November 2004
Last Month's
Meeting
We
saw the lunar eclipse from the top of Lutheran General after our meeting. What a sight!
Like every meeting, we had many speakers and activities in which to
participate.
We
had the customer support group from Hollister, Inc. come and share some
insights with us. They also corrected
some misinformation about their product line.
Hollister, Inc. will be continuing to develop the New Image, two-piece
ostomy system. This is a leading edge
product and is expected to be at the cutting edge of technological advances in
ostomy care. The Floating Flange is a
proprietary feature created by Hollister, Inc.
It allows one to snap the flange and the pouch together without putting
any pressure on the abdomen. They are
going to manufacture this advanced feature on all of the New Image product
line. (If you ever use their floating
flange, you’ll never want to go back to your old stationary one.) And lastly, the oldest product line, which
has been upgraded to New Image with inventory numbers starting with “16”, will
be discontinued.
Peggy Bassrawi, RN and a Chapter member shared this information with us
regarding the upcoming flu season. Ask
you doctor if you may obtain, based on your health condition, a prescription
for Tamaflu. This drug will lessen the
effects of the flu should you contract it and having a prescription ready to
use in case you contract the flu may save you days of suffering. And remember, the two biggest issues with
contracting the flu are pneumonia and dehydration. You should obtain a pneumonia vaccine. And if you become dehydrated—have diarrhea
and/or vomiting but are not urinating—go to the emergency room. They will put you on an IV saline solution,
and you will feel better.
Our featured speaker of the evening was Jo Meissner, BSN from Coloplast
along with her radiating personality that put everyone at ease.
She demonstrated some of the unique features
of the Coloplast product line including:
· A new night drainage system for urostomates that has a long, no-tangle hose from the stoma to the night bottle. Plus it just snaps together!
· To help solve the problem for urostomates of having urine bulge in the bottom of the pouch, Coloplast has developed a multiple chamber pouch that keeps the profile flat while it is filling.
· The Assura AC System features an adhesive coupling pouch, which is available in a standard wear or extended wear version. It also has a fastening system, pouch to flange, that requires no pressure on the abdomen. It just clicks on.
· They have also developed a wide mouth drainable pouch especially designed for people with colostomies that have more formed effluent that is harder to push out of the pouch.
· Coloplast is the first company to have a commercially available clip-less drainable pouch. In addition, on two-piece systems, they put the belt loops on the flange and not the pouch.
We’d like to thank Lois Knaack, Joan Loyd, Jane Michnik, Sally Schinberg and Arlene Townsend for bringing some special treats for our hospitality table. The lucky winner of the 50/50 was first time visitor, Mary Dyer. The consolation prize went to the newly installed treasurer of national UOA, Dave Rudzin. Be sure to come to our Gala Holiday Party on December 15.
President’s
Message:
The holiday season is fast approaching (much too quickly in my opinion), and with it comes the hustle and bustle of shopping, cooking and cleaning. For many, it means traveling and being with family and friends. For those of you who have recently had your ostomy surgery, you may be anxious about how you will deal with the holidays. Will you be able to travel? Will you be able to eat? Will your friends and relatives be able to see your pouch or smell it? The answers are:
· Yes! If you travel, just remember to take at least three times as many changes to your ostomy system as you would normally. (If you need an Ostomy Travel Card for the airlines, please call the UOA national office.)
· Yes! When it comes to eating, follow your doctor’s orders; try newer foods a little at a time; and always chew thoroughly and drink lots of water.
·
No! If you empty your pouch when it gets about ¼
full, then nobody should be able to see it ... unless you show it to them. It should only have an odor when you are
emptying it—and that should be less than normal people. Plus, there are plenty of deodorizing
solutions, like M9 drops, available.
Just remember: you had this surgery to
save or improve your quality of life, so relax, and enjoy the holidays and your
new lease on life! Hope to see you at
our Gala Holiday Party on December 15!
An Internet moment ... A group of students were asked to list what
they considered today’s “Seven Wonders of the World.” The most votes were received for the Great
Pyramids, the Taj Mahal, the Grand Canyon, the Panama Canal, the Empire State
Building, St. Peter’s Basilica, and The Great Wall of China.
One quiet student had not turned in her paper. The teacher asked if she was having trouble
with her list. The girl replied, “A
little—I can’t make up my mind because there are so many.” The teacher said, “Tell us what you have. Maybe we can help.”
The girl hesitated, then read, “I think the Seven Wonders of the World
are: to See; to Hear; to Touch; to
Taste; to Feel; to Laugh; and to Love.”
The room was quiet. The things we
overlook as simple and ordinary, and take for granted are truly wondrous! This little girl’s list is a reminder that
the most precious things in life are not the usual things bought and built by
man.
Jane Michnik
Coming Events
December 15—The Gala Annual Holiday Party. Help us celebrate the holiday season with a potluck dinner. Please let Sally Schinberg know what delicious goodies you can bring. This evening promises to be a good time for all. Bring a gift worth about $10 to the party. A holiday gift exchange will also take place this evening. Entertainment will be provided by our featured and talented Pianist Renard Narcaroti. Sing along and other events will be provided by Sally Schinberg and her crew.
