Evansville Ostomy News

 
Contents:

WHICH POUCHING SYSTEM IS RIGHT FOR YOU?
TOMATOES
SUMMER LIVING WITH AN OSTOMY
SUNSCREEN—FROM BUYING TO APPLYING
NO NEED TO SING, THE POUCH POPPIN’ BLUES
ILEOSTOMY RETRACTION
PRINTER FRIENDLY JUNE NEWSLETTER

Monthly Newsletter Archive

Volume 35, Number 9  June, 2008

WHICH POUCHING SYSTEM IS RIGHT FOR YOU?
By Gwen Turnbull, BS (a pioneer ostomy nurse Via: Northern Virginia Pouch
With so many ostomy products available, it’s hard to know which one is right for you. Regardless of the brand of product or type of surgery you have, there are a few basic features an ostomy pouching system must have to give you a sense of security and confidence. First, it must contain urine or stool, gas and odor without leaking. Second, it must help protect the skin around the stoma from damaging effects of stool or urine. Third, the systems should remain in place for a sustained and predictable wear time. Wear time—This means you should be fairly certain your pouching system will remain intact without leakage for a definite period of time. That time period varies among individuals and ranges from 24 hours to 7-10 days.
Wear time- has a lot to do with the amount and character of your output, the climate in which you live, your daily activities, and the type of skin barrier you use.
Output — High volume liquid output will melt standard, pectin-based barriers faster than the more modern synthetic extended-wear barriers. Using a skin barrier paste as “caulking” around the stoma or a “bead” on the back of the skin barrier, can help increase wear time and skin protection.
Visibility/Intimacy/Cost — Once the above criteria have been met, look at other pouching system features that might impact the way you feel about yourself. For example, is the pouch visible under your clothing, and does that determine your feelings about yourself during periods of intimacy? Do ostomy supply costs, or worry about them, overwhelm you?
Your Adjustment — Researchers believe that such concern can affect your adjustment to, and satisfaction with, your life after ostomy surgery. That’s why it’s important to look at the fine distinctions about ostomy pouching systems. Consider a system’s wear time as it relates to its costs. Calculate your ostomy supply costs on a yearly total-cost basis rather than a cost per change basis. You may find that an inexpensive pouch that must be changed daily costs more in the long run than the more expensive pouch you can wear for three days.
Conclusion — Investigate the size, shape, color, contour, profile and ease of application and emptying of a variety of pouching systems. Which one will be right for you? The one YOU FEEL is right for you!
Editor’s Note: All ostomy manufacturer’s will be glad to send you free samples if you will contact them. Most manufacturers advertise in the OQ magazine and also your ostomy nurse can make suggestions.

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TOMATOES
Via: Magnolia Ostomy News, Jackson, MS
Tomatoes are the most powerful source of lycopene, a nutrient that protects your health 10 times better than vitamin C. Here’s how: We eat them green, red and yellow. We dice and puree them. Now the proof is incontrovertible; the humble tomato is one of nature’s most powerful medicines, thanks to its unique cocktail of disease-fighting compounds. Its benefits include: Potent cancer protection: New research suggests that women who eat the most tomatoes have up to a 45% lower risk of breast cancer! Antioxident rich tomato products have also been shown to prevent colon, ovarian and uterine cancers. “Tomatoes are nature’s number one source of the antioxident lycopene, which appears to inhibit the rampant cell division that’s needed for tumors to grow and spread,” explains American Dieteric Association spokesperson Betty Nowlon, Rd. Better cholesterol levels: Eating as little as one small tomato or one to two tablespoons of tomato paste daily can lower your risk of clogged arteries by 30%, cutting your chance of having a heart attack in half, studies show. Research suggests that same daily dose could cut your artery-clogging LDL cholesterol levels an amazing 23%. “Our best guess is that tomato products help slow the absorption of cholesterol in the intestines,” says University of Illinois pharmacologist Richard Van Breemen, PhD. Healthier lungs: Drink a 12-ounce glass of tomato juice every day, and you’ll reduce your risk of DNA damage to lung tissues from cigarette smoke smoke, car exhaust or other forms of air pollution by 20%, according to a recent University of North Carolina study. “The phytonutrients in tomatoes help nourish and protect delicate lung cells keeping them strong,” says Nowlin. Radiant skin: German researchers say tomato sauce is a powerful sun block. In fact, eating as little as 1.3 ounces of tomato paste daily reduces sun-triggered skin damage by 40%. Not only will that lower your risk of skin cancer, it will help prevent collagen damage, so your skin stays firmer. For best results: Open a jar. To get the biggest nutrient boost, opt for cooked tomato products, such as juice or spaghetti sauce. Cooking breaks down the tomatoes tough membranes, allowing up to 2 or 3 more antioxidants to be absorbed into your blood. If you love them fresh, let color be your guide: “the redder a tomato, the more antioxidants it contains, “ says Nowlin.

