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Ostomy Association
of Southwestern Indiana
Re-Route

 
Contents:

OSTOMATES NEED FAMILY SUPPORT
SWIMMING WITH AN OSTOMY
SOY MYTH OR FACT
WHICH POUCHING SYSTEM IS RIGHT FOR YOU?
STRAIGHT SCOOP ON GENERIC DRUGS
ILEOSTOMY RETRACTION
THOUGHTS ON ODOR MANAGEMENT
 

Volume 34, Number 9  June, 2007


OSTOMATES NEED FAMILY SUPPORT
Via: Greater Cincinnati Chapter & The Hamilton/Fairfield Chapter of UOA
Spouse and Family Support for Ostomates produced by UOA for spouse and family members, especially written for those new to the ostomy experience. Those who have had years of experience as an ostomy family member may also find it valuable. Introduction: The spouse of a person with an ostomy plays a vital role in the rehabilitation process. It is important to understand basic ostomy information and the psychological impact of the procedure. Spouses may experience feelings of grief, guilt and anger. These feelings are perfectly normal and will lessen in time as both parties adjust to the ostomy. Role of Spouse Your role as a spouse is one of support and encouragement. These elements are vital to any relationship and provide a basis for an emotional recovery and acceptance of the ostomy. This life-saving, body-altering procedure can affect people in different ways. How you react to the physical changes from surgery will be conveyed to the ostomate in many ways. Watch your body language. If you were a person who liked to cuddle before the surgery, then continue to reach out to your spouse. Couples have a tendency to “protect” each other and not be truthful about their feelings. Initiate open communications with your spouse and discuss any concerns either of you may have about the surgery (I.e., fear, anger, resentment, relief). Ask questions about changes you do not understand. Remember…the person with the ostomy has not changed, only their anatomy has. How you and your spouse accept that change will influence your quality of life. Armed with adequate information and a positive outlook, you may find that having a family member who has survived body-altering surgery often leads the entire family to a greater appreciation of life.

SWIMMING WITH AN OSTOMY
Via: Chicago North Suburban Chapter
Ostomates swim. We put together a few little items we have gathered to help make you feel more secure. First, allow some time after changing a barrier before swimming so that the seal is secure. Overnight is best, but even taking that extra minute to let the barrier seal should be fine. The newer barriers actually melt to obtain adherence. You have to make sure this chemical action has taken place. To be extra secure, it may be best to picture frame the barrier with a waterproof tape. There is a "pink tape" available through most suppliers that works well to assure the appliance stays on your body. Hollister's new skin like tapes as well as other similar types may be made more waterproof by covering them with a skin prep after they are in place. Cloth belts stretch in water. If you wear a belt, it may be preferred to substitute a rubber one while you are swimming. Swimsuits, with busy patterns camouflage the appliance better than solid colored suits. Wearing solid colors will reveal the appliance more easily. Skirts, bows, sashes, ties, drapes on a swimsuit may also help camouflage the appliance. Boxer-style trunks work well for men. A tight garment under your swimsuit can help hold the appliance in place. Depending on how active you are and the level of comfort you desire some of the following are good suggestions: A lightweight two-way stretch panty girdle; the top part of old panty hose; biking shorts; or sewing 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 are an alternative to people who use two-piece systems. They may be more comfortable and have a lower profile under swimsuits than your usual pouch. 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 make a real mess. Try and plan ahead for swimming. Even non-ostomates should wait two hours after eating before going swimming. Try to roughly 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. The conclusion to all of this, the main reason for writing this article is so that you go swimming. An ostomy does not stop you, or even slow you down from swimming and enjoying all the different type of water activities like hot tubs, beaches, pools, scuba diving, snorkeling, diving, swimming, etc. Enjoy it…you have been given a new life.

SOY MYTH OR FACT
By: Madelyn Fernstrom
What should I know about soy?  Actually, since there is so much information – good and bad – about the health benefits of this interesting food. I remember the days when soy was one of those “weird” foods in the supermarkets, found mostly in giant white chunks in the dairy aisle. Now, it’s everywhere in so many great tasting products. People are always asking me “Should I eat soy?” The answer is a qualified yes – if you enjoy the taste of soy (there’s plenty of other nutritious stuff in the food supply). I think soy products can be a very healthful addition to the diet of many people (except those of you who are breast cancer survivors – more on that later), as long as you keep in mind some fundamentals about soy and soy products. Soy is part of the plant kingdom (the only other one option is the animal kingdom), but it’s not a vegetable. It is called a legume and is a rich source of complete protein (just like beef, chicken, or fish). It’s naturally cholesterol free, and is sort of the chameleon of foods. In its natural state, it is relatively bland in taste, and can take on the flavors of whatever you mix it with. Most scientific studies show health benefits of soy, when consumed in amounts of 25 grams or more. Is that a lot? For Americans, yes. In Asia, where the diet is soy based, it’s not much at all. With the availability of products like Boca burgers, and all kinds of products ranging from buffalo wings to lasagna, one serving can contain 15+ grams of soy protein. With one glass of soy milk, a handful of soy nuts, or edamame all weighing in at around 10 grams each, it’s fairly easy to get there. Soy snacks abound – and while I’m a big fan of the soy crisps as a great substitute for chips – it’s important to limit your selections to a serving, since the calories can add up quickly. So, be mindful of your servings of soy ice cream, chips, and other treats. And watch your intake of fried tofu – even in heart-healthy oil – it can pack on quite a caloric load. Soy sauce is a favorite, not only for use in Asian food, but as a low-calorie seasoning to replace fattier choices. Be sure to select low-sodium soy sauce, since just a couple of tablespoons of the regular provides your entire sodium intake for the day! The health benefits of soy can be documented for some diseases. There are some good studies documenting the role of regular soy consumption in helping to lower “bad” (LDL) cholesterol, and thus helpful in reducing the risk of heart disease. BUT – there is a major BUT here – do not self-medicate, and think that eating soy is a replacement for regular medical care, and that you won’t get high cholesterol if you eat a lot of soy. Make sure you check with your doctor to get your levels measured first. Eating soy can be a help, but your overall diet is also key, as well as your medical history. Food is not medicine, and can promote health, but don’t feel that you’ve failed if you need medications as well. What about cancer and soy? There is a lot of mixed information, so it’s too early to say for sure. Since soy is a weak estrogen, it is NOT recommended for breast cancer survivors.. Theoretically, a weak estrogen might be helpful to offset menopausal symptoms, like night-sweats, but the data are inconclusive; some people think it works, but the studies do not conclusively support it. On the other hand, there are some studies suggesting that soy can contribute to the prevention of colon and prostate cancer. Again, too early to tell. On a final thought, some friends brought to my attention the variety of soy candles, soy lip gloss, and other non-edible soy products, and wondered about the health benefits. While soy candles can be healthy for the environment (they are not petroleum based), your own health will not be affected by soy products that are not edible. Nice thought, though… What are your soy experiences? I’d love to know some products you’ve found that are tasty and healthful, and your thoughts on the health benefits of soy.

