Some Little Ostomy Tips

Articles Included:

· Tips for All Ostomates

· Ostomy Hints

· Urolithiasis

· Cardiovascular Disease

· Stomal Lacerations

· Control Germs for Better Health

· Chemotherapy and Ostomates

· Cure for Diarrhea

· Chicken Soup Helps Colds

· Toss Toothbrush When Sick

· Health Care and Ostomies

· How to Catch a Cold

· What Would You Do?

· Bacteria and Ostomies

· Hints and Tips

· Some Helpful Hints

· Tips and Topics

· Some Helpful Hints

Tips for all Ostomates

--Internet Sources

The following are some tidbits of advice on working with the prosthetic ostomy equipment we use

every day to enhance our new life:

· When you wear a two-piece snap-on appliance, take the extra second to make sure the pouch is snapped to the flange securely. Start snapping it together at the bottom and work your way to the top. Give a little tug on the pouch to test its lock, but make sure you hold the faceplate/wafer so you don't break the seal.

· Do you take better care of your car than of your stoma? Once a year have your stoma and your management program checked out by an ET nurse.

· Do not use antibiotics for colds or flu unless a doctor orders it. Antibiotics have no effect on a virus, but do kill bacteria, friendly and unfriendly. This can change the proper balance of flora, i.e. bacteria in the intestines and may cause diarrhea or other health concerns. Our bodies are not clean. Your system has either bacteria or fungus on tissue. If the bacteria is killed, fungus grows. Fungus may cause many problems for you body, even as far a death.

· Fiber from fruits and vegetables do not have the same scouring results as fiber from grain and cereals. This would be of more concern for people with large intestines.

· Don't shove that parsley aside. It's one of nature's best deodorants. Use parsley in cooking fish to reduce odors for colostomates and ileostomates.

· If you are having gas problems, don't take Bismuth Sub carbonate.

· Store appliances away from warm, humid places. "Melt-out" can render equipment ineffective.

· Pouches can leak for a variety of reasons. Find out why, and correct the cause.

· Make a note of the day you change your appliance so that you know when it is time to change again. Some use a ball point pen and write the date and time on the tape around the flange. This is an easy method for always remembering your change date.

· Don't keep a lifetime supply on hand. Shelf life may be limited. Let the stores stock up on your appliances.

· Fats of all kinds should be kept to a minimum by most ostomates. Fats induce an increased flow of bile into the intestines, and make the body wastes more liquid and harder to control. They also tend to produce gas.

· Do not apply a double coat of adhesive. A second coat rewets the original coat, and results in an inconsistent adhesive layer with unpredictable results.

· A package of frozen vegetables can substitute for an ice bag in emergencies.

· A hug is a very strong pain reliever and you don't need a prescription.

· When you fill a new prescription, ask the doctor or pharmacist to give you only a one or two day supply. If any adverse reactions occur it may be best to immediately contact your doctor. He/she may have you stop taking the medicine.

Ostomy Hints

--Spacecoast Shuttle Blast

· Two piece users: Make sure the pouch is snapped onto the flange securely. Take that extra second to be sure.

· Once a year have your stoma and your ostomy management system checked by an ET nurse.

· Do not use antibiotics for colds or the flu unless a doctor orders it. Antibiotics can change the proper balance of bacteria in the intestines and cause diarrhea. Antibiotics will also make you much more susceptible to fungal infections under your barrier.

· Parsley is one of nature's best deodorants. Do not push it away on your plate. Have some.

· If you are having gas problems, don't take bismuth subcarbonate.

· Store appliances away from warm, humid places. Melt out can render equipment ineffective. Most ostomy equipment does not have a specific shelf life, per se, if it is stored in the proper environment.

· Barriers and pouch leak for a variety of reasons. If yours does regularly, find out why. Do not settle for less than an excellent ostomy system that provides you with confidence, security and comfort.

· If you have a hard time remembering the exact day you put on you system, write the day of the month you changed right on the pouch or barrier with a pen.

· Don't keep a lifetime supply of ostomy supplies on hand. Some do have a shelf life, and manufacturers are always making some improvement on the products they make. You want to be able to take advantage of these so let your supplier keep inventory.

· Fats of all kinds should be kept to a minimum by most ostomates. Fats induce an increased flow of bile into the intestines and make the body wastes more liquid and harder to control. They also tend to produce gas.

