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pageVolume 33, Number 1 October, 2005
STAY AWAY FROM THE FLU: WHAT YOU CAN DO
Via: The Rosebud, Douglas County Ostomy Association
Don’t badger your doctor into prescribing an antibiotic until a culture or other tests show you need one. Antibiotics are powerless against flu and other viruses and may cause side effects.
Keep some generic amantadine (Symmetrel by Endo Labs) in your medicine cabinet to prevent and treat flu symptoms. A prescription is needed. At the first sign of the flu, doctors recommend taking two capsules of 200 milligrams twice a day for five to ten days.
If you don’t wear gloves, don’t shake hands. Give friends a pat on the back rather than a handshake, embrace, or kiss. Use alcohol-based hand sanitizers such as Purell or Kimcare.
Be aware that doorknobs, telephones, and computer keyboards may harbor dangerous germs. Polish and sanitize your home and work areas as much as possible to protect your family.
NOTE: The Oriental people have a better way of greeting. Instead of shaking hands, take two steps back and bow. The “no-hands” custom helps avoid the flu.
ILEOSTOMY ABSORPTION CONCERNS
Via: Cleveland Ostomy Association
Due to the absence of the colon and often altered transit time through the small intestine, the type of medication taken must be carefully considered when prescribing for the person with an ileostomy. Medications in the form of coated tablets or time-release capsules may not be absorbed and therefore no benefit is received. Before the prescription is written, the patient with an ileostomy should inform the physician of his concern. If the medication required is available only in a certain form and the coating would not be destroyed by stomach juices, then the tablet may be crushed between two spoons and taken with water. This often results in an evil-tasting mixture, but absorption is ensured. However, check with your physician first.
The best type of medication for the person with an ileostomy is either in the form of uncoated tablets or in liquid form. Although these are
not the most paletable treatments, these dosage forms ensure that the medication prescribed will be absorbed. A pharmacist can assist in choosing the form of a medication that will be best absorbed. After ileostomy surgery, never take laxatives. For a person who has an ileostomy, taking laxatives can cause severe fluid and electrolyte imbalance.
KEEPING WEIGHT DOWN
Via: Ostomy News Review, Green Bay WI
Keeping weight down is especially important for ostomates. Even a few extra pounds can affect the fit of our appliance and cause the stoma to recess. For new ostomates, extra weight may put pressure on healing tissues. Here are a few ways to drop or maintain weight. Eat your biggest meal at noon and then have a very light dinner by 6 p.m. Eat an apple, or two bread slices, or other fiber-type food 20-30 minutes before dinner. It will help curb your appetite at the table. These foods, combined with a glass of water, will expand in your stomach and reduce your capacity to eat. Chew well and eat slowly. It takes up to 20 minutes for the brain to receive the messages of fullness from the stomach. Don’t eat after 6 p.m. Resist snacking late at night, and your body will reward you with more restful sleep and lots more energy in the morning. Food eaten in late hours will generally go directly into fat production because the body’s energy needs are low at night. Remember that vegetables are considered free of calories when not covered with dip, butter, or
other extras-so you can have these healthier foods without guilt. Finally, instead of plunking down in front of the TV until bedtime, how about a relaxing evening stroll? You’ll sleep better and feel better in the morning.
NEW UROSTOMY PATIENTS
Via: Roanoke (VA) Valley News & South Brevard, FL
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 waste basin and clear measuring container home from the hospital! They are very helpful as you establish a daily routine of washing your night time 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. A five quart pail with metal handle (Home Depot, Wal-Mart, etc $1-$2) is a great night bottle or bag container by the bed and also a safe way to carry this equipment to the bathroom in the morning. The hospital plastic wash basin 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 as it produces a strong odor in urine.
COLOSTOMY BLOCKAGE AND ITS CAUSES
by: Dr. J. Hopkins, Asst. Prof. Surgery, Lankenau Hospital, No. Alabama
Dr. Hopkins states that poor bowel habits probably begin in childhood with people being “bowel conscious.” They erroneously think that a daily bowel movement is necessary for body and bowel functions. He states that four requirements for normal bowel passage are:
1) A balanced diet including some roughage. Attempting a rigid diet after a colostomy is futile and unnecessary. By trial and error one can eliminate those foods which may cause diarrhea and constipation.
2) Exercise to maintain a good body tone.
3) Effects of emotion. This may be difficult.
4) Adequate fluid intake.
He says that colostomy blockage may be due to mechanical defects or failures. The most common cause of this type of stricture is a narrowing of the opening of the stoma. Another mechanical cause is herniation around the stoma. Blockage may also be the result of strangulation, or a sharp bend in the colon. The mechanical problems can be corrected by your
surgeon. Other causes of blockage may be improper diet, medication and the effect of your emotions on your digestive system.
