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Ostomy Association
of Southwestern Indiana
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Contents:

FIND AND PREVENT COLORECTAL CANCER
ANTACIDS & ORANGE JUICE DON’T MIX
BATHROOM HINTS
TOP TEN TIPS FOR HANDLING LEFTOVERS
DOCTOR & PATIENT COMMUNICATION
CRANBERRIES—FOR AND AGAINST FOR UROSTOMATES
BLUE JEANS & THE OSTOMATE
HINTS AND TIPS

Volume 33, Number 5  February, 2006

ANTACIDS & ORANGE JUICE DON’T MIX
Dayton Ostomy Chapter & GB Support Group
“Avoid drinking orange juice for at least three hours after taking antacids that contain aluminum, such as Maalox or Mylanta,” cautions William Ruderman, MD, chairman of the Department of Gastroenterology at the Cleveland Clinic in Ft. Lauderdale, Florida. Orange juice increases the body’s absorption of the aluminum in these antacids as much as tenfold and aluminum accumulation can cause calcium loss, which contributes to Osteoporosis.

BATHROOM HINTS
Lynn Rowell, Editor of the Rambling Rosebud, Anne Arundel County, MD
If you have a very active ostomy with a lot of output, like me, you get to visit the “small room” rather frequently. I have found that one of the toilets in my house doesn’t do a good job of flushing the waste away. In fact, the bowl fills with clean water from the tank and then the surplus is “sucked” down the toilet into the sewer. Unfortunately, a lot of the liquid waste remains and it becomes necessary to wait for the tank to fill and flush again or risk someone thinking you either didn’t flush or the toilet’s not working correctly. Having to flush twice is both annoying and wasteful. Also, these kinds of toilets that have a large bowl with a lot of water in it, means that as you empty, it can create quite a splash—putting in a few squares of toilet paper first prevents the waste from splashing as the pouch is emptied. Newer toilets are sold meeting water saving requirements. Unfortunately some of them are still designed so that clean water from the tank fills up the bowl and then is sucked back out; these also may have problems removing the waste properly. Many public facilities have installed power flush toilets that require little water. They have a powerful sucking action that removes waste. Since they don’t have much water in the bowl, if the output is thick, some may remain after flushing, so it’s best to put down a few squares of toilet paper into the bowl before emptying the pouch. The majority of the waste, hopefully, will be on that paper, which is then pulled away when you flush. I have also found this to be helpful when using the toilet on a plane as they also use very little water. As I have encountered public restrooms minus soap, I carry a small hand sanitizer or pack of travel wipes for such occasions. A few tissues in your supply kit or some squares of toilet paper are also good for the time when you have to go, but the stall is out of paper.

TOP TEN TIPS FOR HANDLING LEFTOVERS
Via: South Beach website & Greater Orlando, Central FL Ostomy Chapter
There’s nothing like eating a great dish two (or three or four) nights in a row. At the same time, it’s better to rid your fridge of some leftovers before they turn into a dangerous meal. If you’re wondering whether to eat or to toss what’s left of last week’s dinner, check out this list of answers to 10 frequently asked questions about leftovers.
1. How long before I need to refrigerate my leftovers? Within two hours of purchase or preparation. Be extra careful about getting meat and dairy products into the fridge promptly.
2. How long can I keep refrigerated leftovers? About three to five days.
3. How do I store leftovers? Store in airtight shallow (1-to 2-inch deep) containers to allow adequate circulation of cool air.
4. How long can I keep cooked lean meat and meat dishes? Three to four days in the refrigerator and two to three months in the freezer. Raw beef can be stored for six months to a year in a freezer set below zero degrees F.
5. How long can I keep cooked lean poultry and poultry dishes? Three to four days in the refrigerator and four to six months in the freezer at below 0 degrees F. Raw poultry can be stored for nine months to a year in a freezer set below 0 degrees F.
6. At what temperature should I keep my refrigerator? 40 degrees F (or slightly lower)
7. What’s the best way to keep track of how long my leftovers have been in the fridge? Label and date every container and keep the older containers toward the front of the fridge.
8. What if I’m unsure how long my leftovers will keep? Check them daily for signs of spoilage, such as an odd odor or color, and be on the lookout for any indication of mold.
9. Can I taste leftovers to see if they are still fresh? If in doubt, throw it out. Never taste a questionable leftover.
10. What if my refrigerator is too full for everything? Clean it out, getting rid of old leftover containers or questionable foods. Cold air needs to circulate to keep foods fresh.