· Do not spread paste on the entire back of a barrier, it will produce less than satisfactory results. Use paste only sparingly to fill uneven areas and around the stoma. Paste is a great filler if used correctly.

· After bathing or showering with the barrier off, hold a cold compress or something similar over the peristomal area for a few seconds to close the pores before putting on a new appliance. Only put an adhesive barrier on dry, that is bone dry skin.

· After surgery you were advised to chew-chew-chew and to drink-drink-drink. It still applies. Chew food thoroughly, and never pass a water fountain without drinking.

· Don’t try to set a world record for the longest time between changes and/or emptying. Therein lies the way to some of the most spectacular messes you have ever seen.

· Don't be so rigid about your stoma management program that the absence of one item throws you.

· Don't stay home. Travel and have fun. But don't put all your appliances in a suitcase that you check through the airline. Always bring some changes in your carry on luggage.

· Don't worry about accidents and problems that may never happen.

· Don't put limitations on yourself just because you have a stoma. You can do most anything anyone else can. An ostomy is seldom a good reason for not doing something.

Urolithiasis

By A. Trudeh, RNET

All ileostomates, transverse colostomates and urostomates have one thing in common: continuous output with a loss of fluids. If the liquid intake does not exceed the output, these ostomates may be dehydrating their bodies, making themselves prone to a condition called urolithiasis, which refers to the presence of stones in the urinary system.

These stones may be found anywhere from the .kidney to the bladder. They vary in size from mere granular deposits, called sand or gravel, to bladder stones the size of an orange. In the majority of stones, 90& are composed of calcium, with 5-8% from uric acid and 1-3% of the rest composted of cystine.

Conditions which predispose us stone formations are:

· Infections

· Periods of immobility

· Concentrated urine

· Abnormally high concentrations of calcium in the blood

· Heredity

· Dehydration

If you were to develop urolithiasis, the symptoms you may experience are:

· Low back pain with sharp pain in the lower back radiating to the groin

· Chills, fever

· Difficulty or burning with urination

· Blood in the urine

· Nausea, vomiting and/or diarrhea

See your physician as soon as possible if any of the above symptoms appear. Measures to prevent stone formation include:

· Drinking two to three quarts of fluid daily—preferably water and juices. Include acidic juices like cranberry juice to maintain acid urine which also helps to prevent infection.

· Urinate during the night if necessary.

· Exercise daily.

· Use caution with fools containing calcium. But, a certain level of calcium is required for good health. Restrict you diet only with the advice of a physician.

Cardiovascular Disease

Adapted by The New Outlook

Heart disease causes more deaths each year than all types of cancer combined. The following are the most common types:

Coronary heart disease (coronary artery disease) is a chronic disease characterized by hardening of the arteries (arteriosclerosis). It is the most common and the deadliest. It is the number one cause of death in the U.S.

What causes it? Throughout a person's life, cholesterol and fatty substances in the blood collect on artery walls. This buildup forms a material called plaque. As the buildup increases, the arteries narrow and harden. The arteries will eventually become too narrow to allow blood flow to the heart. The result is a heart attack.

Stroke is the result of damage to the brain occurring from cardiovascular disease. It is the leading cause of long-term disability.

What causes it? Stroke occurs when a blood vessel bringing oxygen and nutrients to the brain bursts or is clogged by a blood clot or some other particle. Because of this rupture of blockage, part of the brain doesn't get the flow of blood it needs. Deprived of oxygen, nerve cells in the affected area of the brain can't function and die within minutes. When nerve cells can't function, the part of the body they control can't function either. The devastating effects of stroke are often permanent because dead brain cells are not replaced.

Heart failure (congestive heart failure) means the heart isn't pumping blood as well as it should.

What causes it? Clogged arteries, high blood pressure or heart defects cause the heart to become weak. As the heart weakens, it loses its ability to deliver oxygen and blood to the body. When an inadequate supply of oxygen or blood is delivered, people feel weak, fatigued and short of breath.

Hypertension (high blood pressure) occurs when the pressure in the arteries is consistently abnormal range. Over the past ten years the actual number of deaths due to hypertension has increased by 40%.

What causes it? The cause in most cases is unknown. High blood pressure has no symptoms, so it can go unnoticed by patients until serious damage has already been done.

