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

 
Contents:

A PROBLEM TO BE SOLVED OR A MYSTERY TO BE LIVED
THOSE ABDOMINAL NOISES
THE PRODUCT COMPLACENCY SYNDROME
HELPFUL OSTOMY TIPS
CARTOONSVILLE

Re-Route Archive

Volume 26, Number 8  May, 2000

A PROBLEM TO BE SOLVED OR A MYSTERY TO BE LIVED
By: Karen Grieff, LCSW, Via: Orange Oasis & Ostomatic News, Dallas, TX 
A philosophy instructor once said, "Life is not a problem to be solved, but a mystery to be lived." Indeed, there is a profound difference in seeing life's twists and turns as problems needing solutions versus mysteries to be lived. When we take a problem solving approach, we remain outside of the process and create a success or failure tension. Yet, when we understand life as a mystery and become part of it, those tensions are irrelevant. As a medical social worker, I often speak to people with ostomies. Typically, I ask about adjustment. The usual response is "no problem." Several probing (and often unwelcome) questions later it is clear that the individual is focused on the mechanics and maintenance of the appliance. Even if for the most part he/she has come to terms with its intricacies and nuances, learning what works and what doesn't and to accommodate this new and demanding reality, the reply may again be, "no problem." But this can also mean "I don't want to talk." Neither answers the question though, but may suggest that we are simply more comfortable discussing what we believe we have control over. Now, the subject of "ostomy" is a land mine with its attendant emotions and practical frustrations. It is a daily reminder that cannot be escaped. The ostomy patient is different in that there is significant, visible, tangible and enduring alteration. The ostomy patient cannot always control what will happen with elimination or skin integrity or the appliance itself. He/she cannot plan out every moment and be guaranteed the outcome. The unpredictable cannot be ruled out one hundred percent. One must now live with uncertainty about what others take for granted. No two people have the same experience. They may be alike in background and overall health, with similar disease courses necessitating surgery. But they will not have the same "experience", for it is not life's events which shape and renew us, but rather what we understand them to mean. If you see the ostomy and living with it as a problem to overcome, that will be your focus. Conversely, if you see the ostomy and living with it as part of the greater mystery, your focus will broaden and deepen. Having the courage to acknowledge to yourself that the ostomy is often a nuisance and aggravation, while accepting your feelings about what happened, is the first step into the mystery and the potential for personal peace. 

• Return to Contents

THOSE ABDOMINAL NOISES
Rumbles and grumbles, growls and howls - such noises that come from the abdomen. Everyone seems to get messages from inside that are told to anyone within hearing distance. Since it happens to everyone, you'd think that we could just laugh them off or ignore them, but instead, we're embarrassed, and, as ostomates, wonder if something is wrong since it seems to happen more often since our surgery. At least we notice it more. These abdominal growls are officially called borborygmi (bore-bore-rig-my). If pain accompanies the noises, it could be a sign of a bowel obstruction, an ulcer, or gall bladder problems. See your doctor. Usually, however, it is all sound and fury signifying nothing important. Any of the following may be the cause: You are hungry. Peristalsis goes on whether there's anything to move on or not! You are nervous, so peristalsis is increased. You have been drinking coffee, tea, cola, or beer, which stimulate peristalsis. Since these are often drunk on an empty stomach, they produce gurgles as peristalsis redoubles its movement. You have been reading about lowering cholesterol by eating a high fiber diet, so you have added high fiber foods. Digesting fiber foods produces gas, so rumbles increase. If you wear an appliance, you will notice it quickly fills with gas and you are wearing a balloon! You may be eating too many carbohydrates. The intestines don't digest starches and sugars as easily as proteins and fats. Culprits are often lactose (a sugar milk), sorbitol (a sugar free sweetener in snacks), and raffinose and stachyose (sugar in dried beans). The result is more gas gurgling about. You have been eating too fast, with your mouth open, or trying to talk while you eat. Your mother always told you it was rude, but she didn't mention that you would swallow air which grumbles and growls as it is moved along the digestive tract. Prevention: Eat a snack of fruit or vegetables between meals if you are hungry; eat smaller, more frequent meals; eat slowly! Don't gulp! 

• Return to Contents

THE PRODUCT COMPLACENCY SYNDROME
By. Linda Allen, RNET, Fort Worth TX Via: Chambersburg PA Ostomy Group 
If you have an established ostomy (older than one year), you might be a victim of the "complacency syndrome." Complacency can be defined as a feeling of quiet security, often while unaware of some potential danger, defect or the like. Initially after surgery, it takes time to develop a security with management of your ostomy. After a period of time, it normally becomes like a second nature. We are creatures of habit and we sometimes accept a situation even if it's not as effective as it should be, because it is what we are accustomed to. Here's a classic example: About ten years ago, I worked with a young woman whose ileostomy stoma was about ten years old. Following her surgery, she was fitted with improper products, a closed-end pouch for an ileostomy stoma. Since the pouch could not be emptied, she had to change it each time it became full, six to ten times a day. Just imagine, her entire life revolved around care of her stoma, leaving little time for anything else. She had adapted by purchasing special clothes, carrying special equipment in a purse, and setting up a special bed, one with a hole in the mattress! This was done to allow her skin to breathe, since its tendency was to become irritated because of the frequency of pouch changes during the day. Not surprisingly, she also spent a near fortune on purchasing ostomy products and the special accessory items she needed for her care, many hundreds a month. She had adapted to this routine and did not think to question that there could be a better way. Do you have a problem that you may not have realized? After a period of time, stomas and the surrounding skin may change. We may gain or lose weight or develop a hernia. All of these factors affect the way a product works. Maybe it's time for a reality check. Answer the following questions for yourself. Is your current product secure or does it leak frequently? Are you satisfied with the length of wear time? Adequately protecting your skin? Does it fit snugly around your stoma? The peristomal or surrounding skin should look like the skin on the other side of your abdomen. There should be no redness, whiteness, rash or broken area. Odor proof? If no, investigate why. Most current pouches are made with odor proof plastics and if secured well, will not let odor to escape. low profile, discreet? Gone are the days when big, bulky products were our only choice. Choose a product that will not be visible under clothing. easy to apply? Time saving and simple to use? Ostomy care should take no longer than 10 to 15 minutes and many times even less than that. affordable? Seems as though price increases are implemented very frequently. The average price of an ostomy change for one wear time should be around $3 to $5. The cost of supplies is directly related to the frequency of change and the product itself. If cost is an issue, utilize your product carefully and eliminate unnecessary items. Readily available? If the product is hard to find, make sure your local retailer knows you will be ordering a particular product and ask that they keep it in stock for you. 

• Return to Contents

HELPFUL OSTOMY TIPS
From ostomates Everywhere 
A cup of tea can be an ostomate's best friend. Tea is an anti-spasmatic and is soothing to an upset stomach. It also contains potassium, an electrolyte that is often lost by ostomates. Always use cool or lukewarm water when washing reusable pouches. Hot water destroys the odor-proofing qualities built into the pouch. Walking is nature's tranquilizer . If you feel uptight, try a walk. Your troubles may melt away and your body will get a benefit too. Buttermilk or yogurt can help soothe an irritated bowel and control gas. Gas is produced by onions, beer, radishes, cucumbers, beans and those vegetables from the cabbage family. For pizza lovers, 2 to 3 tablespoons of applesauce is helpful in firming up a stool which might result from eating pizza or spicy food.

• Return to Contents