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Volume 32, Number 10 July, 2005
VIRUS AND COLON CANCER
Reuters Health, Via: Northern Virginia “The Pouch”
A common type of herpes virus may play a role in the development of colorectal cancer, preliminary research suggests. The virus, called cytomegalovirus (CMV) is widespread and normally causes no problems in healthy individuals. As many as 90 percent of US adults may carry CMV infection, which in most cases remains dormant. However, some research has suggested CMV infection can help promote heart disease, possibly by causing long-term inflammation in the body. Now, the new study hints at a potential role in cancer of the colon and rectum– although, the lead author told Reuters Health, “It does not prove the virus helps cause the cancer.”
Researchers found evidence of CMV proteins in most of the tumor samples, but not in healthy tissue. The proteins also turned up in most of the colorectal polyps the researchers studied. Colorectal polyps are usually benign growths, but over time, some may develop into cancer. In addition to detecting CMV in patient’s tumor samples, the investigators found in the lab experiments that infecting colon cancer cells with CMV produced two types of proteins that are thought to contribute to the progression of colon cancer.
Still, none of this establishes a cause-and-effect relationship. And considering how pervasive CMV infection is worldwide, a number of other factors would have to conspire with CMV for colorectal cancer to develop. Exactly how CMV might promote colorectal cancer is unclear, but there are several possibilities. For example, CMVinfected colon cancer cells might gain a “growth advantage” or, alternatively, a shield from the immune response that might normally kill them. Research has shown that CMV has the ability to evade key immune-system components.
The finding that CMV could have a role in cancer is something of a surprise. But researchers had previously found a potential tie to brain tumors, and they are continuing to study what role, if any, the virus might have in other cancers.
If more research does confirm that CMV contributes to colon cancer, it is “theoretically possible” that the CMV vaccines researchers are working on could one day help prevent colorectal cancer. Colorectal cancer is the second-leading cause of cancer deaths in the US. Established risk factors include older age, family history of the disease and the inflammatory disorder, ulcerative colitis. Health experts recommend that men and women begin regular colorectal screening at age 50.
PROBLEMS WITH URINATION?
By: Bob White, Via S. Brevard FL
Persons who have problems with frequent urination, or difficulty in urination are commonly diagnosed as having a urinary tract infection (UTI) and treated accordingly. It is possible, however, that your problems may be the result of interstitial cystitis (IC), a different can of worms.
IC is a long-term inflammation of the bladder wall. The bladder is lined with a mucous layer that is designed to protect the bladder wall. IC causes damage to the mucous layer, thus exposing the bladder wall to irritating substances in the urine, aggravating and inflaming the wall. Symptoms of IC may vary, not only from person to person, but from time to time in an individual patient. The symptoms may be different between women and men also.
Symptoms in Women
*
Unexpected pain or pressure in the pelvic area;
* Pain during or after sexual intercourse;
* Frequent, sometimes painful, urination;
* Waking more than once in the night to urinate;
* Feeling the urge to urinate, sometimes even after you’ve emptied your bladder;
* Having UTI-like symptoms, or having more than two UTIs in a year;
* Your symptoms come and go—flare-ups may be associated with menstruation, certain foods, allergies, and stress.
Symptoms in men
*
Unexplained pain or pressure in the penis, testes, and/or scrotum, in the area above the pubic bone, the lower abdomen, the lower back or the groin area, in any combination;
* Pain when you ejaculate, or the day after;
* Frequent, sometimes painful, urination;
* Waking more than once in the night to urinate;
* Feeling the need to urinate, sometimes even after having emptied the bladder;
Symptoms come and go– flare-ups may be associated with certain foods, allergies, and stress.
If you experience these symptoms, keep a record of them in a journal. This will make it easier to identify the problem, and give your healthcare professional useful information. DO consult your primary care physician or urologist when you have reason to believe you may have IC. There are medications available that may be used to treat it.
QUICK TIPS FOR THE WORKPLACE
Via: Better Together Newsletter “Health & Vitality” by: ConvaTec, March 05 & UOA New Directions
Back to work having a stoma has little bearing on your employment. Most people with ostomies return to their jobs after surgery. Though absence of work can be frustrating and isolating, you must allow sufficient time (usually 3-6 months) to recover fully from your operation. Deciding when to return to work should be determined by you, your doctor, surgeon, and ET nurse. You may tire more easily upon returning to work, if so, ask your employer if you can work part-time for the first few weeks back on the job.
On the Job: You will need good toilet and washing facilities at your work site, with privacy for changing your appliance (pouching system). Keep spare wafers, pouches and accessory products-plus another set of clothing-at work, just in case. If using closed-end pouches, put the used pouch in a plastic resealable baggie before disposing of it. After draining an open-end pouch in the toilet, spray some air freshener.
Job Performance:
People with ostomies perform nearly every kind of job. However, some occupations, in which the work is physically uncomfortable or inconvenient, may require some precautions. If your occupation involves strenuous or repetitive physical work such as stooping, bending or heavy lifting, be extra careful as you move about. If your work involves handling food, there is no reason why you cannot continue to do so, providing you exercise good personal hygiene. The risk of spreading germs is the same for those with ostomies as for those without.