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.

STRAIGHT SCOOP ON GENERIC DRUGS
Via The Houston Ostomy Association
Most of us have scanned the shelves of our pharmacy trying to decide if it is worth the extra money to purchase a brand name drug or its generic counterpart. A generic drug is simply a drug with active ingredients identical to those of its brand name counterpart. Generics are manufactured by a different company and often cost much less. When a new drug is introduced, the manufacturer gets exclusive rights to sell or license that drug for the life of the patent, typically 17 years, after which other companies can market the same drug at a reduced price. Many consumers are skeptical of the quality of generic drugs because they associate them with the quality of generic food products. However, pharmaceuticals are marketed under scrutiny of the FDA, which mandates specific quality controls. There are often few differences in how a brand name drug and its equivalent functions in the body. There are certain cautions — certain drugs may exhibit subtle differences across brands. One drug might be absorbed rapidly into the bloodstream and achieve high levels, then disappear rapidly from the bloodstream. Another brand may be absorbed slowly and provide lower levels over a long period of time, even though it contains equal amounts of the same active ingredient. There may be specific instances where it would be advantageous to select one brand over another. Pharmacists are well trained to understand the nuances between various generic brands and can explain how they work in your body. Medications that vary across generics include certain blood thinners, heart medications, and human hormones, such as estrogen and thyroid replacement medications. While you can often save money by using generic drugs, you should discuss any changes with your pharmacist or physician.

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.

THOUGHTS ON ODOR MANAGEMENT
by Rosemary Van Ingen, ET, Via: Northern Virginia Chapter Pouch
Isn’t it interesting that people with normal intact bowel tracts and urinary systems manage odor problems in an acceptable manner in our society? But when disease or trauma strikes, and the person is the owner of an ostomy, the one big concern is the fear of offending society with an odor.
What’s an ostomy? Basically an ostomy is a man-made exit site that changes the point of exit from the bottom or back of our body to the front. Our eyes and noses are obviously on the front of our body, which leads us to be more aware of our changed body image and our odor-producing products. I’m sure you’ve heard the statement, “You’ve come a long way, baby.” Yes, ostomy management has come a long way-considering that as little as ten years ago, we had very few 100% odor-free pouching systems.
Ostomy Collecting Receptacles When ostomy surgery was first developed, ostomates wore anything to collect output. Tin cans, rubber gloves, cups of all shapes and sizes, bread wrappers, and plastic margarine cups just to mention a few, were standard equipment for the ostomate. Not only the feasibility, but the odor problems this type of equipment produced, was enough to give ostomy surgery and people who had ostomies a very deplorable place in our society. Presently, almost all the ostomy pouching systems available to us today are made of odor-barrier materials.
Odor Detective Work Therefore, if an ostomate does have a fecal or urinary odor about them, some detective work should be done: Check out the application of the pouching system to the body. Is it leaking? Check out the closure of the pouching system—is it closed properly so that no fecal matter is oozing out after the closure? Do not put holes in the pouch as gas will seep out continuously.
Urostomy Odor Cautions The urostomate should rinse or wipe off the spout of the pouching system with a bathroom tissue after emptying. Those few drops left in the spout after closing the pouching system can cause a urine odor under clothing It is interesting to note that most urostomy pouching systems on the market are odor-proof, but the connecting tubing and bedside and leg bag are not. You must dispose of and replace these products when they take on urinary odors, or else your entire living quarters will smell.
Elimination in Ostomates vs Non-Ostomates Emptying an ostomy pouching system is comparable to a person with an intact bowel or urinary tract having a bowel movement or emptying their bladder. How does the non-ostomate handle the odor produced by the normal function of their body? Room deodorizing sprays are popular; a quick flush of the toilet when defecation occurs, and opening a window are some acceptable methods that have been used for odor management.
Why are Ostomates so uptight about elimination odors when our pouching systems are emptied? This constant complaint has encouraged ostomy supply manufacturers to create products to meet the need for odor control. Just remember, there is not a man or woman on this earth whose wastes do not smell. If someone tells you that their waste products are odorless, then a nose overhaul is in order for them!