January 26—A “rap session”
will be featured along with Sue Neu, CWOCN, from Northwest Community Hospital.
Friends of Ostomates Worldwide
FOW is a charity made up of caring volunteers for the purpose of sending desperately needed ostomy and medical supplies to people with ostomies in countries where ostomy products are not readily available.
Our world headquarters is located right here at 4304 Regency Drive, Glenview. (Regency Drive is a block north of Central Road on the west side of Dearlove.) It is staffed with dedicated people who volunteer their time and talent to help this most worthy cause. Mario Pardo, a former warehouse superintendent, manages the facility Monday, Wednesday and Friday from 9 a.m. until noon. Joan Loyd manages is on Tuesdays and Thursdays. Mike Cherry manages a group of Hollister, Inc. employees who come on the third Saturday morning of each month.
We always need capable help. When you are able to assist—if you can come on a regular schedule or if you can give just a few hours once in a while—give Joan a ring at 847-724-7453. She will explain the activities that need to be accomplished. You can see which ones appeal to you, and together we will arrange a time when you can join us!
To dramatize a little of what we handle on a daily basis, we like to paraphrase an article in The Jakarta Post—The Journal of Indonesia Today. They say that ostomy patients in Indonesia experience many of the same fears, doubts and concerns as those of us in the United States.
The Indonesian Ostomy Association (InOA) provides mutual aid similar to UOA Chapters. A spokesperson estimates that there are about 500 ostomates in Jakarta alone, with around 100 new cases occurring every year. As many ostomates are not listed with InOA, and nationwide the numbers are not know but estimates put ostomates in the thousands.
The difference in care between ostomates in America and those in Indonesia becomes clearer when we read that the country does not produce or import ostomy pouches. The wife of one patient was quoted as saying, “It is very difficult to find the bags, even if you have a lot of money, as they are available only in limited quantities.” An InOA member stated that Indonesian ostomates depend upon donations from Australia and the U.S. to have a proper ostomy system.
FOW-USA is pleased to be able to help these ostomates in need.
Holiday Party Reminder
Yes, it’s that time of year again—time for our UOA Chapter to get together, have some fun and celebrate the Holiday Season! We’ll have music, games, presents and a sumptuous potluck dinner. We’ve changed the date to Wednesday, December 15 instead of December 1, allowing us time to regain our appetites after Thanksgiving.
The festivities will take place in the 10th floor cafeteria at Lutheran General Hospital, our usual meeting place, at 7:00 p.m. Please bring some food, homemade or otherwise, to share. We need hors d’oeuvres/appetizers, main dishes, side dishes, salads and desserts. Call Sally Schinberg at 847-364-0690, or email her at Sallyschinberg@aol.com, to let her know what you are bringing so we can ensure a balanced meal—having all desserts really would not be a good thing.
Our featured musical entertainment during dinner and the accompanist for our traditional sing-a-long will be talented pianist Renard Narcaroti, who just happens to be a Chapter member. All the new faces that joined the Chapter this year mean new voices too, although I still don’t think we’ll be much competition for the Mormon Tabernacle Choir.
If you want to participate in the gift exchange—we don’t call it a “grab bag” as that conjures up other thoughts among ostomates—be sure you bring a gift to exchange. The gift should be valued at $10 and preferably unisex. And, if you’d like to assist with set-up for the party, we’ll be starting at 5:00 p.m., and we never turn down offers of help.
So call Sally ... and remember to bring food, a gift and most of all, your Holiday Spirit!
Free Chapter Membership
You have already received multiple notices from our national organization regarding the new membership billing procedure that they are implementing December 2004. We want you to know what this means to you and your Chapter.
Currently, a member of our Chapter is also a member of national UOA. This past year you have paid annual dues of $30. Of that amount, $17.50 went to national, and $12.50 stayed with our Chapter—about $3,750 from approximately 300 members. We use this money mainly for the postage and printing of The New Outlook, which is about $7,000 a year.
National UOA has had to deal with every chapter’s different billing procedures to receive their share of the annual dues. They have decided not to do this any longer and only collect their portion of your dues. So the next time your membership is up for its regular renewal, they will send you a bill only for the annual national UOA dues of $17.50, which you will be remitting directly to them. Our Chapter will no longer have any part in this procedure.
This leaves us with the problem of how to collect our portion of the dues from each member. After much discussion by your board of directors as to how to implement this procedure, we have decided the expense of putting anything in place was not worth the return. Too much of your money would go for collection and not to the Chapter. Your money would be better invested by a direct donation to the Chapter. It has no administrative expense. Therefore, for 2005, we will not be collecting dues from our members. Chapter membership will be free!
We will count on you to help support our Chapter by the free-will donations that you have always given so generously. This will be for a one-year trial period. In 2006, we will check our budget to see if we can continue to be viable using this model. If we do not get the monetary contributions that we need to operate our Chapter strictly by donations, then we may have to go back to collecting annual dues from each member.
