Articles of Interest

Our July meeting was presented by Anne Inch of Scotland, UK. Anne had invented for her husband the
ConfiPlus, an extender, to hold ileostomy leaks. Her husband had been hospitalized numerous times for
heart problems, but as an ostomate he was more concerned for the embarrassment caused by the smell
and leaking when he was in a hospital ward with 3 other persons. The difference between this extender and others is the disposable, circular, absorbent pad which surrounds
and extends past the wafer of your bag forming a circular seal, designed to catch and contain any output,
dispersing the liquid around the circle. It will stop the leaks for up to 4 hours so you can get where you need to be to change your appliance without worrying about the leak.
The seal is made with 3M tape, so there were no problems with her husband’s skin for 7 years! When the stoma retracts fluid can be forced out. The ConfiPlus helps with blow outs and with sweating. It is good for urostomates, also. If there are no leaks when wearing the ConfiPlus, it will last for a 5-day period. It can be re-applied if the
skin isn’t oily or there are no medications on the skin.
There is an introductory offer price of $99.00 for 10 pieces. For the offer go to
https://confiplus.com/confiplus-usa/. ■
 

Also, at the meeting Barriers rings were
discussed. One suggestion was the Safe n Simple Resilient Barrier Ring. They also have barrier sprays and barrier films. Others have liked their fragrance-free Pouch deodorant and Assure C Odor eliminator which helps with pancaking. ■

A Urostomy Experience

Forwarded By The Magnolia Ostomy News; via The New Outlook, Ostomy Assoc of Greater Chicago, May 2009

 

   I have been reading articles in the newsletter for a few years now. I had an unusual and awakening experience concerning my urostomy that I thought might be of interest to your readers.

   I have had my stoma for four years now and have had no complications or problems. For the past six months, I have noticed that the skin around my stoma was white and irritated. I tried several different things to clear it up:

·        Changing to different brands of skin barriers;

·        Changing the skin barrier more often;

·        Drinking more water and cranberry juice;

·        Using different powders.

      But nothing seemed to clear it up. So, I just put up with it, hoping that once I had enough time at my new job, I could take off and then get in for an appointment.

   While at work last Thursday, I went to empty my pouch, and it was full of bright red blood. I noticed two small blood clots. This got my attention, and I went directly to the phone and called the doctor who had performed my surgery four years ago.

   The nurse said she would leave a message for him and he would call me back. Meanwhile, I continued to work. I started dramatically increasing the amount of water I usually drink and a couple of bottles of cranberry juice, thinking this would clear things up. After lunch, I again went in to empty my pouch and this time it was so full of huge blood clots that it would not even drain.

   I became more scared than ever, and I called my doctor's nurse and told her that I had an emergency situation. I was told to go directly to the hospital where a urologist came in to look at my stoma. When I took off the pouch, the blood had coagulated so thick that the doctor could not see the stoma.

   He peeled off the skin barrier and blood was spurting from a severed artery next to the stoma. He said that because the skin around the stoma had such severe erosion, it caused the breakdown by the artery and broke loose. He skillfully put in several stitches to close the artery. I had lost quite a bit of blood but not enough to keep me in the hospital.

   I was told my urine would clear up later that evening, which it did. It took several days for me to become myself after the panic of what had happened. Because of this ordeal, I made an appointment with a WOC nurse. She told me that she recommends that people with urostomies wear a convex barrier or a Microskin pouching system (made by Cymed.) These are especially made to keep the urine from pooling around the peristomal skin area. In addition, she showed me how to use barrier seals and powders to complement my skin barrier.

   I have also scheduled an appointment with my doctor to have him follow-up on the excellent care provided by the ER urologist. The urologist told me that he rarely sees an artery burst like mine did. Obviously, he does not see many urostomy stomas.  

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.

Helpful Hints From Here And There

(via Gettysburg/Hanover Ostomy Support Chapter

 

Emotional pressures and over-fatigue can cause bowel upsets, especially when traveling. Do not allow yourself to become over-tired.

*For hard-to-deal-with, irritated skin due to tape burns, scar healing, pouch friction on the skin, etc., doctor often recommends a cortisone cream or ointment. Two products of this nature available without a prescription are: Cortaid or Dermolate.

* If you like mushrooms, remember they don't digest, so chew them well.

