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

 
Contents:

PATIENT ACCESS TO SPECIALTY CARE
OSTOMY PROCEDURES THAT CAN BACKFIRE
LEAK PROCEDURES AND PREVENTATIVES
PASTE HINTS
AVOID THE OSTOMY TRAP
CARTOONSVILLE

Re-Route Archive

Volume 25, Number 11  September, 1998

PATIENT ACCESS TO SPECIALTY CARE
Via: UOA Advocacy Newsletter (Excerpts 7/98) 
Recently, after one of our meetings, one of our members approached me and asked if I would put something in the newsletter regarding something they had heard about called, "Patient Access to Specialty Care" and how it might affect us as ostornates. He is referring to the Patient Choice and Access to Quality Health Care Act of 1998. The short title is the "Guaranteed Access to Patients bill, which was introduced to Congress by Representatives Dave Weldon (R-FL), himself a doctor, and Sherrod Brown (D-OH). The bill has a number in the House of Representatives that is H.R. 3547. The bill came about in part because many healthcare plans are denying patient members the right to seek specialty treatment outside of the in-plan services. Many plans are also not being up front in enrollment periods about what services specifically they will and will not pay for. Other plans are offering financial incentives to rewarding doctors for doing less work and poorer quality work. More and more Americans enrolled in health care plans are being told what kind of doctor they will be able to see when illness strikes. When a serious illness strikes, you want to see the doctor who knows the most about that illness, the specialist. Many people wish to have Congress change the way in which managed health care providers handle the issue of choice for specialty care. UOA has joined a coalition of organizations - both patient and professional groups that is working to educate Congress about the need for such changes. Six principles of the recently adopted "Patients" Bill of Rights" are incorporated into H.R. 3547: Access and choice of doctors through a point-of-service option. All health plans must allow patients the ability to seek medically necessary out-of-network items, treatment and services. No health plan should stand in the way of the health of its patients. If a plan's network cannot provide for the needs of the patient, the plan must let the patient seek care elsewhere. Comprehensive, standardized information. A consumer information checklist should be provided to all patients so they will be able to measure the performance of their health plan and its ability to provide a full range of care. Access to information is the key to wise decision-making. If a health plan chooses not to offer a certain service, its literature should be upfront about it. Patients should know in advance services they will or will not have access to, rather than waiting until they need it before discovering they cannot have ft. A timely appeal mechanism. When a plan denies coverage for a benefit or service, patients should have the right to a speedy appeal. Whether the health plan has simply made a mistake, or whether the patient is justified in his or her claim for a benefit or service, the patient has a right to speedy appeals. Patients should not be shut out of the process that decides their fate. In-network access to specialists. Our health system is based on the fundamental principle of specialization. Doctors choose a specialty when they are still in medical school, and spend most of their careers studying one aspect of human health. To deprive a patient access to specialty care is to deprive a patient of quality health care. Ban financial incentives. Financial incentives that result in the withholding of care or the denial of a referral should be prohibited. Patients are paying for medical care and that is what they should get. Prohibit "gag Clauses". Gag clauses which prohibit a provider from giving patients certain information, including treatment options, should be prohibited. "Gag clauses" are a blatant violation of the doctor-patient relationship. They run counter to the very purpose of doctors, which is to provide a scientific assessment of the patient's health and to recommend a possible treatment for whatever ails the patient. The Coalition that supports the bill has made it very easy for you to be in touch with your Member of Congress to ask for his or her support of H.R. 3547. If you call the toll free number 1-800756-1100, you will be connected directly to your Congressman's Washington Office, so you can tell his staff that you support this legislation. If you have an Internet connection, check out www.patientaccess.com/pac