We have a very small budget to fund the main projects of the Chapter:
· The New Outlook
· www.uoachicago.org (our Internet site)
· The Visiting Program for new ostomates
· Our monthly general meetings (our coffee service is $41 a month)
· Audio and visual equipment (our speakers all volunteer their services to our Chapter)
· Chapter contributions to the Youth Rally, the national convention and UOA
· Postage for membership and Chapter business (about $1000 a year)
We will be asking those who can to make a donation to the Chapter once or twice a year. Remember, this new billing procedure begins in December, but you should not see any difference in the time of the year or the manner in which your membership renews. The only difference is that it will be for only $17.50 instead of $30. There will be no decrease in the benefits you receive from UOA or your Chapter.
Our Chapter is not very good at fundraising, because we do not need very much to be successful and meet our goals. We are all volunteers here and nobody receives any compensation of any kind. In fact, most board members are our biggest contributors. Please remember us.
Advertising Rates
1/8 page $ 400 per yr.
1/4 page $ 600 per yr.
3/8 page $ 800 per yr.
These rates include an ad in
all eleven issues of our Chapter newsletter, The New Outlook, plus an ad
on our Internet site at www.uoachicago.org
.
News...Lake County Ostomy Assn.
L.C.O.A. had been
an inactive chapter for several years. In May 2004, a kick-off meeting
was held at Hollister, Inc. to reorganize the chapter. Our
meeting was a huge success with over 50 in attendance. For many, this was
their first ostomy support group meeting.
L.C.O.A. is fortunate to have these new members with new
ideas. Plus, the meetings are at a new time and at a new place.
You are welcome
to join us on the third Saturday of each month from 10:00 a.m. until 12:00
noon in the cafeteria at Hollister Inc., Libertyville. To confirm a meeting date, please contact Nadine Presley at 847-356-0632 or Judy
Gaughan at judy.gaughan@hollister.com
.
Support
Your Chapter
We are now offering
free membership to our Chapter. But to
provide for our few expenses (mainly the printing and mailing of The New
Outlook) we need your assistance.
Please send your tax-deductible contribution to help maintain our
Chapter’s viability.
Name & Address: ___________________________
__________________________________________
Send To:
Chicago’s North Suburban
Chapter of UOA
Mr. Tim Traznik, Treasurer
40 Fallstone Dr.,
Streamwood, IL 60107-1079
Gladbaggers
On Friday, October 29, we had a great turnout at our
Gladbaggers Halloween Party. Virtually
everyone showed up in costume. We had a
warm evening with the temperature in the 70’s that enhanced everyone’s spirit,
and had some friends we haven’t seen in a while attend. It was a wonderful event.
We are planning
to have our next Gladbaggers in early spring.
Watch The New Outlook for details and be sure to come.
Never doubt that a small group of thoughtful,
committed citizens can change the world.
Indeed, it is the only thing that ever has.
Margaret
Mead
Enteric-Coated Pills Question
UOA Discussion Board
Q I had my ileostomy surgery in 1979 when I
was 51 years old with very few problems these past 25 years. But, I can't seem to communicate to my
doctors in Florida that enteric-coated pills don't usually work with an
ileostomy. They are designed to work on
someone with a complete colon. Of
course, I have no rectum or colon. I
informed them that after about six hours the medicine is in my pouch. They do not seem to understand. Any ideas?
A Show them this information which was translated from the
British National Formulary—the guide for British doctors on prescribing and
considered a world authority.
1.8 Stoma care
Prescribing
medications for patients with a stoma calls for special care. The following is
a brief account of some of the main points to be borne in mind:
Enteric-coated and
modified-release preparations are unsuitable, particularly in patients with
ileostomies, as there may not be sufficient release of the active ingredient.
Laxatives, enemas and
washouts should not be prescribed for patients with ileostomies as they may
cause rapid and severe dehydration.
Colostomy patients may
suffer from constipation and whenever possible should be treated by increasing
fluid intake or dietary fiber.
Bulk-forming drugs should be tried.
If they are insufficient, as small a dose as possible of sienna should
be used.
Anti-diarrhea drugs
such as loperimide, codeine phosphate, or co-phenotype (dioxalate with
atropine) are effective. Bulk-forming
drugs may be tried but it is often difficult to adjust the dose appropriately.
Antibacterials should
not be given for an episode of acute diarrhea.
Antacids have a
tendency for diarrhea if made from magnesium salts. Plus, constipation from aluminum salts may be
increased in these patients.
Diuretics should be
used with caution in patients with ileostomies as they may become excessively
dehydrated and potassium depletion may easily occur. It is usually advisable to use a
potassium-sparing diuretic.
Digoxin used in
patients with a stoma make them particularly susceptible to Hypokalemia, if on
digoxin therapy and potassium supplements, a potassium-sparing diuretic may be
advisable.
Potassium supplements
in liquid formulations are preferred to modified-release formulations.
Analgesics such as
opioid analgesics may cause troublesome constipation in colostomy patients.
When a non-opioid analgesic is required, paracetamol is usually suitable but
anti-inflammatory analgesics may cause gastric irritation and bleeding.
Iron preparations may
cause loose stools and sore skin in these patients. If this is troublesome and if iron is definitely
indicated, an intramuscular iron preparation should be used. Modified-release
preparations should be avoided for the reasons given above.
