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pageVolume 33, Number 9 June, 2006
TO LIVE A LONG TIME AND TO DIE HEALTHY
That Guynurse.com Via: Green Bay Area Ostomy Support Group
It is now possible for the first time in history to live to the full human life-span of ninety to ninety-five years. The challenge is to live in good health throughout that time. This means learning about and understanding the conditions of health. It also means assuming a whole new dimension of personal responsibility.
Within the lifetimes of many who are still alive, advances in medical science have virtually eliminated many of the historical causes of death. Many diseases once lethal either no longer exist or are easily treatable. Trauma care and surgical interventions have advanced to the point where injuries and systemic failures which were once invariably fatal can now be remedied.
The medical system of hospitals, clinics, physicians, nurses and technicians is not, however, a real “health-care” system. Few of the billions of dollars invested in medical care today go to the creation and maintenance of health. The primary focus of medical care is to keep patients alive. It is up to each individual to do what is necessary to build and maintain health and wellness.
Today, we can examine the impacts of the medical system and how it has extended life expectancy in the United States from fifty-four in the nineteen thirties to nearly eighty today. Today’s system emphasizes the critical fact that the American Medical system provides medical practitioners no financial incentives for health. It is a system designed to cure sickness and to repair trauma and to keep patients alive.
The challenge and opportunity of living in good health thus falls to each individual, who through personal life-style decisions has primary responsibility for the maintenance of health through the full human life-span of ninety to one hundred years.
The American medical system must also change. In the twenty-first century, patients and physicians must become partners; working together and sharing knowledge. The American medical system will become a true “wellness system” only when patients assume responsibility for their own health and learn to utilize the skills of physicians, nurses and others in the medical system as vehicles for health rather than as mechanics who fix the things that go wrong. The focus on the new system will be on prevention of disease and trauma and the maintenance of health.
BACTERIA IN THE SMALL INTESTINE
The Greater Cincinnati Ostomy Association
Bacterial overgrowth of the small intestine can be a hidden, unsuspected cause of chronic bowel problems such as indigestion, bloating, abdominal pain, gas, and irregularity.
Normally, far fewer bacteria inhabit the small intestine than the ample growth found in the colon. The secretion of gastric acids and the rapid movement of digested foodstuffs through the intestines (called “intestinal motility”) normally keep the small intestine relatively free of bacteria.
A wide range of abnormalities and malfunctions, however, can encourage bacteria to multiply in the small intestine. There, the bacteria ferment carbohydrates, producing gases such as hydrogen and methane. These gases cause the gas and bloating seen in individuals with carbohydrate intolerances and, over time, can lead to irritations of the intestinal lining.
The most common causes of bacterial overgrowth of the small intestine usually relate to a decrease in gastric acidity or digestive enzymes, which create an un-sterile environment for the small intestine. Other possible causes of bacterial overgrowth of the small intestine include intestinal obstructions caused by Crohn’s Disease, adhesions, radiation damage and lymphoma.
Treating bacterial overgrowth of the small intestine has been shown significantly to alleviate chronic symptoms, such as diarrhea and abdominal pain, in patients with Irritable Bowel Syndrome. For this reason, healthcare experts recommend that a laboratory evaluation for small bowel bacterial overgrowth be performed in patients with IBS, when indicated by their history.
The “Bacterial Overgrowth of the Small Intestine Breath Test” measures breath hydrogen and methane gases in response to a lactulose challenge. Because both gases may be produced in the intestine, testing for both hydrogen and methane is considered more sensitive than testing for hydrogen only.
Without proper detection and treatment, bacterial overgrowth of the small intestine can eventually go on to cause health problems more serious than chronic indigestion. By inhibiting proper nutrient absorption, bacterial overgrowth of the small intestine can lead to systemic disorders such as altered permeability, anemia and weight loss, osteomalacia and vitamin deficiency.
The incidence of bacterial overgrowth of the small intestine increases with age, particularly in people aged 80 and older. Elderly patients may develop malabsorption secondary to bacterial overgrowth. It has been suggested as the major cause of clinically significant malabsorption in the elderly and linked to the “failure to thrive syndrome” seen in older patients.
