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

 
Contents:

YOU CAN’T QUIT
THE RISK OF BEING SET IN YOUR WAYS
TRAVEL TIPS FOR OSTOMATES DURING HEIGHTENED SECURITY
WATER—IT HELPS TO CURE WHAT AILS YOU
BONING UP ON CALCIUM
‘ODE TO THE STOMA’
YOGURT CUTS DOWN ON DIARRHEA
COLOSTOMY CARE—FREQUENTLY ENCOUNTERED SKIN PROBLEMS
IT HAPPENED ONE NIGHT!
SIGN THE GUEST BOOK
OSTOMATES COMPARING NOTES

Re-Route Archive

Volume 29, Number 9  June, 2002

THE RISK OF BEING SET IN YOUR WAYS
By: Sharon Williand, RNET, Metro WA “By-Pass” & Golden Gate Chapter
Sometimes, it takes a catastrophe to shake us out of our complacency. It is easy to fall into the “ostrich syndrome.” This is unfortunate, particularly when it comes to ostomy management. It is only through education that individuals grow, learn and reach their fullest potential as ostomates. While writing this column, I was reminded of several examples of individuals recently seen by our ET team. One gentleman had a sigmoid colostomy performed many years ago and had developed a huge peristomal hernia. He irrigated his colostomy daily and had been using what now classifies as an antique set. The irrigator was a latex bag with no measuring guide to gauge the amount of solution being given. There was a hard rubber catheter with no shield present on the irrigator tubing. He had been forcing the tubing into its full twelve inch length. He poked and poked until it finally went in. All-in-all, it was a miracle that he had not perforated the herniated bowel. He had not been successful with irrigations, continually losing as much water around the catheter as he was instilling. It was difficult for him to accept an explanation of why he was flirting with danger. After all, he had ALWAYS done it this way! Only after a great deal of persuasion was he agreeable to trying a new set with a measuring guide on the irrigator and a cone in place of the catheter. One elderly lady called the ET office in a state of panic. She was no longer able to obtain the rubber pouches she had been using for 25 years. She had been ordering through the mail from a distant state. She had no idea of any other pouch that could be substituted and also had no idea of what supplies were locally available. She was totally amazed at the new light-weight odor-proof pouches now on the market. Another case involved a gentleman who had put up with a continued skin irritation from a cement he had been using for many years to adhere his ostomy pouch. He was obviously allergic to this preparation and would periodically have to discontinue wearing a pouch to allow his skin to heal. Had he known several years ago about the new hypoallergenic skin barriers when these became available, how much more comfortable his life could have been. In conclusion, being an ostrich with your head in the sand is for the birds! Keep updated– read the “Ostomy Quarterly,” attend ostomy support group meetings, ask your doctor, ET, and pharmacist “What’s New?” You may be surprised at the improvements you will discover.

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TRAVEL TIPS FOR OSTOMATES DURING HEIGHTENED SECURITY
Via: Chippewa Valley Rosebud Review & Regina Ostomy News
In these days where extra cautions for security are being taken worldwide, it would be wise for traveling ostomates to do advance planning in order to avoid possible problems. Some suggestions follow: Pre-cut all pouches at home so scissors are not necessary in your carry on luggage. Pack ostomy supplies in at least two places (carry-on and checked luggage). Take extra supplies in case you are stranded where supplies may not be available. A letter from your physician stating your need for ostomy supplies might be helpful—also, a statement requesting a private area be used in case an extended search is needed. If traveling to a foreign country, it’s a good idea to have critical ostomy information written in that country’s language. One of the 70 member associations of the International Ostomy Association (IOA) may be of help with this translation as well as with locating supplies while visiting their country. Check the IOA website at http://www.ostomyinternational.org/. The book, “Yes We Can”, available through UOA, has many helpful hints and advice for traveling. It also has a dictionary of ostomy terms translated in several languages. In addition, there is important contact information for resources worldwide as well as a wallet card statement written in eleven languages that asks for privacy if a search is to be conducted.

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WATER—IT HELPS TO CURE WHAT AILS YOU
Via: Metro Md. & Kentuckiana Chapter
You’ve worked all day and your muscles are sore. Spend some time in the jacuzzi or fill the bath tub for a leisure soak. You will feel like a new person. Drinking water will do even more for your body. Drink water for a diet aid. It helps the liver metabolize fat, helps to control the appetite and maintains muscle tone. It helps the body eliminate salt. The respiratory system needs plenty of water to function at full efficiency. If your sinuses are blocked, drink more water to keep your head from feeling stuffy. Of course, ostomates know that they should drink more water to also flush the kidneys, which will wash kidney stones away. How much water should you drink? It depends upon where you live, how active you are and how much you weigh. Normal weight people who live in humid climates can get by with 64 ounces (8 glasses) a day. Overweight people, those who exercise a lot, desert dwellers and those with an ostomy need more—as much as 96 ounces a day. Purified water is fine if you want to spend the money, but plain old tap water with ice and a lemon slice tastes as good and is every bit as healthful. If your tap water has a chlorine taste, let the water stand in an open container for an hour or so to let the chlorine dissipate. Ice cold water is usually better tasting too. If you get thirsty, you need to drink more water. When the body is dehydrated, the thirst mechanism shuts off. Many people tend to drink beverages all day long, but iced teas and café latte and those sodas do not do much to replace the water we lose through perspiration. Go ahead! Drink plenty of water and enjoy all the benefits you will receive.

