Articles of Interest
Colostomates
Embracing Life After Surgery - UOAA’s Ostomy.org website, June 13, 2024
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Before cancer came into my life, I was a very social person. My various professional ventures along with the diverse group of friends kept me on the go. Even though I dealt with anxiety it was mild enough that I was still a social butterfly.
I was diagnosed with anal cancer on May 5, 2015, that’s Cinco de Mayo. We had the day planned, going to the groceries for Taco & Nacho Day. Watch mindless shows and spend the day together.
Much like others like me, your caregiver becomes your world.
We were three years into our relationship, and this was not on our Bingo card of relationships … Or was it? That whole summer was spent in bed or on the couch sleeping. I couldn’t stand a lot of smells or people- so not much socializing.
Much like others like me, your caregiver becomes your world. You are dependent on them for food, medical needs, and conversation. Chrisitan, my boyfriend, was all that and more. He was also my punching bag and took all my frustration and honestly, I don’t know where he put that energy.
It made our relationship stronger; it tested the relationship and us. He also helped me get back into the real world easier although it takes the caregiver longer to step out of his role. I don’t know if they ever leave completely.
It took almost six months to decide or be convinced for the ostomy surgery. I had done hyperbaric chamber treatment, and we were hoping things would heal. We expected a miracle. My sphincter would not grow back.
Diapers were not very convenient for work. I traveled quite a bit and changing on the go was a pain in the butt. Those changing tables in the bathroom don’t hold an adult! I finally picked a date for the surgery.
My surgery was scheduled for April 1, 2016. If that date sounds familiar it’s because it’s April Fool’s Day. Yes, my surgery was a joke, and I wasn’t laughing. I didn’t have a mentor, buddy or a nurse to tell me what to do. My brain was in constant conflict between I don’t want anyone to see me, and I need to get back out in front of people. I wanted to act, public speak, or at best go shopping and try on clothes.
Go through the feelings and emotions. I denied that anything happened, got very angry, negotiated with my higher power, still dealt with a bit of depression, and I’ve accepted that this is my reality. It has allowed me to move forward faster.
When I first started to go out in public, I would use surgical tape and bind my bag down. I was sure that if I taped it hard enough it would go away. I felt so self-conscious that I would wear shirts one size larger.
Then one day, in a support group, I heard about wraps. I had to look up this miracle device that would give me back my manly figure. As if they were security secrets that you had to find through a scavenger hunt.
I felt confident, strong, and back to me… Kinda. I felt like a piggy bank and that everyone was looking at my belly. Finally, Tommy the Ostomy and I had worked out the kinks, made peace, and became frenemies … Kinda.
Eight years later I am out more, I travel more, and still panic a bit. Tommy still manages to surprise me from time to time. Almost every day I put on my belly-bra to keep things tight and snug, and I watch my weight so things don’t pop out.
I still get panic attacks, I still think everyone is looking at me, and I still think I’ll wake up and It’ll be gone. Except I have more self-esteem, I share my story, and I look great in a tight shirt and jeans!
If I could share any words of wisdom if a new ostomate it would be go hunting online for patient stories and trusted information like this website. Find a support group and ask as many questions as pop in your head. Some things you’ll learn on your own but we’re here to help.
Another thing, go through the feelings and emotions. I denied that anything happened, got very angry, negotiated with my higher power, still dealt with a bit of depression, and I’ve accepted that this is my reality. It has allowed me to move forward faster.
Ileostomates
About Ileostomy Output
Via the Orange Oasis and Up Front, Ostomy Assn of NJ
(MMOA Update 2012)
Dr. Philip Kramer of Boston University has studied and monitored the progress of people with ileostomies over many years. Here are some of his findings regarding ileostomy discharges:
The average output of an Ileostomate is about a pint a day, composed of 90% water and 10% solids, whereas normal fecal matter consists of 70% water and 30% solids. Overeating will increase the output of an ileostomy, the same as it will for a normal person.
The fat and nitrogen content of the ileal discharge is the same as that of a normal person.
The salt output from an ileostomy is high, around a teaspoon a day whereas a person with an intact colon has almost no salt output in the feces. The body seems to compensate for this salt and water loss by discharging less salt and water than normal through the urinary tract and through perspiration. The intake of too much salt should be avoided since it increases ileal output.
Urine output is generally less in the Ileostomate. It is necessary, therefore, to increase water intake above normal so to increase the urine output. This way kidney stone development can be minimized.
