June 2004
Last Month's Meeting
The Des Plaines River crested
the day of our meeting flooding some of the roads accessing Lutheran General
Hospital. Still, there were about 30 people
who made it through stifling traffic congestion to attend anyway. Our people are determined.
We had a special guest for the
evening, Heather M. Budorick, CWOCN who is associated with Holy Family Hospital
and Hollister, Inc. She graciously accepted
our invitation to speak on short notice in order to direct an open discussion
on a variety of ostomy issues.
After the discussion, Jane
presented special recognition to the past members who answered the call to be
officers and committee chairpersons. We
do not say thank you often enough to our dedicated volunteers who help make
this Chapter possible. We know that
there are many others who contribute to our fundraisers and special events that
we missed today ... so ... thank you.
Dave Rudzin officiated the
election of our officers for 2004-2005.
UOA has a traditional installation ceremony which Dave performed
characteristically with all dignity and solemnity. It is an emotional ceremony to behold, and
well worth a meeting on its own.
We’d like to thank Lois Knaack, Renard Narcaroti, Helen Schnieder and an anonymous person for bringing some bakery goods to our hospitality table. The lucky winner of the 50/50 was first time visitor Julie Berman, and the consolation prize went to Jane Michnik. We hope to see all of you in June, and pray for good weather that day.
President’s Message:
We need to constantly keep a positive attitude toward our
lives ... this is one of the most
powerful forces, along with love, on earth.
A positive attitude not only affects how we respond to everyday
difficulties and challenges, but it will actually help us to change the outcome
of events.
This may be seen in our Chapter in many of
our members with ostomies who have overcome devastating diseases. These people with ostomies are going forward
to lead full, productive and happy lives.
The physical aspect of life may be compromised greatly by illness, but
with a positive mental attitude, and a willingness to let go of self-pity and
bitterness, life will go on ... better than before. Life may even be enriched by a painful and
traumatic experience. Look around at our
next meeting to see what I mean.
In closing, I would like to leave you with a short story.
“A flood threatens a town, forcing
everyone to evacuate. But Joe thinks,
“I’m a devout man; G-d will save me,” and he stays put. As the waters rise, Joe’s neighbor comes by
and says, “Joe, come with me; we’ve got to go.”
Joe declines: I’m a devout man; G-d will save me.” The waters keep rising. Joe scrambles to his second floor. A firefighter in a row boat comes by. “Get in the boat or you’ll drown,” he says. Joe again declines, saying, “G-d will save
me.” Finally, the floodwaters force Joe
to his roof. A police helicopter comes
by and throws down a rope. “Climb up or
you’ll drown”, the policeman yells. “No.
I’m a devout man; G-d will save me,” Joe replies. Soon, Joe drowns. He arrives in heaven and
challenges G-d. “Why didn’t you help me?”
“What do you mean?” G-d says. “I
did help. I sent a neighbor, a
firefighter and a helicopter”.
Jane Michnik
Coming Events
June 19—The second meeting of the revitalized Lake
County Ostomy Assn. An informative
session is being planned by Margie Barosko for 10:00 a.m. at the world headquarters of
Hollister Inc. Kathy Krenz, CWOCN will be there for questions and
answers. See the article on Lake County for details.
June 23—We are having an open discussion forum with
our members. This will be a round table
format discussing ostomy issues of interest to us all. Our featured guest will be a new ostomy nurse
to our Chapter who has graciously accepted our invitation to speak. Lorraine Compton, CWOCN from Our Lady of
Resurrection Hospital will answer questions on common ostomy issues.
July 28—A special presentation by Jan Colwell, CWOCN
from the University of Chicago. She has
recently completed writing a medical textbook on the care, treatment and
placement of stomas. Some of us saw Jan
make a presentation to a medical group at Hollister, Inc., and it was
fantastic. She will speak about advanced
topics not always discussed offering us a unique opportunity.
Friends of Ostomates Worldwide
Our world headquarters is located in Glenview, and is run entirely by volunteers. Mike Cherry has organized a group of Hollister, Inc. employees who come once a month on a Saturday morning. Mario Pardo volunteers here Monday, Wednesday and Friday from 9 a.m. until noon. Joan Loyd covers Thursdays and Marilyn Mau Tuesdays.