Stoma Laceration

--Oneonta Chapter, NY

A laceration is a wound or irregular tear of flesh, and it could happen to your stoma. If your stoma protrudes it can be lacerated.

A stoma that protrudes is preferable because the protruding stoma empties the waste into the ostomy appliance more easily with less chance of leaking. But since the stoma extends beyond the skin level, there is the danger that it can be lacerated. Virtually all barriers manufactured today have stiff, rigid or sharp material next to the stoma that can cut it.

The symptoms that may indicate that laceration has taken place are bleeding or swelling of the stoma. Since there are no sensory nerve endings in the stoma, usually pain will not be experienced. The fact that you may not feel pain does not minimize the seriousness of this condition. If not treated effectively, surgical intervention may be the end result.

It is not always obvious what has caused the laceration. It cannot be corrected until the cause is determined. There are many reasons for stoma laceration, but the most common are:

· Improperly centering the barrier

· Shifting of the appliance

· Cutting too small a hole in the barrier

Whenever there is difficulty in centering the faceplate properly, enlarge the opening and protect the skin immediately surrounding the stoma with an ostomy paste. Urostomates may need the intervention of an ET to review their special needs.

Using a mirror may be helpful when centering the barrier to the skin. Remember, the entire stoma—all of the moist bright red tissue—must be exposed through the barrier.

The newer extended wear barriers--ConvaTec's Durahesive and Hollister's Flextend—are manufactured with an inner barrier material that will swell around the stoma. This material is made to actually touch the stoma as it is worn and will not harm it. The outer barrier is a plastic that may still cut the stoma if in contact with it.

When the adhesive barrier washes away—like all other disposable barrier materials—the thin celluloid film remaining is capable of cutting the stoma. Positional changes like bending or even turning when sleeping can cause slippage. If you use an ostomy belt, it may pull the barrier either upward or downward causing the appliance to shift thus cutting the stoma. Outer clothing—a belt, waistband, etc.—that rides over the appliance may cause it to shift.

We have also found a number of people, in an effort to follow the application directions found in all ostomy supplies, cut the opening too small. The opening should be no smaller than 1/16 of an inch to the stoma on any disposable ostomy system. A gap of up to ¼ of an inch is fine for most fecal ostomates, as long as the gap is filled with a quality paste.

Never underestimate a lacerated stoma. Careful investigation should reveal the cause. The stoma will heal by itself—provided it is not too badly damaged—when the problem is corrected. Lacerations usually heal slowly—about four to six weeks. Careful measurement and application of an ostomy appliance is always necessary. As in most things in life, an ounce of prevention is worth a pound of cure.

Control Germs for Better Health

By The Bag-Piper

Infection control procedures need to be part of our every-day lives. In the past it was believed that infectious agents were usually carried through the air. But, now we know that direct contact with infected materials, primarily from our hands, is the number one method.

The hand that covers a sneeze, removes a soaked bandage and scrubs the bathroom, carries micro-organisms on its surface, in skin crevices and under fingernails. If the same hand—unwashed—goes on to handling food, dressing a baby, or bandaging a cut, it can spread germs very effectively.

Frequent and through hand washing is the most important thing we can do to prevent infecting ourselves and others. Thorough hand-washing, we realize, requires some effort beyond the quick rinse we often do.

This relates to our ostomy care. Wash your hands with soap and water before and after pouch changes and after emptying.

Research indicates that "bar soaps" can become reservoirs for organisms of special danger to the aged, the newborn, and any person whose immune system is compromised. Liquid soap dispensers can also be contaminated with airborne organisms spread by sneezing, coughing, air conditioning systems and flushing toilets. Bar soaps do represent a public health hazard, but liquid soaps are a less-likely source of infection.

Most of us would be surprised to hear that the average person gets food poisoning two or three times each year, usually from his/her own kitchen. While the old, the very young, or the debilitated person is most susceptible, we may all become ill from eating contaminated foods.

Hand washing is a primary prevention method along with thorough cooking and proper storage of foods. Prompt refrigeration and adequate re-heating of leftovers are musts. Bleach is a good disinfectant for cutting boards, counter tops and sinks.

Many diseases may be prevented by vaccination. Keep your immunizations up-to-date. To summarize our home care measures:

· Keep up your resistance by eating well, obtaining adequate rest and exercising.

· Handle foods only with clean hands.

· Don't touch your eyes, face or body without washing your hands first.

