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

 
Contents:

OSTOMY SURGERY IN YOUNG PEOPLE
NEW STAFF ADDITION AT OSTOMY CENTRE
POUCH CHANGES AND HOW OFTEN
IRRIGATIONS - TO DO OR NOT TO DO
OSTOMY HELPFUL TIPS
CARTOONSVILLE

Re-Route Archive

Volume 28, Number 1  October, 2000

OSTOMY SURGERY IN YOUNG PEOPLE
By: Marshall Sparberg, M.D., Via: Regina Ostomy News
Colectomy (the surgical removal of all or part of the colon) and ostomy, is a major step in anyone's life. Yet it is still more traumatic when performed on a teenager or young adult. The older person who is married and has found his or her place in the world may rapidly readjust to his or her new situation, aided and encouraged by one's partner. There is a job to resume, usually with renewed vigor and strength. Life is resumed. The younger ostomate may not have this feeling of belonging. If preceded by a long illness, then he or she will have fallen behind classmates, both academically and socially. Returning to school without old familiar friends may seem strange and disquieting. A major difficulty for the young is being different, regardless of the cause. Not being "one of the crowd" is a major consideration. Already singled out previously by the ulcerative colitis with its dietary and physical restriction, the younger person may feel this difference from others more acutely when returning to the social circle with an ostomy. True, no one need know about the ostomy, yet an inner feeling of being different still exists. Gym classes and swimming must be approached carefully, not to mention the more intimate aspects of dating. Another obstacle for the young is the choice of occupation. For the individual who is self-employed, engaged in a profession, or working for a small company, there is no need for concern. However, for those who must work for large companies with employment physicals, there is a great fear of rejection because of the ostomy. The medical examiner or company nurse may be completely unfamiliar with an ostomy and assume that it is a handicap to productive work. They are not aware that the ostomate, freed from debilitating disease, is eager to make his or her mark in the world to show that he or she is normal again. A constant battle is being waged against the type of medical discrimination based on lack of knowledge. The only way victory can be achieved is by unmasking these practices. One approach is to ask for a telephone call or letter on behalf of the ostomate to the medical examiner of the company by another physician, such as the surgeon who performed the ostomy, or the medical advisor to the local group. Constant pressure on companies may bring about the needed reforms. Finally, the biggest barrier of all, to find a mate. Since the ostomy is not noticeable externally, casual meeting and dating does not present a problem. When a deeper relationship is established, then the problem arises as to whether the other person should be told about the ostomy before serious plans are made about marriage. A simple and calm manner should be used to explain about the ostomy. For example, I was very sick at one time and was cured by an extensive operation requiring removal of my colon. I am fine now, but the bowel must empty through an opening. The emphasis is on good health with the ostomy the price for the beneficial results. 

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NEW STAFF ADDITION AT OSTOMY CENTRE
The Ostomy Centre in Evansville is pleased to announce a new addition to their staff. Jenny Robertson, R. N.E.T. will be joining their staff part-time. Jenny will be in the office at the Centre all afternoon on the second Wednesday of each month. The Ostomy Centre tries to hold at least two stoma clinics a year for those who need the help of an ET. Now, they will be scheduling appointments every month so that those who need to see an ET will be able to get help sooner. This will be a free service that the Centre will be offering to serve ostomates better. If you are having an ostomy related problem or have questions that an ET can help you with., then call the Ostomy Centre to schedule an appointment. First appointments will be October 11, so call (812) 473-7000 to schedule your appointment. The Ostomy Centre would also like to extend a warm welcome to all the displaced people from Deaconess & St. Mary's DMES. The Centre is also a Wellborn HMO & United Healthcare provider, and bills private insurance companies, Medicare and Medicaid. Owner Pauline Kothe says, "Call us if we can help you in any way." "We've been around for 15 years and we're not going away." 