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SUMMER LIVING WITH AN OSTOMY
Gwen B. Turnbull, RN, BS, ET
Summer is here. People flock to the beach, languish by the pool, or head out for vacation. However, summer with all its related activities, can be produce a great deal of anxiety for someone living with an ostomy. One of the major concerns for a person with a stoma is body image and fear of public embarrassment (eg, noise from flatus, leakage, odor, or possible appearance of the pouch under clothing). Summer means wearing thinner clothing, bathing suits, and shorts, which can increase the level of unease surrounding these already angst-ridden circumstances. Selecting a bathing suit for a woman or man with an ostomy is somewhat easier than it was several years ago. Men’s swimming trunks tend to be patterned and knee-length. Flowered, patterned, or textured materials often serve as “camouflage” for a pouching system. Today, women have a variety of bathing suit styles from which to choose – many find a one-piece patterned suit appealing while others choose “boy short” bottom “tank-inis” or two-piece suits with a chemise-type top and/or a skirted bottom. As temperatures rise and exercise increases, so does perspiration. Individuals with an ileostomy must be instructed to carefully monitor fluid intake and stomal output, especially during periods of exercise or extreme heat. Many senior citizens live in homes without air-conditioning. Water alone is not sufficient – it does not replace the extra sodium and potassium lost in sweat as well as what is normally lost in ileostomy or high-output effluent. Sports drinks, tea, or colas should replace plain water because they contain valuable electrolytes. Patients should be taught the signs and symptoms of dehydration as well as preventive measures. Should dehydration develop, patients need to contact their physician or report to an emergency room for re-hydration with IV fluids. Higher environmental temperatures and increased perspiration also may decrease the wear time of solid skin barriers or skin barriers with a flange. Patients should anticipate this phenomenon, perhaps reducing wear time during the summer or switching to extended-wear skin barriers that are more resistant to meltdown (ie, erosion) from increased body temperature, high-volume liquid output, and increased perspiration. The need to change pouching systems before entering into physical activities should also be stressed, particularly if the individual is near the end of the usual wear-time. Summer also produces a bounty of fresh fruits and vegetables, such as corn on the cob, watermelon, peaches, green beans, cherries, okra, plums, tomatoes, strawberries, blueberries, raspberries, and peppers — foods that potentially create more gas and/or difficulty with digestion, especially those foods with an abundance of seeds and skins. This is usually more of a problem for people with an ileostomy but an increased amount of fresh fruits and vegetables also can cause problems (eg, diarrhea, excess gas) for people with a colostomy. If gas and odor become a problem, patients should be familiarized regarding closed-end and drainable pouching systems with effective gas relief and odor-reducing filter systems. Activities in the summer (or any other season, for that matter) may drive the individual’s pouching system choice. Some people with an ileostomy may chose to use a closed-end pouch under a bathing suit or switch from a drainable pouch to a closed-end pouch while on vacation (for convenient disposal “on the road”). One-piece pouching systems also may be appropriate during these times. Visiting friends and family can become problematic for people with an ostomy, especially with regards to emptying and/or disposing of soiled pouches. Sadly, many people choose to avoid situations (eg, visiting, sharing bathrooms, and the like) because of these issues. Clinicians should teach their clients to put the soiled pouch in a zip-lock bag or aluminum foil for sanitary and odor-proof disposal to avoid embarrassment. A sense of freedom can easily be restored if people with an ostomy are educated about various pouching options. Some individuals choose to alternate pouch types depending on their activity, output, and the setting in which they find themselves. These are personal lifestyle decisions that can only be made if people with a stoma are shown a variety of pouching options. Something as simple as a different type of pouch can make a huge difference in someone’s life — and what better time to feel better about oneself than during the summer.