· Isolate infected material; e.g. raw chicken and meats, paper tissues, soiled bandages.

· Practice frequent and thorough hand-washing.

· Use bleach to clean inflected home areas.

Chemotherapy & Ostomates

--Ostomy Association of Boston

Peristomal Skin Reactions:

· Skin is more difficult to heal due to a change in blood chemistry. Take extra care of skin when pouch is removed—concentrate on good skin hygiene.

· Chemotherapy may cause deep red or purple skin discoloration under the barrier.

· Small red spots may appear under the barrier due to decreased platelet counts as on other areas of skin—make sure you tell your doctor about this.

Stoma Reactions:

· Stomatitis—small ulcers may appear on the stoma or on the rest of the gastrointestinal tract. If cold sores appear in your mouth, rinse your mouth using a mixture of half hydrogen peroxide and half water, every two to four hours. Your physician may also recommend that stoma dilations and irrigations be stopped until stomatitis resolves itself.

· Due to decreased platelet count, the stoma may bleed more than normal when touched.

· There is an increased need for good hygiene due to low white-cell counts. Your peristomal skin may be more prone to infection. If wearing permanent pouches, it may be necessary to change to wearing disposable or non-adhesive systems to help increase cleanliness.

For Fecal Ostomates:

· Diarrhea is a possible reaction to chemotherapy. Monitor the amount of stool output, and inform your physician if it increases significantly above normal.

Drink adequate amount of fluid—over a gallon a day. This may be difficult due to nausea medicine taken prior to meal times.

Eat foods to help thicken-up your stool; i.e., applesauce, cheese, white rice, bananas, peanut butter, plain tea and milk.

Stay away from fatty foods, highly spiced foods, and foods and beverages which cause gas or could cause cramping.

Potassium is lost in diarrhea and needs to be replaced. Foods high in potassium are bananas, fish, potatoes, apricots, peach nectar, and Gatorade. Doctors may order potassium supplements.

· Constipation is also an occasional reaction to chemotherapy and to some pain medications like codeine.

Warm prune juice daily may help with constipation.

Foods with a laxative effect are: raw fruits, raw vegetables, chocolate and coffee.

Try to stay away from strong laxatives. They will distend the bowel over time causing serious complications.

Urostomates

· Check carefully for skin infection. Fungus infections are common, but easily treated with a micro-granulated anti-fungal powder.

· Some chemotherapy may turn urine colors. Adriamycin turns urine red; methotrexate turns urine yellow.

· If any blood is noted in your urine, report this to your doctor immediately.

· Some chemotherapy drugs; e.g., cytoxan and cisplatinum, need to be adequately flushed from the kidneys. Drink at least one gallon of fluids a day.

Cure for Diarrhea

--The Pouch

The protein and starch in chicken and rice soup can markedly increase the body's ability to absorb water, making it an excellent cure for diarrhea. A team of doctors working in Bangladesh, documenting and testing home remedies used for generations to treat diarrheic illnesses, reported the benefits of protein and starch.

Doctors have known that sugar increases the body's ability to absorb salt and water during digestion, but did not realize that starches and grains can do the same, early in the digestive process.

In the U.S., doctors usually hospitalize dehydrated patients and feed them intravenously, an effective but expensive therapy. In addition, intravenous feeding carries the potential for bloodstream infection. Getting an IV can be frightening to a child.

Diarrhea illness can be fatal, especially in small children in impoverished countries, because they rob the body of water and salt, essential for life.

Chicken Soup Helps Colds

By Bruce Hensel, M.D.

If mom always told you chicken soup is good for you, a recent study shows she was right. Steven Rennard, M.D., from the University of Nebraska studied the soup and published his results in the journal Chest. His team found that chicken soup had an effect on white blood cells called neutrophils, and that it reduced inflammation of the airways.

That means when you're battling cold viruses or other infections, chicken soup might reduce wheezing, coughing and congestion. The simple act of drinking the warm, steaming liquid may also have a soothing effect.

We still don't know exactly what chemicals in the soup are at work, but more study will bring us the answers. In the meantime, mom and grandma can say, "I told you so."

Toss Toothbrush When Sick

By Prevention Magazine—Niagara Frontier Ostomy Assn.

