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

 
Contents:

EDITOR'S COMMENTS
THIS MONTH'S MEETING
NOVEMBER MEETING
FALL OSTOMY CLINIC
REMICADE RECEIVES FDA APPROVAL
COLOSTOMY HINTS
COPING WITH MY UROSTOMY APPLIANCE
PUSH THE SKIN, DON'T PULL THE TAPE
NUTRITIONAL MATTERS FOR THE PELVIC POUCH PATIENT
WHY DO YOU COME?
CARTOONSVILLE

Re-Route Archive

Volume 26, Number 1  October, 1998

EDITORS COMMENTS by: Rodney Crick
Previously I wrote in this column that I would try to publish something for everyone, even mistakes. Hopefully, those go unnoticed by most of you. It's been 30 issues since I began what I thought was a temporary assignment of publishing the newsletter. I guess I'm still looking for a permanent editor, not that I haven't enjoyed doing this for the past several years. Really, at times it has been very enjoyable, especially as I get to read a lot of other newsletters from other chapters. I try to take notes from them. While I was at this year's conference, I had the opportunity to participate with other editors in a discussion of what should be in the newsletter. We all agreed that newsletters should be typewritten or done on a word processor. Of utmost importance, we agreed, the newsletter should contain a lot of helpful articles and hints every month. Some suggested an occasional member profile or two, while, others suggested an occasional poem. We all agreed that a few pearls of wisdom and of course a little humor and cartoons were needed. But most of all, everyone agreed it should contain what our members want. I also believe a publication such as ours should keep our members informed, particularly about healthcare and governmental issues that affect our well-being as ostomates. Last month contained several things in the latter category. This is, after all your publication. So, if you find an informative , brief, healthcare related article or a personal ostomy tip that works for you, send it to me and I'll see if we can get it in the newsletter. Please don't send any recipes. I realize, that you can't please everyone all the time, but I do care and I try to put articles in the Re-Route that will be uplifting., educational and of benefit to all of you. 

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THIS MONTH'S MEETING
Our next meeting will be Monday evening, October 12, at 7:00 PM in meeting room 4 in the basement of St. Mary's Hospital. Barbara Davis, the Hollister representative will present our program that evening, If you would like information regarding this ostomy manufacturer's product line or have a question about a product, please plan to attend. Refreshments for the meeting will be provided by Hollister.

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NOVEMBER MEETING
Our last scheduled regular monthly meeting for 1998 will be on Monday, November 9, at 7:00 PM in Meeting Room 4 in the basement of St. Mary's Hospital. Erin Hambrick, the ConvaTec representative, will present a program relating to her company's ostomy product line. 

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FALL OSTOMY MEETING
Pauline Kothe, owner of the Ostomy Centre, has announced that a stoma clinic will be held October 16th at the Centre at 1655 Lincoln Avenue from 8:30 AM to 5:00 PM. Sonja Stoica, RNET, with the Visiting Nurses Association, will be there to examine your stoma and help with any ostomy related difficulties you may be experiencing. The clinic is being sponsored by ConvaTec and is free to all ostomates. Time slots fill up fast, so call early to get an appointment to see the ET. If you live in the Evansville area, you may make an appointment by calling (812) 473-7000. If you are outside the Evansville area, you may call (800) 347-3394 toll free to get an appointment. Convatec will be providing light refreshments and their area rep. will be on hand. 