Patients are
usually given advice about the use of cleansing agents, protective creams,
lotions, deodorants, or sealants while in the hospital, either by the surgeon
or by an ostomy nurse. Voluntary organizations can offer help and support to
patients with a stoma.
By Terry
Gallagher, UK
When we had our ileostomy surgery, our colon was
removed. In a normal person; i.e., a
person with a full, working colon, the colon is responsible for absorbing much
of the water we drink and that is contained in our food. In addition, electrolytes such as sodium and
potassium, essential to maintaining good health, are absorbed there.
Removal or disconnection of the colon
immediately causes an initial problem because of the removal of the ileo-cecal
valve. This valve is between the ileum
or small intestine and the colon where the appendix is attached. Its purpose is to dispense the contents of
the ileum into the colon with a measured response to maximize food
absorption.
When we lose this valve, food and water
pass through our digestive system without a regulator, for a short time
anyway. The body does adjust quite well
to our new plumbing, and soon our transit rate slows to about a third to a
quarter of that of people with normal colons to help make up for this loss. The ileum begins to absorb more water to
compensate for the loss of the colon but still absorbs much less than a normal
colon usually would.
Effluent from the ileum normally has about
30% of the original water taken into the body remaining, while normal stool
from a colon has about 10% remaining ... quite a difference. In addition, we lose ten times as much sodium
and potassium as someone with a colon.
Because of all this, anything that upsets this balance in our bodies has
a faster and more dramatic effect.
A typical example is gastroenteritis. A normal person with this infection may be
sick and have diarrhea for a couple of days, whereas we could end up in the
hospital with exactly the same symptoms as these because of the loss of fluids
and electrolytes. This may apply to
other problems that upset the digestive system’s balance. When these occur, a normal person may
experience nausea, vomiting, fever, abdominal cramps, bloating, bloody diarrhea
and signs of dehydration—including the veins on the back of the hands and
elsewhere becoming invisible.
People with an ileostomy may experience
these signs differently. When I had flu,
my ileostomy produced enough output to fill my pouch in just a short time. I felt nauseous and developed abdominal
discomfort. I rapidly began to
experience the symptoms of dehydration, which include a dry mouth, decreased or
virtually non-existent urine output, heart irregularities and dry skin.
In my case, I could see my urine output
had ceased as I have a urostomy as well.
This is a medical emergency! In
less than a 15-minute trip to the hospital by ambulance, the driver remarked
that I had visibly deteriorated during the trip, even with a saline IV being
administered. If hospitalized for
dehydration, you may expect IV solutions to be given. The fluid given will be saline, potassium, or
potassium and glucose to replace those essential electrolytes lost through
diarrhea. Expect an EKG to check for
heart problems, bloods to be taken, and stool and urine samples, to check for
infection, and chest and abdominal X-rays.
Dehydration is a serious medical emergency
that can lead to shock, unconsciousness and death if not treated soon
enough. Delaying treatment can also lead
to kidney damage, which may be permanent, requiring life long dialysis or a transplant. If you become ill with diarrhea, have
vomiting and fever that persist, find yourself with a pouch continuously
filling with fluid, and have little or no urine output, seek emergency
treatment immediately.
Normal people may sneer that we’re making
a lot of fuss for a simple “tummy bug” — we’re not! It is much more serious for
us than for people with a normal colon.
My Stoma Changes So Much
UOA Discussion Board
Q I've had my stoma for a year and a half and my stoma protrudes between ¾” to flat with my stomach. One day I can hardly see it sticking out and the next day it seems huge. I talked with this to my doctors and they tell me it is peristalsis. I am not so sure. I know what peristalsis is—the wavelike motion the intestines have in order to propel the contents from the stomach to the outside. Is it normal not to be able to see your stoma? It shrinks down in so far there's almost nothing there, making it hard to put a barrier around so it doesn't leak. Then at other times, it gets big and protrudes just fine. What so you think?
A I would be cautious about dismissing the
physicians' reply so readily. One can
have a stoma situation secondary to peristalsis similar to what you describe—it
is not all that unusual. Without knowing
the nature of your bowel motility and stoma location as it relates to your
bowel anatomy, it would be difficult for me to say anything more certain than
the general comment that peristalsis is quite variable among the general and
ostomy population.
This
being said, let me try to explain why your stoma appears to disappear at times.
Stomas are typically "fixed" in place after a period of time and the
overall appearance and size do not change all that much once all the post op
healing takes place—several months post surgery, on average.
However, in some
cases, a stoma can be uniquely influenced by peristaltic motions, and then it
can become quite "mobile" in position, length and width, and give the
appearance of disappearing at times.
When this occurs, it does challenge one's abilities to ensure a
leak-proof seal at times. Of course, if
you are not having leaks or skin irritation then nothing further needs to be
done from a pouching management perspective.
If, however, you were experiencing reduced wear time and/or skin
irritation you may want to consider adding washers, pastes or strips, which are
designed especially for this need, to help fill in the immediate peristomal
skin zone, especially when the stoma is in its small or "disappearing"
mode.