We have just sent three skids of supplies to Chile and a large, desperately needed shipment to Eritrea just north of Ethiopia. We work very, very hard to surmount the political issues involved in sending humanitarian aid to areas like these. A special thank you to Joan Loyd and our friends at Hollister, Inc. who together use their expertise to overcome these often overwhelming barriers.
When you would like to invest your talent one day a month helping us on a weekday morning—when we actually do our shipping and receiving—please call Joan at 847-724-8002. We are all volunteers here and could really use a few more capable people.
Lake
County Ostomy Association
On Saturday, May 15, the first meeting of the newly organized Lake County Ostomy Outreach was hosted at the world headquarters of Hollister, Inc. There were over 50 people in attendance many of whom had never been to a UOA meeting before.
Nadine Presley, one of the founders of the North Suburban Chapter, along with Gary Ponti, a past winner of the Al Sarno Award, introduced the meeting with a brief history along with the mission of the new chapter. The morning session included one of the best presentations we have even seen on issues relating to ostomy concerns. This session was lead by Hollister ostomy nurse, Lynn Sacramento, CWOCN, who personally answers over 500 inquiries a month from the Hollister Hotline at 800-323-4060. She discussed common errors made by people using ostomy equipment and simple solutions. She discussed the high quality of equipment being manufactured today along with the continuing research to improved ostomy care and the resources available to help people with ostomies.
Renee Picard from Byram Healthcare, a state-of-the-art ostomy supply company, was on hand to discuss their wide selection of product offerings; their ability to accept Medicare assignment as well as private insurance and HMOs for payment of supplies; and their ability to solve a wide range of ostomy concerns. Their team may be reached at 1-800-200-1100.
After a complimentary lunch provided by Hollister, Inc., the afternoon session featured a panel discussion by Ginnie Kasten, UOA Area Director; Jane Michnik, CNSC President; Gary Ponti, UOA leader; Dave Rudzin, UOA Director. An open discussion with questions and answers completed the meeting.
This was a truly exciting experience for
the person with an ostomy. You owe it to
yourself to attend the next informative meeting in Lake County: Saturday, June 19 at 10:00 a.m., at the offices of Hollister,
Inc., located just north of Route 60—by the Vernon Hill Mall—on Milwaukee
Ave. You’ll be glad you did. If you want more information, please contact Nadine Presley at 847-356-0632 or Judy
Gaughan at judy.gaughan@hollister.com
.
Ostomy Nursing Credentials
WOCN Internet Site
A nurse who is certified as a wound, ostomy, and/or continence nurse has voluntarily sought validation of expert nursing knowledge, demonstrated a personal commitment to quality care and has sought a means of self-regulation in order to protect the consumer.
A Certified Wound Care Nurse (CWCN®) has demonstrated knowledge in the assessment, management and product selection for wounds caused by pressure ulcers, venous and arterial disease, diabetes, draining incisions and traumatic injuries.
A Certified Ostomy Care Nurse (COCN®) has demonstrated knowledge in the assessment, management and product selection for patients in the preoperative and postoperative phases of surgery, whether it is for an ileostomy, colostomy, urinary diversion or fistula. Ongoing management and problem-solving may also be done by these nurses.
A Certified Continence Care Nurse (CCCN®) has demonstrated knowledge in the assessment, management and product selection in patients who have urinary or fecal incontinence. They have demonstrated knowledge in skin care and ongoing health education for this group of patients.
A Certified Wound, Ostomy and Continence Nurse (CWOCN®) has successfully completed requirements for all three of the nursing specialties listed above. A CWOCN® is the only officially recognized designation for certification in the Tri-specialty of wound, ostomy and continence practice.
The only officially recognized designations for certification in an individual specialty are:
· Certified Wound Care Nurse (CWCN)®
· Certified Ostomy Care Nurse (COCN)®
·
Certified Continence Care Nurse
(CCCN)®
Requirements
for Certification
1. Currently licensed as a registered nurse.
2. Baccalaureate degree.
3. Completion and filing of an application for
desired specialty certification examination(s).
