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Volume 32, Number 1 October, 2004
WHY YOU SHOULD GET A FLU SHOT
From: The Visiting Nurse Association, Evansville, IN
What do a sore throat, fever, chills, headache, cough and muscle aches have in common? They are all signs of influenza. If you have ever experienced the “flu” once is enough for a lifetime and obtaining a flu shot is an obvious choice. For those who have managed to avoid contracting the flu, subjecting one’s self to an injection may seem unnecessary. If you are considering “skipping” your flu shot this year, please read the information below before you make that decision, it could save your life.
Influenza, more commonly known as “the flu” results in approximately 36,000 deaths each year, making it the sixth leading cause of death in the U.S. Additionally, nearly 114,000 Americans are hospitalized each year as a result of the flu.
A flu shot is recommended every year because the influenza viruses change often and the vaccine is updated every year. A flu immunization should be obtained during the months of October and November, this will allow the body ample time to develop the necessary immunity before the most widespread outbreaks occur in December and continuing into March. It takes one to two weeks for the body to develop antibodies to protect against the flu. This protection lasts through the high-risk months of the flu season and then gradually fades.
Don’t become one of the 90 million individuals who contract the flu this year, get your flu shot and have a healthy winter.
FOR OUR LADY OSTOMATES
Via: Beacon Coos Bay Chapter
Are you one of the many who take Premarin? Editor’s Note: Premarin is an Estrogen supplement. If so, does it work as it should, with the smallest possible dosage? Are there side effects because you need to take quite a bit of the medication?
Watch the drainage from your ostomy. If you ever notice a little beanlike object, probably white, it may be your Premarin tablet with only the yellow coating dissolved.
I found this happening to me and I have worked out a solution that might help others, too. It involves some work, but if Premarin is needed, it is worth the work.
I crush the tablet with a pill crusher, then grind it with a mortar and pestle. When it is crushed rather finely, I spoon it into a “00” size gelatin capsule. It is easier to work up several tablets at a time. One capsule holds approximately the amount in one tablet, at least near enough so it works properly for me.
I have read that medicine in gelatin capsules does not work as well for ileostomates. I believe whoever wrote that was referring to “time release” capsules, which do not work well for ileostomates, but I find that capsules work very well for the pulverized Premarin. A druggist told me that Premarin has the hardest coating he knows of in the coatings used on pills. That may or may not be the absolute truth, but I certainly have found that I don’t get any good from Premarin in the form of tablets. I find it works as it should when its put in the capsule.
RESTORING INTIMACY
Via: The New Outlook & GB News Review
Frequently, among the first things to enter a recovering patient’s mind after major surgery is, “Will I be a whole person in the eyes of my spouse?”
Accepting oneself is the first step toward a happier marriage and sex life—at any time for that matter. By accepting one’s self, one appears as an emotionally well-balanced and relaxed person, appealing to his or her spouse.
When one has fear of rejection, fear of being unable to perform, fear of being un-loved, the fears can be self-fulfilling. A healthy mutual, emotional caring for and about each other’s well being always plays the most important role in a loving relationship.
Another most important ingredient is openness, a comfortable attitude that accompanies self-acceptance and invites acceptance by the spouse. If you are concerned about how your spouse will react to change in your body, that is normal. The hardest part is accepting what you cannot change, but you must for a healthy outlook.
Once you manage to banish fear of rejection and the anger of “Why me?”, you can work toward building emotional health and toward becoming comfortable with your new image. Your spouse may have greater emotional hang-ups than you, that may be magnified by concerns for your emotional health. Your own positive attitude goes far in rebuilding the relationship, rekindling the “old spark”.
COLOSTOMIES—THEY’RE NOT ALL ALIKE!
Via: Metro MD & Des Moines, Iowa
Have you ever wondered why your colostomy is different from the one an acquaintance has? Why it is or is not irrigated? How it differs from an ileostomy? Let’s talk about the different types of colostomies.
Let’s begin with the term “colostomy” which refers to an opening of the colon onto the abdomen. The colon can also be called the large intestine. The pink moist part that you can see is called the stoma. Usually there are other descriptive words that go with the word colostomy. Some of these, such as ascending, transverse, descending, and sigmoid describe where along the colon the colostomy has been made. For example, a sigmoid colostomy is one that is located in the sigmoid portion of the colon. There are also words that are used to describe the type of surgery performed, such as loop, end, and double barrelled. We’ll discuss these later.
To understand how each type of colostomy works, it is helpful to know how and what the colon does. Almost all of the nutrients we
does. Almost all of the nutrients we need are absorbed in the small intestine. The waste products that are left over are passed from the small intestine into the large intestine as a liquid. The colon has three functions: to absorb the water from this liquidy mass, to store the stool, and to produce mucus in order to keep itself lubricated.
The ascending colon is the first section of the large intestine that waste products pass through. If an ascending colostomy is the type you have, you can expect it to function much like an ileostomy with frequent liquid drainage. This is because so little of the colon is being used. If you have a transverse (top lateral portion) colostomy, your drainage may be more pasty in consistency but you are still likely to have several bowel movements a day. Those with descending or sigmoid (terminal end) colostomies probably have formed infrequent bowel movements. Many people with these two types of colostomies choose to regulate their movements by irrigating.