Also the position in which one irrigates (somewhat doubled over, for instance) may result in difficulty in elimination. Exercising of abdominal muscles would not be harmful to the colostomy and would promote good muscle tone in the area. Dr. Hopkins recommends that his patients use the newer cones and tips for irrigations for safety.
QUESTIONS AND ANSWERS
Via: The Tomy Tabloid, Editor: Charlotte Allen, RNC, BSN, CETN
Q: Do you think it is a good idea to rinse out my colostomy bag when I empty it?
Answer: I usually teach my patients the proper procedure for rinsing out your pouch when emptying it, but then leave it up to you if you want to continue to rinse it or not. By proper procedure, I mean rinsing the pouch up to the level of the bottom of the stoma. I find sometimes people rinse the pouch too vigorously and cause the adhesive seal around the stoma to loosen from inside the pouch by introducing water at the seal. Some people feel more comfortable using an opaque colored pouch and not having to worry about rinsing it at all. Again, I think it is a personal preference with what you are most comfortable with. Many people get along just fine without ever rinsing the pouch.
Q: When a colostomate gets a blockage from eating too much food, should a laxative such as prune juice be taken? Should heat be applied? Would it be a good idea to irrigate?
Answer: When a colostomate gets a blockage, in most cases, it is due to constipation caused by eating constipating foods, a lack of physical activity, or use of pain medications. It is quite OK for a colostomate to take a mild laxative. The use of prune juice is an excellent suggestion. Foods with fiber, like bran, make the stools less constipating. For a person who has not irrigated, the other methods should be tried first.
Ileostomates should take NOTE: Treatment for blockage for persons with an ileostomy is different from the above. AVOID laxatives, DO NOT irrigate, and consult with your ET nurse about the best procedures for you to take.
MAJORITY OF AMERICANS TAKE AT LEAST TWO PILLS EACH DAY
By Lee Bowman, Via: Ralph Kaye Chptr, San Antonio, TX
Fifty-one percent of American adults take two or more pills each day—a prescription drug, an over-the-counter drug, or a vitamin or herbal supplement—according to a new survey. And nearly half, 46 percent, said they were taking an average of nearly three prescription medications a week. Predictably, more people tended to take more prescriptions, as they grow older.
Seventy-nine percent of respondents over age 65 reported taking at least one prescription drug each day, vs. 28 percent of those 44 or younger. The survey of 1,000 adults was conducted for the American Society of Health-System Pharmacists, which represents pharmacists who practice in hospitals and other health care institutions. Those conducting the survey did not attempt to track the cost of medications.
But other government and industry surveys indicate Americans are spending well over $120 billion a year for medicine and dietary supplements. The survey also found that about 8 percent of people entering a hospital do not report to doctors or nurses the medications they are taking.
Besides prescriptions, the survey found that 58 percent of respondents had taken an average of two nonprescription medications, including vitamins and supplements, in the past week.
Forty percent said they were taking an average of two herbal supplements or vitamins daily. “This shows consumers are simultaneously using a variety of prescription and nonprescription medications,” said Mick Hunt, president of the society. “We want patients to be aware of the potential for drug interactions that can occur when mixing all these remedies, especially when taking multiple medications each day.”
Women were more likely than men to report taking a prescription medication in the past week, 55 percent vs. 37 percent. Women’s regular use of over-the-counter drugs and supplements
was also greater than men’s by similar margins. Among people who had taken a prescription in the past week, 61 percent said it was for the long-term treatment of a medical problem, with just 10 percent saying they took a drug for short-term treatment. The rest said they took prescriptions periodically for a recurring problem.
The pharmacists recommended that consumers:
* Keep a list of all medications, including nonprescription remedies and home remedies, that they take and share the information with their health-care provider.
* Be honest about how much and how often they actually take medications for any remedy.
* Learn the names of prescribed drug products as well as dosage strengths and schedules.
* Find out if there are any foods, drinks, other medicines or activities that should be avoided when taking a prescribed medication and ask for written information about a drug.
* Be alert to unexpected changes, like a prescription refill that seems to have a different strength or appearance from the original drug. Question anything that doesn’t seem right.
POWDER YOUR STOMA?
By M. Schwankweiler, RN, ET Via: The Northern VA Pouch
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 (fungus,
Candida) 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, such as 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 new extended wear barriers– such as Durahesive and Flextend— and are not recommended. If you use a standard wear barrier, then the barrier is applied over the sealant covering the powder.