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Volume 28, Number 11 September, 2001
THE NEW OSTOMATE
Via: Big Sky Informer & GB News Review
During the first six months, you’re a charter member of the PLOM (Poor Little Old Me) club, and are convinced that nobody ever had troubles such as yours.
Thereafter; you decide that since you’ve got it, you might as well live with it!!
During the first six months, you go to ostomy meetings in fear, convinced that you will be wallowing in self-pity with those whose ostomies can’t be as bad as yours.
Thereafter, you go to the ostomy meeting, have a ball, head straight toward the refreshment table to see if those luscious oatmeal cookies are there, tell jokes, and generally act like normal people out for an evening of fun—which we all are!!!
IN RECOVERY, ATTITUDE IS EVERYTHING
From Omaha, NB Ostomy Digest. Via: South Brevard, FL Ostomy Newsletter
Do you feel as if the bottom has dropped out of your world?
Your doctor has shown you your ostomy for the first time. You cannot visualize how life is going to be from now on. You wonder if you will ever become accustomed to this strange thing. Be assured—you will, in time.
An ostomy is a life-saving device; you can make it, for you, what you desire. You can hibernate, become a recluse and withdraw into your own small world, or you can take it in stride, learn the proper care of your ostomy, then forget about yourself and enjoy the extra time allotted to you.
You will find, as time goes on, the bewilderment will disappear and the problems you encountered at firstwill become minimized. You will be delighted to find that you can still lead a perfectly normal life—swim, dance, work, and participate in things just the same as before surgery. If ulcerative colitis was the reason for your surgery, then you will be able to do more than you did before surgery.
The new ostomate has a tendency to become overly sensitive, particularly to odor. There are many ways of eliminating all odors, should this be a future problem. There are several internal deodorants, as well as many tablets, liquids, and powders to be used in appliance or pouch.
Yes, at first you will be all thumbs, tackling an appliance or irrigating according to whichever ostomy you have. As you become familiar with your appliance, care time will be cut in half. With the new appliances and supplies available, your job will eventually become easier and automatic.
Don’t become discouraged. Summon up all your patience and courage to see you through this phase of your rehabilitation.
Remember that all of us ostomy graduates went through this—whether to bolster your morale, or to assist in choosing an appliance or irrigating equipment, practical hints on skin care, etc. (Be sure to check with your doctor, to get his approval. We don’t practice medicine, but most doctors recognize that ostomates soon become near expert in the care and management of stomas.)
Fight that depression. It’s your enemy. Things are going to get 100% better than they are now. Thank God you are alive, and take comfort in the fact that “YOU ARE NOT ALONE”.
ALERGIC? HOW TO TELL FOR SURE
By: Kathryn Hoyman, RN/ET, Via Minneapolis, Phoenix and space coast shuttle Blast
Many times I hear that people are allergic to adhesive tape, or paper tape or skin prep, or any number of different products that are used in ostomy care. Allergies can occur with any product. They can occur with the first use of a product or after years of using a product without problems. Most people never have an allergic reaction, but a few are plagued with multiple sensitivities.
However, many things assumed to be an “allergic” reaction may be another problem. It is important to know whether or not you are truly allergic to a product, because eliminating products reduces your options. Believing you are allergic may cause you not to try a pouch that might be perfect for you.
Allergic reactions are usually severe and cause blistering and/or weeping skin wherever that pouch touches. Two situations are frequently labeled as allergic by mistake:
First, if a skin sealant wipe is used, it needs to dry completely to allow the solvents to evaporate. If the pouch is applied while the solvents are still on the skin, sore skin can easily occur. Since the solvents can’t evaporate through the skin barrier as they can through the paper tape collar, this will look like an allergy to the skin barrier.
Second, each time you remove a pouch, the adhesive takes with it the top layer of dead skin cells. However, if you are removing a pouch frequently, cells can be removed faster than they are replaced. This is called “tape stripping.” Everyone’s skin reacts differently to having tape removed. But it’s important to be gentle and not remove a pouch more frequently than necessary. Skin that is stripped will be sore in some spots and not in others. Sometimes skin around the stoma becomes fragile and strips easily, and a pouch and tape with very gentle adhesive must be found. To check whether you are really allergic: Take a small piece of skin barrier or tape and place it on the other side of your abdomen or, with the help of someone else, on your back. After 48 hours, take it off and see whether you are reacting. (If pain, itching or blistering occurs, take it off immediately.) If it’s an allergy, you will react. If you have a history of allergies, test this way before trying on a new pouch. It’s better to have a half inch of sore skin on your back than around the stoma, where you need a good seal.