Editor’s Note: Normally, there are 300-400 types of known bacteria in the colon with a concentration of roughly one trillion bacteria for every milliliter of stool. However, the small intestine should have less than 1,000 bacteria per milliliter of stool.
OSTOMY TIPS FOR THE POOL
Via: Philadelphia UOA Journal
“Can I go swimming with an ostomy?” The answer is a resounding YES!!! Swimming is an excellent exercise—an opportunity for a good cardiovascular workout without overly stressing your joints (like knees and hips) or your spine. The pool is a great place to work on those range-of-motion exercises, too. The water helps support your body while you move and water exercises can be done in the deep end or while sitting in the shallow end of the pool. Best of all, swimming is an activity you can enjoy with family and friends of all ages and abilities!
So why are so many of us afraid to get back into the water? Here are some of our issues and solutions…
I’m afraid that my appliance will leak or come off while I am in the pool. This is by far everyone’s number one concern. The thing to remember is that your pouching system is designed to be leak-free and water-proof, and your wafer adhesive actually gets stronger in water. As long as your seal is strong and intact, strap on your swim fins and jump in.
Tip # 1: Don’t go swimming right after you’ve put on a new wafer.
Tip # 2: Make sure your pouch is empty.
Tip # 3 : Picture framing your wafer with water-proof tape isn’t necessary, but may give you the extra confidence you need.
Tip # 4 : Avoid wearing pouches with filters into the pool. Water may get in through the filter.
I’m concerned that people will be able to see my pouching system under my bathing suit.
Dark colored suits with a busy pattern will camouflage your appliance better than light colors like white or yellow, which can become almost transparent when wet. Note—your pouch will dry just as quickly as your suit will, so no need to worry about a tell-tale damp spot.
Tip # 1 : For women, choose a suit with a small, well-placed ruffle or skirt.
Tip # 2 : For men, choose a suit with a higher cut waist or longer leg.
Tip # 3 : You may wish to wear a smaller, non-drainable pouch: those designed for intimate moments work well here too!
Tip # 4 : If you have a colostomy and you irrigate, you may try wearing a stoma cap while you swim.
I’m embarrassed about changing into/out of my bathing suit in the locker room and people noticing my ostomy appliance.
Some of us don’t care who sees what, while others are more modest when it comes to who knows about our ostomies and pouching systems. If you’re a little on the shy side, try to find a spot that is out of the way or less crowded. Don’t let the possibility of problems arising when changing prevent you from an enjoyable afternoon with family or friends.
Tip # 1 : You may wish to change and towel off in a convenient bathroom stall.
Tip # 2 : Put on a dry, over-sized T-shirt as a cover up while you change.
Tip # 3 : A dry suit is easier to take off than a wet one. Relax by the side of the pool with a good book or a talkative friend before heading for the locker room.
Tip # 4 : Wear your bathing suit under a jogging suit or sweat pants and don’t worry about changing at all.
What about using the hot tub or Jacuzzi? Go ahead. Again, as long as your appliance seal is good and your pouch is empty you should have no problems with your ostomy.
General Tips:
*
Do some planning—you know your body better than anyone and how long after eating your ostomy starts to work. Try to arrange your swimming for a time when your output will be minimal.
* If you are still concerned about entering the pool with your appliance, try this—put on your bathing suit, fill your bathtub with water and sit in it for half an hour. You’ll feel more confident when you see there is no leakage. You’ll also get to see what your suit (and your covered pouching system) look like wet.
* A support garment or bike shorts under your suit or a snug, Lycra bathing suit can help to keep your pouching system in place and prevent your pouch and clip from migrating to the groin area. Some ostomates sew pockets into the inside of their suits as a way of providing additional pouch support if needed.
* If you wear an ostomy belt, you should know that cloth belts stretch in the water—wear a rubber one if you want to wear a belt in the pool.
* Again, remember to get your doctor’s okay before you take to the water to begin any exercise program.
* Most of all—have fun!
THINGS I CANNOT DO
By Raymond Miller
The reason I decided to write this article was to demonstrate to people with new ostomies
there are some things you cannot do. You will probably laugh because they are relatively insignificant when compared to life. Most people having ostomy surgery are making a life and death decision. People with
Ileostomates from Crohn’s Disease or ulcerative colitis will generally have a better quality of life after the surgery. In addition, I have received comments from people who tell me that they regularly do many of the things listed here. The more we learn, the more we find that an ostomy is not a very big deterrent to living the same life we would if we were non-ostomates.