4. Fulfill one of the following requirements:
· Complete a WOC Nursing Education Program that is accredited by WOCN. The nursing education program must be accredited at the time of graduation.
· Complete a graduate-level program in nursing with documentation of graduate clinical course work equivalent to two semester hours in each specialty for which certification is sought.
· Have 50 Contact Hours (CEU) and 1500 clinical experience hours over the last five years within each specialty for which certification is sought.
Caring for Excoriated Skin
If, after removing your wafer, you find your skin to be red, denuded of skin, painful or sensitive, you have excoriated skin. Excoriated skin is often caused by pulling off your wafer too vigorously.
The correct way to remove your barrier is to simply hold down your skin and gentle pull the wafer down and away from your skin. If needed, you may use an adhesive remover pad, and going from side to side, carefully take off the old barrier.
After gently washing the stoma and surrounding skin with warm water, dry the skin thoroughly. You may use a hair dryer set to cool. Don’t rub the skin when drying ... pat it. Then, sprinkle the skin with a quality ostomy powder—like Hollihesive or Stomahesive powder—dust off the excess and then you have the option to seal the powder in with a non-alcohol containing skin prep. Wipe the skin with the skin prep until you can’t see any more powder. But be careful, the new extended wear barriers do not adhere well when applied to skin prepared with a skin prep. In this case the powder on the skin alone will work just fine.
Then, if you wear a square barrier, instead of placing your wafer squarely on your skin, put it on “diamond” shape. The next wafer change, put it on your skin squarely and rotate every other change. This gives at least part of your excoriated skin a good chance to heal. Putting a barrier on your skin actually enhances healing. Covered skin heals faster than bare skin, so, don’t feel that you have to air it out for skin to heal properly. And remember, be gentle with your skin and it will be good to you.
The Wonder of Milk of Magnesia
Internet Sources
Because of its alkaline properties, Milk of Magnesia (MM) is beneficial to skin which has been burned by hydrochloric acids or enzymes from intestinal secretions. Good hygienic care of the skin for all types of ostomies is very important. One may use adhesive removers made especially for taking off barriers or alcohol to remove all soap film after washing the adhesive solvent off.
It is usually recommended to only use plain water when washing under the barrier to prevent itching and skin irritation, but there are circumstances when removers and alcohol have there place; e.g., alcohol or adhesive removers will kill most latent intestinal bacteria which can multiply under the barrier.
It is possible for enzymes to penetrate so deeply into the skin that neither soap nor alcohol can remove them. But, MM will neutralize them. Rub it gently into the skin. If the enzymes are there, MM will curdle like cottage cheese. In that case, rinse it off with warm water, pat the skin dry and apply a new film of MM. Let this dry completely and put on an ostomy skin prep that is compatible with your barrier, a quality ostomy powder and proceed with applying your new ostomy system, as usual.
Products such as DiGel, Amphogel and similar products may be used instead of MM. A paste made of MM and ostomy powder is healing to the skin. After the paste is dry, the barrier may be applied. There is no excuse for skin that is in poor condition. If you cannot resolve a problem by yourself, make an appointment to see your ET nurse. He/she will have a solution for you. Do not ever accept less the excellent service from your ostomy system. You don’t have to settle.
Medications
and an Ostomy
By
Jill Conwill, MSN, CWOCN, Corpus
Christi Ostomy News
There are a variety of forms in which medications are dispersed. Many of the drugs prescribed by a physician are done with the knowledge that their patient is a person with an ostomy. With the many specialists in the medical field, it is a good practice to remind your physician that you have an ostomy just in case the medication needs to be dispersed in a more digestible form. The following list discusses some of the forms in which medications are dispersed and how they affect the ostomate:
Chewable means it should be completely chewed. Any fragments left may be found in the effluent—stomal output. If you routinely chew all of your tablets or separate capsules, you may be looking for trouble. Many medications are not meant to be chewed.
Enteric Coated tablets have dissolution delayed. These tablets have diminished or minimal effectiveness for someone with an ileostomy.
Gelatin Coated are less effective than liquids if the person with an ostomy has short bowel syndrome.
