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

 
Contents:

PUSH THE SKIN, DON'T PULL THE TAPE
SKIN ATTENTION
ELECTROLYTES AND WHY WE NEED THEM
A GAS-TLY SUBJECT
MOVING ON
DO COFFEE AND TEA COUNT?
FACTORS WHICH INFLUENCE OSTOMY FUNCTION
SOME ILEOSTOMY DON’TS
ANTI-DIARRHEA AGENTS
HELPFUL HINTS FROM HERE AND THERE
OSTOMATES COMPARING NOTES

Re-Route Archive

Volume 29, Number 8  May, 2002

SKIN ATTENTION
By: John Sarbacker, MD & Kay Carlson, ET , Via: The Good News Helper, Chambersburg Ostomy Support Group, PA
Some ostomates can use anything on the skin and “get away with it”. Others have to search for just the right combination of products for satisfactory use. New ostomates benefit from the follow-up visits to the ET because careful consideration is given to the various products used around the stoma area. If you are experimenting on your own, consider the following information for using a different product. Patch testing is recommended before proceeding to use the new product. The skin on the inner surface of the arm or leg or the opposite side of the abdominal area from the stoma are good areas to use for a simple test. For example, cut a piece of the washer, tape, disc, etc. and affix it to a chosen area. Secure with a strip of micropore tape and leave on the area for 48 to 72 hours. (editor’s note. Be careful of the tape too; it could be a problem also). Any burning sensation or itching during the testing time could signify sensitivity to the material being used and therefore, should be removed Immediately, washed and dried well. After 48 to 72 hours, remove the “patch” and if there is no redness or irritation, it is safe to assume that the product can be used. With some persons, a “delayed reaction” may not occur until a few days later. For more extensive testing than this—contact a dermatologist.

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ELECTROLYTES AND WHY WE NEED THEM
Via: Metro Halifax News
Everyone needs to be aware of the fact that they need electrolytes in their life. If you have ever noticed football players slugging down Gatorade or some other concoction when they return to the bench, it’s because they need to replace the electrolytes they lost with their perspiration. For the ostomate, particularly those with ileostomies, replacing electrolytes is very important. The purpose of your colon is to store food waste and to return the liquid portion of the stool to the body. When you no longer have a colon, that liquid is lost directly into your bag and is gone forever from your body. With that liquid, you lose a good portion of your electrolytes. But, what are electrolytes, and what specifically do they do for us? According to Tabor’s Encyclopedia Medical Dictionary; electrolytes are: 1. A solution which is a conductor of electricity or; 2. A substance which, in a solution, conducts an electric current and is decomposed by a passage of any electric current. Every muscle we move is activated by our nervous system. And, throughout our nervous system, each of our nerve cells (neurons) are connected to each other by means of electrical impulse, or synapse. Electrolytes, largely made up of sodium and potassium, are what give the synapse the spark to function. Each time we move a muscle, we use up a small portion of our sodium and potassium - ergo, our electrolytes. When we lose those electrolytes, we also lose our zip and vigor. For everyone, after excessive perspiration in the summer or prolonged exercise, we can become dehydrated and lose our electrolytes in the process. For the ileostomate though, just doing what comes naturally will cost them their capacity to spark. You can tell when you are becoming dehydrated by a decrease in urine volume, dark orange urine, overly dry skin, marked thirst, abdominal cramps, exhaustion, weakness and/ or shortness of breath. The answer? Drink a lot of fruit juice, Gatorade, Gastrolyte, soda-pop, water, bouillon or tomato juice.

