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

 
Contents:

UROLITHIASIS
TEN COMMANDMENTS FOR THE NEW OSTOMATE
LIVING WITH YOUR ILEOSTOMY
CHANGING HEALTH CARE
FOR COLOSTOMATES
CARTOONSVILLE

Re-Route Archive

Volume 28, Number 5  February, 2001

UROLITHIASIS
By: A. Trudeh, RNET, Lexington, Via: The Ostomatic News, Dallas Area Chapter # 185 
Urostomates, Ileostomates and transverse colostomates, have one thing in common: continuous output with a loss of fluids. If the liquid intake does not exceed the output, these ostomates may be dehydrating their bodies, making themselves prone to a condition called “urolithiasis”, which refers to the presence of stones in the urinary system. These stones may be found anywhere from the kidney to the bladder. They vary in size from mere granular deposits, called sand or gravel, to bladder stones the size of an orange. In the majority of stones, 90% are composed of calcium, with 5—8% uric acid and 1—3% cystine accounting for the rest.
    Conditions which predispose to stone formation are: (1) infection, (2) periods of immobility, (3) concentrated urine, (4) abnormally high concentration of calcium in the blood, (5) heredity, and (6) dehydration.
    If you were to develop urolithiasis, the symptoms you may experience are: (1) low back pain and/or severe, sharp pain in the lower back radiating to the groin, (2) chills, fever, (3) difficulty or burning with urination, (4) blood in the urine, (5) nausea, vomiting and diarrhea.
    See your physician as soon as possible if any of the above symptoms appear.
    Measures to prevent stone formation are: drink 2 to 3 quarts of fluid daily—preferably water and juices. Include acidic juices such as cranberry to maintain acid urine which helps prevent infection. Urinate during the night if necessary. Exercise daily. Use caution with foods containing calcium. Since a certain level of calcium is required for good health, restrict your diet only with the advice of a physician. 

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TEN COMMANDMENTS FOR THE NEW OSTOMATE
By: Anita Price, CET, Via: Cleveland Ostomy Association
1. There is no answer for “Why me?” but it is normal to ask and you do need to work through this and other questions. 
2. Stomas change in size and shape the first few months. The initial stoma swelling will decrease and your stoma diameter will decrease. Check the size of your stoma with a measuring guide each pouch change until the size stabilizes to its permanent size. 
3. Each person’s ostomy is different even as our fingerprints are different. 
4. Support and information from someone who has an ostomy can be helpful. Ask your doctor of ET to arrange for an ostomy visitor.
5. It is your ostomy. Learn to manage your ostomy and do not let your ostomy manage you. It is normal for your new ostomy to be the center of your existence. However, with time and practice your ostomy and its care will become just a normal part of your daily life.
6. Fundamental management techniques can be learned. New experiences and problems that develop must be met and managed as they occur. As you learn and practice these new skills, you will become comfortable with your ostomy care. Do not confuse accidental leakage or spillage with what is normal.
7. One of the most important goals for healthy living is good nutrition. The one difference in having an ostomy and setting your nutritional goals is that you need to take information provided for the general public and adapt it to your needs, keeping ostomy management in mind.
8. You are not alone! Surgeons make at least 500 ostomies every working day. One out of 200 persons has an ostomy and over two million of us make up almost one percent (1%) of the U. S. population. Support groups are available to help you.
9. You’re alive! You will get better and stronger as you recuperate from surgery. Give yourself time to get over your surgery and to adjust to this body change and adapt yourself to your ostomy.
10. Share what you have learned with another new ostomate, with your family, friends and others. It is up to you whom you tell that you have an ostomy. As you grow accustomed to living with an ostomy, there will be opportunities to help others along the way. 

