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Volume 29, Number 2 November, 2001
FINDING RELIABLE MEDICAL INFORMATION ON THE WEB
By: Timothy McCall, MD from Bottom Line Health Via: The Ostomatic News, Dallas,TX.
The Internet has become one of the best ways to research medical conditions. More than 98 million Americans regularly do just that—twice as many as two years ago, according to a recent survey. But two fundamental problems confront Web
Surfers. Where do you find the best information? And who is trustworthy?
Although some Web sites dispense sound medical advice, many spread misinformation—some of it potentially dangerous.
Luckily, you can maximize your chance of locating the facts you need, while minimizing the risk of getting bad information. Here’s what I suggest:
Look for sites run by reputable medical organizations and federal agencies. Typically, experts review the articles for accuracy and the sites list the dates on which the articles were posted or updated.
As a starting point for general medical research, try the federally sponsored site,
Health Finder, which links to dozens of other government agency sites.
CBS Healthwatch, is an excellent
commercial health site.
For specific medical topics, try these:
Alzheimer’s, Alzheimer’s Association,
Arthritis, Arthritis Foundation.
Cancer, Cancer Research
Foundation of America.
Diabetes, American Diabetes Association.
Heart Disease, American Heart Association.
Alternative medicine, National Center for Complementary and Alternative Medicine.
Learn how to perform medical searches. To answer specific medical
questions, consider using a search engine, such as
Yahoo, Google or
AltaVista. There are also search engines
Health A to Z, which are specially designed for people seeking health information. To search the top medical journals, use
the National Library of Medicine. Critically evaluate any
Web site you visit. Ask yourself: Who’s running this site? What’s their
motivation in providing this information? Are they trying to sell something? Do
their claims sound too good to be true? Don’t be overly influenced by a Web
page’s appearance. A questionable site may have slick graphics while a reliable
site may be plain-jane.
Guard your privacy. Any personal data you volunteer could be sold to marketers, compiled in databases or intercepted and traced back to you. Since details about your health could affect your job or your ability to get insurance, it’s a good idea to provide as little information as possible.
Read the privacy policies on Web sites you visit. If you still have doubts about what might be done with any information the site requests, don’t hesitate to use a pseudonym, a phony address, age or other information.
Check with your doctor before acting. If you find potentially useful data or anything that addresses your treatment, print it out and take it with you next appointment—or mail it to him/her ahead of time. Be reasonable, though, you can’t expect a busy doctor to wade through a 50-page printout.
TEMPORARY OSTOMIES
by Nancy Brede, RN, ET, via Big Sky Informer, Great Falls, MT, via Ostomy Toronto
Temporary ostomies are surgically created with the intent of reconnecting in the future. The anatomy of the gastrointestinal system or urinary system is left intact. Permanent ostomies are created with the intent that the ostomy surgery will not be reversed: usually the anatomy in the gastrointestinal or urinary system has been removed. Permanent ostomy surgery is usually performed when disease or injury prevents maintaining the anatomical structures needed for reversal. A large number of temporary ostomies involving the colon are done on an emergency basis. The colon becomes obstructed or blocked, and stool cannot pass-through. Because of the emergency nature of the surgery, the bowel cannot be cleaned and prepped ahead of time. Reversal, or re-anastomosis (hooking the normal anatomy back up), then can be done later, when infection is not as likely, and proper healing can take place.
The most common situations and diseases requiring a temporary ostomy are:
Cancer of the colon with obstruction (or other abdominal cancer affecting the colon)
Hirschsprung's Disease, a disorder/malfunction in infants which prevents passage of stool. Due to lack of nerve cells in certain areas of the large intestine, stool is not moved through, and an ostomy is necessary.
Diverticulitis. Small out pouchings in the wall of the intestine, called diverticula, become infected. The diverticula may rupture or cause obstruction,
Inflammatory Bowel Disease or Crohn's Disease may necessitate a temporary ostomy to allow the diseased bowel to heal.
Persons with temporary ostomies face many of the same problems permanent ostomates have. It is just as important for them to have support, reassurance, and teaching as it is for persons with permanent ostomies. They must learn proper skin care, stoma care, and pouching techniques. Often, stomas are not ideally situated on the abdomen, because of the urgency of the surgery. Thus, pouching and skin care can pose difficult problems.
Following temporary surgery, measures need to be taken to improve the person's health. He or she must be in the best condition physically to undergo the major surgery for reconnection.