* The one thing that some really miss is sleeping on their stomachs. Prior to surgery, some slept on their stomachs all the time. However, with an ostomy, it is just not that easy.
* You cannot take your toddler into the shower with you...a member tried that once and had the whole barrier ripped from her body because that is the first thing the child grabbed when she started to fall down– one word OUCH!
* You cannot take your temperature rectally or use rectal suppositories.
* You cannot run around for long without a pouch on– this applies mainly to people with an ileostomy or urostomy.
* You cannot use enteric-coated medications to their full value, if you have an ileostomy.
* You cannot sleep in the nude—the pouch is always attached. By the way, there is no reason why you cannot sleep almost in the nude with an ostomy. Many of us do it all summer long and never have a problem. There is no more “flopping around” than with PJ’s. If you want, buy a cummerbund to hold everything in place. Of course, with that on you are not totally nude but you are topless and bottomless, and you have the middle covered.
* Potty train a toddler! When one of our member’s grandson accompanied him and asked, “What’s that?” the pouch that is, and what he was doing, his answer befuddled him. At 2-1/2, he is having a hard time understanding why he poops from one end of his body, and his grandfather had this pouch attached to his body. He insists the pouch covers a boo-boo.
* You cannot go without your shirt in public...unless you are a self-confident male. It is prudent to wear pants that are high enough to cover the pouch.
* You can usually not sleep all night without getting up to empty the pouch.
* You can no longer be called anal! Some call us “stomal”!
* You cannot play on my illness anymore and say, ”I’m too sick to go out.”
* You cannot blame your weight gain on prednisone anymore-you just eat too much now!
* A man cannot get a tactile prostrate check each year. He must depend on other tests like a PSA test.
We cannot honestly say that our
stomas have stopped us from doing very much what we want to—and we have met many wonderful people who we otherwise would not have met through our ostomy association.
* You cannot have as many reasons to stay out of a normal life stream.
* You do not feel nearly as bad.
* You have more control as to when you “go”, and where.
* You have something to do every few hours. Of course, I mean you have to urinate. What did you think?
* You do not have to fear being on a dead locked freeway with no place to go to the washroom. This is especially true for people who previously had ulcerative colitis.
* We do not read in the bathroom anymore.
Two things you cannot do with a urostomy:
*
You cannot write your name in the snow.
* You cannot travel overnight without your nighttime equipment.
Sorry to be so contrary, but...we cannot think of very much we cannot do with an ostomy! Some of us have a colostomy and sleep on our belly. Basically, we do virtually everything we did before we had the stoma. No, that is incorrect, we now do more than we used to. Some of us had a very narrow escape with cancer and decided not to mess around any longer. After surgery, we started doing everything we ever wanted to do...right now.
ASSORTED OSTOMY TIPS
Via: Stillwell-Ponca City, OK
If odor is a problem, try rinsing the pouch with water containing a small amount of mouthwash (Scope works well), or antibacterial soap, when emptying the pouch.
If you use a two-piece appliance and rotate pouches, the pouch not in use can be soaked in denture cleaner.
For rinsing the pouch when emptying it, a small watering can with a curved spout works very well.
Smith & Nephew cement improves the seal obtained with some ostomy appliances.
A transparent pouch may help you change your appliance better by allowing you to see what you’re doing. (Editor’s note: Not all “transparent” pouches are equally transparent. ConvaTec’s are extremely transparent; Hollister’s are more translucent.)
If your pouch fills with gas, remember to empty it just as you would empty more liquid or solid contents. If you use a two-piece appliance, you can partially open the flange to “burp” the pouch, and avoid complete emptying protocol. You can also avoid gas build-up by using a pouch with built in gas filter.
It has been reported that barrier wipes should not be used with Hollister appliances. Actually, there’s an incompatibility between barrier wipes and Hollister’s newest (Flextend) barrier material. But there’s no problem using barrier wipes with Hollister’s older appliances.
Perhaps the most important advice: Learn all you can about managing your ostomy, but also be somewhat skeptical of the advice you hear and read.