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REMICADE RECEIVES FDA APPROVAL
Via: CCFA News Updates 9/20/98 
On August 24, the Food and Drug Administration (FDA) approved Remicade (infliximab), a new treatment for Crohn's disease developed by Centocor, Inc. The drug, formerly known as Avakine, is being recommended for the treatment of patients with moderate to severe Crohn's disease for whom conventional therapy is inadequate, and for the treatment of Crohn's patients with draining fistulas. Remicade is not a cure for Crohn's disease. Remicade is a new treatment known as a monoclonal antibody being studied to reduce the severity and number of symptoms associated with moderate to severe Crohn's disease. It blocks the activity of an inflammatory agent called tumor necrosis factor (TNF) and has been shown to heal the lining of the intestine. In controlled clinical trials, Remicade has also been demonstrated to be the first drug to be effective in closing enterocutaneous fistulas (abnormal passages between the bowel and the skin). Tumor necrosis factor (TNF) is a key mediator of the inflammation process. Overproduction of TNF may lead to some diseases associated with inflammation, such as Crohn's and Rheumatoid Arthritis. Because Remicade blocks TNF in Cohn's patients, it is known as an "anti-TNF" antibody. "This is an exciting development for two reasons: It is the first therapy for Crohn's disease derived by molecular techniques. Secondly, it has the possibility of improving the quality of life for patients with either active disease or fistulae, who do not respond to traditional therapies, including corticosteroids," said R Balfour Sartor, M.D., Chairperson of CCFA's National Scientific Advisory Committee. "Remicade demonstrates the ability of a large international group of clinical investigators and a biotechnology company to jointly apply the dramatic recent advances in molecular biology. The initial studies have been very positive. Of course, it is important to keep in mind that the long-term outcome of patients, as well as potential side effects, must be determined."  To learn more about Remicade, you may call Centocor at (800) 457-6399 or (610) 651-6399, or visit the company's Web site at: http://www.centocor.com. 

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COLOSTOMY HINTS
Metro Maryland & The Osto-mee News, Hamilton, Ohio 
Save money by making your own elastic belts for holding your irrigation sleeve or appliance. Save the end attachment from the old worn-out belt and transfer to the new elastic. A cup of buttermilk in irrigation water can help control odor. If you irrigate, try adding about 1/4 cup of Vaseline Intensive Care Bath Beads into the irrigation sleeve when you are cleaning it. Rinse with clear water. Odors will be gone and fecal matter will slip out easily. Water cans with long, curved spouts are excellent for rinsing reusable appliances. If you notice a persistent odor after changing your appliance, check to see if you have cleaned the tail piece properly. It isn't necessary to clean the inside of an appliance (as it is acting like the inside of your colon ), but the end of the tail flap is exposed to the outside and will cause odor if fecal material is not removed. A careful swipe with a piece of tissue will do the trick. Always carry an extra appliance and an extra closure clip for emergencies. Check it periodically to make sure that it is not showing wear and tear. When traveling, carry a collapsible plastic cup for water, a packet of tissues, and a small plastic bag for any other unforeseen need. Check your stoma whenever you change your appliance. You want to make sure that you catch any possible problems early. Look for changes in color, shape, or function. Also, look around the stoma for changes in the skin. If you spring a leak while wearing your best "dry clean only" winter whites, get them to the cleaners quickly. Explain the nature of the stain. You can help educate the public and you have the best chance of getting the stain out if you "come clean" as to what caused it. If you can't eliminate odor from your faceplate, try taking an old toothbrush and scrubbing the faceplate with toothpaste. If you find the scissors sticky when you cut Stomahesive wafers, lubricate the scissors with KY Jelly or clean the blades with rubbing alcohol. Try using one of those small seam rippers (available in any fabric store) for cutting the size you need from Stomahesive. It is quick and gives a nice smooth edge .... but be careful. Be careful with zippers. The pouch can get caught in the zipper when zipped in a hurry. Be careful with what you place in your pockets. Ballpoint pens, keys, nail files, tooth picks, and other sharp objects could puncture the pouch. Before you leave for travel abroad, call Intermedic, Inc. in New York City at: (212) 486-8974. They can provide you with names of English-speaking doctors abroad. 