There is also a time for the person to psychologically deal with past surgery, upcoming surgery, and possibly a newly diagnosed disease. It may be a difficult time with all the
changes and new challenges. Often, there are many fears and unanswered questions. Other people with ostomies and ET nurses may provide reassurance and the answers to many questions.
RUMBLES & GRUMBLES
Via: Greater Cincinnati & Hamilton, Ohio Chapters
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 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 surgeries. 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 bowel obstruction, an ulcer, or gallbladder problems. See your doctor. Usually, however, it is all sound and no 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 often are consumed 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 often are lactose (a sugar in 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 moves along the digestive tract.
HOW DOES FIBER AFFECT THE ILEOSTOMATE
Via: GB News Review & Loraine County Chapter
Whether or not to include fiber, and to what extent, should be based on the ileostomates tolerance of foods. The intestine has a remarkable capacity to adapt. Digested food in the small intestine is quite watery, and after it moves into the large intestine, a good portion of the water is reabsorbed into the body.
Most fiber is indigestible material (from plants) that acts like a sponge, soaking up water and increasing the bulk of the intestinal contents-making matter move through the system more quickly. In a person with a colon, fiber is essential in preventing constipation and keeps a person “regular”. This is the main function of fiber. Another theory about fiber is that it promotes mucosal growth, thus keeping the intestines healthier, promoting gut function.
Usually, a person without a colon (ileostomate) doesn’t have a problem with constipation and may have mostly watery stools or diarrhea. Again, over time, a person may adapt, especially if the last section of the small bowel (ileum) is still intact. So, consuming
too much fiber, or too much “insoluble” fiber, may aggravate a person’s diarrhea or watery stools. If this is the case, limiting insoluble fiber such as bran, popcorn hulls, seeds, nuts, skin/seeds, stringy parts of fruits and vegetables may be helpful.
However, another type of fiber (soluble) may be beneficial to the ileostomate. The function of soluble fiber is to make intestinal contents “thicker” and can actually prevent diarrhea. This fiber is found in oatmeal, barley, dried beans, peas, Metamucil and the pulp of fruits and
vegetables. Most foods have a combination of both types of fiber, but the above examples show the difference.
OSTOMY TIPS
Polident and Efferdent are very effective for soaking your appliance. They deodorize, remove stains and clean.
Scotchgard sprayed on your elastic belt will keep it clean longer and make it hold its shape better.
When draining your pouch, put the clip underneath your watchband to keep from misplacing it.
Pull skin tight before applying tape or adhesive. If you don’t, it can cause skin irritation because skin stretches but the tape doesn’t.
PREVENTING SKIN IRRITATION
Via:
Metro Maryland & So. Nv. Town Karaya
You do not have to put up with irritated skin. A properly fitting pouching system changed as needed will prevent skin irritation in most instances.
Irritation right around the stoma can be a sign of poor adhesion which permits leakage of body waste. Your skin barrier should be changed as soon as it starts to leak. The time you can wear it comfortably will vary depending on your activities. You may need to change it more frequently when you exercise strenuously or when the weather is hot and you are perspiring.
Itching, redness, or rash may be caused by constantly pulling the adhesive away from the skin. It may also indicate that you are allergic to the adhesive. Report any such reaction to the doctor, nurse, or ET nurse immediately.
There are several types of skin barriers available. You should be able to use at least one of these with no problem.
HELPFUL HINTS FROM HERE AND THERE
Write down the name of the ostomy supplier and the number and size of all your equipment. This information should be kept in a safe place for easy reference. When planning a trip, be sure to include the information in your ostomy emergency kit.
Some people find that a large teaspoonful of bulk gelatin dissolved in water or lemon juice once a day will firm up a loose stool.
Butternut will soothe an irritated digestive tract and will not cause diarrhea or constipation.
The application of a couple of capsules of vitamin E oil broken down and rubbed on sore and irritated skin around the stoma promotes overnight healing.
Drinking tomato juice will help eliminate odor and is a tool to retard dehydration and keep the electrolytes in balance.
Excessively oily skin can affect adhesion of your wafer. Wiping the skin around the stoma with alcohol is helpful, but be careful the alcohol does not contain glycerin, as this kind of alcohol will hinder adhesion.
If you are taking chemotherapy and your mouth is sore, gargle with one teaspoonful of baking soda in a half glass of water.
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