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POUCH CHANGES AND HOW OFTEN
Via: Metro Maryland & The Spacecoast Shuttle Blast
This question is among those most frequently asked, particularly by ileostomates and urostomy patients. Like any other question, there is no one answer that applies to all ostomates. An informal survey revealed that people change their appliances as frequently as 3 times a day, and as infrequently as every 2 to 4 weeks. Obviously, there must be reasons for this great variation. After pointing out that the great majority of ileostomy and urostomy patients change in the range of once daily to once weekly, let us explore some of the reasons. People on either side of the spectrum can have a skin problem or skin that is nearly indestructible. Some of the reasons for the variation in time between changes include: Stoma Length: A short stoma exposes the adhesive material to moisture which decreases wearing time. Amount or Consistency of Effluent: Profuse effluent tends to loosen the stool. Skin Type: Moist or oily skin tends to decrease adhesion time. Skin Irritation: Decreases adhesion. The appliance should be changed more frequently to evaluate success of your attempts to heal the skin. Experience: Good technique, such as allowing the skin or glue to dry well, increases adhesion. Personal Experience: Preferences, convenience and odor control. 

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IRRIGATIONS - TO DO OR NOT TO DO
Via: S. Brevard Florida Ostomy Newsletter
Lately, I've talked to a number of people who have been having a problem with irrigating which I'd like to discuss with you. Their problem is that they just don't like to irrigate. They find the whole procedure disagreeable, time consuming and often unsuccessful. Despite irrigation they experience passage of stool one or more times a day. Irrigation does not work for everyone. For one thing, your colostomy has to be in the descending or sigmoid colon. If your colostomy is in the ascending or transverse colon, the stool will be watery and you won't be able to regulate it. People who had a very unpredictable bowel schedule before surgery may continue to do so after surgery, despite efforts to achieve regulation with irrigations. Some people have work schedules or lifestyles that do not permit them to irrigate at a consistent time each day. This too can cause irrigation to be unsuccessful. The thing you need to know is that you don't have to irrigate your colostomy in order for it to work Your bowel will work anyway, irrigation or not. The purpose of irrigating is to achieve regulation of the bowel so that no stool is passed between irrigations. The reason for regulating the bowel is for the ostomate's comfort and convenience. If irrigating is not accomplishing regulation (and is making you more uncomfortable) you should not be doing it. Why were you told and taught to irrigate in the hospital? Some doctors use irrigations to stimulate the bowel after surgery. Some simply assume it is preferable for the ostomate. If your doctor told you to irrigate but you no longer want to, check to see if there is a medical reason for doing so. If there is not, the choice to irrigate or not to irrigate is up to you. If you prefer to irrigate and are not having success, before you give up, seek professional advice from an ET. You may have to modify your technique and her experienced knowledge can help you. For your own knowledge, here are some general pointers to keep in mind for successful irrigations. It may help to review them right now. 1. Have the irrigating container about 18 inches above shoulder height. 2. Use no more than 1,000 cc of tepid water. 3. Insert the lubricated cone into the stoma gently. You don't have to push all of the cone in - just enough to create a snug fit so that no water leaks out around the cone. 4. If you use a catheter, never insert more than 3 or 4 inches as there is danger of perforating the bowel. Press the plastic disc that comes with the catheter tubing against the stoma to prevent leakage. In fact, unless your stoma is so tight or so small that only a catheter will fit, you might consider switching to a cone since cones pose less risk to the bowel. 5. Install the water slowly over a period of 5 to 10 minutes. Choose a rate that is comfortable to you and causes no cramping. If cramping does occur, stop the flow, take a few deep breaths, wait for the cramping to stop, and resume the flow at a slower rate. 6. When you have instilled all the water, remove the cone from the stoma, close the top of the sleeve and wait for the returns. After about 20 minutes you can wipe off the end of the sleeve, fold it up or clamp it, and do whatever else you want to do for the next 40 minutes or so until the returns are complete.7. Remove the sleeve, cleanse the skin and apply a pouch cap or gauze pad (whichever you use as a stoma cover). But let me repeat again: If you are not having success with your irrigations, seek professional help from an ET. 

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OSTOMY HELPFUL TIPS
Don't allow yourself to get caught short on ostomy supplies. Always have some on hand when you re-order. Keep a list of equipment you use, with number, size and manufacturer. Let a family member know where the list is in case of emergencies. Do not apply second coating of adhesive. It re-wets the original coat and gives unpredictable results. Paper tape can be made more waterproof by covering it with Skin Prep after it is in place. Cheap club soda is good for cleaning feces and urine spots.

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