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SUNSCREEN—FROM BUYING TO APPLYING
Via: Rosebud Review & GB News Review
As the days get warmer, you’ll likely spend more time outdoors. While you’re getting ready for a long walk or a day working in the garden, don’t forget to protect exposed skin from the sun. One of the easiest ways to do this is to use sunscreen. To maximize skin protection, it’s important to know how to select and apply a good sunscreen for your skin type and daily activities.. The Burning Facts About ninety percent of skin cancers are linked to sun exposure. There’s no such thing as a safe tan. Ultrviolet (UV) exposure intense enough to cause sunburn clearly increases your risk of skin cancer even without a sunburn. But UV exposure also contributes to premature aging of the skin, cataracts, and supression of the immune system. Although people with light skin are more susceptible to sun damage, all skin types can be affected. Other risk factors include the presence of moles or freckles, a family history of skin cancer, certain medical conditions such as lupus, and some medications. Screening your options There are many brands making claims such as waterproof and all-day protection. How do you know what’s best for you? It’s important to read the label carefully. Be sure the sunscreen protects against both UVA and UVB rays. Both play a role in damaging your skin. Also check for a sun protection factor (SPF) of at least 15- - many dermatologists recommend an SPF of 30. SPF ratings are based on how much longer you may be protected from sunburn than you would be if no sunscreen were used. For example, if you normally burn after 10 minutes of sun, a sunscreen with SPF will allow you to be out in the sun 15 times longer before burning—– about two and a half hours if you’ve applied it properly. Look for a sunscreen that’s personalized for your activities and skin. Use a waterproof brand if you’ll be sweating or swimming, and check the ingredients if your skin has special needs. Use a water-based sunscreen if you have oily skin or are prone to acne. If your skin reacts badly to the sunscreen you’re using, try one with different chemicals. Not all sunscreens contain the same ingredients. Those containing zinc oxide or titanium dioxide tend to be the most effective at blocking UV rays.
How to apply To maximize protection:
* Prepare in advance- - Apply sunscreen about 30 minutes before going out. Use it even on cloudy or hazy days. UV rays can penetrate cloud cover.
* Cover all exposed areas—– Don’t forget your nose, lips, ears, feet, hands, bald spots, the back of your neck, and the part in your hair. Also apply to areas under bathing suit straps, necklaces, braceletsand sunglasses. Be careful when applying sunscreen around eyes.
*  Apply thick and thoroughly—– Most people use sunscreen too sparingly. A liberal application is one ounce— the amount in a shot glass—to cover all exposed skin.
* Reapply regularly—To maximize protection, reapply your sunscreen every two hours. Heavy perspiration, water, and towel drying can remove the protective layer, even from waterproof sun-screens.
* Use with other protective measures—Limit your time in the sun between 10 a.m. and 4 p.m. Seek shade whenever possible. Wear a wide-brimmed hat and clothing made of tightly woven fabrics.

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NO NEED TO SING, THE POUCH POPPIN’ BLUES
Adapted by The New Outlook, Chicago’s North Suburban Chapter, Via: Charlotte NC Chapter, Pittsburg PA & Fairfield OH Chapters
Worried about your pouch popping off? Good! You’re not dead, yet! Take heart. These days with the advances in modern appliances, and if care has been taken when the pouch was applied, this will almost never happen. But we need to do our part. Look, pouches pop off when they’re full, and we move fast. So, if you don’t want to stop moving, better keep that pouch pretty empty. For this reason, some ostomates wear the big pouches. Many of our members wear 9 inch pouches because they show less and are more convenient. Some of the smaller pouches actually look sporty. I personally like a sporty looking pouch. There is no real issue with having a full pouch, if you empty when you urinate. A male member said, “The biggest change my ostomy has made in my life is that I never use the urinal any more.” He empties his pouch every chance he gets, which means that he empties it when he urinates. Most of us don’t make special trips to the bathroom just to empty a pouch, unless one has a urostomy. This statement applies mostly to ileostomates.

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ILEOSTOMY RETRACTION
by Gail Wilhite, RN, ET, from Metro Maryland, Via: Ocala FL & S. Brevard FL Ostomy Newsletter
An ileostomy stoma should be at least 3/4” in length and some surgeons advocate a longer length of 1” to 1 1/2 “. A spout-like stoma is necessary to deposit the effluent into the bag preventing pooling of contents at the base of the stoma. Conversely, a stoma that is too long is subject to external trauma and injury. Weighing the consequences, it is preferred to have a stoma somewhat too long than one too short. There is a difference between the creation of colostomy and ileostomy stomas. Frequently, when fashioning a left-sided colostomy, the surgeon will create a flush stoma. The contents of the left colon are relatively inert and usually regulated with irrigation, therefore, little or no functional problems occur with a flush colostomy stoma. An ileostomy stoma is never constructed as a flush stoma; nevertheless, sometimes the stoma may retract for various reasons. The common cause of stomal retraction is post-op weight gain. Prior to their operations, most ileostomates have lost considerable weight. Following surgery, weight gain can be rapid, and, many times, excessive. What once was an adequate stoma, now retreats within the expanding environment! Another cause of retraction may be inadequate fixation of the opposing serosal layers following eversion. If these layers fail to adhere, healing and subsequent scarring may tend to draw the stoma into the abdomen. Problems resulting from retraction are decreasing adherence of the appliance and skin breakdown. The pooling of the excoriating intestinal contents cause the loosening of the adherent bond resulting in leakage of ileal effluent on the skin. This skin –effluent contact naturally produces breakdown. The combination of irritated, weeping peristomal skin and continual pooling leads to an unbearable situation, which must be remedied. The treatment for a slightly retracted stoma is the use of a convex faceplate. The convexity applies pressure on the skin surrounding the stoma, thus pushing the stoma up. When using a convex faceplate, it is important not to lose the convexity by applying thick washers or foam pads, etc. The skin and faceplate should suffice to maintain the advantages of both convexity and skin protection. If the use of a convex faceplate proves unsuccessful or if the retraction is severe, then surgery is advised to create a new, longer stoma.

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