If you develop an allergy to a product you have used for a long time, you can call the manufacturer and find out if they have made changes in the manufacturing process. Calls from users are sometimes their first notice that the new improvements aren’t working.
WHY IS A UROSTOMY ALWAYS ON THE RIGHT
By: Thomas Rosvanis, MD Via; Pittsburg and Indianapolis
A urostomy is not always on the right side, but most commonly it is because the terminal ileum is used, the last little bit of ileum before it goes to the colon ( a segment of 10-12 cm. long in the ileocecal valve). It just so happens to be closest to the RLQ (right left quarter), and it is easiest to bring it out there to keep the blood supply intact. It is important to find a site that is convenient to the patient, far enough away from the incision to allow a pouch to be put on early after surgery. You do not want it in a roll of the skin where leakage occurs more frequently. The ET will typically evaluate the patient with his/her clothes on to see where the belt line is, how his/her clothes fit and what it looks like with him/her lying, standing and sitting. The ET will then place a mark with indelible ink at the best stoma site. That is something one cannot do on the operating table.
I’ve worked on cases where we used a piece of the sigmoid colon going into the bladder for a patient with severe rectal cancer eroding into the bladder. In conjunction with general surgeons, the bladder was removed, and we took a piece of the sigmoid colon in the left upper quadrant for the ileal conduit and in the left lower quadrant for the colostomy.
WHAT AN OSTOMATE SHOULD KNOW ABOUT MEDICATION
VIA: S. NV. Town Karaya
Liquids are faster acting than pills.
The degree of compression of a tablet determines the rate the medicine is dissolved in one’s system.
The amount of medication absorbed by the body depends on the amount of intestine available. Therefore, the type of drugs to be taken must be based on the “absorption power” you have.
Time-release capsules are not for the ileostomate. They do not have enough time to dissolve in the short remaining intestine and are passed virtually intact.
Time-release medicine will completely dissolve at once if alcohol is consumed with it or shortly thereafter. An overdose could result!
Most medication is available in a variety of forms—be sure to tell your pharmacist that you have an ostomy so that he/she can provide the right form of the prescribed medication.
OSTOMY OUTPUT
Via: S. NV. Town Karaya
What to do if your ostomy output becomes thin, watery, or greatly increases in volume:
Never limit your food intake in order to thicken the drainage, since this can lead to dehydration.
Avoid food which you know from experience makes drainage too loose and too frequent.
Begin a low-residue diet, avoiding especially, green beans, broccoli, spinach, highly spiced foods, raw fruits and beer.
Add strained bananas, applesauce, boiled rice, tapioca, boiled milk and peanut butter to your diet.
Pretzels help in thickening and add bulk to the drainage. The salt, also, helps stimulate thirst.
Many people take an enzyme which is responsible for the metabolism of milk and sugar (lactose). This condition can cause diarrhea, gas, bloating, nausea and cramping. The elimination of milk products may cause a dramatic improvement in the symptoms.
What to do if your ostomy output becomes thick, or if you develop constipation:
Increase your fluid consumption, especially fruit juices.
Increase the amount of cooked fruits and vegetables you are consuming.
Very few foods need to be omitted from your diet because of fear of food blockage. Perhaps more important than the food in avoiding blockages is chewing well. You can reduce your intake of foods which are very high in fiber, and foods with seeds that are hard to digest if they appear to be a problem. Examples are Chinese vegetables, raw onions, nuts, pineapples, corn-on-the-cob, raw carrots, raisins, celery, mushrooms, popcorn, coconut macaroons and coleslaw.
UOA PRAYER
Founders First Meeting of The St. Paul Ostomy Assn. Held in December 1954
Dear Lord, be with us always and make us ever mindful of the many blessings you have given us’ OUR HOMES, OUR JOBS AND OUR UNDERSTANDING FAMILIES.
But most of all, make us ever mindful of the life, which has been given back to us. Give us the courage to face its challenges daily.
Dear Lord, make me a worthwhile member of this group by performing willingly and often the task for which it was begun. Let me never say that I am too busy to help someone in doubt or need.
Thank you for bringing us together again and bestow, we pray, Your blessing on each of us here, until we meet again.
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