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Volume 30, Number 8 May, 2003
MORE ON THE GRAPE
Ex-
Via: Solano County Chapter & Green Bay News Review
If you don’t drink alcohol, or prefer white wine over red, can you reap the same heart-protecting benefits of red wine by drinking purple grape juice instead? Maybe so!!
Both red wine and purple grape juice are rich in flavenoids — substances found in many fruits, vegetables and nuts that have been linked to a lower risk for heart problems. Flavenoids help relax blood vessels and prevent damage from LDL (bad) cholesterol. That may be why red wine seems to have an edge over other alcoholic drinks when it comes to helping the heart. Still, drinking any type of alcohol in moderation ( 2 drinks daily for men, one for women) may lower the risk of dying from heart disease.
For the study, 15 adults with coronary heart disease drank purple grape juice twice a day for two weeks. The amounts were based on how much they weighed—a 180 lb. Man would have drunk nearly three cups a day, for example. Most had high cholesterol and were taking lipid-lowering drugs and/or vitamins E and C as part of their treatment for heart disease during the study.
At the end of the study, participants arteries had relaxed slightly as shown by an ultrasound of an artery in each participant’s right arm. Their LDL cholesterol was also less prone to oxidation (the process that damages blood vessels) than at the start of the study. This study didn’t directly compare the effects of purple grape juice with red wine, but earlier studies have suggested the alcohol in wine helps boost the absorption of flavenoids. If you don’t care for red wine, purple grape juice might be a good alternative. Bear in mind that three cups of either grape juice or red wine contain between 450 to 500 calories—too many for most weight-conscious people. And, as we’ve said before, tee-totalers needn’t take up drinking as a hedge against heart disease.
TWICE BURNED
Men’s Health, June 2002, Via: Space Coast Shuttle Blast
The relief you get from treating heartburn may come at a price. According to a new study, taking too many heartburn medications can increase your risk of developing an ulcer.
Researchers at the Howard Hughs Medical Institute in Michigan found that a class of prescription heartburn medications called proton pump inhibitors (including
Nexium and Prevacid) are actually too good at stopping the production of stomach acid. Without that acid, harmful bacteria grow out of control, colonizing the lining of your stomach and eventually creating an ulcer. To protect yourself, researchers suggest taking a few days off from your regular medication every 10 days to 2 weeks. “This will allow some acid back into your stomach to keep bacteria levels under control”, says Juanita Merchant, M.D., the author of the study.
THE CHALLENGE OF POUCHING IN DIFFICULT SITUATIONS
By: Liz O’Connor, RNET, Metro Maryland OA & Holy Cross
Hospital, Via: Greater Orlando & Central Florida Chapters
“What can I do to pouch a difficult stoma or to work with creases?” These are questions frequently asked of the ostomy association. Most likely, you need an evaluation by your ET Nurse. Here are some helpful hints that might solve your problem. If not, seek professional assistance.
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 loose 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 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. Remember, it is like painting woodwork.
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 flexible flange will only take one of them.) The discs are reusable. Clean them and save.
What if I have gained or lost weight and the stoma is now in a crease? You might want to try a more flexible pouch, rather than a stiff one. There are many brands available. All of the major manufacturers now have them. Your surgical supply dealer probably has them and you might want to try a few. Some even have a skin barrier attached to the pouch.
What if I am allergic to a certain pouch? Sometimes allergies develop even after patients have used a product for a long time. If this occurs, try another brand, at least temporarily. Give the skin a break. Then you could patch test your old product on a spot other than the peristomal skin to see if you are still sensitive. Just tape a little piece of the pouch backing or skin barrier to a spot and see how it reacts.
Many patients develop rashes just under adhesive tape. There again, try another tape. There are hypo-allergenic tapes that let the skin breathe.
Good luck and remember, if these solutions aren’t the right ones for you, contact your ET.
DON’T GIVE UP THE THINGS YOU LIKE TO DO
Via: The Right Connection & Indianapolis, IN Chapter
Ostomates don’t have to give up things: It’s just that we may not be able to do them to the same extent and with the same vigor. Avoid stress, just driving to a meeting can be stressful. Get adequate sleep, and don’t overeat. If you sleep 14 hours a day, something is bothering you and you are using the bed as a withdrawal from life. Even overeating is a withdrawal mechanism, and it causes the heart to work much harder.
When did you last read a good book or visit a museum? Keep alert, because that keeps your intellect functioning. If you believe you are something, you will become it.