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A GAS-TLY SUBJECT
Via: San Mateo UOA & The Ostomist”, Greater Seattle Chapter, UOA
If one were to search for the most embarrassing bodily phenomenon, the passing of gas would certainly come out on top. The average person passes gas about fourteen times a day, in spite of all attempts not to. Physicians refer to the process as flatus or flatulence which only rarely requires a visit to the doctor’s office. Technically speaking, gas can pass either by way of the mouth (belching) or by way of the anus (flatulence). Each is considered unacceptable in polite society. In some societies, the belching after a meal is deemed complimentary to the cook/host. As a result of incomplete digestion, gases are formed in the alimentary canal. Normally food is broken down into simple sugars, amino acids and fats in order to be absorbed and used by the body. However, complex sugars found in certain foods tend to resist this process and end up in the large intestine where they begin to ferment, forming carbon dioxide which works its way to the outside. While beans are notorious gas producers, eggs, cheese, cucumbers, onions, garlic, fish, dairy foods and coffee, as well as such high fiber foods as cabbage, whole wheat bread and broccoli are known to produce their ample share of gas. To avoid intestinal gas, chew food thoroughly, eat slowly and leisurely in a quiet atmosphere. Avoid washing solids down with a beverage. Don’t gulp liquids. Avoid drinking from small mouth bottles or through straws. Do not lie down or sit in a slumped position immediately after eating. Learn to enjoy yogurt and parsley. Never put a pin prick in your pouch to release gas; it will also release odor. Consult your friendly appliance dealer or ostomy nurse about venting pouches; see your friendly physician about oral deodorants. Don’t take bismuth sub carbonate against gas. If authorized by your doctor, Mylicontablets or Mylanta liquid can relieve excess gas.

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MOVING ON
Excerpted from a story by: Joe O’Brien, President of the Harrisburg, PA Ostomy Association
As ostomates, one of the most difficult things we face after surgery is moving on. We tend to question everything that we once did without too much thought, and we ask ourselves, “Will I ever be the same?” I have always tried to write an article that went along with a season or holiday theme, but this one will be a little different. The eleventh day of September, 2001, will be a day that none of us will ever forget. This great nation of ours was put in a place that we never thought possible. We found out that we are vulnerable, and that our hearts and spirits could be damaged. How long did this feeling last? Not too long! Almost immediately, we came together and proved that we truly are the greatest nation, and that we will indeed move on and become even stronger. Not only will we be stronger, but we will have a renewed respect for the men and women who serve and protect us each and every day. Over the last several weeks, we have learned that we have many things to be thankful for, and even more importantly, many people. The love, support, and caring that we all seem to be sharing now make us all proud to be Americans. We are once again united and are moving forward together. In no way would it be fair to make comparisons between the happenings of 9/11/01 and an ostomate, but it is great to witness our whole nation embracing a way of thinking that many of us have already learned….we must move on. Moving on not only helps us, but it shows others who may follow in similar footsteps that they too can go on. Do not underestimate the dramatic effect that you may have on a new ostomate and their family just by living a normal life. You may serve as the light at the end of their seemingly endless tunnel. You could possibly give them vision for the future—something to set their sights on. Wearing a smile on your face, or even tight blue jeans may give them hope as they are healing

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DO COFFEE AND TEA COUNT TOWARD THE EIGHT CUPS OF WATER I SHOULD DRINK EACH DAY?
Via: Northern Virginia & Regina Ostomy News
Caffeinated beverages let you retain only about 50 percent of the water in them. Milk, fruits, and vegetables are 90-99 percent water, and all count toward your daily water dose. The best way to know if you’re staying hydrated is to use your thirst as a guide. But during hot and humid summer days, the better indicator is urine color. If it is cloudy and yellow, drink more water. A clear and pale color indicates your body is getting the liquid it needs. Water also stimulates the production of saliva, which is your mouth’s first defense against plaque. It is important to drink even more water as you age, since saliva output decreases with age. Tip: Don’t pass up a water fountain without taking a drink!