Whenever you get a sore throat, get rid of your toothbrush. It could be the cause. Even if it is not, it certainly may contribute to re-infection. According to Richard T. Glass, DDS, "As soon as you start feeling ill, throw away your toothbrush immediately. Often that is enough to stop the illness in its tracks."

A toothbrush can be a harbor for bacteria. The doctor suggests replacing it every month. The cost isn't that much compared to the suffering of just one illness or trip to the doctor.

Health Care & Ostomies

By Peggy Christ, RNET and Ed Gambrell

What do health care personnel need to know about ostomy surgery? Communication is the key.

Now that you have an ostomy or an internal diversion, some changes have occurred in the normal routines of life. This is especially true of medical treatment and hospitalization.

Some medical and hospital assumptions and routines applicable to non-ostomates may no longer apply to you. For your comfort, well-being and in some instances, your health and personal safety, it is important that you know how you need to be treated differently. You need to communicate this information appropriately to doctors and medical attendants who need to know.

Your doctor, ostomy nurse and others who normally attend your ostomy are no doubt well-informed of the differences in treatment you require and will help you communicate with medical personnel uninformed about ostomy matters.

The fact that some health care personnel may be uninformed is quite understandable. The staffs of the thousands of hospitals in North America see relatively few ostomy patients. Few nurses and other hospital attendants have ever cared for an ostomy patient. And many of those who have are not aware of the different types of ostomies and the special considerations each requires.

Doctors have become highly specialized to bring more expert care to patients. Therefore, many rarely have the occasion or the time to develop expertise in ostomy, which is very much a specialty in itself.

So don't be shy about communicating your condition and its special requirements to all who attend you for non-ostomy ailments. This is for their benefit as well as your own. If strong insistence should fail to bring about understanding, you have the right to refuse any procedure you consider harmful to yourself.

Dr. Marshall Sparberg, author of the excellent book Ileostomy Care and a frequent writer on ileostomy matters, has this to say:

It is within the individual patient's right to refuse any hospital procedure, and no amount of insistence from an uninformed individual should change this decision.

Ostomies are different. One of the most serious misunderstandings is that all stomas represent colostomies, and that all colostomies are the same. This can be disastrous for the patient who has an ileostomy or urostomy. It can cause trouble for the person with a transverse colostomy when treated as a sigmoid colostomy. In addition, even those with the same type of ostomy require variations in care and treatment. Ostomies vary greatly in nature just as individuals vary.

Irrigations and enemas: Those with urostomies should never be given an irrigation or enema through the stoma. An irrigation could cause serious kidney infection and damage.

Those with ileostomies should never be given an irrigation unless a doctor, ET or other expert gives one to break up a blockage, or for other compelling reasons. An irrigation or enema of the small intestine may cause the ileostomate ill effects. However, a colostomate may require irrigations; this poses no danger if it is done properly.

A stoma is not an anus. Some medical attendants do not realize the difference between a stoma and an anus. The may treat a stoma as roughly as they treat an anus. If an enema or irrigation with a catheter is involved, care must be taken to avoid bowel injury. Some catheters, though streamlined on the end, are stiff and should not be inserted into a stoma unless performed by a physician or ostomy nurse. A cone is much safer, easier to use and does a better job than a catheter.

How to Catch a Cold

--Hope Heart Institute

Make sure your immune system is a little hay-wire. Avoid vegetables and fruits—especially citrus. Don’t take vitamin C. Forget about performing daily exercise. Fill your life with un-necessary activities so that your stress level reaches new heights. Give humor the heave. Limit sleep to five or six hours a night.

Smoke cigarettes. Smokers are more prone to viral infections and are more apt to pick up secondary bacterial infections which demand doctor's visits and antibiotics.

Hang out with the crowd. Take packed office elevators instead of the stairs. Go to the movies instead of renting a home video. Shop during peak hours. Throw a birthday party for 20 sniffling pre-schoolers.

Don't wash up. Shaking hands, picking up a phone or touching a doorknob can transfer live cold and flu viruses onto your hands. Don't disturb the germ's breading grounds by washing up every few hours.

Rub your eyes, nose and mouth frequently. This is one of the most effective ways of helping a live cold or flu virus make its way from your hands into your bloodstream.

Don't get a flu shot. Hay, you're tough. Take your chances. If you're laid up in bed, don't worry. There's always chicken soup.

What Would You Do?

