Evansville Ostomy Association
Re-Route

 
Contents:

NEW OSTOMATE CORNER
POTASSIUM, IMPORTANT MINERAL
ALL APPLIANCE WEARERS
FUNGAL RASHES
FOODS THAT INTERFERE WITH YOUR MEDICATION
ANTIHISTAMINES AND THE ELDERLY
UROLOGY CONCERNS
CURE FOR DIARRHEA
HELPFUL HINTS
GLOSSARY OF OSTOMY TERMS

Re-Route Archive

Volume 34, Number 8  May, 2007

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POTASSIUM, IMPORTANT MINERAL
Via: Metro Washington, Battle Creek, MI & Southern Maryland Counties Chapter
Eating foods like apricots, bananas, kidney beans, pears, potatoes, oranges, spinach, and tomatoes every day not only add flavor, fiber and fluid to your diet, they just might add up to a longer life. These foods are good sources of potassium, a mineral that has been linked to decreasing blood pressure and possibly decreasing the risk of stroke. According to a medical report cited by the Harvard Health Letter, people who ate a diet rich in potassium (8 servings of fruit and vegetables a day) were the least likely to suffer a stroke. In addition, those whose doctors prescribed a potassium supplement along with a diuretic to treat hypertension were at a significantly reduced risk for a stroke. If you are not taking a diuretic, you should not take a potassium supplement because you can get a toxic dose of this mineral. But if you do take a diuretic for hypertension (high blood pressure), that is potassium wasting Talk to your doctor about a prescription for potassium. Adding fruits and vegetables to your diet is always a safe way to increase your intake of vital nutrients that can help you protect your health. Avoiding a stroke is just one more reason to increase your intake of these power packed foods. (If you have kidney disease, check with your doctor before increasing your potassium intake).

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ALL APPLIANCE WEARERS
Via: Coos Bay OR Beacon & The Greater Orlando/Central FL, Picture Frame
Avoid letting your appliance get too full, either of waste or gas. Although one of our members says, he likes his pouch to “balloon up” because it makes him lighter on his feet, it’s not a good practice. Normally, you should empty your appliance when it becomes 1/3 to 1/2 full, and before trapped gas makes it feel firm. As the pouch becomes more full, it places a greater strain on the snap fastener holding the pouch onto the flange, for two-piece appliance wearers, and increases the tendency for the adhesive part of the appliance to pull away from the skin around the stoma with ALL appliances. If it is not convenient to empty a filling appliance, perhaps you can get somewhere you can discretely “pop” the seal, and at least release the gas pressure. This trick can buy you a little more time before emptying is necessary. Also, for ileostomates, if you know that you are going to be traveling or in a situation where easy access to a rest room is not available, adjust what you eat to avoid high-residue food. Instead of eating two bran muffins and a bowl of Raisin Bran for breakfast, consider pancakes, which have much less residue. Be aware of how fast your body responds to eating. If you know that you can expect lots of stoma activity about two hours after eating, time your meal so that you won’t have to deal with a pouch approaching capacity at an inopportune time. Similarly, urostomates may want to consider temporarily adjusting their rate of fluid intake for a short time. The caution here is that urostomates should consume plenty of fluids during the day. This technique is not advisable for periods of more than a couple of hours. Ostomates shouldn’t skip meals before going out socially. In general, the less an ostomate eats, the more gas he or she will produce, with its attendant problems. Actually, a quick elbow to the stoma will usually silence it if it becomes operative at the wrong time.

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FUNGAL RASHES
by: Lyn Kramer, RN, CETN, Via: The Pouch & Southern Maryland Counties Chapter
Fungal rashes are more prevalent in late spring and summer. This rash is the same as the one you can get on your feet, groin, or in any dark moist skin fold. This is the perfect place for this natural body organism to flourish—it is called a yeast infection. People who have high blood sugars or eat higher quantities of sweets than normal, those with diabetes or people who take prednisone type medications, are more prone to this rash. Persons with an ostomy who wear a plastic pouch on their side are also more prone to this. The plastic ostomy pouch, plus the contents of the pouch increase the body heat and perspiration in this area during the warmer months. The old adage of “an ounce of prevention is worth a pound of cure” comes to mind. If you know you fit into the above mentioned groups with these indications, then take action before you get the rash. Some simple things that you can do are:
* Make sure the barrier that sticks to your body is kept dry after showers and baths. You may use a hair dryer set to cool or dry this area very well with a towel.
* Use a micro-granulated, anti-fungal powder around the intact barrier area as well as under the pouch area. The area under the pouch may be applied daily. There are many over-the-counter brands available. The main active ingredients to look for are miconazole nitrate 2% or zinc oxide. These are not prescription items and are less expensive than Mycostatin powder that is often prescribed by a doctor for treating fungus.
* Use a pouch cover between you and your pouch. Some newer style pouches have an extra layer of material on the back that is called a pouch cover, but it is still made of plastic. You need a cloth or a very good quality absorbent towel cut to fit under the pouch area. You need to change the cover when it becomes moist or it can also grow the fungus.
* If you do develop a rash, do not use a cream on your skin area that is und area that is under your barrier. The barrier will stick to the cream and not your body, thereby falling off. You only need to use the miconazole nitrate powder on the infected area. If the manufacturer’s instructions on your barrier allows it, you may seal the powder in with a skin seal; i.e., Skin Prep, ALLKare, etc. You may need to change your pouch more frequently until the rash clears. It should clear in one or two changes.