DOCTOR & PATIENT COMMUNICATION
Via: Mesa-East Valley Chapter & The Phoenix, & Des Moines, Iowa
Talk to your doctor, too many doctor visits open with a general statement about aches and pains, followed by silence as patients wait for a diagnosis. But good medical care depends upon teamwork, with physician and patient pro-actively talking to and listening to one another. Physicians must often be private eyes before the healing process can begin. Body language is important, a patient’s posture, facial expressions, speech patterns and even clothing can provide valuable insights to what lies behind “I don’t feel well.” Initial reasons given for visits to the doctor are often not the entire story. A patient sometimes suffers from underlying fears which must be dealt with by a perceptive physician. If you’re worried about something that appears minor on the surface may in fact be more serious, ask the question. The doctor can understand your concerns and, in many cases, help dispel them. Here are some tips that can help you improve communications with your doctor. Write down your questions on paper beforehand; use these as a guide during your appointment. Be sure that you understand your diagnosis—the recommended treatment and the prescribed medication. Don’t walk out with unanswered questions. Don’t hold back family and personal medical history—for whatever reasons. If you are consulting other doctors, say so; even better, have those records sent ahead. Be specific as to medications you are currently taking—better yet—take your medication bottles with you so the physician has an accurate picture of the prescriptions and d dosages. Keep a list of your medication and dosages at home. It can be invaluable in an emergency. Know what preventive tests you should get and when. Be accountable for those test. Take the initiative in following up with your doctor. If the relationship is not working, change physicians. As with other relationships, sometimes the chemistry just is not there. Two-way communications is a very important component in total patient care.

CRANBERRIES—FOR AND AGAINST FOR UROSTOMATES
Via: Snohomish Co., WA S. Brevard FL & Hemet-San Jacinto, CA
FOR– The secret ingredient in cranberries that is pivotal in preventing urinary tract infections (UTIs) is concentrate tannins in the juice, called proanthrocyanidins. In a Boston study published in the Journal of the AMA, cranberry juice was found to be effective in reducing the incidence of UTIs and the need for antibiotic treatments. This has important implications for persons with ostomies and continent diversions. Recurrent UTIs can be common in persons who catherize frequently. These can be more evident if proper hand washing and cleaning of catheters is not done routinely. In addition, a large proportion of women over age 65 will experience at least one UTI per year. How does this special ingredient in cranberry juice work? The tannins from cranberries simply prevent E-coli bacteria, the main culprit in urinary infections, from adhering to cells that line the walls of the bladder and kidneys. The bacteria thus will “wash our” before infection can develop. Scientists in the Boston study believe that the routine addition of cranberry juice to dietary regimes in circumstances where UTIs have a high incidence, would be sensible.
AGAINST– An article from the Mayo Clinic says drinking cranberry juice to prevent recurring bladder or urinary infections is an “old folk” remedy. Does it work? Maybe—but don’t count on it. A key to prevent bladder infection is blocking the growth of the bacteria that causes the infection. But scientists don’t know whether a realistic amount of cranberry juice can produce enough change in urine acidity to affect bacteria. The second theory is that cranberry juice keeps bacteria from “sticking” to the bladder wall where they multiply and cause infections. This theory was confirmed in the laboratory and in mice, but results vary in humans. We do know that taking 500mg of vitamin C (ascorbic acid) twice a day along with cranberry juice cause acidity of urine. Still, if you think you have a bladder infection, don’t try home remedies. See your doctor. The usual treatment is antibiotics and lots of liquids.

BLUE JEANS & THE OSTOMATE
Via: New Outlook Excerpted & Modified by the Editor
Most ostomates can wear blue jeans just as normal people do. We have some concerns about wearing tight fitting clothes around the stomas and this is legitimate. But, if your jeans are tight around your stoma, they will also be tight around your waste. You will be more uncomfortable with pants squeezing your waist than your stoma. We have members coming to our meeting wearing jeans all the time. Most do not wear the waistband across the stoma. This might restrict to normal operation. There are many brands of blue jeans that are comfortable for a person with a stoma. Some jeans don’t have a very high rise, and the belt line hits right across the stoma. This is a problem. It is better not to wear any type of pants that have a waistband across the stoma. Khakis and most other pants have a high enough rise that this isn’t a problem. Also, some pants are pleated and allow room for expansion of the pouch as it fills—which isn’t the case with some jeans. The following is some information on brands that some of our members wear:
* LL Beans most relaxed fit blue jeans with some elastic on the waistband, has the waistline too low and they weren’t very roomy in the midsection.
* Try Lands’ End—they have an elastic waist and pleated jeans. They are comfortable. You can look for them at www.landsend.com or just call 1-800-356-4444 to order a catalog. They also have all shades of sports pants. Big and Tall men’s store has options. The waistband of their jeans have a higher rise. They are comfortable and allow room for expansion. Try wearing shirts on the outside. You only need to tuck in with pleated slacks.
* J.C. Penney has some nice casual pants with full elastic waistband that are quite nice.
* Calvin Klein has high quality jeans that have a high rise and may be worn comfortably.
* Ralph Lauren also has quality jeans that are form fitting but have sufficient room to be comfortable to wear and yet be gentle around the stoma.
* Levi’s and Lee have a wide variety of pants that are stylish and may flatter one’s figure.
* Ladies may want to wear stretch jeans, and if all else fails, the good old maternity one without that cotton panel. *Docker’s makes a pleated jean that works very well with an elastic waist band. Likewise, Haggar makes an elasticized side button adjustable jean and slacks that are very comfortable and can be worn by ostomates immediately after ileostomy surgery. They can be purchased single or double pleated in almost all department stores. These suggestions are just a few based on experiences of many ostomates. Wearing clothes is very much a personal preference, just like it is to non-ostomates. Some ostomates may have issues because of the placement of their stoma or for other special reasons, but most of us do not. We wear whatever we like. If your stoma is above your waist, you will have special challenges to meet. You may also talk to your ET nurse. He/she can help. But if your stoma is lower than your belly button, like most of us, you can wear virtually any jean you want.