Work Rights & Responsibilities:
Under the Americans With Disabilities Act, some employers may be required to take certain accommodations for you. Inquire about this with your human resources specialist. Individuals may, however, be required to undergo a re-employment physical. Before accepting a position with a new employer, find out the name of their health insurance company and contact it directly to find out whether the plan covers your ostomy-related needs.
ANOTHER SIDE OF THE STORY
Lynne Rich, Ph.D., Via: Hemet-San Jacinto Stoma-Life
If anyone walked a mile in the shoes of an ostomate, how would they feel? Maybe a little tired, but their ostomy would work just fine, thank you. What does having an ostomy mean to you? Survey says: good health, no pain, belonging to a group of strong, caring and compassionate people—ostomates, savvy individuals who’ve learned how and where to get and share knowledge, help, humor and hope.
Okay, there hasn’t yet been a comprehensive survey. Are you living as actively as you’d like to? If not, Why? An ostomy is merely tissue that’s been surgically relocated and designed to function smoothly. If ever temporarily an ostomy doesn’t work correctly and trouble free, it may only need a little extra attention and care. You and your ostomy deserve the time necessary to be taken care of really well. After that, let your heart and brain take charge.
Living through health problems that led to ostomy surgery, you no doubt gained strength and fortitude. Your ostomy won’t break and neither will you. You might develop feistiness and greater determination. You may also discover more bad hair days are likely than bad ostomy days especially in a tropical, humid climate, during blustery winters, or in the windiest rainstorms.
If you are not sure whether an activity is medically or physically all right for you to do, before you stop yourself from trying ask your physician and ET (Enterstomal Therapist) if actual medical or physical restrictions prevent you from participating in or learning to: water ski, play the guitar, swim, play canasta or poker, scuba dive, speak Spanish, French or Italian, dance, (ballet, tap, waltz, samba), eat Cajun, sushi, or Greek foods, hike, canoe, kayak, take a trip by car, bus, ship, plane or train, ride a horse, run a marathon, walk 30 minutes, do yoga, golf, garden, sing or laugh.
Ostomies don’t prevent working, traveling, living anywhere, swimming, scuba diving, hiking, or water skiing. Don’t allow inaccurate information or a negative attitude to prevent you from doing what you want. Adjust your attitude with realistic information. Just as you adapted to the ways your body changed as you were growing up and as an adult too, you can adapt again and resume living as millions of other ostomates have done.
Learning how to take care of an ostomy is not as difficult as originally learning —earlier than you remember— to walk, or later, perhaps, learning to drive a car, to wear contact lenses or bifocals. Ask questions. Terrific at sharing information, ostomates are resilient, inventive, practical and creative. At ostomy association meetings, notice how well people look. That’s due to deliberate effort and an optimistic attitude. Give yourself the same quality of care you expect from your doctors. Don’t ask less of yourself.
Having an ostomy might mean better health now, and living longer. Decide each day what you’d like to do. Socialize with other people, or spend time alone. Count on the people most important to you to remain living and supportive. Call people you’d like to see. Let your family and others know when you want them to join you in various activities. Don’t think or expect the
worst from anyone, including yourself.
An ostomy gives you health and options. Consider the Spanish proverb: Living well is the best revenge. Live well!!
(Two recommended books provide valuable information. In The Ostomy Book, Barbara Dorr Mullen and Kerry Anne McGinn, R.N., present basic information about all three types of ostomies (colostomy, urostomy and ileostomy), and tips about best ways to return to good health following surgery and continuing to feel well. After ileostomy surgery, Maureen Bender wrote A Secret No More about her experiences as she resumed working, dating and started an exercise program for ostomates.)
OSTOMY FAQ's
Via: Hemet-San Jacinto
What should I do if hospitalized again?
Take your ostomy supplies with you, since the hospital may not have your brand in supply. If you are in doubt about any procedure, ask to talk to your doctor. Ask to have the following information listed on your chart: 1) type of ostomy or continent diversion, 2) whether or not your rectum is intact, 3) a detailed description of your management routine and a list of the ostomy products used. For urinary stomas, do not take a urine specimen from the urostomy pouch; use a catheter inserted into the stoma.
Do you have any tips on emptying the pouch?
Check the pouch occasionally to see if it needs emptying before it gets too full and causes a leakage problem. Always empty prior
to going out of the house and away from a convenient toilet. Most people find the easiest way to empty the pouch is to sit on the toilet with the pouch between the legs. Hold the bottom of the pouch up and remove the clamp. Slowly unroll the tail of the pouch into the toilet. Clean the outside and inside of the pouch tail with toilet paper. Replace the clamp.
Does insurance cover the cost of ostomy supplies?
Medicare Part B covers ostomy equipment. Medicare allows only a predetermined maximum quantity each month. Medi-Cal is the federal/state insurance of last resort for low income persons. Check with the state Medi-Cal office for specifics.
Individual Health Insurance: most plans typically will pay you 80% of the “reasonable and customary” costs after the deductible is met.
What effects will oral odor control medications have on my ostomy?
Some individuals who have a colostomy report that they experienced some constipation from bismuth products found in oral odor control medications. Individuals who have an ileostomy have more benefits and fewer side effects from oral preparations (chlorophyll tablets, bismuth subgallate and bismuth subcarbonate). Most foods do not affect an individual with a urostomy. A strong urine odor may be an indication of dehydration and the need for increased fluid intake. Check with your doctor or ET nurse about oral preparations and don’t exceed the recommended dosage.
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