The Adjustments for Ileostomates

 

Articles Included:

·        Ileostomy and the Immune System

·        Ileostomy Preps

·        How Fiber Effects an Ileostomy

·        The New Ostomy

·        Should My Family Help with the Care of My Ostomy?

·        Adjustment for the Ileostomate

·        Caring for Your Ostomy

·        Questions and Answers

·        Things Not to Do If Your an Ostomate

·        Things I Cannot Do As an Ostomate

 

Ileostomy and the Immune System

Forwarded By ReRoute, Evansville, IN Chapter

 

     In response to a query about the possible effects of ileostomy surgery on the immune system, Dr. Beck—a loyal supporter or UOA—notes that the surgery, by itself, should have no long-term effect on the immune system.  Although there is some transient reduction in a patient’s immune responses right after major surgery, this usually returns to normal in a couple of days.

     However, the diseases that cause patients to need a stoma—such as inflammatory bowel disease—and the medications used to treat these diseases (steroids) or malnutrition associated with the diseases may affect the immune system.  If you are concerned, there are several tests that a doctor can perform to test your immune system.  One of these involves placing chemicals or allergens into the skin to see how the body responds.  Others involve blood tests.

     We are continually learning more about the human immune system from our experience with HIV infections.  Most efforts are directed toward identifying and then treating the cause of the immune dysfunction.  Although good nutrition and some supplements—such as vitamins—are necessary for the immune system to work, little has been proven to improve the immune function.

 

Ileostomy Preps

UOA Discussion Board

 

Q  I am also having an endoscopic examination through my ileostomy stoma next week.  My doctor has given me a sheet with standard orders on how I should prepare for the exam.  Part of the order requires me to use a cleansing preparation like those used by people with colons.  I have no colon or rectum.  I am to be on a clear liquid diet the day before the exam and NPO—nothing by mouth—after midnight ... so why the prep? 

 

A  It is not necessary for an ileostomate to prepare their bowel with any of the purgatives normally intended for a colon.  It is evident that many practitioners simply order bowel preps as a matter or routine without considering the unique circumstances or a person with an ileostomy.

     For all people with an ileostomy, I would suggest that you challenge the order for a purgative or prep—any laxative or electrolyte solution intended to cleanse the remaining small bowel—and stick to your guns.  Do not take them. 

     Part of the responsibility for all of us who had ostomy surgery is to educate not only ourselves but also the medical profession about the special circumstances for ileostomies.

     Normally, a period—usually the day before—of clear liquids and NPO—nothing by mouth—status the night before a planned procedure is all that is necessary.  In some extenuating circumstances; e.g., you have sluggish bowel motility, one may have to prolong the clear liquid period as long as 36 to 48 hours.

     As an added note:  The British National Formulary states, "Laxatives, enemas and washouts should not be prescribed for patients with ileostomies as they may cause rapid and severe dehydration”. 

Answer provided by Mike Orizio, ileostomate, RN/ET

 

How Fiber Affects an Ileostomy

By Kay L. Peck, Registered Dietitian, Napa Valley, CA

 

     Whether or not to include fiber, and to what extent, should be based on the any person’s tolerance of foods.  The small intestine has a remarkable capacity to adapt. 

     Matter/digested food in the small intestine is quite watery, and after it moves into the large intestine, a good portion of the water is reabsorbed into the body.  Most fiber is indigestible material from plants that acts like a sponge, soaking up water and increasing the bulk of the intestinal contents—making matter move through the system more quickly. 

     In a person with a colon, fiber is essential to preventing constipation and keeping a person “regular”.  This is the main function of fiber.  Another theory about fiber is that it promotes mucosal growth, thus keeping intestines healthier, promoting gut function.  Usually, a person without a colon; i.e., with an ileostomy, doesn’t have a problem with constipation—in fact it is virtually impossible, and may have mostly watery stools or diarrhea.

     Again, over time, a person may adapt, especially if the last section of the small bowel—the ileum—is still intact.  Consuming too much fiber or insoluble fiber may aggravate a person’s diarrhea or watery stools.  If this is the case for you, limiting insoluble fiber, such as:  bran, popcorn hulls, seeds, nuts, skin, seeds, stringy membrane parts of the fruits and vegetables may be helpful.  However, another type of fiber—soluble—may be beneficial to someone with an ileostomy.

