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Volume 35, Number 2 November, 2007
HINTS FOR NEW UROSTOMY
PATIENTS
Via: Ostomy Association of Long Island
Train yourself to shut the pouch valve as soon as you have emptied the
pouch! If you forget, the resulting disaster within the next 10 minutes could
ruin your day. Be sure to take the plastic washbasin and clean measuring
container home from the hospital. They are very helpful as you establish a daily
routine of washing your nighttime equipment. Gallon bottles of white vinegar and
cheap liquid detergent make the daily washing-up an inexpensive chore. If you
change the pouch first thing in the morning, there is less chance of the stoma
misbehaving as you do the change. Irrigate the pouch daily with a solution of
4/5 water and 1/5 vinegar. The hospital plastic washbasin is an ideal container
for supplies when traveling and can be used to hold the night drainage bag. In
the morning, it is handy for washing-up wherever you are. It fits nicely into
most carry-on bags and is not heavy. In most cases, urostomy patients enjoy a
completely normal diet. Cranberry juice, yogurt, or buttermilk will help combat
urinary odors. Asparagus should be avoided by urostomates as it produces a
strong odor in urine.
POWDER YOUR STOMA?
By: Schwankweiler, RNET
Powder is normally not required during the routine servicing of a stoma. As
a matter of fact, most modern disposable barriers are designed to adhere to the
skin by themselves. Powder is used to treat irritated skin or a fungal
infection. Yeast (fungal) infections are very common, especially during summer
or when one perspires during regular exercise. Micro granulated anti-fungal
powder is used only when there are signs of a yeast infection, i.e. an itchy
rash and raised red bumps. Use the powder until the infection clears, then
discontinue. Pectin-based powders, like Hollihesive, or Stomahesive, or Karaya
type powders, are used to treat irritated skin. To apply any kind of powder,
clean the peristomal skin well with plain water and then dry. The skin should be
completely dry before applying the powder. Dust the skin with the powder, gently
rub it around and then brush off the excess. The barrier can be applied directly
over the powder. You may also seal in the powder by applying a skin sealant over
the powder and allowing it to dry. Be careful: skin sealants retard the adhesion
of the extended wear barriers and are not recommended! The barrier is applied
over the sealant covering the powder.
WHY
ARE SOME PATIENTS TOLD TO IRRIGATE THEIR COLOSTOMIES?
Via: Augusta Area, OA, Stillwater—Ponca City OK, & Worcester
MA.
Bowel control after colostomy depends in part on the nature of the person.
Patients with right-sided colostomies do not have as much remaining colon as
those with a left-sided colostomy. Because of this, there is usually too little
colon to absorb enough water to make a solid stool. This type cannot be
controlled by irrigation, but instead behaves very much like an ileostomy with a
fairly continuous discharge. The sigmoid, or left-sided colostomy, is often
described as a dry colostomy because it discharges formed stool. One has the
choice of attempting to manage this type either by trained control or irrigation
control. Only one-third of the people who attempt to train themselves to control
their colostomy without irrigation are successful in doing so. This type of
training relies very heavily on diet and medications to achieve regularity. Most
physicians in the country feel that control is more easily and satisfactorily
achieved by irrigation. However, there are some patients who cannot achieve
irrigating control because they have “irritable bowel”. This problem has nothing
to do with the colostomy. It’s just part of some people’s makeup. Some people,
even before they had their colostomy, may have had irregular bowel habits. They
may retain these habits after their colostomy is performed so that regular
irrigation does not assure them regularity. When this condition exists,
physicians will sometimes suggest the patient dispense with irrigation since it
will not produce the desired regular pattern and the person may become
frustrated trying to achieve this.
ARTHRITIS AND THE INTESTINES
Via: Northern VA.
Arthritis is the most common non-intestinal condition associated with Crohn’s
Disease and Ulcerative Colitis. Although most people with these diseases do not
develop arthritis, three primary kinds may develop, namely:
1) rheumatoid-like arthritis,
2) ankylosing spondylitis and
3) large joint arthritis.
The first form of arthritis mimics rheumatoid arthritis in many ways. It usually
involves the wrists and fingers and may improve or worsen without regard to the
course of the bowel disease. Sometimes people with this form of arthritis have
an antibody in the blood called
rheumatoid factor which is found in persons who have rheumatoid
arthritis. Not all people with the rheumatoid-like arthritis have this antibody,
however.
Ankylosing Spondylitis is a condition that involves the lower part
of the spine and adjacent joints. In addition to pain, it may cause stiffening
of the spine, hips, neck, jaw and rib cage. Its course is independent of the
course of the underlying bowel disease. As time goes on, the condition may get
better or worsen and on occasion, it may develop even after the bowel disease
has been removed or has improved. The disease usually commences before age 30.
Large Joint Arthritis usually affects the knees, ankles, hips and
occasionally the elbows and shoulders, The small joints of the hands and feet
and the spine are not usually involved. Unlike other kinds of arthritis, this
form often worsens as the bowel disease worsens, and improves as the disease
improves. It sometimes worsens before the bowel activates. This kind of
arthritis does not leave permanent joint deformities. We do not know what causes
these three forms of arthritis that develop with either Crohn’s Disease or
Ulcerative Colitis. Many physicians have attributed the arthritis to some
immunologic process which may accompany the intestinal disease, but convincing
evidence for this is still lacking.