By Ellice Feiveson

Trust me, every ostomate has had or will have an "ostomy accident". By accident, I mean a pouch leak of some kind.

The question is, "are you prepared in case an accident occurs away from home?" Not so much prepared as far as having a change of clothes and extra pouches but prepared emotionally to deal with the unexpected mishap.

The reality of it is that every ostomate must think of what he/she would do if his/her pouch leaked at a party, in a restaurant, at work … or anywhere else. Your appliance may leak because it is not put on securely, the clip falls off, you put it on wrong, a manufacturer's defect … whatever, and the contents come spilling out.

Embarrassing things happen to everyone at anytime. I think you must feel confident when you venture out and not constantly worry that something will happen. The questions is what do you do if you feel your pouch is not on securely, or you feel wet around the pouch?

First of all, you will probably think that everyone is noticing you and knows what is happening. Actually, you are probably the only one who knows there is a problem. Stay calm. Go to the nearest bathroom and take care of your business. Most likely, your companions are continuing conversations in the restaurant or in the workplace, and no one knows you are even missing.

When I encountered an accident while I was in a group situation, I just removed myself and took my time in freshening up and then rejoined my friends. No explanation was even necessary.

The more outings you take and the more public situations you are in, the more confident you will be as time goes on. Most normal people have more accidents with stool in their pants and gas emissions than we could ever possibly have with an ostomy.

Obtain a reliable ostomy system, then go out and live life just as you want too. If you have an accident, never let that deter you from picking up and just going on once again.

Bacteria and Ostomies

By Liz O'Connor, RN/ET

Many patients having ostomy surgery worry about bacteria. Those with colostomies and ileostomies ask if their stomas will become infected from the discharge of stool … they heard this from concerned sources.

This is a myth! The stoma is accustomed to the normal bacteria in the intestines. Definitely, keep the skin around the stoma clean and be careful of adjacent wounds. You want to keep the fecal drainage away from the incision.

Don’t' worry about the ostomy becoming infected from the normal discharge. This doesn't happen. Nature has provided for us well. Our bodies are made so that the intestine is accustomed to stool on it. Stool is what it was made to handle. We also have good bacteria in the stool that works with our bodies to help in the digestive process. These bacteria do not hurt us.

The urinary ostomy patient is more likely to be susceptible to infection than fecal ostomates. Urine is normally sterile. Therefore, it is important to keep the urinary pouch very clean.

On days it is not changed, the pouch should be rinsed with a solution of 1/3 parts white vinegar to 2/3 parts tap water. This can be allowed to run up over the stoma and will also prevent crystals being formed on it. The vinegar produces an acid environment in your pouch Bacteria cannot multiply as readily in an acid condition.

The night drainage system should be cleaned daily. White vinegar and water can be used for this too. Perhaps some of you use an ostomy disinfectant or diluted Lysol solution. When the drainage system has sediment that cannot be removed by cleaning it, the system should be discarded and replaced with a new one. Saving a few pennies by using it too long can cost more in the long run if you have to treat an infection.

Drinking plenty of liquids is important for all ostomates, but especially for the urostomate. Many urologist also prescribe vitamin C to help keep urine acidic; therefore, less susceptible to infection. Cranberry juice also helps to keep urine acid. Check with your doctor taking these first as some people have reasons that would be exceptions to this.

What are the signs of urinary infection? Some are: fever, pain in the region of the kidney, very strong odor to the urine, excessive mucous. All urinary ostomates produce mucous. You learn what is normal for you. When it is excessive, you will be aware of a difference.

Urinary pouches should be changed on a regular basis, if possible. People wear them for a day to a week. It is not advocated that you keep any pouch or barrier on you skin more than seven days—maximum. For one thing, the skin under the barrier must be inspected at least once a week so that problems may be solved before they become too serious.

Hint & Tips

--Town Karaya

· A medium-sized potato contains more potassium than a 10-inch banana. Other good sources are fish, meats, fruits and vegetables. Potassium deficiencies occur in people on chemotherapy drugs, and those with anemia or blood loss.

· Keep a bottle of grape juice on hand—it easily stores for a year. Grape juice works wonders if you eat something that causes a blockage. Mineral oil works well also but is not advisable for all people.

· Some of our members have obtained relief using Pepto Bismo or Mylanta over the tape that holds their appliance whenever there is itching or irritated skin underneath it.