     The function of soluble fiber is to make intestinal contents thicker and can actually prevent diarrhea.  This fiber is found in oatmeal, barley, dried beans, peas, Metamucil and in the pulp of fruits and vegetables.  Most foods have a combination of both types of fiber, but the above examples show the differences.

     Just as a side note, I worked with a woman years ago who had short bowel syndrome.  All of her colon and a significant part of the small bowel had been removed.  She found that adding pectin—Certo, which is used to make jam and jelly—to her daily diet helped to minimize diarrhea.  She added a little too some applesauce every day.

 

The New Ostomy

By Mark Shaffer, Metro Denver Ostomy Newsletter

 

     At a recent chapter meeting, a subject came up that I found intriguing.  One of the participants in the rap session stated that he found himself depressed and withdrawn even though it has been a year since his surgery.

     He wondered how long he could expect that feeling to last and, I think, whether it would go on for the rest of his life.  Some people with ostomies adjust almost immediately.  These folks see an ostomy as a cure for an illness that threatened their lives or restricted their activities.  Others take a few months, generally feeling better about the situation as soon as they master the fine art of pouch changing and maintenance.

     For many, ostomy surgery begins a process that appears, and is, very close to the grieving process, and like any grieving process, the amount of time needed to feel emotionally whole again will vary.  It took me almost two years following my surgery before I felt like I had regained my former personality and was ready to move on with my life.  Therefore, there is no magic amount of time needed to adjust to your new ostomy.  Allow yourself the time you need and realize that the feelings of depression and isolation will eventually go away.

     If the depression is severe, do not be afraid to seek professional help.  If your isolation is caused by a lack of confidence in your appliance, seek help from an ET nurse and come to a chapter meeting.  There are people there who have been through all that you are going through and have succeeded in achieving an excellent quality-of-life.  If your appliance is working fine but you still feel separated from others, come to a chapter meeting and fellowship with other people with ostomies.  Come to a UOA meeting and meet others in the same situation.  If you do not already have one, call your local chapter and ask for an ostomy visitor who can talk to you about how they managed their post-operative emotions.  Above all, give yourself time to adjust ... and be happy, you have been given a new life.

 

Should My Family Help with the Care of My Ostomy?

By Mary Bawn, LPN/ ET


     Not if you are able to care for yourself.  Make yours a “do it yourself” family.  I am sure any normal person would not ask a member of the family to accompany him/her in the bathroom to help with the elimination process.  Why should you . . .  unless, of course, you are not physically able to care for yourself.

     Too many ostomates never like to view their stomas, so use the well-known crutch of “I can’t do it myself.”  For years, they have someone perform daily tasks of personal hygiene that could have been done by themselves without any problems or aid from another person.  This person with an ostomy is handicapped . . . mentally, not physically. 

     If you cannot tolerate your own body, how can you expect someone else to tolerate you?  Be independent and lead a normal life.  Having an ostomy does not mean a life of being unable to function as a whole person.  Although, a family member should be aware of needs and care in case of serious illness.  Help can then be given if it is necessary.  Including family members in teaching the care of an ostomy is part of the ostomy nurse’s function.

 

Adjustment for the Ileostomate

--Metro Maryland, adapted by The New Outlook

 

Apparel
Whatever you wore before surgery, you can wear afterward, with very few exceptions.  Many pouches made today are not bulky, and do not show under even the tightest, most stylish apparel for men or women.  

 

Diet
If you were ill before surgery, you may find you can now begin to eat normally for the first time in years.  As your appetite returns, you probably will gain a lot of weight.  This can affect the clothes you choose more than the pouch itself.  Keep in mind, it is harder to be properly fitted for an appliance if you are over weight, so be careful you do not gain too much weight.

 

Undergarments--for women

Girdles are not necessary for the ostomy, but most women who use them prefer the lightweight stretch type.  A girdle that does not stretch may cause pooling of the drainage around the stoma, making the seal loosen.  An old girdle, or one that is a size too large, may be more comfortable at first.  It is not necessary to cut a hole in the girdle for the pouch, when the ostomy system is worn inside the girdle; it will have support and will be even less noticeable.  A little air around the stoma in the pouch will often prevent discomfort from a tight girdle and provide space for drainage.  In addition, cotton knit or stretch underpants may give the support and security you need.  Some women find a maternity garter belt suits them best in the first weeks after surgery.  Panty hose are also comfortable.

 

Undergarments--for men

Men can wear a girdle designed especially for them.  Jockey-type shorts or a wide-belted athletic supporter with the crotch cut off can also be appropriate.