NOTES FOR NEW OSTOMATES
Via: Grand Rapids, MI & The Right Connection, San Diego Area
Chapter
Do you ask “Why me?” You are very lucky to live in a time when doctors are able
to perform ostomy surgeries. Did you know that rectal bleeding was one of the
leading causes of death 100 years ago? If you and I lived back then, we would
probably be dead. We have been given a great gift—a new life. It is natural
though to grieve over loss of important organs. Stomas change in size and shape
during the first few months. The initial stoma swelling will lessen and the
diameter will decrease. It is prudent to check the size of the stoma each pouch
change until the size stabilizes. Each person has a different ostomy just as our
fingerprints are different. We have more similarities than differences.
Attending UOA meetings gives us the opportunity to explore with others, seek
support and information from someone with an ostomy to ease the transition time.
UOA has experienced visitors who are generous in helping people who had or are
about to have surgery. They will assist with concerns about this new phase of
life. It is your ostomy. Learn to manage it and do not let it manage you. It is
normal for your new ostomy to be the center of your existence; however, with
time and practice, your ostomy and its daily care will become just a normal part
of your daily life. You are not alone. About 500 ostomies are performed daily in
the U.S. Some are permanent and some are temporary. Help others along the way.
Be happy you have been given a second chance.
LIVING WITH YOUR ILEOSTOMY
By: Lawrence R. Davis, M.D., Via: Spacecoast Shuttle Blast, &
Metro Maryland
This article is from a talk about “The Surgeon’s Responsibility to You and Your
Responsibility to the Surgeon.” My talk will be on what a physician expects of
an ileostomy patient. Being an ileostomate myself, I have jotted down things I
experienced and what I (as a physician) expect of you as you learn to cope.
1. Immediate post-op care, the most important thing the doctor expects is the
patient’s acceptance of the change in body image: One of the biggest hurdles
with patients who will not even look at their stoma is to let him or her take
care of it. This is the beginning of the road to recovery and complete
recuperation. This patient should and must be independent by the time he or she
leaves the hospital.
2. Get the patient to look at the positive effects of their operation. They are
free of the disease, cancer, diarrhea, pain. Most Ileostomates say they are so
happy to be rid of 20 trips to the bathroom and sometimes getting there too
late. The new ostomate should be made aware that he has not been mutilated but
changed for the better.
3. The next big obstacle is “bagging the stoma,” or finding the right appliances
for the patient. The patient needs to know that their stoma is going to change.
With weight change, the need will change. It is very important to understand the
problems a surgeon faces. Keep in mind that the individual’s problems dictate
the surgeon’s techniques. Individual problems dictate different stomas and
locations. You do not swap dentures for eyeglasses, so don’t compare stomas. Go
to your ostomy meetings and learn all you can about ostomy care. The caring and
sharing will help more than anything else. Usually, the ileostomate has been on
diets for years, and after surgery, does not want to talk about diets. However,
there are foods that may cause problems, gas or odors. The patient should be
aware of possibilities that the doctor waits until some of the problems occur.
This way, the patient is not overwhelmed with so many “iffy” things to think
about.
AGING AND THE OSTOMATE
Via the Oakland County, MI Chapter
Growing old is a life-long process, and the physical, social, and psychological liabilities of aging are all part of it. Thanks to gerontology and geriatrics, we know more information than ever before on an intelligent approach to aging.
As we grow older, subtle changes occur in our bodies. The most insidious is our skin. It loses elasticity and becomes thinner and drier, thus becoming prone to wrinkles and irritation. These changes can become real problems for those who must wear an appliance all the time. To prevent leakage as the skin becomes more wrinkled, one should stand up straight when changing the appliance. With one hand, stretch the skin so that it is tight, and with the other hand attach the appliance (using a mirror may help you see what you are doing).
The skin over the entire body tends to bruise more easily and heal more slowly as we age. We need to be more careful when removing an appliance. A skin barrier covering the entire area under the appliance, or a very thin application of a skin-care product may help protect the tender skin.
Aging may also result in less strength in the hands. Arthritis, lessening mobility, or pain in the fingers can make it difficult to put together a two-piece appliance. A one-piece appliance may eliminate the task of stretching a pouch over a faceplate. To sum it up, aging is a phenomenon we must all face, and when one considers the alternative, it’s not too bad!
IS YOUR APPLIANCE SHOWING?
Via: The Right connection, San Diego Area Chapter
Are you worried about your appliance showing under your clothes? Or your stoma
protruding enough to show? People today lead busy lives at a fast pace. Everyone
is concerned with his or her happenings. Aren’t you? By the way, what is the
color of your bus driver’s hair? Did the sales clerk wear a dress or slacks
today? What color was the bank teller’s tie? Give up? Forget about the uncalled
for worries and enjoy each day. Remember that your attitude about your image
will affect the attitude of your family and friends.
HELPFUL HINTS AND BORROWED
BITS
It is important that you be aware of the symptoms of kidney infection: elevated
temperature; chills; low back pain; cloudy urine (ileal conduits normally
produce mucous threads in the urine, which give a cloudy appearance, but bloody
urine is a danger sign); and decreased urine output. It is a good idea to avoid
alcohol when taking any drug, but be particularly cautious with: pain
medications, tranquilizers, antidepressants, antihistamines, and muscle
relaxers. Rice Krispies can help slow the amount of stool; a great breakfast
choice with skim milk or eaten dry.
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