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Volume 32, Number 6 March, 2005
CAN RELAXATION TECHNIQUES HELP ME CONTROL MY CANCER PAIN?
Via: Cancer Information Service & Hemet San Jacinto, CA
For some people, cancer pain can be helped by relaxation techniques, imagery, and massage. These techniques may be helpful used alone or with pain medicine.
Relaxation relieves pain or keeps it from getting worse by reducing tension in the muscles. It can help you fall asleep, give you more energy, make you less tired, reduce you anxiety, and make other pain relief methods work better.
Some techniques may work better than others for you, and your ability to relax may vary from time to time. When you find a technique that works well; do it at least 5 to 10 minutes twice a day. It may take up to two weeks of practice to feel the first results of relaxation.
Relaxation may be done sitting or lying down. Choose a quiet spot and close your eyes. Do not cross your arms and legs. If you are lying down, put a small pillow under your neck and under your knees.
One relaxation method you might try is imagining a peaceful, calm scene while you or someone else gently massages near the area of pain in a firm, circular manner. Avoid swollen or tender areas.
Another technique is deep breathing while you slowly tense and then relax groups of muscles. However, if you have any lung problems, check with your doctor before doing deep breathing.
If you have trouble using a particular method, ask your doctor or nurse to refer you to a therapist who is experienced in relaxation techniques. Do not continue any techniques that increases your pain, makes you feel uneasy or causes any unpleasant side effects.
BLADDER CANCER
Via: S. Brevard, Fl & GB News Review
Cancer appears in the bladder more often than in any other organ of the urinary system. It is one of the more common forms of cancer among men. It occurs about twice as often in men as women. It occurs after the age of 50 about 90% of the time.
Cancer of the bladder has one outstanding and readily detected sign — blood in the urine. Fortunately, this sign usually appears while the cancer is still in its early stages, when it may be treated most successfully.
Most people with blood in the urine do not have cancer –urinary infections also may produce blood. But, it is an important warning sign that warrants investigation at the earliest possible moment.
Blood in the urine is not always a bright red color. If it is present in small quantities, the urine may appear to be merely “smokey” or “pink” in color. But any change from the usual appearance of urine should be investigated promptly.
Do not be misled if the bleeding occurs only once and then stops. It often appears intermittently; therefore, a single appearance warrants a visit to your doctor.
Cancer of the bladder usually is diagnosed by means of a cystoscope—a medical instrument with tiny lenses and a light which enables a physician to examine the interior of the bladder. The patient is given a mild anesthetic so that he or she is comfortable and without pain during the procedure.
A small piece of tumor is taken and submitted to a pathologist for examination to confirm a diagnosis. A urine test is also administered, and a microscopic examination is made.
Usually, the cancer is controlled without surgery by scrapping the cancer out of the bladder or by implanting radon. Radon –a gas– is a cancer killing radioactive agent that has been extracted from radium. It is enclosed in a gold capsule and placed in the bladder.
Regardless of the treatment you receive, the earlier you see a doctor, the better are your chances for a cure.
WHY COME?
Via: So. NV Town Karaya
If you were wondering why you should attend meetings….
If no one came, there would not be an organization and we wouldn’t know what was going on to update the care of our ostomates, and the new appliances that were coming out.
Say you don’t need a new appliance? Did you start out with the old karaya ring appliance that melted almost as soon as it was applied? When was the last time you used one? How did you learn that there was something better? Certainly not from your doctor or neighbor. Think about that!
Think about the new ostomates (yourself included) that timidly came to the first meeting, and what it felt like to know that you weren’t the only one in town with a “pouch”. Think about the appliance representatives who give of their time because they care about you.
How about the ET’s who speak at meetings? Don’t you believe you may have learned something from them? Aren’t there times when we all need each other? What could be old hat to you could be the most important fact to another with a new ostomy.
Think about this article when you are deciding whether or not to attend the March Chapter meeting.—Ed.
COLONOSCOPIES—HUMOR
Via: Seattle WA & Stillwater –Ponca City OK & Hemet San-Jacinto, CA
A physician claims these are actual comments from his patients made while he was performing colonoscopies.
1) “Take it easy, Doc. You’re boldly going where no one has gone before.”
2) “Find Amelia Earhart yet?”
3) “Can you hear me NOW?”
4) “Oh boy, that was sphincterrific!”
5) “Are we there yet? Are we there Yet? Are we there yet?”