 

Physical labor

Ileostomates can do most jobs; however, heavy lifting may cause a stoma to herniate or prolapse.  A sudden blow in the appliance area could cause the barrier to shift and cut the stoma.  There are ileostomates who do some lifting, such as firefighters, mechanics and truck drivers.  There are athletes who have stomas.  Check with your doctor about your type of work.  As with all major surgery, it will take time for you to regain strength after your operation.  A letter from your doctor to your employer may be helpful should the employer have doubts about what you can do.

 

Fair employment rights

Sometimes a person with an ileostomy finds his or her employer thinks the ileostomy will impair ability to do the job.  This also happens to some ileostomates who are applying for a new job.  You should know that your right to work is protected by sections of the US.  Rehabilitation Act of 1973, by the Americans with Disabilities Act, and by sections of your state laws.  If you feel you are being treated unfairly because of your ileostomy, check with a local legal resource about protecting your rights.

 

Sports participation

An ileostomy should not limit your participation in sports.  Many physicians do not allow contact sports because of possible injury to the stoma from a severe blow or because the appliance may slip, but these problems can be overcome with special equipment.  Weight lifting can result in a hernia at the stoma.  Check with your doctor about such sports.  Some ileostomates are distance runners, skiers, swimmers and participants in most other types of athletics.

 

Bathing
Bathe to your heart's content with or without your appliance.  If you wish to take off your appliance to shower or bathe, you can do so.  Normal exposure to air or contact with soap and water will not harm the stoma and water does not enter the ostomy opening.  If you are concerned about ileal contents dripping into the bath or shower, you may want to choose a time for bathing when the bowel is less active.  You can also leave your appliance on while bathing.

 

Caring for Your Ostomy

By Pat Murphy, RN, CETN, Alexian Brothers Hospital

 

Here are some simple pointers for ostomy care.  They may not be new, but sometimes it is good to be reminded of them.  Good ostomy care habits can catch and nip problems in the bud—the rosebud that is.

 

1.      Inspect your stoma and skin each time you change your appliance.

 

Your stoma should be bright red, smooth and shiny.  Inspect the lower edge especially well.  Use a mirror if necessary.  Look for any signs of irritation or bleeding.

 

It may mean your appliance is rubbing there.  Your skin should not be pink, purple or gray, even right next to the stoma.  Although, when you first take your appliance off, you will notice some pink skin under pressure points.  This is the same as when you take off your watch or a pair of stockings.  This is normal.

 

Also, inspect your skin in a sitting position to see if creases or low areas from around the stoma.  This will tell you where to take special steps to even out the area when you put on your appliance.

 

Stretching the skin to be smooth may be all you need to do, or you may need a dab of paste or one of the new seals like Hollihesive or Eakin.

 

2.      Remember, a new stoma changes size for up to a year.

 

Re-measure your stoma every time you change the barrier for the first six months and every month thereafter.  Always re-measure if you are having a problem with leaking.  Measure the stoma at the base from side to side and from top to bottom.

 

Many stomas are oval.  If you are cutting a skin barrier or a one-piece ostomy system, no skin should show when it is in place.  However, make sure the barrier is never touching the stoma.  This is a bit tricky to do, thus manufacturers developed the seal allowing a slightly bigger opening to be made.

 

If your stoma is not perfectly round, do not trace and cut a round circle.  Instead, make the barrier fit exactly.  It should just miss the stoma, sealing down on the skin right next to it.  Your appliance or barriers should not go over any red, wet mucosal tissue—the kind that forms the stoma.  If you wear a pouch with a karaya ring on it, the ring should gently touch the stoma all around.

 

Even an "old" stoma can change size temporarily.  It can change from round to oval if you are experiencing some abdominal distention or if you have gained weight.

 

3.      Be sure you know the steps involved in treating sore skin.

 

Many people use too much powder.  This may interfere with the adhesion of the appliance and cause the problem to worsen. 

 

A tiny amount of powder should be placed on the sore area, and then wiped off with a dry tissue.  It will stick where you need it; i.e., if you have wet, irritated skin, powder will protect it so the barrier will stick to it.  A barrier will not stick to a wet surface.  The barrier will then protect the skin against the output, and the skin will heal better under the barrier.

 

If you use a liquid skin barrier—never with extended wear barriers, like ConvaTec's Durahesive or Hollister's Flextend—it should be applied over the powder until you can no long see any powder.  Fan it dry quickly and then put on your appliance as usual.