Appreciate that
you should size the barrier opening for the largest diameter of your stoma and
allow these specially designed pieces—like an Eakin Seal or a Hollister
Flextend Barrier Ring—to fill-in and protect the skin when the stoma narrows.
Hope this helps your understanding somewhat.
Mike
D’Orazio, ET
The Final Word on Nutrition
It's a relief to know the Truth after all those conflicting
medical studies and misleading TV ads:
The Truth...
·
Japanese
eat very little fat and suffer fewer heart attacks than Americans suffer.
·
Mexicans
eat a lot of fat and suffer fewer heart attacks than Americans suffer.
·
Africans
drink very little red wine and suffer fewer heart attacks than Americans
suffer.
·
The
French drink excessive amounts of red wine and suffer fewer heart attacks than
Americans suffer.
·
Germans
drink a lot of beer, eat lots of sausages and fats, and yet still suffer fewer
heart attacks than Americans suffer.
Conclusion: Eat and drink what you like. Speaking English is apparently what kills
you.
Holiday Drink Tips
·
Do you
have lactose intolerance? Avoid milk
drinks like eggnog, or take Lactaid®.
·
Carbonated
beverages can cause gas, so have only small amounts if this bothers you.
·
To sleep
better, limit evening fluids.
·
Drink 8
to 10, 12-ounce glasses of water a day.
Also have some cranberry instead of orange juice; it may help make your
urine acidic.
·
Drink
extra water every day to counter the dehydrating effects of alcohol and caffeine.
·
Limit
alcohol to one drink a day for women, two a day for men.
By Marjorie Kaufman, via ReRoute, Evansville, IN
No one can tell at a glance that I have an ostomy. Only those close to me know it for sure. Perhaps that is why it is difficult for me to recognize a curious fact: Some people do not realize it’s a blessing and not a doom!
One wonders whether this knowledge might have some value to the human race—at least that part of the human race that tends to look upon an ostomy as a disaster. Acceptance is part of being happy. People need happiness as much as they need food; without this, they are devoured by restlessness and discontent.
How many people who think they resent an ostomy would, if they were truthful, recognize it as the thing they most needed to enjoy life again? How many could, with a simple change in mental outlook, admit it is a blessing? Many people never learn, they never achieve, the peace of mind and contentment this knowledge brings. They spend their lives in a prison where an ostomy is the eternal punishment.
An ostomy is not doom—–that is a negative mental attitude that is not based on reality. Most things are not really a joy or a burden if you think about it; only your attitude about a thing tends to make it a positive or a negative influence in your life. How can we avoid that feeling of compulsion that makes an ostomy a burden? We don’t disclaim it. There’s no use kidding ourselves about that.
Nevertheless, there are things we can do to take the edge off the feeling of compulsion and make things more pleasant. We need to expend our mental and physical energies. If these energies are not utilized in a constructive fashion, they turn inward and poison our minds, and therefore our bodies, with resentment and dissatisfaction. We need that warm sense of accomplishment, to be needed, wanted and useful. We need it to give balance to our lives. Contentment depends not so much on the blessings we have received—for we all have our special gifts—as on the attitude that we take towards our life—the challenges included.
via ReRoute, Evansville, IN
Can an ileostomy be controlled with strict diet or irrigation? The answer is a definite “no” to both questions.
Occasionally, a doctor may irrigate an ileostomy with a lavage set for food obstruction. This procedure should be done only by an experienced doctor or ostomy nurse to prevent perforation of the small bowel and further surgery. An ileostomy cannot be controlled by any diet. It is vitally important, that everyone with an ostomy eat at least three nutritionally balanced, but small, meals a day.
If your doctor has given you a special diet, remember that when your stomach is void of food, it will fill up with gas. Excessive gas will result in a noisy ileostomy.
Fasting may increase the activity of the small bowel, causing the ileostomy to discharge very liquid feces. Diet is an individual matter. Some people can eat all varieties of food, including foods with skins, without affecting the consistency of the stool or the activity of the bowel. Others find that any violation of a low residue diet leads to frequent and watery stomal activity. Each person must discover his/her own dietary pattern through trial and error. Another word to people with an ileostomy ... If you are ever depressed about your surgery, just think of all the ailments you no longer have to worry about: rectal cancer; colon cancer; hemorrhoids; diverticulitis; appendicitis; constipation. Sometimes, it’s amazing that anyone can survive with the colon intact!
New Crohn’s Disease Study
Contributed By Jane Michnik
A U.S. survey conducted by Voices of Crohn's finds those who suffer from Crohn's Disease underestimate the effect of the disease on their daily lives. The survey finds of the 500,000 people in the Unites States who have Crohn's Disease, 60 percent between the ages of 18-34 were hospitalized within the past two years and more than half-required surgery within the past five years. One in five respondents ages 18-27 reported Crohn's affects their relationships with employers, friends, family members and the general public. It limited their desire to date and their confidence to pursue higher education. More than 93 percent of respondents reported the disease impacts their overall emotional well-being.
