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Volume 31, Number 6 March, 2004
PAY ATTENTION TO SIGNALS BODY SENDS TO AVOID COLORECTAL CANCER
Via: The Greater Cincinnati OH. Chapter, Excerpted
Colorectal cancer...it’s a killer secret!
Each year, almost 150,000 Americans are diagnosed with cancer of the colon or rectum. About 50,000 people die annually of this disease.
It is the third most common cancer in our nation, second only to lung cancer in its deadliness. Most likely, someone affected by colorectal cancer lives near you.
That may surprise you. Although few people discuss colon health, understanding normal bowel habits, recognizing changes and realizing when to seek help will allow us to fight this deadly disease. No one should die from embarrassment.
That is why March has been designated National Colorectal Cancer Awareness Month—a time dedicated to educating people about colorectal cancer signs, symptoms, risk factors, evaluations and treatments.
The first step in combating the disease is talking about it. Don’t be shy about discussing bowel habits with your doctor. A change from a regular daily movement to a frequent loose, or infrequent hard movement may signal that something in the bowel needs attention.
Abdominal or pelvic pain can also be a sign that an evaluation is needed. The presence of blood—red, maroon or black—is never normal and should immediately be discussed with your doctor. While something as common as hemorrhoids or a fissure may be causing the problem, your silence can be deadly.
Jay Monaghan, for example, the husband of Katie Couric, delayed telling his doctor about blood in his bowel movements. When finally evaluated at the age of 42, his colorectal cancer was advanced and a cure was not possible. He died several months later.
In addition to talking with your doctor, talk with your relatives, especially your immediate family, to find out if anyone has had a polyp or a cancer of the colon or rectum. Colorectal cancer does not discriminate on the basis of age or sex, and a family history of this disease increases a person’s risk several times.
Research has verified that colorectal cancer is passed from generation to generation through a genetic abnormality. Multiple polyp clusters in families demand screening in adolescence.
A history of inflammatory bowel disease, such as ulcerative colitis and possibly Crohn’s disease, also increases the risk of developing colorectal cancer.
Finally, lifestyle choices such as smoking, a lack of exercise or a diet high in fat and low in fiber can increase your risk.
Colonoscopy examines the large intestine, is performed in an outpatient endoscopy suite under sedation, and takes about 30-45 minutes. This procedure remains one the best means for early detection of colorectal cancer and could save your life.
The authors are Assistant Professors of Surgery at UC.
FAMILY & SPOUSE…THEIR NEEDS
by: Donna Hoffman
Much has been said and written about the ostomate who has to undergo ostomy surgery, his physical recovery from the surgery and his emotional recovery (also important). But what about the spouse and children? They must suffer in their own way. In the hospital, doctors and nurses hurry around seeing to the ostomate’s needs. Who is there for the family? Spouses suffer just as much (if not more). They must put up with outbursts of anger, despair and depression. They work with us, giving love and support, and have to go home to an empty house and wonder…what next?
There is usually no one to help them through their anxious days of worry and uncertainty. “How will my love one accept me? After all, I’m not the one to have an ostomy. Will he or she be the same?”
After the ostomate comes home from the hospital the family and spouse have to put up with inconveniences such as pieces of skin barrier stuck to the bathroom floor, cements spilled on a favorite brush or comb, learning to leave the bathroom free at that certain time of day, making extra pit stops when traveling. And on the spouse’s end, “What about our sexual life? Will it be the same? Will it be worse, better or maybe none at all?” Spouses and families need the same support during the hospitalization phase and recovery at home as the ostomate. They need to be included in the teaching
of ostomy care to feel they are still wanted and needed. Children should have the surgery explained to them so Mom or Dad will seem the same and love them all the more. They will not think anything of it if explained in a simple understanding way.
An ostomy is nothing to be ashamed of and should not be treated any different than someone who has to take insulin or wear a prosthesis. Spouses should also have the option of talking to another spouse who has had ostomy surgery in the family.
HOW TO PREVENT MEDICAL ERRORS
Via: Ottawa ON Ostomy News & Brevard FL Ostomy Newsletter
1.
Get involved with your medical care and you will get better results.
2. Be certain your doctor knows about all the medications you are taking, including over-the-counter medicines, supplements, herbs, and prescriptions.
3. Inform your doctor of all allergies and adverse reactions to medications.
4. Make sure you can read a prescription.
5. Ask for information about your medications in terms you can understand.
6. Make sure the pharmacy gives you the medicine that was prescribed.
7. Ask questions about directions, e.g. does “four doses” mean just in daytime or around the clock?
8. Ask the pharmacist for the best device to measure liquid medication.
9. Ask for written information about side effects
10. Don’t hesitate to ask hospital workers to wash their hands.
11. If you have a choice, choose a hospital and a surgeon that does a lot of the surgery you need.
12. On discharge from the hospital, be sure you understand your home treatment plan.
13. Be sure that you know and agree about what exactly will be done in your surgery.
14. Speak up if you have concerns.
15. Make sure that someone, such as your personal doctor, is in charge of your care if you have multiple health concerns.
16. Don’t assume health professionals know everything you do about your care.
17. Ask a family member to speak for you when you cannot.
18. Find out if you would be better off without certain treatments or tests.
19. Don’t assume that no news about a test is good news.
Be informed about your condition and treatment. An informed, involved patient is a better patient.