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FACTORS WHICH INFLUENCE OSTOMY FUNCTION
Via: Metro Maryland
Quite often, patients experience a sudden reversal in normal ostomy function due to medications or treatments they are undergoing. The following information might be helpful to keep in mind. Antibiotics—These often cause diarrhea, even in patients without an ostomy. Ostomates are no exception, and if the problem becomes severe, notify your physician immediately. In the meantime, keep Gatorade or a like drink on hand to maintain adequate electrolyte balance. Pain Medications—These are often constipating. Extra irrigations or laxatives or stool softeners might be required for colostomates to combat the side effects of medicine. Perhaps the dosage of pain reliever can be reduced to eliminate the situation. If not, consider one of the above alternatives. Chemotherapy— Many cancer patients have follow-up chemotherapy after surgery or as an alternative to surgery. That often produces nausea and/or vomiting. Gatorade is again good to keep on hand for electrolyte balance. Radiation Therapy— This often produces the same effects as chemotherapy and should be treated accordingly. Travel— Travel can cause constipation in some patients and diarrhea in others. Be aware that these are possibilities. Altered diet when traveling accounts for some of this, plus the excitement of new surroundings. Allow sufficient time for irrigations and take along an anti-diarrhea medication. Check with your doctor if you are not familiar with what works best for you to control diarrhea. Antacids— Those with magnesium can cause diarrhea. Perhaps you will want to ask your doctor to suggest some with aluminum rather than magnesium. Drink plenty of liquids– Tea is always a good source of potassium (so are orange juice and bananas). Coca Cola also contains some potassium. Bouillon cubes are a good source of sodium. Remember that some of the signs of electrolyte imbalance are irritability, nausea and drowsiness. Be prepared and prevent this problem when possible.

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SOME ILEOSTOMY DON’TS
Via: Ostomy Spotlight, UOA Oshkosh, Wisconsin Chapter & Chambersburg Good News Helper
Don’t fast. Fasting can lead to serious electrolyte imbalances, even when adequate fluid intake is maintained. Don’t limit fluid intake. Ileostomates are always slightly dehydrated due to the constant outflow of fluids, so maintaining fluid intake at all times is a must. Be cautious about giving blood. A constant state of dehydration places enormous stress on the kidneys when blood is given. Serious damage can occur. Giving blood is not recommended practice for Ileostomates, but if you want to do it, consult your own doctor first. Don’t eliminate salt from your diet. Because salt is also lost with the fluid outflow, even those with high blood pressure should not eliminate salt altogether. Consult your doctor for your recommended mended salt intake when other physical problems are a consideration. Don’t put anything in your stoma. Don’t allow anything to be put in your stoma without your own doctor’s personal supervision. Doctors have sometimes incorrectly given routine orders in hospitals— for enemas, for example. Question any procedure that intrudes upon the stoma, including suppositories. Don’t take any medication unless you know it will dissolve quickly and be fully absorbed. Before filling new prescriptions, be sure to ask your pharmacist whether or not it will dissolve in the stomach quickly. Coated and time-release medications will not be absorbed and will pass through without benefit. If in doubt, purchase only six pills and try them before getting the rest of the prescription. Women should be especially alert when taking birth control or estrogen replacement medications. Don’t take any vitamin B-12 product for granted. Have your doctor check your B-12 level whenever you have a blood test taken. Some Ileostomates with short bowels may require B-12 injections when they do not absorb enough of the vitamin.

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ANTI-DIARRHEA AGENTS
Via: Coos Bay & Metro Maryland
If you are in need of an anti-diarrhea agent, you would do well to consider Imodium, rather than Lomotil. Not particularly new, Imodium has become more and more the drug of choice in reducing the volume of discharge in ileostomies and colostomies. Its great advantage over Lomotil is that it contains no atropine and anti-cholinergic. Atropine in large amounts has several serious side effects, including difficulty in urinating and dryness of the mouth and it can increase intraocular pressure in persons with closed angle-glaucoma. Lomotil requires a prescription.

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HELPFUL HINTS FROM HERE AND THERE
A bit of spearmint vinegar in a glass of water calms the stomach and digestive system. It also relieves gas and adds a tangy zest to iced tea. Trouble with itching under the tape or stomahesive? Mix 50% white vinegar and 50% water, apply gauze sponges and soak the skin for 5 to 10 minutes when changing your appliance. Be sure the skin is washed and rinsed well to remove the vinegar before applying the new appliance. A good rule to follow—if it is safe to put in your mouth, it is safe to put in your pouch. Try GREEN MINT MOUTHWASH as a pouch rinse. Use CERTS if nothing else is available. PEPTO-BISMOL is an effective deodorant. Take one tablet immediately after meals. Its effectiveness is lessened the longer you wait after a meal. Eat parsley to eliminate odors. You do not have to be a baby to discover the merits of Johnson and Johnson diaper liners. You may try them as a barrier between ostomy pouches and the skin. They come 60 to a box and cost under a dollar.

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