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

 
Contents:

WE CAN'T SAY ENOUGH ABOUT THAT BANANA
TIPS FOR TAKING MEDICATION
LUNCHTIME SPECIALS
ABDOMINAL CHANGES
BEWARE THE BAY LEAF
STORAGE OF SUPPLIES
WHY DOES MY APPLIANCE KEEP COMING OFF?
Q's and A's
CARTOONSVILLE

Re-Route Archive

Volume 26, Number 6  March 1999

WE CAN'T SAY ENOUGH ABOUT THAT BANANA Via: 'Table Talk', Better Together Newsletter, Via: The Ostomatic News
What food comes in its own carrying case, is eaten raw or frozen like a pop, or dried like a chip, and has a perfect proportion of the minerals needed to power life? Yes, it is our old friend Musa Sapientum, better known as the banana. Once bananas grew in the Malay Archipelago and nowhere else. Today, we get 80 million bunches a year from Central and South America and the West Indies. In the early part of this century, immigrants to the United States marveled at two American foods: white bread and the banana. And the banana is a marvel. The banana is a rich source of sodium and potassium, with an excellent balance of both. These minerals, when they dissolve in the body, form electrically charged particles called electrolytes, necessary in sending nerve impulses to muscles, including the heart. The ratio of potassium to sodium determines the flow of water and other liquids in and out of the cells. The body needs three parts potassium to one sodium. If there is too much sodium in the blood the body must excrete it. The blood pressure may go up to force the sodium out of the kidneys, and the body may retain fluids to dilute the sodium until it leaves the body. People who lose a lot of fluid, such as those with ileostomies, need to pay particular attention to getting enough potassium. Supplements are not the answer unless recommended by a physician. That brings us back to our old friend the banana! A medium sized banana has 451 mg of potassium plus an excellent ratio of potassium to sodium. Remember also, that bananas thicken stool.

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TIPS FOR TAKING MEDICATION From Heartline, Via: Orange, CA
One of the most important things you can do to protect your health is to become better informed about the benefits, as well as the possible risks, of the medications you are taking. Start by compiling a list of all the drugs you take. This should include dietary supplements, skin, rectal, and vaginal medicines, eye and ear drops, antacids, cold and cough remedies, inhalants, pain relievers, salt and sugar substitutes, oral contraceptives and sleeping pills, etc. Then jot down the doses and the reasons why you are taking each medicine as well as any positive or negative effects you have experienced. You now have a medication profile to give to your health care providers. Be sure to update this information whenever your medication program changes. Know your medication. Take out each one of your pills and place them on a table. Jot down the following information: The color, shape, size and any numbers, letters or special markings that appear on the pill. Always follow instructions to the letter. Fifty percent of prescription drugs are not taken properly. Recheck the label or package direction before each use to be sure you are taking the right medicine in the right dose at the right time. Never take your medicines in the dark. Don't share your prescription drugs or use someone else's medication. The potential side effects and other factors make this a dangerous proposition. Never take medication with alcohol. According to the US Food and Drug Administration, over 50 percent of all prescription drugs interact with alcohol. Use one pharmacy for the whole family. A pharmacist who has a complete prescription record can counsel you more effectively and alert you to possible drug interactions or duplications of medications

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LUNCHTIME SPECIALS Excerpts from an article by: Jeanine Barone Kansas City, MO. Grapevine

A Mexican lunch consisting of a cheese tortilla with chilies and a cup of tea could be enough to keep the doctor and the dentist away. Cheese seems to have a cavity sparing effect. Scientists haven't pinned down the exact mechanism, but cheese stimulates saliva flow, which washes away corrosive acids. It also leaves a coating of fat on your enamel protecting your teeth from these teeth damaging acids. Cheddar, Monterey Jack and Swiss as well as Mozzarella, Edam, Muenster and Gouda all seem to fight tooth decay. Investigators found that when cheese is eaten before a sugary food, acid levels in the mouth don't climb. In fact, eating cheese four times a day for two weeks. built up the mineral content in material similar to tooth enamel by 5 to 10 percent. Cheese is high in fat, so don't eat too much. Capsaicin, the chemical that gives chili peppers their heat, prevents cancer-causers from attaching to and damaging the genetic material DNA. Chili peppers can neutralize nitrosamines, powerful cancer-causers that form in the body after eating hot dogs, sausage and luncheon ' meats. Capsaicin may also clear the blood of clots. Researchers found that right after eating hot pepper-laced food, clot dissolving activity rises, but only for a short time.

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ABDOMINAL CHANGES By Arthur Clarke, RNET, Gettysburg Via: Metro MD. & S. Nevada's Town Karaya
Throughout the lifetime of a person with a stoma, the ostomate will probably have to change the type of stoma equipment several times. One reason for a change is that the shape of an abdomen changes with time, resulting in the need for equipment with different characteristics. I would like to discuss the reasons requiring a different appliance and the characteristics of some common appliances. To begin with, the surgeon allowed only so much moveable bowel in the construction of your stoma. Once that piece of bowel was pulled through your abdominal wall, it was tacked down on the inside of the abdominal wall and on the outside of the skin. That length will remain constant throughout your life; therefore, if the wall of your abdomen thickens (say with fatty tissue), and the length of the bowel used for your stoma is not affected. One result of the limited length of bowel with increased abdominal wall thickness, is that when you sit or stand, the changed position allows the abdominal wall to shift forward and down, and the stoma segment prevents the peristomal skin from shifting as much as the rest of the abdomen. The limited movement results in a "skin swell" around the stoma when you sit or stand. Skin adjacent to the stoma becomes quite mobile being pulled down, then flattened by your changing positions. Any skin barriers can hold up under the strain. I have found that by using an appliance with a firm, convex surface which "pushes" the skin back and holds it stable, relative to the stoma, it works much better than the highly flexible pouches.