SO, YOU HAVE A COLOSTOMY
Via: Indian River, FL Ostomy Association & Greater Cincinnati Area Chapter
Veteran colostomates usually know the difference between different colostomies, but what about the new colostomate? All this person knows preoperatively is the doctor is going to operate on his/her bowels. If the patient is lucky, an enterostomal therapy nurse will visit and explain what is going to happen. Surgeons
have one concern—getting the diseased portion of the colon removed, and if necessary, forming a stoma outside the body. The patient may have been told what and why this operation is needed. But, what about when the patient awakens after the surgery? TERROR! This is when an ET becomes a friend for life. She will visit (upon the doctor’s orders) and explain the difference between having an anus and having a stoma. If it is a left sided stoma, then it’s a sigmoid colostomy. The fecal output will eventually regulate (if the patient doesn’t irrigate) itself and behave similar to anal evacuation.
There is also an ascending colostomy. As the word ascend describes, this part of the colon discharges a semi-liquid and fecal matter rich in digestive enzymes which irritate the peristomal skin. On the other hand, there is the transverse colostomy which is located within the transverse (crosswise) colon and the output is usually liquid to semi-formed because digestive enzyme content decreases as the stoma moves farther to the left of the transverse colon.
If you have a descending colostomy, it is located within the descending colon and the output is semi-formed. This occurs because much of the water has been absorbed as waste moves through the ascending and transverse colon. If you are confused, just picture your colon as down, across, up, and again across the abdominal cavity. Of course, you can just say the heck with it all, and go out and enjoy life.
ARE YOU A CARROT, AN EGG, OR A COFFEE BEAN?
Via: Regina Ostomy News
A young woman went to her mother and told her about her life and how things were so hard for her. She did not know how she was going to make it and wanted to give up. She was tired of fighting and struggling. It seemed as one problem was solved, a new one arose. Her mother took her to the kitchen. She filled three pots with water. In the first, she placed carrots, in the second she placed eggs and in the last she placed ground coffee beans. She let them sit and boil without saying a word. In about twenty minutes she turned off the burners. She fished the carrots and eggs out and placed them in two bowls. Then she ladled the coffee out and placed it in a bowl. Turning to her daughter, she asked, “Tell me, what do you see?”
“Carrots, eggs and coffee,” she replied. She brought her closer and asked her to feel the carrots. She did and noted that they had gotten soft. She then asked her to take an egg and break it. After pulling off the shell, she observed the hard-boiled egg. Finally, she asked her to sip the coffee. The daughter smiled as she tasted its rich aroma, and then asked, “What’s the point, Mother?”
Her mother explained that each of these objects had faced the same adversity — boiling water, but each reacted differently. The carrot went in strong, hard and unrelenting. However, after being subjected to the boiling water, it softened and became weak. The egg had been fragile. Its thin outer shell had protected its liquid interior. But, after sitting through the boiling water, its inside became hardened. The ground coffee beans were unique, however. After they were in the boiling water, they had changed the water. “Which are you?” she asked her daughter.
When adversity knocks on your door, how do you respond? Are you a carrot, an egg or a coffee bean?
Think of this: Which am I? Am I the carrot that seems strong, but with pain and adversity, do I wilt and become soft and lose my strength? Am I the egg that starts with a malleable heart, but changes with the heat? Did I have a fluid spirit, but after a death, a breakup, a financial hardship or some other trial, have I become hardened and stiff? Does my shell look the same, but on the inside, am I bitter and tough with a stiff spirit and hardened heart? Or, am I like the coffee bean? The bean actually changes the hot water, the very circumstance that brings the pain. When the water gets hot, it releases the fragrance and flavor.
If you are like the bean, when things are at their worst, you get better and change the situation around you. When the hours are the darkest and trials are their greatest, do you elevate to another level? How do you handle adversity? ARE YOU A CARROT, AN EGG, OR A COFFEE BEAN?
HELPFUL HINTS
Via: Metro MD
For Colostomies: If you use just a pad instead of an appliance, use a little K-Y Jelly over the stoma to keep things soft and lubricated. If you irrigate; allowing too much water to enter the stoma too quickly may cause a sudden evacuation of waste but leave much of the feces still in the colon, along with most of the water. Periodic evacuation may follow. This is not really diarrhea, but is simply a delayed emptying of the colon.
For Ileostomies: Usually ileostomates experience hunger more often than other people. When this happens, they should drink fruit juice or water and eat soda crackers, followed by a meal as soon as possible. If you do need to eat a snack at bedtime or during the day in order to ward off nausea, try to cut down on calories somewhere else in the daytime or you will gain weight. Never skip meals in order to lose weight. An ileostomy keeps working whether the ostomate has eaten or not.
For Urostomies: If it is necessary to have a urinalysis, remind the nurse to take the specimen directly from the stoma, not from the appliance. If you are out of Uri-Kleen, soaking your urinary pouch in straight white vinegar for thirty minutes will kill all common bacteria found in urine. Mucous in the urine is normal. The ileal conduit is made of mucous secreting intestinal tissue. It doesn’t stop doing its job even though it is transporting urine.
Added Tip: If you use a two-piece system, the pouch may not be totally secured when you snap it on and could fall off when half full. Make sure the pouch is snapped to the flange securely. Start snapping it together at the bottom and work your way to the top. Give a little tug on the pouch to test its lock, but make sure you hold the faceplate/wafer so you don’t break the seal.
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