Liquids are more rapidly absorbed. If you have difficulty swallowing pills, ask for the medication in a liquid form.
Sustained Release medications take 8 to 12 hours to absorb. These capsules should not be chewed or opened—unless approved by your pharmacist. These capsules are designed to release slowly after they pass through the stomach, not before. Side effects may be exacerbated if directions are not followed.
Sugar Coated tablets do not dissolve completely until the tablet reaches the ileum. Watch for traces of the tablet in the effluent.
Uncoated tablets begin to dissolve in the stomach. But, the complete time taken to dissolve may vary among different products ... always ask your pharmacist to be on the safe side.
Here are some special notes regarding certain medication groups.
Antacids use basic compounds—alkaline—which are used to reduce acidity of the gastric contents. Sodium bicarbonate based antacids are high in salt. Magnesium based antacids have a laxative effect—which means do not take them if you have an ileostomy, irrigate, or have renal failure. Aluminum based antacids delay the emptying time of the stomach; inhibit the absorption of iron; are constipating; and increase the excretion of products in urine like aspirin.
Antibiotics may often result in diarrhea. If so, then increase your fluid intake. Antibiotics alter the normal bacteria found in the large intestine and may result in a fungal—yeast, candida—infection. The large intestine has either bacteria or fungus, it is never “clean”. Make sure you use a micro-granulated anti-fungal powder under your barrier whenever you are taking antibiotics in order to fight off fungal invaders.
Anti-flatulent medications help in the dispersing and prevent the formation of gas—Mylicon or Gas-X. If the flatus is the result of the types of foods; i.e., beans, broccoli, try Beano.
Chemotherapy may cause gastrointestinal tract disturbances. If you are currently irrigating and diarrhea begins, stop until the stool regains consistency. Make sure you inform your doctor about all side effects as well as any vitamins, supplements or medications you are taking. Many react to chemotherapy.
Diuretics may result in fluid and electrolyte imbalances. Ileostomates should not take these—unless seriously researched by your doctor. If you irrigate, you may find you get poor results due to the dehydration of the colon.
Laxatives should never be taken by a person with an ileostomy. Mineral oil should not be taken with a meal ... it delays the emptying time of the stomach. Bulk-forming products—Metamucil—must be taken with sufficient water or it will be constipating. The best way to control output is through diet. Natural laxatives like warm prune juice as well as adding fruits, vegetables and fluids are best.
Odor Control can be obtained by medications that have a bismuth subgallate base—Devrom Tablets. Chlorophyll is in parsley but may be purchased in capsule form. They will turn the stool green.
Pain Medications are constipating so be sure to drink plenty of fluids.
Salt Substitutes reduce sodium and should be avoided by people with ileostomies.
Vitamins are often taken without consulting your physician. Always inform your doctor if you are taking vitamins. There are instances when prescribed medications can interact with vitamins resulting in ineffective absorption or cause adverse reactions.
When starting a new medication, ask what you should expect in the way of side effects related to your ostomy. Most pharmacies present a list of actions and side effects with each prescription. If problems arise, call your physician so that the problem does not get out of hand. Communication with your doctor and your pharmacist will always pay off in the end. Plus, most doctors and pharmacist will have to call the drug manufacturer on some medications because absorption by someone with an ostomy may be obscure.
Stress
and Intestinal Gas
Space
Coast Shuttle Blast, Cocoa, FL
One of the most common gastrointestinal complaints is caused by stress. Flatulence occurs in people during stressful situations.
While under stress, breathing is deeper and one sighs more, encouraging a greater than normal intake of air. In fact, studies show that the average American belches about 14 times a day. The person with a flatulence problem does not belch more often. However, they may experience the sensation of needing to belch and get little relief from doing so. Here are some ways to relieve gas:
· Avoid heavy fatty meals, especially during stressful situations.
· Reduce the quantity of food consumed at one sitting. Eat small low-fat meals about every three hours.
· Avoid drinking beverages out of cans or bottles.
· Avoid drinking through a straw.
· Avoid foods and beverages you personally cannot tolerate.
· Avoid any practice that causes intake of air; e.g., chewing gum, smoking.