 

When treating any skin problem, always change your appliance more frequently than you usually do until the problem is solved.  This is so you may examine the progress of the healing, and prevent and additional damage from occurring.

 

4.      Be sure you are not over-cleaning either your skin or the pouch.

 

The skin around your stoma is best washed with plain water.  A mild soap may be used for particular circumstances, but is not recommended for regular use for most people.

 

When rinsing out an appliance—like a one-piece—while it is on your body, do not use too much agitation or you may loosen the barrier.  Being too aggressive may loosen the pouch by making the inner seal wet.  The skin barrier may pick up too much moisture too soon, and wearing a moist barrier may cause a yeast—fungus infection—rash under the appliance.

 

5.      Do not try to set a wearing-time record.

 

Change your barrier before the part next to your skin is washed away or gets soft and mushy.  It usually is not wise to wear any type of appliance more than seven days.  Most people change two or three times a week. 

 

When you inspect your stoma and skin; and you have a question about what you are seeing; and what you should do about it, you may want to call your ET nurse and arrange an appointment.

 

If you can describe the situation well, the WOC nurse may be able to advise you immediately right over the phone.  If not, have the WOC nurse look at it before it becomes a bigger problem.  You should have an ET examine your stoma and peristomal skin every year or two. 

 

Questions & Answers

By Angela Kelly, RNET, Vancouver General Hospital

 

Q      When I take off my Appliance, there is a red circle around my stoma.  It is about the distance to the round inner-circle of my barrier.  It is not painful or sore, but I am wondering if I should be worried about this?

 

A     The main reasons for red skin around the stoma are incorrect appliance fit, leakage, moisture irritation or sensitivity to the ostomy products.  (Note that we are talking about red skin and not the pink skin caused by the pressure of the barrier or paste.  This is normal and expected.)

 

From what is described in the question, the red skin is the result of the most common problem, an opening in the appliance that is too large, thereby exposing the skin between the stoma and the seal.  To check this, measure your stoma—there is usually a paper stoma guide in most boxes of barriers—with a measure guide, then check the size of the opening in the barrier that you are using.  If the appliance opening were larger by more than 1/8th of an inch than your stoma, this probably would account for the red skin.

 

The fact that the condition described is not painful indicates that the stoma under discussion is a colostomy.  People who have an ileostomy or ileal conduit can get very irritated sore skin from using too large an appliance opening because the drainage from these is much harder on the skin.

 

To correct the problem, measure and if there is a gap between stoma and seal, choose a barrier with a smaller opening; i.e., one that fits to 1/8th of an inch around your stoma and this will eliminate the red skin.  If the problem persists, make an appointment to see your ET nurse and get it checked out.

 

Q     I have come across faulty appliances lately.  Three to five pouches out of a box have small pinprick holes in them.  Is this a common problem with appliances?

 

A     In a word . . . no:  This is not a common problem, although, I did hear of someone who had a cat as a pet and discovered that when this kitty sat on her lap, it would knead its claws into her clothing to show its pleasure at being stroked.  Unfortunately, its claws would sometimes dig through the clothing and make small holes in her pouch.  There may be a message here somewhere.

 

Let us go back to the question.  The manufacturers of ostomy equipment maintain very high standards in the production of their supplies.  However, the machinery used is very complex and sometimes if not calibrated properly, the seams on the pouches will not bond correctly.  This would soon be detected by the numerous checkers of the machine and finished product.  However, in the thousands made, some faulty pouches do slip through and end up in the packages.

 

If you do come across a faulty appliance, call up the manufacturer.  They will gladly exchange them.  They will want to know the stock number on the box.  This will help them trace down the problem and correct it.

 

If you are nervous about putting on a pouch that is faulty, check it before you wear it.  A good way is by filling it with water.  That ways, you can be sure of putting on a sound pouch.

 

Q     I have an ileostomy and when I have a blockage, should I dilate or not?

 

A      An ileostomy blockage is most commonly caused by food.  There is a narrowing at the point where the small bowel comes through the muscle of the abdominal wall, and sometimes, undigested food particles can become stuck in this narrowing causing an obstruction.

 

The best way to prevent this from happening is to be sensible about what you eat, and chew your food really well.  However, if you just could not resist that extra bran muffin or raw carrot and you do get a blockage, dilation of your stoma is not always the best answer.

