waiting for them. Years of fast foods and stress make a breeding ground for intestinal problems. When they can no longer deny that their fast-paced lifestyles and poor eating habits have caught up to them, they seek medical help. When tests confirm intestinal problems that require surgery, their whole world seems to explode around them when the doctor says, “You need an ostomy.” If the patient is fortunate enough to have a doctor who is aware of the local Ostomy Association, he will ask an Enterostimal nurse to visit. After surgery and recovery, the ET, hopefully, will know of an ostomy support group. It is only when an ostomate talks to other ostomates that the problems that seemed insurmountable are gradually chipped away. That is what the UOA and local associations are all about — ostomates helping other ostomates. Where is the best place to get information and help? Why, at an ostomy meeting!

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ILEUS — THE OTHER BLOCKAGE
Excerpted from Coquitlam (BC) Coquitlam Connection, Via: S. Brevard Florida
Bowel obstructions come in two varieties, mechanical and non-mechanical. Most Ileostomates have encountered the mechanical variety, usually when we eat something fibrous and do not chew well enough. Ileus, also called paralytic ileus, is the non-mechanical variety. It happens when peristalsis stops. Peristalsis is the natural wave-like contractions of the intestines that move material through the bowel. The symptoms can be very similar to those of mechanical bowel obstruction, and includes pain, vomiting, constipation and diarrhea. Several causes are cited for ileus: infection of the peritoneum (the lining of the abdomen and pelvic cavities), or disruption for lowering of the abdominal blood supply. Heart disease or kidney disease, when coupled with low potassium levels, can trigger the condition. Certain orthopedic surgeries, such as joint replacements or back surgeries and some chemotherapy drugs such as vinblastine (Velban, Velsar) and vincristine (Oncovin, Vincasar PES, Vincrex) also can cause ileus. So how do you know if your bowel obstruction is due to ileuseus? First, see a physician. Ileus is characterized by a few or no bowel sounds, which your physician can easily check with a stethoscope. Diagnosis can be confirmed by x-rays and CT scans. Blood tests can also be useful in diagnosis. If you do go for x-rays, note that barium swallows are definitely contra-indicated as they can complicate the situation. Barium enemas can be used to visualize blockages but administration can be a problem in persons with ostomies. A soft catheter should always be used in the case of ileostomies. Colostomates who irrigate should bring their irrigation catheter or ask for something similar. Hospitalization is indicated. Treatment involves rest and intravenous administration of necessary salts, water and glucose. The stomach intestinal contents may be removed via a nasogastric tube. Peristalsis usually restarts spontaneously after two to three days of resting the bowel. In cases where a partial mechanical blockage triggered the condition, surgery may be performed. Fortunately, ileus is a relatively rare condition. The total rate is about one in one thousand for both mechanical and non-mechanical blockages. (Coquitlam editor’s note: Unfortunately my source did not say what the rate in ostomates was.)

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FOLLICULITIS
Via: S. NV. Town Karaya & GB News Review
Folliculitis is an inflammation of hair follicles. It is usually caused by traumatic hair removal, for example, hair under the pouch skin barrier is pulled out when the skin barrier is removed. Prevention is the key to managing skin complications, so, in this case, you should use an electric razor or scissors to clip the hair. If folliculitis does occur, it can sometimes be confused with yeast infection. The skin under the faceplate or wafer is red and small pustules may appear. On closer inspection, though, in folliculitis these pustules will be seen only at the hair follicles. Treatment includes modifying the shaving and the pouch removal method as needed to prevent further damage. Usually the use of a skin protective powder will permit the skin to heal. Consult your doctor or ET Nurse if the problem continues. (Footnote to this article by the Editor of the “Re-Route” Evansville, IN chapter: Folliculitis can also occur when using an electric razor. If the peristomal skin is not thoroughly cleaned each time before using an electric razor, you may actually “gum-up” the razor’s blades causing it to pull the hair from the skin instead of cutting it. This can cause the same redness and irritation that occurs when hair is pulled out when the faceplate is removed. If you use an electric razor, keep the heads clean and replace them if they show any signs of “gumming-up”. Replacing electric shaver heads can get rather expensive. As an alternative, you might consider using the disposable safety razor blades such as Bic that are about $1.98 for a package of 10 at most discount chains. Just use a mild soap without cold cream, lathering the skin lightly before shaving the peristomal area. Then rinse well and dispose of the razor along with your used pouch. The use of a straight-razor is not recommended at all for hair removal. Very few people use straight razors anymore, but the obvious reason for not using them is that they would be somewhat awkward to use in that area and could easily slip in the user’s hand causing damage to the stoma.

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