6) “You know, in Arkansas, we’re now legally married.”
7) “Any sign of the trapped miner, Chief?”
8) “You put your left hand in, you take your left hand out. You do the Hokey Pokey….”
9) “Hey, now I know how a muppet feels!”
10) “If your hand doesn’t fit, you must quit!”
11) “Hey, Doc. Let me know if you find my dignity!”
12) “You used to be an executive at Enron, didn’t you?”
13) “Could you write me a note for my husband, saying that my head is not, in fact, up there?”
CREATION OF A STOMA
by: Joshua A. Katz, M.D. Dept of Colorectal Surgery, Cleveland Clinic Florida
The creation of a stomaurostomy-represents a major, immediate and sometimes permanent change in the life of a human being. This can have profound effects upon lifestyle, intimacy, employment, recreation and travel. Fear, misunderstanding, loss of self-image and social isolation can compound the situation.
Colorectal surgeons and nurses who care for patients with a stoma must recognize that to save someone from a life-threatening condition means little if the life the person returns to is made miserable by a poorly functioning stoma. The objective of any operation involving a stoma is to create a stoma that the patient can care for with simple routine using an appliance that fits reliably, comfortably and protects the surrounding skin. Time between ostomy changes should be a least once a day, and never longer than seven. There should be no leakage of feces around the appliance.
Creation and utilization of a stoma is a team approach involving the patient, the ostomy nurse and the colorectal surgeon. Patients must assume responsibility for their own health and well-being. They need to learn about their disease and understand what operation is being performed and why. They need to know whether they have a colostomy or ileostomy, and whether it is permanent or temporary. An important rule to keep in mind, is “when you do not know, ask.”
It is useful to keep a medical summary of one’s medical and surgical history written down. So be sure to list current medications, physician’s names, addresses and telephone numbers. If a relative or friend has power of attorney or is a health proxy, or if there is a living will, this should also be recorded.
One may also choose to obtain copies of operative notes and discharge summaries from recent or complex procedures and hospitalizations. This record is particularly critical when traveling or relocating. It is important to know that by law all information about a patient must be made available upon request of the patient. This means that at any time, you can request a copy of your medical record. In particular, patients planning a long journey-usually more than a week-or relocation, should notify their doctor, travel with a copy of their medical record, and prior to leaving, seek and obtain the name and number of a physician at their destination.
The ostomy nurse also plays a critical role in the preoperative and postoperative management. Prior to surgery-in elective or non-emergency cases–the surgeon and nurse sit down to review with the patient what procedure is being done and why. The patient then has his/her body examined while standing, sitting and lying down to determine the best place on the abdominal wall to locate the stoma. One or more sites are then marked so that the surgeon knows where to place the stoma during the procedure. Principles of stoma location and creation include:
* Keeping the stoma away from bony landmarks like ribs, hips, scars and creases.
* Making sure the patient can see the stoma.
* Placing the stoma so it is not in the midline abdominal incision.
* Keeping the stoma within the rectus muscle to prevent peristomal hernias.
* Preventing stoma tension and assuring an adequate blood supply
* Budding the stoma so that it is inverted to permit proper pouch placement. This is particularly important for ileostomies so that the pouch can be placed right next to the stoma with no exposed underlying skin and thus prevents skin irritation, ulceration and breakdown.
An ostomy nurse can help patients adapt post-operatively to living with their stoma by assessing the quality of the ostomy system and its fit, and modifying the pouching method. Particularly in the several months following surgery, patients may gain or lose weight depending upon their disease and may undergo several different pouching methods before developing a regimen with which they are comfortable. The ostomy nurse can facilitate and direct the process. Patients with ostomies should consider a yearly visit with an ostomy nurse to reassess pouching methods and to assess for problems.
While these principles of preoperative assessment and operative management are considered standard of care by colorectal surgeons, there is as yet no data that prove the validity of these principles. Also, there are some patients with optimally constructed structed stomas who function well. For this reason, Cleveland Clinic Florida is conducting the research to determine if the currently espoused methods actually impact upon quality of life and stoma function. We have developed a “stoma scoring system” and have used this to assess 70 patients in conjunction with validated quality of life estimates as well as appliance wear time and leak rate. Data are currently undergoing statistical analysis and the results will be published.
The Cleveland Clinic gratefully acknowledges the participation of UOA and its members and is always pleased to participate in UOA activities.