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A Note from Your Treasurer
By Tim Traznik
I decided it was time to write an article about dollars and cents. This article will hopefully answer some questions such as, where has our money come from, and what did we do with it once we had it?
To answer the first question our previous sources of income have been as follows:
· The main source of income used to be membership. Your membership fee was $30 of which $17.50 went to national UOA. We are eliminating Chapter dues for 2005.
· A very important source of income has always been our annual fundraiser. This will be our primary source of raising operating funds for the Chapter in 2005.
· Another source of income is paid advertising in The New Outlook. Small amounts also come from the 50/50 raffle, the Annual Bake Sale to name just a few.
So where does the $$$$$ go? Here is where it goes:
· Our biggest investment is in the publishing of The New Outlook. It costs approximately $550 per month.
· In the past, we used to pay national UOA $17.50 per every $30 received for membership (either new members or renewals). National UOA will now bill you for this directly. We will have no part in it. Chapter membership will be free for 2005.
· We pay Lutheran General $41 for the beverage service at our monthly meetings. We also pay for the rental of visual equipment if needed by our speakers. Our speakers all volunteer their time to attend our meetings and share their knowledge with us.
· We reimburse the President for attending the convention as well as the registration fees for all other attendees. We have no paid staff. We are all volunteers. Most of us use our own personal funds to help manage our committees.
· Lastly, we donate to the Friends of Ostomates Worldwide and to the Youth Rally.
As you can see, we use our income prudently. We do a lot of good with our $$$$$$. It is important to note that without your support we would have a difficult time covering these expenses. Thank you again for your support.
Why Does My Stool Smell Worse After My Ostomy?
By Michael D’Orazio, CWOCN
This is a concern and question commonly expressed by fecal ostomates, and their observations are not without solid physical foundation—in other words, it is not in their heads, only. It is fair to say that all who poop, no matter the route taken, stink at times!
The traditional or non-ostomy way of evacuating the stool in many developed countries is relegated to a well-accepted and orchestrated routine of sitting upon the commode. By doing this, one seals the rapid escape route of smell with the butt or derriere plastered against the toilet seat. The only exit port is the space between the legs, where one has the urinary tools mounted, and which space opening can be regulated as desired. Ok Ok, I know it sounds hokey to phrase it this way, but I am trying to make a visual point here. As the turd, stool, fecalith or poop exits the anal canal and drops into the water below it is engulfed by the water as it sinks. This action surrounds the stool and traps the odor causing gas, struggling to escape from the sides of the stool mass, from immediately reaching the nose; thereby mitigating the smelly offense. Of course, if a fart or gas escape occurs simultaneously with the deposition of the stool then the odor offense will be more readily detected by all noses in the immediate vicinity.
Now, with a fecal ostomy, the stool character and surface area are changed and the laws of physics and chemistry reveal the true reasons why a fecal ostomate tends to smell more so when emptying the pouch. In this case, as one approaches emptying of the pouch, whether seated upon the throne as before or standing or kneeling before it, the surface area of the stool is much greater than the fecalith that previously exited the anal canal. In the case of the ileostomate and high colostomate, whose stool character is softer or looser, the surface area is greatly increased. As the pouch is emptied of its contents, the stool—be it liquid or pasty—is plopped into, the water and often times will float a while before sinking. Because the stool is softer and slower to sink it allows for greater amounts of gaseous diffusion or escape of odor offending molecules to occur. The greater number of offending odor molecules bombard the nose at a given time and the bystander(s) recognizes the greater degree of smelly offense.
An additional cause for increased odor offense is that the exit point for the stool from the pouch is now directly under the nose; unless an attempt is made to empty the pouch by tucking it beneath the butt or between tightly closed thighs and magically opening it only when fully seated on the toilet. However, I think this approach would be impractical, don't you?
A simple analogy of this “smelly” phenomenon, before the ostomy, is to compare episodes of diarrhea and the enhanced odor offense. I think it is safe to say that most people would acknowledge that their watery stool tended to smell worse than their formed stool.
So, there you have it. Gaseous diffusion is the underlying principle that allows the nose to perceive a greater quantity of offending odor molecules from the increased surface area of softer or liquid stool, as is typically found with fecal stomas. Take heart in knowing that you are not stinkier because of the ostomy, merely that gaseous diffusion is finally being recognized as the phenomenon underlying a very normal process, previously hidden or impeded. Fortunately, many of the aids for ostomy odor management work quite well in this new potty environment.
Too Much of
a Good Thing
By Wanda Herdzina, CWOCN
Do you need an hour and a half to change your ostomy system? Does your stock of supplies resemble the storefront of the local pharmacy? Do you need a roadmap to remember what product goes on first, second, etc.? If so, you may be the victim of the “too much of a good thing” syndrome many ostomates have.
Occasionally, an individual will come to a stoma clinic carrying a large sack with a vast array of skin care products. He/she explains, “All these items are needed in order for me to apply my appliance”.
Unfortunately, the reason he/she usually needs assistance is due to a problem with the adhesion of the barrier—usually due to scars, skin folds or weight changes; skin irritation or skin breakdown. One particular gentleman who comes to mind was utilizing a special skin cleaner and cream, two types of skin cement, a double-faced tape disc, a paste and a popular skin-barrier wafer before the pouch was applied.
