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pageVolume 33, Number 10 July, 2006
KNOW
WHEN YOU ARE DEHYDRATED
By: Michael Blume, MD, CCFA & IANY
The human body is composed of more than 50% water. Drinking adequate
amounts of water is essential for maintaining adequate blood volume and its flow
to such vital organs as the brain and the kidneys. Also, it is important for
maintaining optimal function in the cells of the body. Dehydration can be
defined as a significant decrease in the total water content of the body. It
occurs when the rate of water intake (mostly by mouth) is lower than the rate of
losing water from your body (urine, skin, lungs, gastrointestinal tract). When
you lose a significant quantity of water, you begin to develop symptoms and
signs of dehydration. Some of these are nonspecific, such as dizziness upon
sitting or standing up from a lying position. Why should you be worried about
becoming dehydrated? The major reason is that it is important to avoid the
complications of dehydration. When you become dehydrated, the volume of
circulating blood decreases, and this in turn decreases the flow of blood to
your vital organs. Not only is the blood flow a major problem, but as you become
dehydrated, you lose water and two minerals (potassium and sodium), which are
essential for optimal functioning of the body. If dehydration is mild, you might
try to rehydrate yourself by taking Gatorade or a similar drink slowly. In
addition to water, Gatorade contains important electrolytes (sodium and
potassium) that the body loses through vomiting or diarrhea. When must you seek
medical attention for dehydration? All situations which indicate concern about
maintaining adequate hydration are significant. These include, but are not
limited to, profuse diarrhea, protracted vomiting (unable to keep down liquids)
and a very high fever. Obviously, if you develop any of the signs of dehydration
you should be concerned. Urgent attention to the problems should involve not
only treating the underlying causes, but replacing the liquid and electrolyte
losses with intravenous liquids, if adequate replacement by mouth is not
feasible. While there are no clear-cut guidelines as to when you should seek
medical attention, if any of the above concerns exist, the best advice is to
check with your doctor before complications develop.
CARING FOR
EXCORIATED SKIN
By: Diane Duran, MSN RN CWOCN N.Y.
If after removing your wafer you find your skin to be red, denuded of
skin, painful or sensitive, you have “excoriated skin”. Excoriated skin is
often caused by pulling at you wafer too vigorously, along with moisture under
the wafer. When removing your wafer use a non-alcohol adhesive remover.
Simply hold down your skin with the adhesive remover pad and going from side to
side, gently pull your wafer down and away from your skin. After gently
washing the stoma and surrounding skin with warm water, dry the skin thoroughly.
Sprinkle the skin with stomahesive powder, dust off the excess and seal the
powder in with a non-alcohol containing skin prep, i.e. Cavilon spray.
Wipe the skin with the skin prep until you can’t see any more powder. Then
instead of placing your wafer squarely on your skin put it on “diamond” shape.
The next wafer change put it on your skin squarely and rotate every other
change. This gives at least part of your “excoriated” skin a good chance
to heal. Remember be gentle with your skin and it will be good to you!!
RELIABLE SCREENING FOR BLADDER CANCER
The Journal of the American Medical Association, Via: Loraine County Chapter
Doctors may soon have an easy, reliable screening for bladder cancer, A common
but difficult-to-detect condition, suggests a study in the January 17, Journal
of the American Medical Association. The key? A protein called survivin that is
made in detectable quantities only by cancerous cells. Researchers measured
survivin levels in the urine of 158 participants, some of whom had already been
diagnosed with bladder or other types of cancer and some of whom were
cancer-free. Survivin was present in the urine of all the people with bladder
cancer but not in that of healthy participants or in that of people with other
types of cancer, whose cancer cells may have been making survivin but not
releasing it into the urine. The cancer marker was also present in the urine of
4 out of 30 people with non-cancerous urinary tract disease, but 2 of them later
developed bladder cancer.