HINTS AND TIPS
Via: Hemet-San Jacinto, CA
One cause of obstruction you don’t think about is from too many “soft drinks”. The gas from carbonated drinks can distend the bowel to a point that kinking can occur.
The teabag is an ostomate’s best friend. Tea is an anti-spasmodic and soothing to an upset stomach. It also provides fluids containing electrolytes and potassium so frequently lost from diarrhea.
Gas problems can be relieved by eating several spoonfuls of yogurt or applesauce. Much air is swallowed at night while sleeping and this will result in gas. A few swallows of club soda will help to get rid of gas bubbles. You just burp them up. The manner of eating is also a factor in relieving gas problems. If you can avoid drinking while eating, the effluent will become thicker, and liquids can be ingested before and after the meal.
If one can avoid greasy foods, this may serve to lessen gas problems. Also some roughage in the form of grain cereal will move food more rapidly through the digestive tract and lessen gas formation.
Vitamin E and Fatty Soaps (Dove for Example) may be great for the skin but they can cause the appliance to fall off. Polident and Efferdent are very effective to soak your appliances: to deodorize, remove stains and clean. If it’s good for your teeth, it is good for your appliance.
Does your stomach gurgle? Try eating solid food first at meals and then drink. But be sure to get enough fluids too, so you don’t become dehydrated.
Eating bran muffins is a simple and delicious way for colostomies to solve a constipation problem.
If stool sticks to the pouch and is hard to rinse out, spray the pouch with PAM before applying.
When the lock is broken on the restroom door, a wad of folded tissue will sometimes hold it shut.
Carry an extra tail closure or rubber band with you in case yours “goes down the drain”. It could prove critical to your entire program.
Ziploc sandwich bags are useful for disposing of used pouches and taking care of odor of used pouches.
Don’t be afraid to take a shower without your appliance. Soap cannot hurt the stoma. Just rinse well.
After bathing with the faceplate off, hold a cold compress over the peristomal area for a few seconds to close the pores before replacing the appliance.
A bit of spearmint vinegar in a glass of water calms the stomach and digestive system. It also relieves gas and adds a tangy zest to iced tea.
A good rule to follow—if it is safe to put in your mouth, it is safe to put in your pouch. Try GREEN MINT MOUTHWASH as a pouch rinse.
Trouble with itching under the tape or Stomahesive? Mix 50% white vinegar and 50% water, apply gauze sponges and soak the skin for 5 to 10 minutes when changing your appliance. Be sure the skin is washed and rinsed well to remove the vinegar before applying the new appliance.
Use CERTS if nothing else is available. PEPTO-BISMOL is an effective deodorant. Take one tablet immediately after meals. Its effectiveness is lessened the longer you wait after a meal.
Eat parsley to eliminate odors.
You do not have to be a baby to discover the merits of Johnson and Johnson diaper liners. You may try them as a barrier between ostomy pouches and the skin. They come 60 to a box and cost under a dollar. (Editor’s Note: I don’t know how old this tip is, or if they are still available.)
Don’t behave as if having an ostomy makes you less of a person or some freak of nature. There are lots of us and most of us are glad to be alive!
Build a support system of people to answer questions when you have a problem. Consider our ET’s and your officers who are listed in this newsletter.
Don’t play the dangerous game of making your appliance last by over taping or putting off a change. There aren’t any prizes given for the longest wear time except accidents!
Don’t wait until you see the bottom of your supply box before ordering more. Always count on delays in shipping, holidays, etc. when calculating what is needed.

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