· Skin Prep rubbed or sprayed on your hands before you use a garden rake or hoe helps prevent blisters. If you have mosquito bites, rub some skin prep on them. It seals the bite and takes away the itch.

· If you are beginning a new medication for any reason, keep a close eye on your appliance. Contact your doctor if the medicine is going straight out into your pouch.

· If your pouch doesn't stick well: Are you applying it right after showering in a high-humidity bathroom? Skin must be bone dry to obtain satisfactory results from today's disposable barriers. Also, oily skin care products; like vitamin E, Dove soap, etc., can cause the barrier to loosen and fall off.

· Write the day you change your appliance in ink on the outside of the barrier itself to help you remember when its time to change again.

· Bring your problems and questions to meetings; don't be afraid or embarrassed to ask questions. At our meetings, many have gone through the same experiences as you.

Some Helpful Hints

--Ostomy Highlife

· Tobacco smoke can interfere with medication taken for unrelated illness. Benzopyrene, an ingredient in smoke, forces some medications to move through your system too quickly.

· Did you know oily products such as Vitamin E and Dove Soap can cause a barrier to loosen and fall off?

· Fiber from fruits and vegetables does not have the same scouring effect as fiber from grains and cereals. Some ostomates find bran muffins an agreeable alternative to bran.

· Being overweight can interfere with proper fit for ostomy appliances. Try the "RSVP" diet: ripe fruit, salads, vegetables and proteins. Stay away from sweets and carbohydrates; drink lots of water. Don't substitute soft drinks, coffee, tea or fruit juices for water.

· One cause of obstructions is too many soft drinks. Gas in carbonated drinks can distend the bowel to the point of kinking.

· Polident and Efferdent can be used to soak a used disposable or a permanent pouch in order to deodorize, remove stains and clean it so it may be used again.

· Ammonia will remove spilled powder or paste from a bathroom floor or sink.

· To relieve intestinal cramps, try running a hot shower on your back. It will relax muscles and help hurry food through the digestive tract. Or, help push the food along by drinking very warm water or hot tea.

· A package of frozen vegetables can substitute for an ice bag in an emergency.

· Time-release pills will dissolve all at once if alcohol is taken with or shortly after taking the pill, therefore you will receive a heavy dosage of medication all at once.

· Parsley is one of nature's best deodorants. Use parsley in cooking fish to reduce odors; also works great for colostomates and ileostomates.

· To avoid intestinal gas, chew food thoroughly, eat slowly in a quiet atmosphere. Avoid washing down solids with a beverage. Don't gulp liquids or drink from small-mouth bottles or through straws. Do not lie down or sit slumped immediately after eating. If you do these things, the worse that can happen is that you have a little gas…big deal.

· Antihistamines can slow down bowel motility and lead to constipation in the colostomate.

Tips and Topics

--Internet Sources

· You should leave a little air in you appliance after you have emptied it. Very often there is a tendency to flatten the pouch as much as possible so that it won't show under your clothing. There is always moisture in the pouch, and by flattening it too much, the walls of the pouch stick together leaving no room for the discharge to drop down. If the effluent collects around the barrier, the pressure may eventually cause it to leak out. In saying leave a little air, we mean just that. The pouch doesn't have to have a balloon affect, but just a soft cushion of air to keep the walls free.

· It is not necessary to use sterile supplies. Wash cloths, cotton balls and tissues may substitute for sterile gauze pads. The stoma and surrounding skin are not sterile and only require cleanliness.

· Parsley is one of nature's best deodorants for our insides. Eat it.

· Always carry an extra tail closure with you if you use a drainable pouch. It could prove critical if your are away from home and you accidentally flush yours down the drain.

· Use a hand mirror for a better view of the stoma. It's about the only way for you to see the bottom side of the stoma and the skin under it.

· Ileostomates should watch their appliances when beginning any new medication. Contact you doctor if you suspect the medicine is going straight into your pouch.

· Colostomates may have slower motility when taking antihistamines in allergy or cold medications. If you become constipated or have trouble irrigating while on antihistamines, ask your doctor to suggest alternate medication. Some colostomates report relief from drug side effects by increasing fluids on the day they irrigate.

· When ill with a virus and diarrhea, eat pretzels. They are something which you can usually keep down, and they may help to thicken the stool. The added salt may help to maintain your electrolyte balance.