A colostomy irrigation is an enema given through the stoma daily or every other day. The purpose of an irrigation is to stimulate the bowel to empty all at one time instead of occasionally throughout the day. The usual routine for irrigating is to put about a quart of tepid water into the stoma. Then most people sit on or near the toilet for 45 minutes to an hour, waiting for the water and stool to come out. It is a very neat, procedure because the ostomy manufacturers make long irrigating sleeves that fit around the stoma and hang right int
fit around the stoma and hang right into the toilet for easy drainage. After all the stool is out you can apply a small gauze bandage or odor proof stoma cap for the rest of the day.
As anyone who irrigates can tell you, each person’s system is a little different so no two people irrigate exactly the same way. Remember, only descending or sigmoid colostomies should be irrigated, and then only after checking with your doctor or ET nurse. It could be very dangerous for someone with another type of colostomy or ileostomy.
Another confusing thing about colostomies is that surgeons perform different types such as loop colostomies, double-barrel colostomies and end colostomies. A loop colostomy is one in which the surgeon brings a loop of colon up to the surface of the abdomen. For the first few days, he places a plastic rod behind it to keep it on the surface while the skin heals. After the skin heals, he cuts an opening in the loop of the bowel for the stool to exit through.
A double-barrel colostomy is one in which there are two stomas brought to the surface of the abdomen. Only one drains stool, the other drains just mucus. This second stoma is called a mucus fistula.
An end colostomy is one in which the end of the colon is brought to the surface of the abdomen. Usually descending and sigmoid colostomies are end colostomies, because the rest of the large intestine has been removed.
There are different types of colostomies. It is very important to know which type you have so you can take care of yourself in the most convenient and effective way. If you have any questions about just what kind of colostomy you have, check with your surgeon.
CHANGING POUCH
Via: Hemet San-Jacinto, CA
I don’t know about anyone else, but changing this pouch, to me, is like doing dishes...It’s something that I HAVE to do, but I greatly dislike the task. Of course, I don’t know of anyone who would be jumping for joy, shouting, “it’s pouch changing day! Whoppeeee!
I’ve had this ostomy for 1 year, 5 months. Protocol for changing has differed a bit over the length of time, due to body changes, weight gain and stoma size changes. It has gotten easier for me though. I used to be soooo paranoid about it. I’d cry if I didn’t do it fast enough and it decided to “work” while I changed it.
I’ve learned a few tricks...Eating peanut butter or marshmallows before changing slows things down. Using the hairdryer to dry the skin barrier quickly. Placing a hot water bottle over the wafer after changing helps mine seal. It’s almost time to change it again. I’m grateful to be alive because of it!
I just wish someone would invent a model that you could push a button and it’d change itself!!
Schedule For Pouch Change
Also from Hemet San-Jacinto, CA.
There is no preset schedule for pouch changes; the idea is to find your individual schedule for pouch change that prevents leakage and provides you with control. The un-
complicated stoma that is appropriately sited and well-constructed usually can be managed with a pouch change frequency of every 5-7 days; with more durable products some individuals can maintain secure seals for 10 days or even longer. In contrast, the person with a poorly sited stoma or a retracted stoma may require twice-weekly pouch change to prevent leakage; occasionally, daily or alternate-day changes may be required.
Establishment of the optimal frequency for pouch changes requires individual adjustment and experimentation. Signs of undermining and impending leakage are itching and burning of the peristomal skin, odor when the pouch is closed, or visible melting down of the skin barrier. The pouch should be changed promptly when any of these signs are present.
THE COLONSCOPY PROCEDURE
Via: The Pouch, Northern VA
What is a colonoscopy? During this procedure, a long flexible tube is passed via the rectum into the lower digestive tract. This allows the physician to examine the lining of the colon and possibly, the terminal ileum (the end of the small intestine). Abnormalities suspected by X-ray can be confirmed and others may be detected which are too small to be seen on X-rays.
What preparation is required? For the best possible examination, the lower GI tract must be completely empty. Stay on a clear liquid diet the day before, and the day of, your procedure.
Your doctor will also prescribe some form of laxative regimen. It is very important to follow those instructions closely to assure a valid test. Be sure to tell your doctor or nurse if you are allergic to any drugs. You will be given medication to help you relax. It will make you drowsy, so you will not be allowed to drive after the procedure. Even though you may not feel tired, your judgment and reflexes will not be normal.
What should I expect during the procedure? You will receive medication through a vein to make you drowsy. While you lie on your left side, the doctor will perform a rectal examination and then insert the lubricated colonoscope, which will give you a mild urge to move your bowels. The doctor will carefully advance the scope and examine the lining of your colon. You may experience some cramping or feel bloated due to the air being introduced during the procedure. You might be asked to change your position and the nurse will occasionally assist the passage of the scope by pressing on your abdomen. Biopsies may be taken for microscopic examination. The doctor may also apply some therapeutic measures, such as removing polyps, which do not cause any pain.
What happens after the procedure? You will be kept in the recovery area for at least 30 minutes, or until the effects of the medications have worn off. You may feel bloated after the procedure. Expelling the air will make you feel more comfortable. You should eat soft foods after the procedure and can return to your normal diet the next day.
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