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

 
Contents:

YOUR SPECIAL GIFT: EMPATHY
UROSTOMY TYPING
CONVEXITY
STOMAL SHAPES AND LEAKAGES
OSTOMATES: THEN AND NOW
QUESTIONS AND ANSWERS
OSTO-TIPS
CARTOONSVILLE

Re-Route Archive

Volume 27, Number 2  November, 1999

YOUR SPECIAL GIFT: EMPATHY
By: K. Jeter, Ed.D., ET Oakland, Via: The Ostomatic News, Dallas, TX  
Empathy differs from sympathy. We in the medical, nursing and healing professions can offer sympathy for a patient’s disease or defect and the need for an ostomy. The offering of empathy, though, can be done only by ostomates; only they have the unique understanding derived from experiencing a similar situation. Without even a word, the sight of a vigorous individual with an inconspicuous ostomy is testimony to acceptability of a stoma. Beyond the reassuring appearance comes the shared concerns and triumphs, solutions to problems, answers to questions. This exchange facilitates the rehabilitation of new ostomates and is a source of enormous pleasure to those who are reaching out to a fellow human being.

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UROSTOMY TYPING
By: Victor Alterescu Via: News Pouch, Carrell, Iowa  
Urostomy is the general word for any type of urinary ostomy. There are, however, several types of urostomies. Some people have Ileal conduits. In those cases, a piece of ileum (the third portion of the small intestine) is removed from the intestinal tract and the two ureters (tubes that carry urine from the kidneys to the bladder) are attached to the portion of the ileum. One end of the ileum is stitched closed and the other end is brought out into the abdomen as a stoma. Very often, people who have ileal conduits think that they have an “ileostomy” because health-care personnel often incorrectly call this surgery an ileostomy. Remember that if the urine is coming through your stoma, you do not have an ileostomy. Sometimes the ileum is not used, and instead, a piece of the large intestine is used, usually from the sigmoid colon. In this case, the surgery is called a colon conduit. Urostomies are formed for many reasons. In adults, the surgery is most often done to remove a cancerous bladder. For people with spinal cord problems, a urostomy of one sort or another may save someone from irreparable kidney damage. Sometimes after urostomy surgery, a bladder may be left in place, but if the bladder is diseased, it is usually removed. Drinking fluids is essential for urostomates. Kidneys are happy when they have lots of work to do. Show me someone who does not produce much urine and I’ll show you two unhappy kidneys! Drinking water may be the single most important thing that a person with a urostomy can do. Urostomies are the most complex of the three major types of ostomies. They can be found in all age groups. They are performed for more varied reasons than the other two categories, and they can present incredibly complex problems, but when they work right, they are winners! Remember, an ostomy is a cure, not a disease!

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CONVEXITY
By: Loree Siebert, RN, ET .Via: Greensburg Chapter & Johnstown, PA  
What is convexity? Who needs it? Unfortunately, many of us have less than a perfect stoma (for many reasons.) The less perfect the stoma, the more difficult it is to obtain a good pouch seal. Convexity is the adaptation of a barrier or faceplate, so that it protrudes (the stoma), thereby pressing into the skin around the stoma. The use of convexity is indicated when one is unable to maintain a pouch seal for an acceptable length of time or when persistent skin irritation occurs even without leakage. Stomas that are flush (level with the skin) or peristomal skin with irregular contours, frequently result in the stomal discharge undermining the barrier. A pouching system that incorporates convexity may help to eliminate the undermining and improve pouch adherence. Naturally there are always those individuals who have their own unique problems and need the help and guidance of your ET nurse. It was not too long ago that people with problem stomas requiring convexity were forced to use reusable faceplates and pouches. Now, there are several ways of achieving convexity from the addition of an insert into a two-piece system, to the use of a pouch with built in convexity, (to a flange with built in convexity). Numerous manufacturers of disposable products have built convexity into the barrier. Several companies even offer varying depth of convexity—shallow, medium or deep. If your stoma is less than perfect.

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STOMAL SHAPES AND LEAKAGES
Via: IA Ostomy News & Dallas TX Chapter  
Are you aware that stomas sometimes change shape? This can happen when you change from a standing to a sitting position. Mirrors are handy gadgets – take a look! The stoma that is nearly round when you are lying down or standing, may be oval when you sit down. This may be a source of a leaking problem and merits some thought. Remember, the stoma is a portion of the intestines brought to the surface of the abdomen. The healthy red color of the stoma means there is a good blood supply. The natural lubricant of the intestines is mucous. No adhesive will stick to the stoma because of the mucousal lining. Therefore, any part of the faceplate that comes in contact with the mucous on the stoma automatically will refuse to stick. Thus, the seal around the stoma does not change even though the stoma shape changes. This means that if the stoma is oval in the sitting position, perhaps the opening on the faceplate should be oval. This particularly applies to people who are sedentary most of the day. This is not an absolute rule, but a consideration if you find a leakage problem. Note, most ostomates get a better pouch seal by applying their pouch in a standing position.

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OSTOMATES: THEN AND NOW
Via: Lifesaver & The Spacecoast Shuttle Blast  
In the first six months after your surgery, you spent 53% of your time in the bathroom checking the fit of your appliance, and often wore out the adhesive testing to be sure it was tight. Thereafter: You slap your pouch on and forget about it. In the first six months you were terribly embarrassed when your stoma gurgled. Thereafter: You gurgle right back. After the second year, you might try for two part harmony. In the first six months, for a weekend trip you filled a medium sized suitcase with slightly less stock of supplies than your supplier . Thereafter: You just tuck a couple of pouches in your handbag or back pocket and take off. Funny how time puts us in the correct perspective

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QUESTIONS AND ANSWERS
Via: Northwest Arkansas Mail Pouch  
What’s involved in stoma inspection? At each pouch change, check your stoma for color, shape and function. Watch for any stoma problems such as swelling, retraction, stenosis or prolapse. Urostomates should be on the alert for crystal formation or alkaline encrustation (gritty white deposits coating the stoma). Any stoma complication should be reported to your doctor or ET

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OSTO TIPS
From everywhere  
When returning to the hospital for any reason, take along your own ostomy equipment. All hospitals do not stock all brands of supplies. The staff may not have your particular brand available or they may not know how to use your brand. The stoma should have the same color all over. If you have a lot of color changes, have your stoma examined by your medical professional. Pouches should be emptied when 1/3 to 1/2 full. If a pouch is allowed to become too full, the weight of the effluent can break the seal and cause leakage. Never use a commercial hair remover on the skin under your barrier. Commercial hair removers will greatly irritate the skin. Once paper tape is in place, it can be made more waterproof by spreading any liquid barrier over it. Gently stretch the skin to remove wrinkles even if you are standing. Avoid vacuum lock by keeping a little air in your pouch. This action will avoid pouch-stoma adhesion. A camera bag, a diaper bag, or an insulated six-pack bag is excellent for carrying appliances and equipment needed when traveling. The insulated carrier is especially good as it keeps everything from getting too hot in the car. Try spraying the bathroom before you empty your pouch or irrigate. It is more effective against odors to spray first than to spray after you have emptied. Inflate a disposable pouch like a balloon before using, to test for defects.

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