Those seeking care, a second opinion or information from colorectal surgeons in the United States and Canada may contact:
* American Board of Colorectal Surgery—734-282-9400 or
www.abcrs.org
*
American Society of Colorectal Surgery—847-290-9184 or
www.fascrs.org
*
Department of Colorectal Surgery—Cleveland Clinic Florida —954-659-5251
YOU ARE AS YOUNG AS YOUR CONFIDENCE
Via: Charleston Area OA & Great Falls, MT & Greater Orlando, FL Chapter
Youth is not a period of life, it is a state of mind, it is the vigor of the will, the agility of the imagination, the strength of feeling, the victory of courage over cowardice, the triumph of the spirit of adventure over inertia.
Nobody becomes old because he has a number of years behind him. One becomes old when one says good-bye to one’s ideals.
With the years, the skin becomes wrinkled, but the renunciation of enthusiasm wrinkles the soul.
Sorrow, doubt, lack of self-confidence, anxiety, and hopelessness are like long years that drag the head down to earth and bend the upright spirit into the dust.
Whether seventy or seventeen, within the heart of every person lives the longing for the wonderful, the uplifting amazement at the sight of the eternal stars. Within every heart lives a fearless venture, the insatiable child-like tension of what the next day will bring. Within lives the frolicsome joy and gaiety, the joy of life.
You are as young as your confidence, as old as your doubt, as young as your self-confidence, as old as your fear, as young as your hopes, as old as your despondency.
As long as the messages of beauty, joy, boldness, the greatness of men and of infinity reach your heart, you are young.
Only when the wings hang down and the inside of the heart is covered by the snow of pessimism and the ice of cynicism have you become truly old.
NOT EVERYONE KNOWS
By Sharon Williams, RNET, Via: The Triangle, Abilene TX & GB News Review
The experience of having a new ostomy can be quite frightening if one does not understand what is normal in stomal appearance and ostomy function and what is not normal. Although each ostomate is uniquely individual, there are some basic generalizations which can be cited in the postoperative period. For example, the normal, healthy stoma is bright red in appearance, resilient to the touch and may bleed slightly if rubbed stoma is bright red in appearance, resilient to the touch and may bleed slightly if rubbed when the peristomal skin is being cleansed. A marked change in stoma mucosa color or appearance should be reported to the physician or enterostomal therapist. Also, bleeding from inside the stoma (whether urinary or fecal) should signal a call to the physician for further testing.
It is normal for an individual with an ileal conduit or sigmoid conduit urinary diversion to have some mucus in the urine. Drinking sufficient amounts of water (8-10 glasses per day minimum) will help to keep the urine and mucus diluted.
It is normal for the skin surrounding the ostomy to be in the same condition as the skin on other portions of the abdomen. Redness, rashes, urine crystal build-up etc. are not normal and should be reported to the enterostomal therapist or physician.
In individuals with colostomies and ileostomies who still have a rectum intact, it is normal to expel mucus through the rectum. The mucus membrane lining the rectum will continue to produce mucus, even though an individual is “re-routed.”
It is normal for the stoma to change slightly in shape and size due to peristalsis (the contracile motion of the bowel which propels contents through the intestinal tract). However, marked swelling, prolapse, or shrinking in size of the stoma, should be checked by a professional.
It is normal for some colostomates and ileostomates to feel as though they still need to have a bowel movement (phantom
rectum sensations) even though the rectum has been removed. The sympathetic nerves responsible for rectal control are not interrupted during surgery and therefore the sensations are still present. Knowledge of this fact may alleviate anxiety.
In summary, get to know your stoma and what is normal for you. Only by recognizing the norm can one know when and if a problem develops.
HELPFUL HINTS FROM HERE AND THERE
If your pouch doesn’t stick well there may be an easy solution: Are you applying it in a high-humidity bathroom right after showering? Skin must be perfectly dry to hold the appliance. Oily skin care products, such as vitamin E and Dove Soap, can cause the wafer to loosen and slip. If you change your appliance before a shower, wait 15 minutes or so until the appliance seal is secure.
Pre-warming of the tube of appliance paste will make it easier to apply. The tube can be held under hot water.
When taking a new medication, keep a close eye on your appliance to see if the undigested pill appears there. Contact your doctor immediately if you suspect the medicine is going straight through.
To get the most out of your supplements, take vitamins with meals. That will boost your absorption and lessen your chances of getting an upset stomach.
Thirst is a great indicator of liquid needs. If you are thirsty, drink up!!!
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