· Drink at least eight glasses of water a day.
· Experiment with foods in your diet to achieve adequate bowel regularity.
· Avoid eating too many fiber foods in one meal.
· Avoid skipping meals. An empty bowel encourages small and gassy stool.
Poor digestion can often exaggerate the symptoms associated with flatulence. Digestive enzymes aid in food assimilation and chemical digestion. Enzyme supplements should always be taken immediately before or after eating. Food coats the stomach and helps prevent gastric juices and acids from destroying the enzyme action.
Bladder
Cancer
By
T.R. VanDellan, M.D., The Ostomy News Review, GB, WI
Most tumors of the urinary bladder are malignant. They are likely to develop after the age of 50, and men are more susceptible than women. At least 95 percent of these tumors are carcinomas or papillomas.
When the first tumor is removed, another develops months or years later. It is a new lesion and likely to be more malignant than the first. This type of recurrence may happen over and over again. This is the reason urologists insist on looking into the bladder every three to six months after the first neoplasm is removed.
The incidence of bladder tumors is increasing among our population. In 2004, it is estimated that over 55,000 new cases will be reported. Overall, bladder cancer incidence is about four times higher in men than in women. On the other hand, the death rate has not risen due, perhaps, to improvements in early diagnosis and treatment.
Cancers of the bladder may grow for varying periods of time without producing any symptoms. They are always suspected when the individual suddenly, and for no apparent reason, urinates blood. Should this painless, but serious, sign develop, consult with your physician without delay. He/she may recommend a urologist who will try to find the source of the bleeding. Note: The most common reasons for urinary bleeding in men are urinary tract infections and inflammation of the prostate gland, which are both relatively minor when compared to bladder cancer.
If nothing is done about the sudden bleeding, regardless of its source, it may stop spontaneously. However, signs of bladder irritation and infection may soon ensue with frequency, urgency, and difficult and painful urination.
Diagnosis is made by looking into the bladder with a cystoscope and doing a biopsy. With this procedure, the surgeon determines the size, shape and location of the tumor. In some instances, the top of the lesion has sloughed off, leaving a bleeding ulcer. A pap test of the urine may reveal cancer cells. X-rays of the kidneys and an examination of the prostate gland in men complete the study.
Some vesicle tumors can be removed with electro-coagulation or cutting electric currents inserted through the opening in the scope. Radon seeds can be placed in the bladder in the same way. Serious lesions require abdominal surgery, which involves removal of part or all of the bladder.
Stoma
Management
By
Loree Siebert, CWOCN, By Word of
Mouth, Kankakee, IL
Ostomy
Paste
Most people with ostomies have tried ostomy paste at one time or another. Considerably more that half of us use it on a regular basis as part of our ostomy system.
What is it? Technically, ostomy pastes are skin barrier compounds—manufactured for sale by several companies—that are molded around a stoma or skin surface irregularities to provide additional protection. Paste provides a uniform sealing surface around the stoma and under the barrier. Stoma paste usually comes in a tube similar to toothpaste.
The name of this compound—paste—does not accurately describe its application. The manufacturers certainly could have found a better name to describe it. It is not, as the name implies to some, a glue that is used to adhere the barrier—or by other names, wafer, faceplate—to the skin.
What does it do? When applied correctly, stoma paste provides an additional degree of protection around the stoma and on any exposed skin between the base of the stoma and the opening in the barrier. It may be used to fill in any irregularities; i.e., wrinkles, folds or suture scars, on the skin underneath the wafer. This will provide a smooth skin surface, better barrier adhesion and less chance of leakage.
The easiest way I know of to think of how
ostomy paste actually works is to compare it to the caulking around your
bathtub. It is used to fill in the
voids. The bathtub caulk keeps water
from leaking outside the tub area. It
does not glue the tub in place. Ostomy
paste keeps the effluent from leaking outside the pouch. It does not glue the ostomy system to your
skin. Note: Paste should be used with fecal ostomies
only. With urostomies, the paste may backwash
into the kidneys causing injury. Talk to
your ostomy nurse about your particular situation.