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FOODS THAT INTERFERE WITH YOUR MEDICATION
By: Madelyn Fernstrom
While most of us read food labels closely, there's often little attention paid to the labels on prescription medications. Almost 70% of all adults regularly take medications. A recent study showed that nearly half of the patients studied misunderstood the labels - which can be a toxic mistake. Those package inserts, and little labels on the side - "do not crush", "take with plenty of water", "do not drink alcohol", "take with food", "avoid dairy products" - are not optional suggestions. These are all important in making sure that the medications - like foods - are properly broken down and absorbed by our bodies. So, taking a drug correctly requires three easy steps: (1) understanding your prescription; (2) knowing what foods or dietary supplements to avoid; and (3) asking for help from your doctor or pharmacist. Information starts at your doctor's office. Make sure you know the name of the medicine, the dosage, and what it's for (write it down, if you take more than one drug). At the pharmacy, check the bottle for medication name and dosage, to make sure it matches up. There are many "sound alike" medicines, with very different actions, so beware. Read the information pamphlet about the "how to's" of the medicine, and ask the pharmacist if you're confused. Terms like "take two tablets twice daily" can be interpreted differently - does it mean at 12 hour intervals? Breakfast and dinner? Take both tablets at once? Better to check then assume it doesn't matter. Pay attention to the terms "take with water" or "take with food". A 6-8 ounce glass of water is fine - no need to feel like you're floating away. And, "take with food" means a lot of different things to people. If you're taking it with a regularly scheduled meal, that's great, and a no-brainer. But what about other times? A good rule of thumb is about 100 calories - your choice, whether it's a piece of fruit, small bowl of cereal, or a few slices of lean turkey. If there's one thing you take away from this article it's the idea that MANY FOODS AND MEDICINE DO NOT MIX. Here's a list of some major medicines and foods that should not be combined. Check with your doctor or pharmacist for more specific information.
Avoid:
Grapefruit Juice — If you take some types of cholesterol lowering drugs, heart medications, immune system drugs, and allergy medicines, grapefruit juice interferes with the metabolism of these drugs (not all citrus does this, and orange juice can be substituted).
Dark Green Vegetables — Vitamin K rich foods like broccoli, spinach, asparagus and red leaf lettuce interfere with the blood thinning medicines like coumadin (Warfarin). Coumadin prevent blood clotting, while Vitamin K promotes blood clotting - counteracting the effect.
Dairy Products — If you take iron supplements or certain antibiotics, the calcium in dairy products can block some of the absorption of these compounds, giving less active ingredient of the medicine.
Alcohol — If you take medicines affecting the brain, including antidepressants, sleeping pills, sedatives, antihistamines, and some antibiotics, you should cut out alcohol.
Caffeine — If you take asthma medicines or anti-anxiety drugs, avoid caffeine.
Red Wine and Hard Cheese — If you take certain antidepressants, red wine and hard cheese contain a compound called "tyramine" that increase the effect of the medicine.
High Fiber Foods — If you take penicillin or some other antibiotics, fiber slows the rate of stomach emptying, and slows the release of the medicine into your system.
And don't forget to check for interactions with dietary supplements. While not FDA-approved, many have biological activity, and can interfere with the action of many medications. One last thing, check for the expiration date - and toss the bottle if it's out of date. Some medicines can lose potency over time. And avoid storing your bottles in a steamy bathroom - like we all do! A kitchen counter or drawer is a better place to avoid big changes in temperature and humidity that occur regularly in your bathroom cabinets. When it comes to taking medicine, take control, and be an informed consumer. Your health is worth it.