He had started out with a fairly simple ostomy system right after surgery. However, in his quest to achieve what he felt should be a seven-day wearing time, he had been adding product after product. Besides the many items he was now using, he had what he described as a “closet full of products at home”.
After checking his abdomen, it became obvious that what he needed was to change his ostomy system to one that used convexity and not the addition of another product. He also needed a more realistic view of wearing time for his particular situation.
Practically speaking, not everyone may be
able to achieve a seven-day, leak-free wearing time with no skin
irritations. It is much better to
anticipate leakage and establish a regular changing time prior to this. You know, there are ostomy systems for
colostomates designed to be changed in about 30 seconds, whenever full—even
several times a day. Europeans prefer
this method. Here are a few hints to
remember to help achieve a successful ostomy management system:
Keep it simple. Do not use
extra cement, skin-care products or whatever unless medically necessary. Usually, extra products actually interfere
with barrier adhesion or create skin problems—especially with the new extended
wear systems. And as far as washing your
peristomal skin, plain water is still the best cleaning agent.
Do not continue to use therapeutic products after a problem has been solved. As an example: A steroidal cream and an anti-fungal micro-granulated powder should not be used routinely when changing the barrier. These products are prescribed for particular skin problems. A steroidal cream is usually recommended for its anti-inflammatory effects, chronic skin itching and systematic relief of the discomfort associated with skin irritation.
However, continued and prolonged use of steroidal creams after the problem is resolved may lead to thinning of the outer layer of skin. This will lead to a greater susceptibility to skin irritations. Also, stop using an anti-fungal powder when the fungus—also called a yeast infection—is gone.
Running the Boston Marathon
By Charlie Grotevant, Kankakee, IL
My fifth entry for the Boston Marathon was in 2004 having previously participated in ’90, ’91, ’94 and ’97. After leaving our friend’s condo where we were staying, my wife Joyce and I follow our traditional custom of visiting Leominster, MA, where we lived during the early years of our marriage when I was stationed at Ft. Devens. Our two older children were born there. Some things remain the same with the passing of time, but much has changed.
The heat in Boston was a forbidding challenge, 85 degrees at the noon starting time on Monday. This was proof the God has a sense of humor. It had only been in the upper 50’s on Saturday and Sunday and would also be in the upper 50s on Tuesday when we returned to Illinois. God was messing with the minds and bodies of the nearly 18,000 runners amassed for the start of the race. Yes, we were given an extra burden for our day in the sun.
With a 13,745 seeding number, it took me 12:20 to reach the starting line. My qualifying time was 3:41:58 at Clearwater, FL in February 2003. I needed four hours or less to gain entry to Boston at age 62.
Actually, when I started there were nearly 14,000 ahead of me. Laurie Baker of Normal and Marla Styck of Bourbonnais, about half my age, were there with me. Their qualifying times were only a few minutes faster than mine, putting them with me as well. A much faster runner Tamara White from the area started ahead of us.
With a computer chip timing us—each of us had a chip tied to our shoelace—there wasn’t much pushing at the start, although it was crowded the entire race. We crossed a mat at the start line beginning the timing process. At each five-kilometer marker of the race, we again crossed a mat that recorded our respective times. The finish line mat gave the official running time of each person’s marathon.
I was constantly sidestepping or cutting around people because of the almost 18,000 runners starting the race. Over 20,000 were officially entered, but probably because of the heat, more than 2000 people did not participate.
The first mile was easy. 8:17! I was already sensing impending doom. The crowd was large and enthusiastic with over a million lining the one-way route from Hopkinton into Boston. It was wonderful weather to be a spectator, as evidenced by the non-stop cheering and applause. Actually, I still felt good at the half marathon mark in 1:51:48. But then I started losing it. I had already passed Tamara, without either of us knowing it.
Walking and drinking Gatorade and water every two miles gave me some measure of relief, but the pain started arriving by 15 miles. Way too soon! The Newton hills from miles 18 through 21 really pulled me down. I had to walk some of the up hills because I couldn’t run any more. But once on top of the rises, I could take off again. Most of the other runners around me were also walking up parts of the hills. The muscle pain of dehydration was grabbing us all.
I was very nauseated because my fluid intake wasn’t being absorbed into my body fast enough. A side stitch—a sharp pain—started at mile 23 and stayed with me until the end. I was mentally lost beyond 17 miles and have no idea how I was able to finish the race without being one of the thousands treated by the emergency medical teams. Some went down without a sound and were given priority by the medics. Some went down writhing in pain and screaming while squeezing their leg muscles. It was ugly!
I finished under the clock at 4:04:47, thinking all my three friends were ahead of me. Not so! My chip time of 3:52:27 renewed my qualification for next year’s Boston Marathon, which we are not doing. My finish order was 6260. I started with nearly 14,000 ahead of me with the net result of having passed at least 7000 more runners than had passed me. Yes, I was aware of constantly passing people, but I was so out of it that I didn’t have a clue to the total I had actually passed.