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COPING WITH MY UROSTOMY APPLIANCE
By. John Baird, Via: 0stoline, Sherman Area Ostomy Association 
Let me share with you some of the tricks I've found useful, over the past seven years since my ileal conduit was installed, to keep on good terms with my appliance. I keep attached with a three-piece appliance, (a base which is fastened to my abdomen by cement, a vinyl pouch attached to the base by an elastic "O-ring," and a belt). For ostomates, as much as for Scouts, our watchword is "Be Prepared." I keep a fairly complete supply of extra pouches, etc. in my office, as well as at home, including extra underwear for the rare, but potentially devastating occasions when my appliance comes loose while I am at work. I always take my extra kit with me when I travel. Another device which helps me keep prepared is the hole, specially cut in my cotton under shorts, to fit around my appliance. This serves not only to place cloth between my pouch and my skin to absorb and prevent sweating, but also to serve as an early warning signal when the base begins to separate. An ear syringe comes in handy every morning, for squirting diluted white vinegar into my pouch, through the lower tip, for rinsing urea crystals from my stoma, as well as cleansing my pouch. I fill the pouch to soak my stoma while I'm shaving, then empty it, leaving the pouch refreshed. This routine also confirms whether I ought to change pouch at that time, since the pressure from the filled pouch (with the tip drawn up and tucked under my belt) will stimulate beginning leaks. When dampness appears, I look carefully to see whether it comes from a seam in the pouch which would then need to be thrown away and replaced. 

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PUSH THE SKIN, DON'T PULL THE TAPE
By: Milly Johns, North Wind News, Anchorage, AK 
Damaging the skin around a stoma (or anywhere else), is asking for infection. Don't peel your pouch away from your body. Take hold of an edge of the adhesive sections or tape, and push the skin away from the tape. In older people and babies with thin skins, you can peel their skin off by pulling on tape. Take a good look at what is happening when you pull tape. The tape is pulled upwards, dragging the skin with it until it is pulling hard enough to break loose. It even looks painful! Owie! Now look at what happens when you push the skin away from the tape. It doesn't hurt and the outer layer of skin is not torn off, which sometimes happens with pulling. These people who think yanking it fast is best, ought to take a good look at the skin afterwards. If you have a leak, digestive enzymes in the discharge will excoriate your damaged skin quicker, and deeper than if your skin is okay, or protected with some sort of skin preparation. Be careful in removing the appliance around excoriated skin, as pulling may further damage and irritate the skin. Learn to treat skin quickly.

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NUTRITIONAL MATTERS FOR THE PELVIC POUCH PATIENT
By: Barbara E Wendland, RD 
Pouchitis, or inflammation of the pelvic pouch, is a well recognized complication of pelvic pouch surgery. Approximately 10 to 25 percent of patients experience an episode of pouchitis at some time. Our experience has not indicated that food intake causes pouchitis. Patients with pouchitis have been found to respond well to antibiotics, which suggests that bacteria are major participants in the inflammatory reaction. Nothing has been published in the research literature to indicate that specific food or food preparation methods contribute to the inflammatory reaction of pouchitis. After pelvic pouch surgery, follow a meal pattern that consists of three main meals or four to six smaller meals, taken throughout the day, depending on your tolerance. It's important to take meals at regular times, to give your bowel a consistent message. Choose nutritious foods from each of the four food groups (breads and cereals, meats and meat substitutes, fruits and vegetables, and dairy products) as tolerated. Increasing the intake of dietary starch products that are easily digested such as potatoes, pasta, and soluble fiber sources (oat bran, oatmeal bread, and barley) is important. easily digested starches should act to assist the pelvic pouch adapt to its new role.

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WHY DO YOU COME?
Via: Metro MD & S. NV's Town Karaya
1. Our presence is encouragement to others. 2. No matter how long ago your surgery, no matter how many meetings attended, there's always information to be gained. 3. Keep up on newer developments and hear the speakers who are invited with information pertinent to ostomates. 4. We may have questions and problems that can be asked and answered at the meeting. 5. Give support and encouragement to the volunteers (leaders and trained visitors) and to each other. 6. Be role models for new ostomates to show an active life can continue. 7. See that many of those who were in trouble are now helping others. 8. Learn what's new in management equipment. 9. Feel good with our peer support group. 10. Experience a sense of accomplishment and renew a positive attitude for life and fulfillment.

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