Convexity
Unfortunately, many of us have less than a perfect round, protruding stoma—for many good reasons, or we have a urostomy. It is difficult to obtain a good pouch seal if the stoma is less than perfect or the output from the stoma is liquid—like a urostomy or an ileostomy with a short bowel.
Convexity is the adaptation of a barrier so that it forces the stoma to protrude. It does this by changing the usually flat portion of the barrier that touches the skin with a convex backing so that when applied will gently force the skin to go in thus making the stoma go out. The use of convexity is indicated when one is unable to maintain a pouch seal for an acceptable length of time, or when persistent skin irritation occurs even with leakage.
Stomas that are flush—level with the skin—or peristomal skin with irregular contours, frequently result in the stomal discharge undermining the barrier. A pouching system that incorporates convexity may help to eliminate the undermining and improve pouch adherence.
Naturally there are always those individuals who have their own unique problems and need the help and guidance of an ostomy nurse. It was not too long ago that people with problem stomas requiring convexity were forced to use a permanent faceplate with pouch. These are usually made of hard plastic or rubber, cemented onto the skin and then held on with a belt.
Today in 2004, there are several ways of achieving convexity from the addition of an insert into a two-piece system, or the use of a barrier manufactured with built-in convexity. There are over a dozen manufacturers of state-of-the-art convex ostomy systems. These are usually made with the convexity actually built into the barrier. Some companies even offer varying depths of convexity—shallow, medium or deep. If you think you need convexity, see your ET nurse. There are systems specifically made to benefit urostomates, ileostomates or colostomates. A system that may be wonderful for a colostomate may not provide satisfactory ostomy management to a urostomate; e.g., karaya barrier systems are excellent to manage a colostomy where slight convexity is needed. But, this system may not provide the best solution for managing a urostomy—urine melts karaya.
A reprint for everyone who may have missed this follow-up to the letter regarding ostomy surgery on April 4. Dear Abby tells us at UOA that she was flooded with inquiries after the original article. Dear Abby published these articles because of the huge response. Too bad ABC News doesn’t share our positive attitude toward encouraging those going through ostomy surgery. ABC News appears to think it is annoying that so many of us are vocal about having a high-quality of life.
Dear Abby: "B.J. in Georgia" was seeking support from others who have had a permanent colostomy. I'm here to say there is definitely life after such an operation. I was operated on 20 years ago. I resumed riding my motorcycle a month afterward, and my exercise running program soon thereafter. At the time, I was directing the flight testing department for a major combat aircraft manufacturer, and flying F-16s on test flights. Within four months I was again flying the ultra-performance F-16s with no difficulty. The permanent colostomy need not be a show-stopper or agent of great change in one's lifestyle. I'm now retired and lead an active life at 72, and yes, I'm still riding my motorcycle. --Phil
Dear Phil: It would be an
understatement to say that you qualify as a role model for those facing this
kind of surgery. I have been inundated with messages of support for him. Read
on:
Dear Abby: A permanent colostomy is not the end of the world. I am a strong believer that a person has two choices: Feel sorry for yourself and stop living, or get up, brush yourself off, and go back to what you were doing before the surgery. The latter course of action has worked well for me.
If B.J. can do something similar, he'll find that his surgery and colostomy will not greatly hinder his ability to live a good life. --Glass
Dear "Glass": You
have a healthy outlook. Thank you for sharing your philosophy, because it can
benefit B.J. and many more people who are coping with a variety of challenges.
Dear Abby: Please assure B.J. that he's not alone. My husband had an ostomy six years ago. Common sense, a desire to live, a loving and supportive family, an excellent surgeon and a good ostomy nurse at the hospital have helped tremendously. My husband swims with his shirt off, plays golf, hikes, travels and has a full life in all respects. He isn't missing a thing, and neither am I -- and B.J. shouldn't, either. --Nancy
Dear Nancy: I'm sure he
won't. Lester in Milwaukee informed me that after his colostomy 27 years ago,
he has played racquetball, lifted weights and hiked. It's a matter of attitude.