How did my ileostomy system hold up during this severe test of body heat and constant motion? Better than you would suspect. I put on a new barrier and pouch the day of the race; picture-framed it with water-resistant tape, and wore a belt to hold it to my body—if the barrier should melt away during the course of the marathon. It had partially loosened by the time I was able to stumble to our hotel room with Joyce’s help. Ugly looking juices were oozing out, but nothing was running down my legs. Probably one more mile would have made it a disastrous situation. We’ll never know.
That evening Laurie, Marla and I were able to dine proudly in our 2004 Boston Marathon jackets. We had earned the right to wear them. The severe pain of the struggles we had endured earlier in the day was overridden by the elation of having accomplished the goal of finishing the marathon on this impossibly hot day. Joyce could unwind from her very busy day of being our driver and caretaker.
Like all previous 13 marathons, I slept like a baby that night ... I tossed and turned and cried all night. No, it wasn’t really that bad. The nausea continued throughout the evening, even after eating a filet. But Tuesday morning, I had my appetite back and we flew home to the real world. Our real world was blessed with an inch of rain enabling me to take the afternoon off instead of resuming corm planting.
Hospital Stays
By Dawn Trice
Many older people view hospitals as places from which their contemporaries have not returned. So it’s no wonder they are loath to check into them. But identifying and dealing with illness earlier rather than later still gives a person a much better shot at recovery.
Another challenge to getting the most out of the health-care system is that some seniors view doctors in awe and may be reluctant to ask questions. But doctors are not superhuman, and any medical “miracle” that may occur comes as a result of the hospital staff and the patient working together. So it is incumbent upon patients and family members to be as detailed and as educated about an illness as possible.
This is not easy because relatives may not be forthcoming about their health. Some simply learn to cope with pain or discomfort. Some even try to salve wounds and solve problems with home remedies.
Patients and family members should not be afraid to request a formal consultation with hospital staffers—doctors, nurses, social workers. Write down questions ahead of time, do research and ask them to reword answers if you do not understand them. Your good health is your responsibility.
Surgery to Cure Stoma Problems
By Arthur J. Vayner, Jr., M.D.
There are many people with ostomies that have a “problem stoma” that may obtain improved efficacy through a surgical intervention. UOA estimates that about 10 percent of all ostomies require surgical intervention for complications associated with the stoma.
The first, easiest and best step in treating the problem stoma is to create a stoma correctly. The foundations of stoma construction are similar to the old real saying, “Location, Location, Location”. Location is important so that the patient may properly care for the stoma. Skin folds and irregular surfaces are avoided, if possible, and the stoma should be visible to the patient, avoiding placement too low on the belly wall. Placement should also pay regard to wardrobe consideration, such as the belt line.
· Location through the rectus abdominus muscle: Placing the stoma through the rectus abdominus muscle—the one used to do sit-up exercises—takes advantage of the strongest muscle of the belly wall and minimizes the chance of developing a hernia.
· Location of the “spout” above the skin: An ileostomy should have a long spout—about an inch—to keep the caustic small bowel effluent off the skin. A urostomy or colostomy should have a smaller sized “bud”.
Despite proper construction, any of several complications may develop that require surgical correction. Retraction of the stoma is apparent as the “budding” disappears. The most common causes of stoma retraction are technical problems at stoma creation and post-operative weight gain. Stoma retractions occur in about three percent of ostomy patients.
Therapy for stoma retraction can involve weight loss, if weight gain is the culprit. Often times this approach is not practical since many patients had weight loss from their disease—notably Crohn’s Disease and ulcerative colitis—and go back to their normal weight after the disease is removed. Most commonly, the stoma will need to be revised operatively. An intra-abdominal procedure is needed. Therefore, surgery for correcting a stoma is major.
Stricture of the stoma (a narrowing of the intestine) will first show up as difficulty with evacuation at the stoma—like constipation—and possible cramping abdominal pain. The combination of a tight stricture and hard stool can result in impaction when the stool truly blocks the stoma and cannot come out.
Stoma stricture will occur in about two percent of ostomy patients. The stricture is made up of scar tissue and can be at the level of the skin or fascia—the tough muscle covering—for skin strictures. This repair is simpler and may be done as a local procedure. Fascia level strictures may require the relocation of the stoma.
Since the bowel is a contaminated organ, a relatively common problem after surgery is the development of an abscess or fistula. Patients with Crohn’s Disease are most prone to this complication, since fistulas tend to develop commonly in Crohn’s Disease anyway. Stoma abscess or fistula will occur in about five percent of ostomy patients. If such an infection occurs, it needs to be drained. Drainage of the infection should be done either right next to the stoma or well away from the stoma to allow proper care of the ostomy system. Making an incision to drain an abscess that will be covered by the skin barrier will either doom the attempt at drainage or the proper seal for the ostomy system. Complicated infections may require relocation and/or revision of the stoma.
Prolapse of the stoma is evident as the bowel telescopes out into the pouch, resembling an elephant’s trunk. Prolapse will occur in about three percent of ostomy patients but is rare in those with a urostomy. If a prolapse is bothersome or causes symptoms, the stoma will need to be revised.