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BEWARE THE BAY LEAF Via: Ostomy Assoc. of Eastern Maine Metro Halifax News
The journal of the American Medical Association recently reported on two patients who inadvertently ate the bay leaf in their spaghetti dinners - and ended up in the hospital! The first patient was admitted with abdominal pain resembling an appendicitis attack and had to be operated upon to dislodge the sharp, central spine of the bay leaf from the intestinal wall. The other patient complained of severe rectal pain and needed anesthesia before the bay leaf could be removed. Their doctors' advice, "Always take out the bay leaf before serving the spaghetti!!"

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STORAGE OF SUPPLIES By: A Hayman, Albuquerque Via: Big Sky Informer & Nevada's Town Karaya
Many ostomy products contain organic matter that can break down with age or excessive exposure to heat or cold. The most common examples of non-manmade substances in ostomy supplies are : Karaya in Hollister products, gelatin and aroxymethylcellulose used in Squibb Stomahesive. Karaya-Seal rings should be kept in a cool, dry place so that the karaya won't break down. When these rings get cold or dry, they become less tacky and very firm. If they get too cold or dry, they will crack. A little warm water applied will often soften karaya and allow for proper adhesion to the skin. If exposed to high storage temperature, karaya will ooze, melt and lose some adhesion and protection properties, even if cooled later. This is one disadvantage in buying from mail-order suppliers, because the pouches must be shipped twice and a great deal of breakdown can occur. Stomahesive is the most sensitive product to temperature extremes and age. Carboxymethyl cellulose and gelatin will absorb moisture rapidly, and extreme cold will cause brittleness and cracking. Each box of Stomahesive is dated to insure freshness. Ask suppliers the age of the supplies and how they should be stored. Tip: Store appliances away from warm, humid places. "Melt-down" can render equipment ineffective.

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WHY DOES MY APPLIANCE KEEP COMING OFF? Via: Triangle, Pittsburgh, PA. & GB News Review
One of the most embarrassing situations that can befall an ostomate is to have an accident with the appliance pulling loose, resulting in soiled clothing and an instant loss of self-assurance. This may happen once in a great while to many ileostomates without being a cause for concern. But if accidents occur too frequently, then the situation should be investigated thoroughly for a possible explanation. Multiple factors may help explain the loss of an appliance not working, such as the stoma itself, the skin around the stoma, the cement (or adhesive) or the appliance. The stoma may be improperly placed too close to a scar, a crease or bodily (bony) prominence, so that twisting or bending loosens the appliance. There is no single solution for a misplaced stoma. A different faceplate may be tried one with a soft and pliable surface to fill in irregular areas, rather than an unyielding hard faceplate that pries off with motion. An irregular area may be built up with tissue and cement. Ultimately, the stoma may have to be moved if leakage continues. A prolapsed stoma will push off the appliance at the times the stoma is maximally protruded. Conversely, a flat or recessed stoma will cause pooling of intestinal contents around the stoma with erosion of cement (adhesive), eventually lifting the face-plate from the skin. This situation is difficult to remedy, but convex appliances may be used which adhere by pressure. The skin around the stoma might be too oily to accept the cement (adhesive). Sometimes, in an effort to enhance beauty, women add oils to their baths, resulting in artificially oily skin. For those who use an adhesive (cement), the cement may be too thin. Leaving the top off the can for a short period of time will allow some of the solvent to evaporate, thus, thickening the cement. If the can is not shaken sufficiently to mix up the cement that settles at the bottom, the thin layer will not be strong enough to support proper adherence. Not enough time may be given to allow the cement to dry properly, yielding an unstable base. Finally, changing the brand of cement or using an adhesive disc would be a simple thing to try before more desperate measures are taken.

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Q's and A's Via: Dallas Area Ostomatic News
What can I do to pouch a difficult stoma or to work with creases?
Creases are a constant source of frustration. Filling them in with a product like Stomahesive Paste or Hollister Premium Paste might be of benefit. The trick is to make a level surface. Be sure to spread the paste with a wet finger to avoid sticking. If the pouch tends to pull lose at a certain spot, a little skin bond cement or some type of adhesive made for skin can be of benefit. Be sure to protect the skin first with a skin prep, skin gel, skin shield or one of the coatings made for ostomates. Let the cement dry before applying the pouch. (Read directions on whichever product you choose.) Sometimes, it helps to cement both the pouch and the skin. Always use a thin coat.

What if the stoma retracts?
If you are using the Squibb two piece system, it might help to try their Convex Insert. This is a saucer like disc that pushes the skin in and the stoma out. Their regular wafer will even accommodate 2 inserts if there is a need for more convexity. The discs are reusable if you clean and save them. However, both ConvaTec and Hollister have two-piece pouching systems with built in convexity in the wafer. This eliminates the need to remove the insert rings and clean them between changes. Also, the built in convexity in wafers are a better choice in that they are easier to deal with without the pushing on the wafer to insert the rings, especially if you have arthritic hands.

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