 

Rather, remove the barrier—give that stoma a chance to stretch—and let the stoma be free or at least apply a barrier with a larger opening.  Hop into the bath or shower.  Sometimes the warm water will relax your muscles and allow the obstruction to pass.  Another suggestion:  Sipping warm tea without cream or sugar will cause the bowel to peristalsis thus pushing out the offending blockage.

 

If things do not resolve in a matter of hours, then seek advice from your physician or ET nurse.  Possibly a gentle irrigation with normal saline will be required to remove the blockage.  A professional familiar with the procedure should do this procedure.

 

A word I want to say on dilation.  Do not, unless specifically ordered to do so by your physician.  Rough dilation can cause accidental perforation or injury to the stoma, which may produce scarring when it heals compounding an already tight situation.

 

A     What is a good way to hide or conceal your appliance during sex?

 

Q     First, make sure you are using a good, secure, odor-proof appliance—one with an opaque pouch being preferable to transparent.  A well-fitting ostomy system will not dislodge during lovemaking and if you use a two-piece system, a smaller pouch may be exchanged for a larger one at these special times. 

 

There are now available many different and attractive pouch covers.  If you are good with the sewing needle, how about making your own fashioned out of soft sensual material?  Also available in the stores are attractive underwear designed to come up to the waist so covering the appliance with wider legs for women, or if you want to be really daring, how about trying "Anticipants" (crotch-less panties) available in specialty stores or see advertisements in the Ostomy Quarterly.  Some folks prefer to drape a cummerbund around their middle.

 

May I recommend for further ideas, the excellent pamphlets available through the UOAA entitled Sex and the Single Ostomate, Sex and the Female Ostomate, and Sex and the Male Ostomate available at www.uoachicago.org on the Tips page.

 

Q     My stoma seems to protrude more one day than another.  Is this OK or should I worry?

 

A     The contents of the bowel are pushed along by progressive, simultaneous, contractions and relaxations of the muscles in the bowel wall.  This is known as peristalsis.  This wave of movement can sometimes be seen traveling through the stoma itself causing the stoma to wiggle, and swell a little and contract.  All this is perfectly normal.

 

A stoma that is flatter when one is lying down but protrudes significantly when sitting or standing may indicate a prolapse.  This is often associated with a peristomal hernia or excessive weight gain after surgery.  Although there is no urgency to this, it is a good idea to have it checked out by your physician or WOC nurse.  

 

Things Not to Do If You’re an Ostomate

Adapted By The New Outlook

 

Attached is a collection of items compiled from the Internet and many other sources.  It is just a reminder that we should not take ourselves too seriously. 

 

·        Drop a clip in the toilet.  It is a prudent idea always to carry a spare clip. 

 

·        Stand up too quickly when the clip is caught on the edge of the toilet seat.  Most of us have gotten up too quickly and ended up stopped instantly in mid-air, because the clip caught on the inside edge of the toilet seat.  The clip will lift the seat, and you feel like a fish caught on the end of a line.  Quite a bad visual, but we only do it once; or  maybe twice; no, we'll make this goof your whole life and it will surprise us every time.  This is especially a problem for a woman.  Imagine being at someone's home and dropping the toilet seat loudly just before you leave the bathroom.  Everyone just looks and wonders why a woman would be dropping a toilet seat.

 

·        When drying your appliance with a hairdryer, use the cool setting only.  Plastic melts.

 

·        Do not have your dog jump on you when your pouch is full.  The dog’s nails will puncture the pouch.

                                                                                                                                                                    

·        Drink PowerAde Mountain Blast or Gatorade Blue Bolt before a doctor visit.  It turns your output bright green.  This is especially true if you have an ileostomy.  All food dyes turn your stool the color of the dye, temporarily.  It will surprise you the first time it happens.  This includes Blue Hawaiians or red beets.  Beet makes you look like your bleeding to death. 

 

·        For men only:  You may want to angle the pouch toward your leg.  This warning is especially true if you use a drainable pouch.  This will keep the clip away from your private parts.  Sorry if this is a wee bit graphic for the faint of heart, but it will make you more comfortable.  

 

·        For woman only:  The clip may bother you also.  You have the same option.  Also, keep the clip away from a sanitary napkin.  If the clip is caught on the pad's adhesive, the clip could be pulled off.

 

·        Put a cat on your lap.  A cat's claw could cause a tear in your pouch.  If you sleep with a cat, they sometimes curl up next to it when you sleep to keep warm.

 

·        Beer may blow up your pouch with gas.  This may be helpful when you need a floatation devise.

 

·        Do not accidentally lean against an oven door, barbecue grill or fireplace.  The pouch melts instantly.  

