United Ostomy Association, Inc.
Evansville, Indiana Chapter
Re-Route

 
Contents:

HINTS FOR SUMMER
OSTOMY STOMAL "BUMPS" WHAT ARE THEY?
ABOUT COLOSTOMIES
ASK THE ET NURSE
FOR THE NEW OSTOMATE
CARTOONSVILLE

Re-Route Archive

Volume 26, Number 9  June, 2000

HINTS FOR SUMMER
Via: Loraine County Chapter & Metro MD. 
Do not expect to get the same wear time as you do in the fall, winter, or spring. If your wafer or ring skin barrier melts out faster, change the pouch more frequently. If wear time is very poor, have your ET nurse recommend a different skin barrier. If plastic against your skin is uncomfortable or causes a heat rash, purchase or sew a pouch cover. If you are wearing a two-piece system and are participating in very active sports, use a 10" strip of 2" or 3" tape to secure the pouch and the barrier. Be sure to drink plenty of liquids, unless contraindicated because of other health problems so that you will not get dehydrated or constipated. For extra security during swimming and water sports, use waterproof or "pink" tape to fix your pouch. Monila is a common summer problem. This raised, itchy red rash on the peristomal skin is uncomfortable and keeps the pouch from holding well. If you suspect a monilial rash, contact your physician as soon as possible for a prescription for anti-monilia powder. Osto-Tip! Skin barriers should be stored in a cool dry place. They have an expiration date of 4-5 yrs.. 

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OSTOMY STOMAL "BUMPS" WHAT ARE THEY?
By: Liz O'connor, RN, CETN, Via: Metro MD 
ET nurses are often asked about small "bumps" which appear on a formerly smooth stoma. They can be on the surface or around the edge where the stoma base meets the skin. They can occur in a single area or around the circumference. Most of the time these are granulomas which are benign in nature. Granulation tissue is a normal defense reaction of the body to in injury. Those at the edge can be due to (1) a reaction to suture being sewn through the stoma and to the skin or (2) too rigid or too tight a face plate rubbing the stoma. This can happen when the stoma points down. What should you do? Most of the time these are nothing to worry about. Don't second guess, though. See your ET nurse and if he or she advises you to visit your GI doctor or surgeon, please do so! Occasionally these can be a manifestation of some other condition like a recurrence of Crohn's disease, for instance. Often they can be taken care of by treatment with Silver Nitrate sticks. Occasionally they may need to be biopsied. Quite often a change in pouch or face plate can help resolve the problem. You can develop an allergic reaction to a particular plastic, even after using it a long time. The ET Nurse can suggest other types to try. The ET Nurse can recommend something softer. Your stoma size can be recalibrated if it fits too snugly. If you are concerned about anything unusual regarding your stoma, don't fret and don't procrastinate! Pick up the telephone and make an appointment to get it checked out. Usually it is nothing to worry about. Give yourself the benefit of peace of mind. You deserve it. 

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ABOUT COLOSTOMIES
Via: Metro MD 
There are several types of colostomies. The word colostomy means to create a new opening in the colon for stool to pass through. A stoma is the opening on the abdominal wall for the colostomy. The location of the stoma defines what type of colostomy a person has. An Ascending Colostomy is on the right side of the abdomen and is made from the upward (ascending) portion of the colon. The stool is usually semi-soft to liquid. Bowel movements usually occur shortly after a meal. The pouch should fit well around the stoma without skin showing. Stool will irritate any skin that is exposed. If skin shows between the stoma and pouch opening, a pouch with a smaller stomal opening is needed or the skin should be protected with paste. A Transverse colostomy is on the upper part of the abdomen and can be located anywhere along the horizontal (transverse) portion of the colon. The stool is usually soft to slightly formed. Usually a bowel movement will occur a few hours after a meal. Again, the pouch must fit well to prevent skin from being irritated by stool. A Sigmoid colostomy is on the lower left side of the abdomen and is made from the downward portion of the colon. The stool is usually soft to firm. After a period of time a person's bowel movement may occur about the same time of day as they did before surgery. People with sigmoid colostomies, usually, have a choice of whether, or not, to irrigate. An irrigation is an enema given through the stoma to help the colon have a bowel movement at a certain time of day. Whether or not a person irrigates is a personal choice, depending on how regular bowel movements were before surgery. Irrigation is not painful but needs to be done on a regular schedule to train the bowel with a new habit. Regardless of what type of colostomy a person has, once strength is regained, they may return to a normal day's activities. Having a colostomy will not handicap anyone in any way as long as they manage the colostomy instead of letting it manage them. 

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ASK THE ET NURSE
Via: The Lewistown Ostomy Outreach 
Q: What is the correct way to use powder on the skin around my stoma? Answer: Provided By : Karen  Sckankweiler, RN, WOCN Powder is used to treat irritated skin or a fungal infection. Yeast (fungal) infections are very common, especially in summer. Nystatin powder is used only when the itchy rash is present and then discontinued. Powder with a pectin base (Stomahesive) or Karaya Powder is used to treat irritated skin. To apply any powder: Clean skin well with water and dry. Dust the skin with the powder, rub in well and brush off any excess. The wafer can be applied directly over the powder when a small amount is used or you can seal it in by patting a sealant over the powder and allowing it to dry. The wafer is then applied. Powder is not needed routinely, as the new barriers are designed to adhere to the skin. 

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FOR THE NEW OSTOMATE
Via: The "Side Exit" Santa Barbara, CA Chapter 
Don't forget that Rome wasn't built in a day! If changing your appliance seems to take forever, with a little practice it will soon become a small part of your normal week. If you have cramps, try running a hot shower on your back. It will relax the muscles and help hurry the food through your digestive tract. When you travel and fear that you may have an accident during the night, buy "PEE WEE' pads in the baby department and take them with you to place under you when you sleep. If you have a leak, no one would be the wiser. Gas at night can be controlled by not eating after 8:00 PM. This allows the small intestine to "quiet down" by bedtime. Watch your appliance if you are beginning a new medication. Contact your doctor immediately if you suspect the medication is going straight in and straight out. Try spraying the hole you cut in your Stomahesive wafer with skin prep. Let the spray dry completely before peeling off the backing; this may increase your wear time by a day or two. Two or three tablespoons of plain baking soda in water when washing around the stoma will not only help heal the skin, but relieve itching too. The application of a couple of capsules of Vitamin E oil broken down and rubbed on sore and irritated skin around the stoma promotes overnight healing. Be sure to re-order supplies before they get too low. Your supplier may be out of your particular brand and will need time to notify the company.

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