WHAT TO DO IN CASE OF FOOD BLOCKAGE
Via: Los Angeles News & Indianapolis Chapter of UOA
It may happen around midnight. That severe cramping sensation coupled with
cessation of ostomy flow or watery projectile flow. When the cramping strikes,
that memory of having consumed some problem food follows soon afterward. What is
the proper course of action for the ostomate? Food blockage is an experience
that many ostomates will have at one time or another. The enzymes of the
digestive tract cannot digest cellulose or foods with high fiber content. Nuts,
corn, popcorn, coconut, celery, Chinese vegetables, fruits and tough cuts of
meat are a few foods that may cause blockage problems. Ileostomates who do not
chew their food thoroughly, eat rapidly, do not drink sufficient liquids or have
dental problems will be more prone to have a food blockage. When food blockages
occur, a post-op pouch should be applied. The size of the opening should be a
little larger than normal because the stoma may swell and with a clear post-op
pouch, the section of the stoma may be observed. The next step, if no nausea or
vomiting is present, is to start forcing liquids ...coke, tea, or whatever
liquid produces a rapid peristalses movement, is best. A few crackers may be
eaten as a pusher. Sometimes a change in body position, such as assuming a knee
chest position, may encourage movement of the bolus of food. Massaging of the
abdomen may also produce the same effect. Diarrhea may follow the blockage,
therefore, it is necessary to replace fluids. Gatorade may be used for
replacement of both fluids, and electrolytes. Cheese, bananas, and peanut butter
help to slow the diarrhea. It is normal to have a sore spot in the abdomen
following an episode of blockage. A low residue diet should be followed for one
or two days to allow the intestine to heal. If nausea and/or vomiting occur with
the food blockage, one should go to the emergency room immediately.
THE
NEW OSTOMATE AT SENIOR AGE
Via: Johnstown UOA & GB News Review
Because the population as a whole is living longer, greater numbers of people
are suffering illnesses that require ostomy surgery. Problems the senior new
ostomate may face (which all of us can help with) include: FEAR of increasing
dependence and non-acceptance by family. Family acceptance and support is
essential for complete rehabilitation. UNPREPAREDNESS for a stoma. Surgery may
often be done as an emergency procedure, and there has been little time for an
older person to adjust to this change in body image. Often the older person is
confused after surgery because the hospital routine is foreign; side rails are
up and he/she is confined as though a child. It is in this condition that he or
she first gets acquainted with their ostomy. A HARD TO MANAGE STOMA.
Particularly if created in emergency surgery, the stoma may be adjacent to a
wound or done in haste and poorly positioned. Experienced ostomates and
caregivers can and should work to teach the senior or new ostomate acceptance
and self-care. It might take extra patience. Ability to learn does not diminish
with age, but speed of performance and reaction time decline and it takes longer
to learn new tasks. A word of advice to those working with new ostomates in a
senior category: allow your student to learn one task well before proceeding to
the next one.
TIPS
FOR SWIMMING WITH AN OSTOMY
Via: Metro, MD.
Allow considerable time after changing a flange before swimming (overnight is
best, but at least several hours). Flanges with waterproof tape built into the
flange (flexible ostomy system ) work best. If not using a flexible flange,
“picture frame” the flange with waterproof tape (that is, put tape around all
four sides of the flange, as if you were putting it in a picture frame). Some
say the pink tape is most effective. Micropore and similar paper-like tapes can
be made more waterproof by covering them with Skin Prep after they are in place.
Cloth belts stretch in water, so wear a rubber belt if you wear one at all.
Swimsuits, with “busy” patterns camouflage the appliance; solid colors reveal
the appliance. Skirts, bows, sashes, ties, drapes on a swimsuit can camouflage
the appliance. Boxer-style trunks work well for men. A tight garment under your
swimsuit can help hold the appliance in place. Try a lightweight two-way stretch
panty girdle, the top part of old panty hose, biking shorts, or sew a pocket in
the lining of your swimsuit to support the pouch. These are “unisex” ideas! Men
can also try a pair of jockey shorts for similar support. Mini, non-drainable
pouches may be more comfortable and have a lower profile under swimsuits than
your usual pouching system. They may be used over and over if you rinse them out
and air dry after every use. Avoid pouches with built-in filters for swimming.
Water can get in, and water mixed with stool can soil your clothing. Plan ahead
for swimming. Try to calculate your transit time (how long it takes food to get
from mouth to pouch), and eat your meals at a time that will allow you to have
the least amount of output when you plan to swim. For most people, the first few
hours after getting up in the morning will be the time of least output.