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LIVING WITH YOUR ILEOSTOMY
By: Lawrence P. Davis, M.D., Via: Spacecoast Shuttle Blast & Metro Maryland 
This article is from a talk about: “The Surgeon’s Responsibility To You And Your Responsibility To The Surgeon.”
    My talk will be on what a physician expects of an ileostomy patient. Being an ileostomate myself, I have jotted down things I experienced, and what I expect of you as you learn to cope.
1. Immediate post-op care, the most important thing the doctor expects is the patient’s acceptance of the change in body image; he must accept the fact that he is changed for the better. One of the biggest hurdles with patients who will not even look at the stoma is to let him take care of it. This is the beginning of the road to recovery and complete recuperation. The patient should and must be independent by the time he leaves the hospital.
2. Get the patient to look at the positive effects of his operation. He is free of the disease, cancer, diarrhea, pain. Most Ileostomates say they are so happy to be rid of 20 trips to the bathroom and sometimes getting there too late. Make him aware that he has not been mutilated but changed for the better.
3. The next big obstacle is “bagging the stoma,” or finding the right appliances for the patient. The patient needs to know that his stoma is going to change. With weight change, the need will change.
    It is very important to understand problems a surgeon faces. Keep in mind that the individual’s problems dictates the surgeon’s techniques. Individual problems dictate different stomas and locations. You do not swap dentures or eyeglasses; don’t compare stomas. Go to your ostomy meeting and learn all you can about ostomy care. The caring and sharing will help more than anything else.
    Usually, the ileostomate has been on diets for years, and after surgery he does not want to talk about diets. However, there are foods that may cause problems, gas or odors. The patient should be aware of possibilities that the doctor waits until some of the problems occur. This way the patient is not overwhelmed with so many iffy things to think about. 

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CHANGING HEALTH CARE
Via: Healthy Thoughts, Old National Bancorp, October 2000 
Health care in the U. S. Is undergoing a shift in focus—mainly in an attempt to control costs, but also to better meet patient’s needs. The “emerging” health-care system is based on:
1. Unconventional therapies, most of which seek to create balance in people’s bodies and lives rather than control only their symptoms with drugs and technology.
2. Professional and public acceptance that lifestyle plays an important role in health (I.e., nutrition, exercise, stress control, etc.).
3. A doctor-patient relationship based on connection, two-way communication and trust—all fundamental to the healing process.
4. The knowledge that each of us can—and should—play a role in our health and healing. We’re moving away from the view that medical technology alone can (and should) fix our health problems for us.
    Bottom line: The U. S. health-care system is beginning to take a more integrative approach to medicine—combining the best natural healing methods (used for thousands of years in many cultures) with the best of modern medical technology. 

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FOR COLOSTOMATES
Via: Spacecoast Shuttle Blast 
     If you use a Stomahesive wafer and cut your own center hole, save the leftover pieces and use them to fill in any skin indentions around the stoma underneath the wafer.
    Spray the inside of your pouch with PAM to help the contents keep sliding down instead of sticking on the sides and top of the pouch.
    Apply the pouch standing, lying or sitting down, but do not allow abdominal wrinkling or this will break the seal when you straighten out.
    Colostomy diet is fairly normal. You will discover which foods may not agree with you by trying everything, a little at a time. If it doesn’t work the first time, wait a few weeks and try it again. If it doesn’t work then, leave it alone for a few months...or forever, if necessary.
    If you have difficulty with constipation, a glass of apple juice every morning and the night before irrigation may prove helpful. If you prefer, you might try taking your apple juice heated. (Add a little cinnamon...mmm!)                
    Colostomates who take antihistamines during the sneezing season may find that these drugs have a tendency to slow down intestinal action and the irrigation process becomes slower. Some report relief from the drug reaction by increasing the fluid intake the day they irrigate, or eating laxative foods (in moderation).
    If you are irrigating and having problems with leakage between irrigations, try using less water. Too much water may contribute to leakage.
    Buttermilk will soothe an irritated digestive tract and will not cause diarrhea or constipation.
    Some people find that a large teaspoon of bulk gelatin dissolved in water or lemon juice once a day will firm up a loose stool.
    If you are a colostomate who uses a convex insert in your face plate, and the insert becomes gucky and sticky, try good ol’ Uni-solve to remove the guck. It really works great!!!
    Especially in hot weather, wear protection between the pouch and your skin to prevent rash from perspiration. You can make a pouch cover with an old handkerchief, a baby’s bib, etc. Pouch covers can be purchased also.
    If you are taking a bismuth preparation, try to stop taking it for one day before having an intestinal X-ray or tell the doctor, because it sometimes shows up opaque on an X-ray.

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