Some foods increase ileal output while others do not, such as prunes, raw figs, dates, stewed apricots, strawberries, grapes, bananas, beans and cabbage.
High fluid intake, such as a gallon of water a day, did not increase the ileal discharge, but did increase the urine output.
The Nerve(s) of Those Stomas! By
Mike D’Orazio, RN, ET Broward Ostomy Association FL, via Ostomy Sasketchawan News, CA
The question or comment about stomas lacking sensory nerves, or the more broadly stated claim that stomas have no nerves, is a myth that dies very hard. Allow me to borrow from one of my presentations that partly address this issue.
In summary, - Putting this in perspective, the claim in the first paragraph that “stomas do not have any pain sensation” is false, as is the claim that “stomas have no nerve endings.” Stomas definitely have nerves that are sensitive to stretching. However, it’s also true that stomas tend to be insensitive to certain other stimuli, notably cutting. This creates real danger, as stated in the first paragraph, that you can cut your stoma without being aware of it. And it’s also probably true that, in most cases when people talk about stoma pain it’s really from the peristomal skin. “... most of the information carried by gastrointestinal primary afferent neurons is not consciously perceived. This is nicely demonstrated by tests on fistula patients who report no sensation when the healthy stomach is probed or in patients that have had the intestinal lining cut to take a biopsy.”
Additionally, there are more than 100 million nerve cells in the human small intestine, a number roughly equal to the number of nerve cells in the spinal cord. Add in the nerve cells of the esophagus, stomach, and large intestine and you will find that we have more nerve cells in our bowel than in our spine. We have more nerve
cells in our gut than in the entire remainder of our peripheral nervous system.
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Urostomates
Tips and Tricks by Gary Oddi, Metro Maryland
Please highlight and click on the link below to view this article because it is with photos.
https://docs.google.com/document/d/1ZSX-eqOU6MadJHt7K9UXiI4yDAjCMk92CmVx4anOuQ4/edit?pli=1&tab=t.0
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Here's a glimpse:​
The following information is for people who have had a urostomy (ileal conduit). This is based only on my experiences. So take only what makes sense to you.
First of all, you have to be sure to try as many of the different products out there in order to find the appliance that works for you. I have tried Hollister, Convatec and Coloplast.
My final choice was Coloplast. There are things that bugged me about the Hollister and Convatec appliances. But each person is different so be sure to get the free samples from all of them and try them out.
After almost a year, I found that the Coloplast SenSura Mio Convex Flip 2-piece worked best for me. Only the flange of the SenSura Mio Convex Flip is ‘convex’. (It does not use ‘convexity’ where it would push in the skin around a stoma that is flush or retracted.) Their ‘convex’ flange fits better for rounded abdomens. After you stick the flange around the stoma, you then just ‘flip’ the flange onto your skin.
(Go to link above to finish article)
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Information for Ostomates
Tips for Choosing the Right Ostomy Supplies - UOAA
This aticle contains photos which need more space than is available here.
Use this link for the article:
https://www.ostomy.org/tips-for-choosing-the-right-ostomy-supplies/
Colostomy Complications
Via Tri-state ostomate, Iowa 2011; via Metro Maryland (no date)
One of the most common problems after colostomy surgery (other than skin irritation) is herniation around the colostomy. This is manifested as a bulge in the skin around the stoma, difficulty irrigating, partial obstruction, and occasionally a prolapse of the colon at the colostomy (the bowel pushes itself through the stoma).
Many of these problems can be avoided if the stoma site is marked before surgery at a place that lies within the rectus abdominus muscle near the midline. The WOC Nurse can be of great help in this. The nurse is also helpful in managing complications should the need arise.
WHEN YOU SHOULD CALL THE DOCTOR:
You should call the doctor when you have: cramps lasting more than two or three hours, a severe unusual odor lasting more than a week, unusual change in stoma size and appearance, obstruction at the stoma and/or prolapsed, excessive bleeding from the stoma opening, or a moderate amount in the pouch in several emptyings. (NOTE: the eating of beets will lead to some red discoloration), injury to the stoma, continuous bleeding at the junction between stoma and skin, severe watery discharge lasting more than five or six hours, and any other unusual occurrence regarding the ostomy.
A stoma can become narrowed (stenotic) over the years. This may reflect continued injury from irrigation or a temporary poor blood supply immediately after surgery. This can usually be corrected with a small operation if the condition is significant. With the introduction of irrigation cones, rupture or perforation of the colon is rarely seen. This can happen when an irrigation catheter is used if care is not used when introducing the catheter into the stoma.
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