* Asparagus generates a strong odor in the urine.

* Yogurt, cranberry juice, and buttermilk help to combat urinary odor.

* Parsley is excellent in combating fecal odor, besides being a good source of potassium.

* Keep grape juice in the refrigerator. If you eat something that causes a blockage, just try drinking a glassful. It really works.

* Never wait until you've used your last appliance before ordering new ones. Keep a list of your equipment, complete with order numbers, sizes, and manufacturers. Let a member of your family know where you keep the list so they can get the necessary supplies in the event of an emergency.

* Use a round clothespin to roll up your tube of paste. Works for toothpaste, too.

* If you still have your rectum and have pain or a full feeling, you may have a collection of mucus which should be washed out. Check with your doctor regarding this.

* Buttermilk will soothe an irritated digestive tract and will not cause diarrhea or constipation.

* Colostomates should not use water that is too cold or too hot as it may cause cramps, pain or nausea.

* Do allow 45 minutes to one hour for a complete return of water when irrigating. Arrange to sit for comfort and relaxation. Do not hurry through irrigation. Anxiety, frustration and spillage may result. Getting up tight can cause little or no return.

* Rounding off the square edges of a firm wafer or skin barrier will decrease the chance of the belt catching on the corners.

* For urostomates, if your drainage tube is clogged, try soaking it in a solution of Tide for about two hours. Then rub the tube between your fingers, insert a baby bottle brush as far as possible, pull out and rinse.

* One cause of obstruction you don't think about is from too many "soft drinks." The gas from carbonated drinks can distend the bowel to a point that kinking can occur.

* Tea is an anti-spasmodic and soothing to an upset stomach. It also provides fluids containing electrolytes and potassium so frequently lost from diarrhea.

* Gas problems can be relieved by eating several spoonfuls of yogurt or applesauce. Much air is swallowed at night while sleeping and this will result in gas. A few swallows of club soda will help to get rid of gas bubbles. You just burp them up. The manner of eating is also a factor in relieving gas problems. If you can avoid drink while eating, the effluent will become thicker and liquids can be ingested before and after the meal.

* Polident and Efferdent are very effective to soak your appliances: to deodorize, remove stains and clean. If it's good for your teeth, it is good for your appliance.

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.

Quick Tips For The Workplace

Rambling Rosebud, Gambrills, MD, via Metro Maryland; Contra Costomy News, CA May 2011

 

Back to work having a stoma has little bearing on your employment. Most people with ostomies return to their jobs after surgery. Though absence of work can be frustrating and isolating, you must allow sufficient time (usually 3-6 months) to recover fully from your operation. Deciding when to return to work should be determined by you, your doctor, surgeon and ET nurse. You may tire more easily upon returning to work. If so, ask your employer if you can work part-­time for the first few weeks back on the job.

ON THE JOB - You will need good toilet and washing facilities at your work site, with privacy available for changing your appliance. Keep spare wafers, pouches and accessory products - plus another set of clothing - at work, just in case. If using closed-end pouches, put the used appliance in a plastic re-sealable baggie before disposing of it. After draining an open end pouch in the toilet, spray some air freshener.

JOB PERFORMANCE - People with ostomies perform nearly every kind of job. However, some occupations, in which the work is physically uncomfortable or inconvenient, may require some precautions. If your occupation involves strenuous or repetitive physical work such as stooping, bending or heavy lifting, be extra careful as you move about. If your work involves handling food, there is no reason why you cannot continue to do so, providing you exercise good personal hygiene. The risk of spreading germs is the same for those with ostomies as for those without.

      WORK RIGHTS AND RESPONSIBILITIES Under the Americans with Disabilities Act, some employers may be required to make certain accommodations for you. Inquire about this with your human resources specialist. Individuals may, however, be required to undergo a pre-employment physical. Before accepting a position with a new employer, find out the name of their health insurance company and contact it directly to find out whether the plan covers your ostomy related needs.

 

Rambling Rosebud Newsletter Editor Note - In the unlikely event you might need to change your appliance at work due to leakage, keep spare supplies and rotate them regularly. Also, since storing an entire set of clothing at work is not very practical for me, just keep spare underwear in case of a leak. The one time it happened at work I felt it quite quickly and it didn't go through all layers of clothing. Using a handicapped bathroom stall also gives you more room when changing an appliance.