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OSTOMY PROCEDURES THAT CAN BACKFIRE
Via: S. NV's. Town Karaya 
There are times when we think we are doing the right thing or take a "logical" shortcut, but inadvertently get ourselves into trouble. As is said, the road to hell is paved with good intentions. Here are some instances to think about: Using alcohol to clean the skin surrounding the stoma. Alcohol is a powerful drying agent. Prolonged contact with the skin can have serious consequences. Wrapping the drainable pouch tail around and around the clamp before closing it. This will not make the clamp work better. All it will do is spring the clamp out of shape which will insure that the clamp will not work for future applications and will make the releasing of excess gas more difficult. Snapping the pouch off the face plate ring to expel gas. This procedure does not do much for odor control. It is better to hold the tail of the pouch beyond the clamp with a tissue with deodorant on it. Then hold the pouch up so that only the gas is at the clamp, open the clamp and push the gas out through the tissue with deodorant. Then use the tissue to clean out the end of the pouch and replace the clamp. Wearing the appliance for as long as you can until it leaks. The object is to change the appliance before leakage occurs. This way your skin gets the best protection and care. Five to seven days wearing time is good. Washing pouches in the washing machine and using the same pouch for months. Eventually, the plastic of the pouches is saturated with the odor off the chemicals and no amount of washing will get rid of it. Throw the pouch away when throwing the faceplate away. Insisting on trying every new pouch and new product you hear about. Although it is fine to experiment with new appliances, especially if you are unhappy with your usual equipment. You will generally get the best service from the equipment you have the most experience and practice with. Ignoring skin problems. All skin problems are easier to treat if they are found early. Letting the pouch get full before emptying it. Excess weight will separate a 2 piece system and will put excess weight on the face plate, resulting in early failures. Empty the pouch when it is one-third to one-half full. Not using seat belts in a car. A well placed and adjusted seat belt should not interfere with the stoma function or damage your stoma. True, in an accident your stoma may be damaged, but it is a lot easier to repair a stoma than a crushed skull. It is not a good idea to try to live with a condition you can't correct yourself. When in doubt, see your friendly Enterostimal Therapist (ET) or your doctor. 

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LEAK PROCEDURES AND PREVENTATIVES
Via:. Coos Bay, OR 
Abruptly sitting up straight from a flat-on-your-back position can pop your pouch loose. So can bending over to clean out the bathtub or picking something up off the floor, or stretching high to reach for something. Learn to get in and out of bed on your side. Get in bed by sitting far onto the bed and going down on your elbow while holding the mattress with the other hand and swing your legs up. To get up, roll over on your side and use your elbow to push up, while holding the mattress with the other hand and swing your legs sideways off the bed. Use a broom and a cleanser for cleaning the bathtub. Your broom needs washing anyway. Get a clamp type reacher for reaching down, and a stool for reaching high shelves. Learn to lift and carry on the side of your leg. Carry things high, or on your shoulders, or drag it, or get someone to help. Ostornates get hernias easier than anyone else.

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PASTE HINTS
Via: Raleigh, Via: Metro Maryland 
Paste brand names available: Coloplast; ConvaTec (Stomahesive) Hollister (Premium, Hollihesive and Karaya pastes). This product is often misused and , it could be argued, misnamed, Pastes and should not be used as adhesives. The purpose of paste is to fill in any uneven areas on the skin under the wafer to make the area level, which will help to gain a good seal to the wafer. The second function of paste is as a caulking material around the base of the stoma to keep discharge from leaking at the base and getting under the wafer. All of the pastes contain alcohol and therefore will sting some when applied to irritated skin. This stinging will subside as the alcohol evaporates. If feeling in deeper depressions in the skin surface, it will be better to layer the paste, allowing 30 seconds between each application to allow the paste to set up. Caution! Be sure to use a dampened, but not quite dripping wet, washcloth, tissue, cotton balls or your fingers to tap the paste into place, or else you will have the paste all over everything within reach. At this point, paste becomes a cement which attaches to anything dry and you become frustrated. Recap the paste tube immediately after use to prevent it from drying out. 

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AVOID THE OSTOMY TRAP
 Via: Tulsa, By way of Owensboro Area Ostomy Association 
One trap we must avoid is to let our whole life revolve around our ostomy. Preoccupation with managing an ostomy can sometimes make us fail to realize how unimportant it is to other people. Our families and friends are only concerned that we join them again in our usual activities of work and play. Surely, we have problems at times, and if we think back we can remember when we had more than our share. Now, we can enjoy a freedom not possible before our operation. We will continue to have upsets from time to time, but so do those who never had an ostomy. Our own experience, together with the shared knowledge of our fellow ostomy members and the advice of our doctors and ET Nurses, will see us through these infrequent and unpleasant episodes.

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