Dear Abby: The Wound, Ostomy and Continence Nurses (WOCN) Society is a professional specialty organization of nurses who treat individuals with wounds, ostomies and incontinence. Studies substantiate that when a WOC nurse specialist is involved with the care of patients with ostomies, everyone benefits. We develop individualized rehabilitation plans to facilitate the patient's return to a productive lifestyle. We help to select the optimal stoma site, provide patient and family education and follow-up care, and promote rehabilitation. Our Web site is www.wocn.org, and our phone number is 888-224-9626 for those who would like more information.
-- Laurie McNichol, MSN, CWOCN, president
Dear Laurie: Thank you for the helpful information. Another excellent resource for information is the American Cancer Society: 800-227-2345, or www.cancer.org.
Ileostomies
& Quality of Life
By
Kevin McHugh, MD--Canada via Evansville, IN
I have postulated for some time that both medical professionals and, to some extent, people involved with ostomy associations have some wrongly-skewed impressions about living with an ostomy. I have heard a young gastroenterologist say, “Ostomies are fine, as long as you never want to go to the beach”, and a member of the executives of IOA said to me: “I don’t believe a person with an ostomy can ever feel truly normal.” These are only two examples of a prejudice that I believe is pervasive.
My contention is this: Medical professionals and, to some degree, people involved in ostomy groups interact far more with people who have difficulty adapting to life with an ostomy than with those who adapt well. I would go so far as to opine that the majority of people who have the surgery adapt well, have few problems, and do not interact with either the medical or ostomy communities, thus leading to the false perception that there are many more problems associated with the procedure than found in reality.
The term, “quality of life” is used in medical research to define a person’s ability to participate in and enjoy their chosen activities of daily life. A quick search of “Medicine” (a catalogue of all medical publications), reveals over twice as many articles in the last ten years on “mastectomy” and “quality of life” than “ileostomy” and “quality of life.” Moreover, the articles on ileostomy often compare the surgery only to people who have alternative procedures; i.e., pelvic pouch and not to the general populace.
This discrepancy is also found with regards to publications on colostomies and mastectomy, which is remarkable in that both are generally performed in the same age group and for cancer, albeit in a different anatomical location. Further investigations will reveal if this reflects a higher incidence and prevalence of breast cancer over colon cancer or if there is another explanation. Note: Colon cancer is the biggest cancer killer of non-smokers in the U.S. and has a higher incidence in the general population than breast cancer.
A recent publication in the “Journal of The Royal College of Surgeons of England”, by Brennan and Steele, of Dundee, Scotland, entitled: “Objective Assessment of Quality of Life Following Pan-proctocolectomy and Ileostomy for Ulcerative Colitis”, is some of the first research comparing the “quality of life” of people who have undergone ostomy surgery to that of the general public. While the fact that this study only examined people undergoing ileostomy for ulcerative colitis, limits its applicability to other ostomy surgeries, some extrapolation is possible.
The study compared forty-nine patients who had a permanent ileostomy for ulcerative colitis with population norms of similar age and gender in the UK. The study found that not only is “quality of life” good after surgery, but it is similar and in some ways, better than ... that’s right, better than that of the general population. Patients with an ileostomy reported less body pain, more energy and vitality, and higher social functioning. This research finding stands in stark contrast to the attitudes I described having encountered in the medical and ostomy worlds.
I hope that this research spurs more and larger studies of this kind. Moreover, I would urge all people with ostomies to discuss with their surgeon and ostomy nurse if they are actively involved in ostomy research. The United Ostomy Association of Canada could be a significant resource for this research and would benefit from having better knowledge of the number and status of people with ostomies in the country.
Some Canadian surgical centers are already leaders in this area and others should be prompted to follow their example. While some may wish to view their ostomy with the attitude, “it is better than death”, this report clearly demonstrates that a significant cohort of people undergoing ileostomy surgery have little or no negative impact due to their stomas.
I think the research underscores the importance of the ostomy association fulfilling its mandate of assisting people in adjusting to their ostomy. With this demonstration of the successful adaptation of a group with ileostomies, the importance of addressing the needs of those who are having difficulty in adapting, is reinforced. Clearly, research of the nature described here is critical to improving the lives of all people with ostomies.