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ANTIHISTAMINES AND THE ELDERLY
Source: AARP Bulletin
At one time or another nearly everyone has taken diphenhydramine, an antihistamine that can have a sedating effect on the central nervous system. Millions of people take it for dust, pollen and other allergies; others for nausea, vomiting or vertigo; some for Parkinson’s disease. And untold millions use it as a sleep aid. Best known under the brand name Benadryl, it’s also in myriad other over-the-counter medications, including Excedrin PM, Nytol, Sleep-Eze, Sominex, Tylenol PM and Unisom, to name just a handful. For people age 60 and older, however, diphenhydramine is mostly bad news because its adverse effects are amplified A study published in 2001 in the Archives of Internal Medicine found that a group of hospitalized patients 70 and older who were given the drug “had significantly increased risk of altered attention level, disorganized speech, change in consciousness and alertness, and behavioral disturbances,” according to the study’s lead author, Joseph V. Agostini, a professor at the Yale University School of Medicine. In the worst cases, diphendydramine can cause delirium and even hallucinations. What’s more, it often causes urinary retention, which can lead to urinary tract infections. “It really can have profound effects in older people,” says Agostini. “When you weigh risk-benefit overall, you may experience more harm than good, and that’s never the end result that you want.” But, millions of older Americans use forms of diphenhydramine with no knowledge of the medical problems it can cause. And bad advice abounds: A popular website on arthritis, for example, calls the medication “particularly useful in the elderly patient.” Agostini’s assessment of the drug as a sleep medication for an older person is blunt: “This is a horrible choice—I almost can’t think of anything worse.”

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UROLOGY CONCERNS
Via: The Rosebud, & G.B News Review & S. Brevard, FL.
Germs are all over the world, but when they are in the urinary tract, either in the conduit, the ureters, or the kidneys, they are in an abnormal location, and that is what causes an infection. What causes infection? Mostly, the reasons are unexplainable. Why do some people get more colds than others? Infections can be caused by obstructions, kidney stones, tumors, cysts, or scar tissues. Almost synonymous with obstruction is infection, and then too often comes stone formation. Once you have stone formation, it’s hard to get rid of the infection. It’s a kind of a cycle that goes around and around. Infection can be caused by urine being forced back to the kidneys through the conduit. This could happen if you fall asleep with the appliance full of urine and accidentally roll over on the pouch, causing urine to be forced back through the stoma and the urinary tract with tremendous pressure. Invariably, the urine in the appliance is contaminated. In general, to prevent and treat the infection, you need a good flow of urine, much like a stream. That not only dilutes the bacteria or germs in the urine but also helps wash them out. Two and one-half quarts of liquids daily are required for the average adult. Night drainage is a MUST. Otherwise, you run the risk of urine backing up into the kidneys which can cause irritation or infection. This is especially important for urostomates with only one kidney. It’s important to be aware of the symptoms of a kidney infection: elevated temperature, chills, low back pain, cloudy urine, or decreased urine output. People with ileal conduits normally produce mucus threads in their urine which give a cloudy appearance, but bloody urine is a danger sign. You must see your doctor if any of these symptoms occur.

CURE FOR DIARRHEA
Via: Sherman Area, Ostoline, TX.
The protein and starch in chicken and rice soup can markedly increase the body’s ability to absorb water, making it an excellent cure for diarrhea. A team of doctors working in Bangladesh, documenting and testing home remedies used for generations to treat diarrheic illnesses, reported the benefits of protein and starch. Doctors have known that sugar increases the body’s ability to absorb salt and water during digest digestion, but did not realize that starches and grains can do the same, early in the digestive process. In the U. S., doctors usually hospitalize dehydrated patients and feed them intravenously, an effective but expensive therapy. In addition, intravenous feeding carries the potential for bloodstream infection. Getting an IV can be frightening to a child. Diarrhea illness can be fatal, especially in small children in impoverished countries, because they rob the body of water.
  

HELPFUL HINTS
From Everywhere
Scraps and cut-outs from barriers are great to relieve pressure of blisters or corns on one’s feet. Keep them in a small jar with a tight lid and the paper backing left on until you are ready to use them. If you still have your rectum and have pain or a full feeling, you may have a collection of mucous which should be washed out. Check with your doctor regarding this. Bring your problems and questions to chapter meetings; don’t be afraid or embarrassed to ask questions. If you are beginning new medication—for any reason – keep a close eye on your stoma discharge. Contact your doctor if you suspect the medicine is going in and straight out. Discard expired medications to prevent any potential adverse affects. Aspirin can be toxic to the kidneys just two or three months after expiration. The same is true for tetracycline Many drugs just lose their effectiveness. Lack of bulk in a colostomate’s diet can be part of the difficulty in elimination. This may be caused by eating to much highly refined food and not enough bulk, like bran. Laughing is healthy for your body as well as your mind. When you laugh, you exercise your heart, lungs and adrenal glands. You also breath more deeply, increasing the body’s oxygen flow. Laughter may ease physical pain by triggering production of endorphins—natures pain killers. Your attitude about your image will affect the attitude of your family, friends and the people around you. Be happy...you’ve been given a new life. Ileostomates should not sit in one position for a lengthy period of time This may force pouch contents upward around the stoma and cause possible leakage. Stand up frequently. Sharks do get cancer; therefore, shark cartilage pills offer no protection against cancer. If your pouch doesn’t stick well, are you applying it right after showering in a high-humidity bathroom? Skin must be perfectly dry to receive and hold the appliance. Also oily products such as vitamin E and Dove Soap, can cause the wafer to loosen and fall off.