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BONING UP ON CALCIUM
Journal of American Medical Association, Vol 286
There’s more to calcium than what comes from cows. The good news about the bone-thinning disease osteoporosis is that it is largely preventable through exercise, not smoking, and getting enough calcium in your diet. The amount of calcium you need daily differs according to your age. Teenagers (ages 9 to 18) require the most, 1300 mg. People over 50 should get at least 1200 mg, and adults 19 to 50 need 1,000 mg. Kids 4 to 8 should get 800 mg, and for toddlers and infants under three, 500 mg is enough. Dairy products are one of the best sources of dietary calcium. Just one cup of yogurt (415 mg), and two 8 oz glasses of nonfat milk (604 mg) meet the needs for adults under 50. An ounce of Swiss cheese has 272 mg. One cup of ice cream gives you 164 mg, and cottage cheese weighs in at 164. But what if you don’t like milk and cheese or have an intolerance or allergy to dairy products? You can find calcium fixes in dark green, leafy vegetables like kale and beet and turnip greens. Each have about 100 mg for 1/2 cup cooked. Canned salmon with the bone, has 181 mg in 3 oz., and two canned sardines provide 91 mg. Black eyed peas have a generous 211 mg in a cup, and a cup of cooked, frozen broccoli has 94 mg. One medium orange is good for 52 mg while one cup of calcium fortified orange juice has 333. Dried figs are also abundant in the bone-building mineral, with 269 mg in 10. Calcium-fortified breakfast cereals are another good choice. Make sure you get your calcium from a variety of foods, and if you aren’t getting enough in your diet, ask your doctor about taking calcium supplements.

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‘ODE TO THE STOMA’
Via: Ostoline, Sherman TX Area OA

I think that I shall never see
A stoma well behaved like me
A stoma that will understand
When restrooms aren’t near at hand
A stoma that will be quiet
When the room is full of company
A stoma that will rest
When I change at a time when I think best
But let’s not dream and let’s not pray
And work it does, both night and day
A stoma has a head, but not a mind
It sometimes can be so unkind
Yet thankful we must always be
That surgeons work so skillfully
Sure God can make an anus perk, but
Only man can make a stoma work
. …...and a bit of humor
A man was hospitalized with a severe intestinal blockage. So, on his first day at the hospital, he was given fifteen separate enemas. Late that night, he heard a knock on his door. Thoroughly exhausted by his ordeal, the patient asked in a weak voice, “friend or enema?”

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YOGURT CUTS DOWN ON DIARRHEA
Via: “The Pouch”, Northern VA
Many people suffer from stomach upset and diarrhea while taking antibiotics. Fortunately, relief may entail a simple trip to your supermarket’s dairy case. A study reported at the annual meeting of the American College of Gastroenterology followed 202 hospitalized elderly people who were taking antibiotics. Researchers found that patients who consumed two eight-ounce servings of yogurt daily for eight days reduced their incidence of diarrhea by half, compared to those who ate no yogurt. Although the research has been divided on the yogurt phenomenon, bacteria cultures in yogurt may help replenish those in the gut that have been depleted by antibiotics. These cultures have also been found to break down the lactose in yogurt, making it more digestible for people who are lactose intolerant.