Mississippi Healthcare Panic
Lawmakers are readying for a "panic" when 65,000 Medicaid beneficiaries receive letters informing them they will no longer be eligible for the program. The state House and Senate last week approved legislation that decreases Medicaid costs through enrollment reduction. Many of the 65,000 people have disabilities or are elderly and have low incomes and are eligible for Medicare as well.
About 5,000 of those who would be removed from Medicaid are not immediately eligible for Medicare. Legislators already have received calls and letters from concerned Medicaid beneficiaries, and "many are expecting a deluge of calls as word spreads." Many of these people have ostomies and receive supplies through Medicaid. This support will now be ended leaving many people with ostomies desperate for ostomy equipment. More to follow as news breaks.
New Drug for Crohn’s Disease
Two Abbott Laboratory drugs, Humira and ABT-874, help promote remission in patients with Crohn's disease. The research, presented at Digestive Disease Week in New Orleans, showed that 30 percent of Crohn's patients taking Humira in one trial achieved remission in four weeks. In the second test, researchers looked into the effectiveness and safety of Humira in Crohn's patients who stopped responding or had become intolerant to the drug infliximab (Remicade). In this trial, 29 percent of the Humira patients went into remission after 12 weeks. In another trial, researchers found the compound ABT-874 improved remission rates in Crohn's patients. Humira is an approved drug currently being prescribed for patients with rheumatoid arthritis.
Proud
to be Your Friend
Contributed
By Jerry Schinberg
I've learned...
· That life is like a roll of toilet paper. The closer it gets to the end, the faster it goes.
· That we should be glad God doesn't give us everything we ask for.
· That money doesn't buy class.
· That it's those small daily happenings that make life so spectacular.
· That under everyone's hard shell is someone who wants to be appreciated and loved.
· That the Lord didn't do it all in one day. What makes me think I can?
· That to ignore the facts does not change the facts.
· That when you plan to get even with someone, you are only letting that person continue to hurt you.
· That love, not time, heals all wounds.
· That the easiest way for me to grow as a person is to surround myself with people smarter than I am.
· That everyone you meet deserves to be greeted with a smile.
· That there's nothing sweeter than sleeping with your babies and feeling their breath on your cheeks.
· That no one is perfect until you fall in love with them.
· That life is tough, but I'm tougher.
· That opportunities are never lost; someone will take the ones you miss.
· That when you harbor bitterness, happiness will dock elsewhere.
· That I wish I could have told my Dad that I love him one more time before he passed away.
· That one should keep his words both soft and tender, because tomorrow he may have to eat them.
· That a smile is an inexpensive way to improve your looks.
· That I can't choose how I feel, but I can choose what I do about it.
· That when your newly born child holds your little finger in his little fist, that you're hooked for life.
· That everyone wants to live on top of the mountain, but all the happiness and growth occurs while you're climbing it.
· That it is best to give advice in only two circumstances; when it is requested and when it is a life threatening situation.
· That the less time I have to work with, the more things I get done.
· Show your friends how much you care.
Warning: Don't Step on the
Ducks!
Three women died
together in an accident and went to heaven.
When they got there, St. Peter said, "We only have one rule here in
heaven: Don't step on the ducks!"
So they entered
heaven, and sure enough, there are ducks all over the place. It is almost impossible not to step on a
duck, and although they try their best to avoid them, the first woman
accidentally stepped on one. Along comes
St. Peter with the ugliest man she’s ever seen.
St. Peter chains them together and says, "Your punishment for
stepping on a duck is to spend eternity chained to this ugly man!"
The next day,
the second woman stepped accidentally on a duck and along comes St. Peter, who
doesn't miss a thing. With him is
another extremely ugly man. He chains
them together with the same admonishment as for the first woman.
The third woman
has observed all this and, not wanting to be chained for all eternity to an
ugly man, is very, VERY careful where she steps. She manages to go months without stepping on
any ducks, but one day St. Peter comes up to her with the most handsome man she
has ever laid her eyes on ... very tall, long eyelashes, muscular, and thin.
St. Peter chains them together without saying a word. The happy woman says, "I wonder what I did to deserve being chained to you for all of eternity?" The guy says, "I don't know about you, but I stepped on a duck!"