 

·        Do not put underarm type deodorants around the pouch or barrier.  It is made of either plastic or a latex material and it will dissolve it.  If you want to use some type of order control, although modern pouches are odor proof, use mild mouthwash or one of the commercially made products that will not harm your stoma or your pouch.  Many chemicals can damage an appliance.

 

Things I Cannot Do Since My Ostomy

Adapted By The New Outlook

 

Our Comments:

The reason we decided to write this page was to demonstrate to new ostomates that there are some things you cannot do with an ostomy.  You will probably laugh because they are relatively insignificant when compared to life.  Most people having ostomy surgery are making a life and death decision.  People with ileostomies from Crohn's or colitis will have a better quality of life after the surgery.  In addition, we have received comments from people who tell us that they are doing some of the things listed here.  The more we learn, the more we find that an ostomy is not a big deterrent to living the same life we would if we were non-ostomates.

 

·        The one thing that I really miss is sleeping on my stomach.  Prior to my surgery, I slept on my stomach all the time.  However, with an ostomy, it just is not easy.  

 

·        You cannot take your toddler into the shower with you...I tried that once and had the whole appliance ripped from my body because that is the first thing she grabbed when she started to fall down--one word OUCH!

 

·        You cannot take your temperature rectally or use rectal suppositories.

 

·        You cannot run around for long without a pouch on.

 

·        You cannot use enteric-coated medications.

 

·        You can no longer sleep in the nude (the pouch is always attached).  

 

By the way, there is no reason why you cannot sleep almost in the nude with an ostomy.  I do it all summer long, never had a problem, there is no more "flopping around" than with PJ's.  Get a cummerbund to hold everything in place.  Of course, with that on you are not totally nude but you are topless and bottomless, and you got the middle covered. 

 

Do you wear a belt with your pouch?  The clip end of the pouch may be stuffed under the belt out of the way, and with no flopping.  Nude is good for sleeping.  Try those cute little tube tops the girls wear all summer, just a little lower on your body.  It works for me and fits the budget quite well.  H-m-m-m-m-m…one of those cummerbund-style belts/covers might make interesting sleepwear for a man, at least from a woman's point of view!

 

·        Potty train a toddler!  When my grandson accompanied me and asked, "What’s that", the pouch that is, and what I was doing, my answer befuddled him.  At 2-1/2, he is having a hard time understanding why he poops from one end of his body, and I have this pouch attached to my body.  He insists my appliance is a boo-boo.

 

·        You cannot go without your shirt in public…unless you are a self-confident male.

 

·        You cannot sleep all night without getting up to empty the pouch.

 

·        I forget I can no longer be called "anal"!  My husband calls me "stomal".

 

·        I cannot play on my illness any more and say, "I'm too sick to go out."

 

·        I cannot blame my weight gain on prednisone anymore--I just eat too much now!

 

·        A male cannot get a tactile prostrate check each year.  They must depend on other tests like a PSA test.

 

I can't honestly say that my stoma has stopped me from doing anything I want to--and I've met a lot of wonderful people who I otherwise would not have met through my UOA Chapter.

 

·        You cannot have as many reasons to stay out of a normal life stream.

 

·        You do not feel nearly as bad.

 

·        You have more control as to when you go, and where.

 

·        You have some thing to do every 4 hours.  Of course, I mean I have to urinate.

What did you think?

 

·        You do not have to fear being on a dead locked freeway with no place to go to the washroom.  This is especially true for people who previously had ulcerative colitis.

 

·        I do not get 90% of my reading done in the bathroom anymore.

 

·        Nude is good for sleeping.  Try those cute little tube tops the girls wear all summer, just a little lower on your body.  Again, it works for me and fits the budget quite well.  H-m-m-m-m-m…one of those cummerbund-style belts/covers might make interesting sleepwear for a man, at least from a woman's point of view!

 

Two things you cannot do with a urostomy:

 

·        You cannot write your name in the snow.  

 

·        You cannot travel without an extra suitcase for equipment changes.

 

Hey, sorry to be so contrary, but . . . I cannot think of anything I cannot do with an ostomy!  No, really, I cannot.  I have a colostomy, sleep on my belly; I do everything I did before I had the stoma.  No, that is incorrect, I now do more than I used to.  I had a very narrow escape with cancer, stage three, and so I decided that I had better not mess around any longer.  After my surgery, I started doing everything I ever wanted to do.  Right now.  And, so I am.

 

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