· A hand-held hair dryer set on "cool" will greatly speed the drying time of peristomal skin before applying your skin barrier.

· Itching under the appliance may be caused by the body drying out. You may save yourself an unnecessary appliance change by drinking more fluids. Also, try rinsing your peristomal skin with baking soda and water, some have had good results. Using Mylanta, or products like this on peristomal skin also sometimes works. You see, all these products reduce acid. Acid on your skin will itch, and these produce reduce that affect.

· Try changing a urostomy appliance first thing in the morning. Most report their stoma is the most quiet at this time, although urostomies always work when healthy. Also, urostomates should always use a night drainage system to avoid the urine puddling and backing up into the kidneys leading to serious infection.

· If you are irrigating your colostomy and having problems with leakage between irrigations, try using less water. Too much water may contribute to leakage.

· Spraying a skin prep on top of the tape holding your barrier helps to waterproof the tape for swimming. Skin prep on mosquito bites will help take away the itch.

· Aspirin may be great for aches and pains, but never put it in your pouch as a deodorant, despite claims of its deodorizing capabilities. Should aspirin touch the stomal area for any length of time, ulcers could form. If you feel you must deodorize the inside of your pouch, there are many excellent commercially available products made just for this purpose.

Some Helpful Hints

Adapted by The New Outlook

· Avoid “vacuum lock” in your pouch by keeping a little air in it. This is a big reason that new ostomates get leaks.

· If you use a soup on your abdomen, make sure you use one like Zest that does not leave an oily residue. You probably don’t need to use any soap on your belly, just gently rub and rinse.

· If your an irrigating colostomate, you may use a toilet paper cylinder to keep your irrigation sleeve open to allow for drying after use.

· Parsley is an excellent natural internal deodorant.

· Never wait until you have used your last ostomy appliance before ordering new ones. Always keep a list of your equipment with you on a small piece of paper complete with order numbers, sizes and manufacturers.

· Let a good friend or a family member know where you keep your list of ostomy information just in case of an emergency.

· If you have been an ostomate for years, there are new products that may cost a little more, but may give you more comfort as well as longer and more reliable wear time. In the long run you may actually save money as well as time, frustration, cleaning, confusion, odor, comfort, comfort and of course comfort. Just because you learned an ostomy system way back when, doesn’t mean you can’t change a product or habit. You might want to try something new. Call a manufacturer and ask them to send you some samples to try before you buy.

· Urostomates—Wrap your stoma in a tissue or a paper towel to absorb drops of urine which flow during appliance changing.

· Urostomates—Make sure you empty the pouch before it passes the half-full level. If the pouch becomes full, there is a chance of urine back-up—the urine flowing back through the stoma into the conduit, through the ureters into the kidneys. This will lead to a kidney infection.

· Colostomates—Irrigating action—for those that irrigate with a descending or sigmoid colostomy—may be stimulated by gently massaging the abdomen starting at the lower right side and coming up across your abdomen above your belly button then down the left side like a question mark.

· Ileostomates—These ostomates will experience hunger more often than other people. Eat a snack of fruits or vegetables in-between meals if you are hungry; eat smaller but more frequent meals; eat slowly. An ileostomy continues to work—function—whether or not you have eaten, so don’t skip meals.

· Time release pills will dissolve all at once if alcohol is also consumed resulting in a heavy dosage of medication all at once.

· If you want medicines to work quickly, drown them. They dissolve and absorb faster with lots of water.

· Vitamins should be taken on a full stomach, otherwise they irritate the lining of the stomach and produce the sensation of feeling hungry.

· When skin under porous tape becomes irritated or itchy, simply rub calamine lotion or Maalox over the tape. It seeps through the porous tape and soothes the skin.

· Ileostomates should never give blood. Dehydration occurs which will put serious stress on your kidneys.

· Be careful about zippers. They can catch a pouch when zipped up in a hurry. Also, watch out with ballpoint pens, keys nail files and any sharp object in your pocket.

· It is not necessary to use sterile supplies. The stoma and surrounding skin are not sterile and only require the same sort of cleanliness that the rest of the exterior body does.

· Don’t:

· Wear an ostomy system over seven days;

· Be so rigid about your system that the

absence of one item throws you;

· Stay home, travel and have some fun;

· Worry about accidents and problem that may never happen;

· Put limitations on yourself just because you have a stoma.

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