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Volume 31, Number 4 January, 2005
THE DUMBEST THINGS EVER SAID…
Via: “The Pouch” Northern VA. Ch.
I’m sure these stories will bring to mind some funny things that happened to you that weren’t so funny at the time.
- After my ostomy surgery, a well-meaning aunt told me not to worry. She said I was still a beautiful girl—it’s not like I wore the bag on my face.
- Back when I had my ileostomy for about three years, I had to have some surgery to clear up a lingering Crohn’s related infection. While I was recuperating from this surgery, my new-age nurse tried to convince me of the rejuvenating powers of enemas. The pitch was “Rejuvenation Through Elimination.” This with “ileostomate” stamped on my records.
- Last year, I went for a doctor showed up with a student doctor, looked at my chart and then proceeded to tell me to drop my trousers while putting on a pair of rubber gloves. Then, he asked me to turn around and bend over. I stood there in total bewilderment and asked, “what exactly are you going to do, doc?” After telling me about the usual probing method involved, I smilingly informed him that he would have no results with this exam. Miffed, he asked, “why not?” I kindly told him, “re-look at my chart.” One advantage of my ostomy is that I’m sewn up tighter than a drum back there—no one is ever going to cause me discomfort in my butt again, thank you.” He slumped in a chair. Now he had the bewildered look. Needless to say, I pulled up my pants and hastily left his office. Makes you wonder, doesn’t it?
- Right after I returned to work from my ileostomy surgery, I was in the lunch room eating my lunch. A co-worker who had seen me there several days in a row, looked at my lunch and said, “I want to give you some advice. If you don’t eat more roughage, you’ll end up getting colon cancer.” I looked up at her and said, “not likely.”
- I was in a grocery store at the check-out counter. I had a little gas and my pouch was sort of puffed out, but hidden under my shirt. The cashier challenged me as to what was under my shirt—assuming I may have stolen
assuming I may have stolen something. I tried to explain, but her facial expression dictated I show off. So I opened my pants revealing a full pouch. The girl turned purple with embarrassment. But the little boy of the lady in the line behind me responded, “oh neat, I want one Mommy!”
- I was in class one day when as I like to call it, my carry-on-bag sort of broke—it was falling off. I went up to the teacher and asked her if I could go to the bathroom. She replied, “Can’t you just hold it?” I said pathetically, “I am.” Needless to say, she didn’t get the joke.
- After removal of my colon, on my ET’s first visit, she told me the things I could and could not do. “Don’t have stoma intercourse for at least six months, and, “cut the end of the pouch so it is shorter, and use a rubber band over the clip.” The former will produce a quick trip to the surgeon, only a moron would even attempt this. The latter produced a stupendous mess right there in the hospital. This occurred 12 years ago in a military hospital in Germany. I have to say, since her, I have only had very helpful and technically competent ET’s
- “No, we can’t go to that shopping center. Karen doesn’t know where all the bathrooms are.”
- A co-worker said, “How much do you think a colon weighs? “I’ll bet you ‘d lose 7 lbs if it were removed.”
ILEOSTOMATES & THE IMMUNE SYSTEM
Via: OAGS Newsnotes, & GB News Review
In response to a query about the possible effects of ileostomy surgery on the immune system, Dr. Beck notes that the surgery, by itself, should have no long-term effect on the immune system. Although there is some transient reduction in a patient’s immune responses right after major surgery, this usually returns to normal in a couple of days. However, the diseases that causes patients to need a stoma (such as inflammatory bowel disease) and the medications used to treat the diseases (steroids), or malnutrition associated with the diseases may affect the immune system. If you are concerned, there are several tests that a doctor can perform to test your immune system. One of these involves placing chemicals or allergens into the skin to see how the body responds. Others involve blood tests. We are continually learning more about the human immune system from our experience with HIV infections. Most efforts are directed toward identifying and then treating the cause of the immune dysfunction. Although good nutrition and some supplements (such as vitamins) are necessary for the immune system to work, little has been proven to improve the immune function.
BLADDER CANCER
by: T.R.. VANDellan,, M.D.
Most tumors of the urinary bladder are malignant. They are likely to develop after the age of 50, and men are more susceptible than women. At least 95 percent of these tumors are carcinomas or papillomas. These cancers are unique, especially papillomas.
When the first tumor is removed, another develops months or years later. It is a new lesion and likely to be more malignant than the first. And this type of recurrence may happen over and over again. This is why urologists insist on looking into the bladder every three to six months after the first neoplasm is removed.
The incidence of bladder tumors is increasing among our population. In 2002, it was estimated that 56,500 new cases would be reported. Overall, bladder cancer incidence is about four times higher in men than in women. On the other hand, the death rate has not risen due, perhaps, to improvements in early diagnosis and treatment.