Find somewhere to go every day that you consider a job. Don’t worry about memory lapses; no one has a perfect memory. Don’t get upset over little annoyances. Tell yourself that you are going to have a good day. Tell yourself at night, “it has been a good day.” Give yourself pep talks.
We love and hate each other at the same time…. Love someone as a human being but hate his behavior. Be honest. Get your hostility out. Don’t be angry with yourself. Do things for others. Have contact with others. Our bodies are only a conveyance for our minds. No one is more beautiful than each of us in our own right. Keep active and don’t withdraw— so watch out when you stop going to parties. There is no idealistic setting except as you make it for yourself. Stress and tension can lead to acidic indigestion. A happy mind should produce a happy stomach.
SO YOU HAVE A COLOSTOMY
Via: Indian River, Florida Ostomy Association
Veteran colostomates usually know the difference between different colostomies, but what about the new colostomate? All this person knows pre-operatively 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.
EMOTIONAL ISSUES OF OSTOMY SURGERY
By: Julie Maloy, R.N. CETN, Via: Los Angeles Ostomy News & Hamilton, Fairfield, Ohio
Ostomy surgery causes a threat to one’s self esteem and causes a readjustment of one’s body image. Self esteem is based on how each person accepts and values himself or herself. Fears have a negative effect on self esteem. Some of the common fears that one who has had an ostomy may experience first after surgery are fear of rejection, leakage, odor embarrassment and a decrease in feelings of personal attractiveness. Not only can these fears lower one’s self esteem, but also, they can create a barrier in an intimate relationship. Successfully fitting, changing and caring for an appliance independently, along with honest, open communication, are the steps necessary for restoring one’s self esteem and returning to the previously held roles in a relationship.
There are several phases in rehabilitation from ostomy surgery. The meaning the diagnosis has to each person can cause an emotional impact, as well as the adapting and adjusting to an ostomy. In the first few weeks after surgery, energy is exerted toward recovery and toward the task of mastering ostomy care. Independence, when possible, has a positive effect on self esteem.
The need to wear a pouch may cause anxiety. To minimize appliance anxiety, a pouch that is unobtrusive, odor proof and secure, is essential. Develop a routine of changing the appliance before a leak occurs. Check the appliance regularly for signs of wearing or undermining, such as staining under
the tape or discoloration from the stoma to the edge of the pouch. Keep the tail of the pouch clean. Individual moist towelettes carried in a pocket or purse are handy to clean the pouch tail after emptying.
As one masters the task of stoma care, it is not unusual to discover that there is a hypersensitivity to the reaction of others. Any behavior or reactions that are interpreted as negative can have an effect on interpersonal relationships, self esteem, self confidence and the physical competence of the person. The person with an ostomy who can be independent yet allows the spouse to stay in a caregiver role is fostering an invalid image and not promoting the return of the previous sexual relationship.
Good personal hygiene will help decrease anxiety and promote confidence, particularly during intimate times. Pouch covers that are plain, lace or in pastels or prints are available for those who would like to cover the appliance. Taping the body of the appliance in place will help prevent pouch movement during sexual activity. A common fear of the spouse is one of hurting the partner or the stoma.
Reassurance will dispel fears. Experiment with positions that will not rub or irritate the stoma. During recovery from ostomy surgery, holding, touching, caressing and kissing are all important methods of expressing affection that should not be forgotten.
The readjustment period continues for several months after surgery as each person reestablishes a suitable lifestyle. The supportive network of friends, family and health care team is important; however, the overall adjustment is ultimately the responsibility of each person. Patience is necessary with oneself as the process unfolds; however, if a particular hurdle seems very large, seek help to put things in the proper perspective.
HELPFUL HINTS & TIPS
Use a small amount of soap or vegetable oil in your pouch to make things slide down easier.
Use a squirt bottle with a small amount of soap and cool water to rinse pouch from bottom.
Do not use warm water to rinse a pouch as it may make the plastic more permeable to odors.
Be careful not to rinse water up to the level of the stoma as it may cause the adhesive to loosen from the inside.
When using paste around the stoma, apply to pouch rather than skin and allow to dry for one minute before touching, so it will not stick to your finger.
Change your pouch before a bath or shower or wait several hours after changing before getting wet, to prevent adhesive from loosening before it is set.
After changing your pouch, allow 15 minutes to lie down for the adhesive to set before starting to bend. It will increase the adherence if you have any creases in the peristomal skin.
Hold your hand over the stoma after changing pouch so your body heat from your hand will help melt the adhesive into your skin and the seal will hold better.
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