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COLOSTOMY CARE— FREQUENTLY ENCOUNTERED SKIN PROBLEMS
Via: Metro MD, & S. Brevard FLA Ostomy Newsletter
Skin problems are usually caused by improperly fitting pouches, leakage of stool on the skin , hair follicle irritation, perspiration, or the misuse of skin barriers. An important aspect in preventing skin problems is keeping a seal. To keep a pouch on irritated skin, it is necessary that the skin is dry. When the skin is irritated, it does not remain dry and cannot be dried with a cloth. A basic method of drying the skin includes a warm heat lamp or hair dryer. “Heat lamp” refers to any type of lamp with a maximum 25-watt bulb placed at least one foot away from the stoma and allowed lowed to shine for only 10 minutes. You will find a desk lamp good to use. Cover the stoma with a piece of damp tissue or cloth to prevent a drying effect directly to it. Never use a sun lamp. This is an ultraviolet Light and will burn your skin. If you have had radiation therapy to the skin around your stoma, do not use any lamp or light to dry your skin. A hair dryer, of less than 850 watts may be used if there is a cool setting. If you find you need to purchase any new skin products listed under remedies, it would be advisable first, to call your ET nurse for suggestions. You may be familiar with the use of one or two products from your hospitalization. If you are comfortable using them, go ahead. Rash can be located under the tape, under the face plate and on any part of the skin where the pouch comes into contact with the skin. A generalized reddish appearance that covers an entire area, similar to a diaper rash, will be seen. It may be caused by a leaking appliance; perspiration, allergies to tape or hair follicle irritation. To remedy, use a hair dryer to dry the skin; sprinkle a small amount of powder (karaya, stomahesive) on the skin, wipe off the excess, then blot with a skin sealant to seal the powder to the skin. Make sure it’s dry before applying the faceplate. Wearing a pouch belt too tight may also break the seal. If the rash does not clear up in two to three days, consult an ET nurse. Ulcerated areas can appear anywhere on the stoma because the stoma opening of the pouch was too small and/or activities were causing the faceplate to rub or cut into the stoma. To remedy, enlarge the size of the pouch opening. (The opening should be at least 1/8 inch larger than the stoma.) Evaluate your activities; you may need a different size or shaped face plate; loosen your belt; if too tight, the belt may cause the face plate to press into the stoma. If this does not help in clearing up the ulcerations around the stoma in two to three days, consult an ET nurse. Infected or irritated hair follicles under the face plate, raised red areas (similar to acne) at the shaft of the hair follicle, are caused by not keeping the area under the faceplate shaved. To remedy this, you must let the irritation improve before removing anymore hair by shaving or cutting. Use a hair dryer and/or very low heat lamp to dry the skin if oozing is present. Use a skin barrier between skin and pouch adhesive until irritation improves. If irritation doesn’t clear in two to three days, consult your ET nurse. Weeping skin can prevent a pouch or a skin barrier from adhering to the skin for long periods. If your skin is severely irritated and weeping, it may be necessary to change your pouch more frequently to prevent leaking and further damage.

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IT HAPPENED ONE NIGHT!
By: Teresa Murphy, Via; “The Good News Helper” Chambersburg, PA. (Excerpted)
It’s been 25 years since I had ileostomy surgery and more than 20 since I had a blockage. Not a bad record; I’ll take it. Alas, I slipped up recently and ate my lunch in too big of a hurry and worst of all, had not been getting enough fluids for a couple of days when it happened. Yes, a blockage. Throughout the evening, I tried the usual home remedies: warm bath, drinking hot tea, massaging the abdominal muscles and several other of the suggestions that come from our WOC (ET) nurses, but to no avail. Finally, I had to make the decision to continue to try these home remedies or go into the emergency room to get help before things got worse. Yes, of course, these things happen at night not in the morning to give you the daytime to get help from some other source than the ER. So, by 11:00 pm, I was describing my symptoms to the ER admitting desk receptionist. Four hours later and with the aid of a shot to completely relax the muscles and small bowel, I went home painless and with a functioning ileostomy. No surgery, no overnight stay. Whew! The reason I bring up this experience is to point out several things that ALL persons with any type of ostomy should incorporate into their care. I have read about all of these admonitions for years and have advised new patients in visits and in our monthly support groups to do these things. I did these things in the beginning but have failed to follow these important guidelines as my ostomy experience has matured. And, I paid the consequences one night recently. But, I have set forth to do all of them from now on. First, chew all foods thoroughly and avoid rushing through a meal. Drink plenty of fluids all through the day. Keep an “extra” change of your pouching system “packed” and ready to go—you know, the one you carry around with you just in case. Yes, you will even need this change if you go to a hospital. Keep a written description of your pouch changing procedure along with the product line name and numbers of your favorite pouching system. Also on this record, provide a description and any particulars needed by healthcare professionals: Example: Total colectomy with end, intestinal ileostomy, Rectum closed; no rectal temperatures; must wear pouch at all times; No irrigations (Exception: Lavage performed on the advice of a colo-rectal surgeon or WOC (ET) nurse. Should you become separated from this record, you will need to plan on being able to tell the healthcare professionals what you have. Don’t assume they will know all they need to know by just saying, you have an ileostomy. Establish yourself as a patient with a highly qualified colo-rectal surgeon—even if you are many years post ileostomy surgery. Put their name and phone number on your “record”. Establish yourself as a patient of a qualified WOC (ET) Nurse—No matter how long you have had your ostomy, just as you still need to have a surgeon to call on you also need to have a WOC (ET) Nurse to call when you need management advice.

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