Cancers of the bladder may grow for varying periods of time without producing any symptoms. They are always suspected when the individual suddenly, and for no apparent reason, urinates blood. Should this painless, but serious, sign develop, consult with your physician without delay. He may recommend an urologist who will try to find the source of the bleeding.
If nothing is done about the sudden bleeding, it may stop spontaneously. However, signs of bladder irritation and infection may soon ensue with quency, urgency, and difficult and painful urination.
Diagnosis is made by looking into the bladder with a cystoscope and doing a biopsy. With this procedure, the surgeon determines the size, shape, and location of the tumor. In some instances, the top of the lesion has sloughed off, leaving a bleeding ulcer. A pap test of the urine may reveal cancer cells. X-rays of the kidneys and an examination of the prostate gland in men, complete the study.
Some vesical tumors can be removed with electro coagulation or cutting electric currents inserted through the opening in the scope. Radon seeds can be inserted in the same way. Serious lesions require abdominal surgery, which involves removal of part of, or the entire bladder.
ADHESIONS & OTHER PAINS THAT CRAMP YOUR STYLE
Via: The UOA Insider Nesletter
Adhesions are tough, string-like fibrous bands, often in the small intestine. They may form spontaneously but are more common after surgery, where disturbances caused by tissue manipulation may lead to healing in the form of fibrous tissue, hence adhesions. Some people form them more easily than others.
Adhesions may grow to interfere with the normal motion of the intestine, causing a blockage or obstruction, with food, liquid or even air unable to pass the blocked area. Severe bloating, abdominal pain, vomiting and constipation are symptoms of blockage and present a serious situation requiring medical attention and possible immediate surgery to cut the obstructive adhesive bands.
Abdominal pain, though, doesn’t always mean adhesions are blocking the intestines. A frequent cause for such pain is a spasm of muscles responsible for peristalsis, the rhythmic muscular contractions that propel the bolus through the intestines. Muscle spasms in the calf are referred to as a “charley horse”; spasms in the intestines are essentially the same thing but assume the name “irritable intestine” or “irritable bowel.”
Even ostomates who function without colons are not immune from painful intestinal spasms—in the small intestine. An ileostomate may sometimes suffer from pain that can’t be traced to blockage and may be told that adhesions are responsible; the actual cause may instead be a spasm.
TEMPORARY OSTOMIES
By: Nancy Brede, RN ET from “The Pacesetter,
St. Paul, MN) & Rosebud Review
Temporary ostomies are surgically created with the intent of reconnecting in the future. The anatomy of the gastrointestinal system or urinary system is left intact. Permanent ostomies are created with the intent that the ostomy surgery will not be reversed; usually the surgery is performed when disease or injury prevents maintaining the anatomical structures needed for reversal.
A large number of temporary ostomies involving the colon are done on an emergency basis. The colon becomes obstructed or blocked, and stool cannot pass through. Because of the emergency nature of the surgery, the bowel cannot be cleaned and prepped ahead of time. Reversal, or reanastomosis (hooking up the normal anatomy), can be done later, when infection is not as likely and proper healing can take place.
The most common situations and diseases requiring a temporary ostomy are:
- Cancer of the colon with obstruction (or other abdominal cancer affecting the colon).
- Hirschsprung’s disease, a disorder/malfunction in infants which prevents passage of stool. Due to lack of nerve cells in certain areas of the large intestine, stool is not moved through, and an ostomy is necessary.
- Diverticulitis. Small out-pouchings (called diverticula) in the wall of the intestine becomes infected. The diverticula may rupture or cause obstruction.
- Inflammatory bowel disease or Crohn’s disease may necessitate a temporary ostomy to allow the diseased bowel to heal.
Persons with temporary ostomies face many of the same problems permanent ostomates have. It is just as important for them to have support, reassurance, and teaching as it is for persons with permanent ostomies. They must learn proper skin care, stoma care, and pouching techniques. Often, stomas are not ideally situated on the abdomen because of the urgency of the surgery. Thus, pouching and skin care can pose difficult problems.
Following temporary surgery, measures need to be taken to improve the person’s health. He or she must be in the best condition physically to undergo the major surgery for reconnection. This is also a time for the person to psychologically deal with past surgery, upcoming surgery, and possibly a newly diagnosed disease. It may be a difficult time with all the changes and new challenges. Often, there are many fears and unanswered questions. Other people with ostomies and ET nurses may provide reassurance and the answers to many questions.
A FEW OSTOMY TIPS
Scraps and cut-outs from barriers are great to relieve pressure of blisters of corns on one’s feet. Keep them in a small jar with a tight lid and the paper backing left on until you are ready to use them.
Some applesauce with breakfast sometimes controls stoma noise, and the pectin in it may have a thickening effect on a too liquid output.
Gas from carbonated drinks can distend the bowel to a point where kinking can occur causing a painful bowel obstruction.
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