April 2007
Last Month’s Meeting
A special friend of ours, Bret Cromer, President of the DuPage Ostomy Association gave a wonderful and moving presentation on the Youth Rally. Bret dramatized the enormous benefits the campers receive as well as those, like him, that volunteer to be counselors for the five days of this annual event.
Of course, none of us are between 11 to 17 so we would not go to the camp, however, the story of Youth Rally enhanced the feeling of gratitude we possess at being fortunate enough to wear an ostomy ourselves. We have the opportunity to see, meet and talk to people with ostomies ever month at our general meeting. The children going to the Youth Rally for the first time have often never seen another young person like themselves who has suffered from a medical condition that requires an ostomy. This may be their only opportunity to network with other children so they do not feel so alone.
The camp has multiple goals of ostomy and health education; the positive reinforcement of the self-image of the campers, as well as having some fun. Most of the children develop a special affection for the people at the Youth Rally and look forward to every year’s event. Graduates, those over 17, many times return as counselors. Youth Rally people are fiercely dedicated to the organization because of the benefits they see firsthand the camp has on these young people.
Along with Bret, Heather Boudrick, a WOCN from Hollister, Inc. and an active participant at the Youth Rally explained how volunteer nurses like her check the ostomy and pouching system of each camper. (We were fortunate to have an entire contingency from Hollister, Inc. come with Heather to demonstrate their support of our ostomy association and the work performed at the Youth Rally.) They make sure every child is wearing the best ostomy system for his/her needs and that he/she is educated on correct ostomy management techniques. Our ostomy association is a regular contributor to the Youth Rally in part by funding an annual scholarship for some fortunate young person.
Marilyn Mau, former UOA President, OAGC President and a key person in the first Youth Rally, was the lucky winner of our 50/50 and Marge, who we hope to see again, won the consolation prize. We would like to thank Rhoda Gordon, Renard Narcaroti, Ken Niebuhr and Sally Schinberg for bringing treats to our Hospitality Table. We also would like especially to thank Ken Niebuhr for accepting to manage our publicity committee. Ken is very highly qualified and we are fortunate to have someone with his talents on our team.
As a side note, I would like to thank
everyone who remembered my birthday, albeit a month early. It meant so much to me . . . Renard
Do not forget to come to our Anniversary Meeting in April when one of our favorite speakers, Jan Colwell will be our featured.
Remember: You can currently park in the attached parking structure for about $4.00 and come to our meeting by taking just a few steps more. Valet parking and wheelchairs are also available.
Coming
Events
April 25—Our Anniversary Meeting will feature another
informative presentation by one of the leading researchers and practioners in
the field of ostomy care . . . Jan Colwell, RN, MS, WOCN from the University of
Chicago, and President Elect of the WOCN.
Jan will talk about pouching system wear time along with a current scientific
study now being conducted on this topic.
May 23—Our special friends from Hollister, Inc.,
specifically Mary Rome and a group of customer care specialists, are coming by
to talk to us about the wonderful resources available to us, whenever we have
ostomy issues we cannot solve ourselves.
June 27—Our “Welcome to Summer” meeting featuring
Tina Nardi from Byram Healthcare
July 25—We are honored to have Madeline Grimm RN, MS,
WOCN from
August 22—Discussions on the successes of the UOAA
Conference held in
September 26—Our “Welcome to Fall” meeting featuring a
favorite of our Association, Connie Kelly, WOC nurse from
October 24—Gail Meyer and Kathy Krenz, WOC nurses from Centegra-Northern
Illinois Medical will come to talk us
about convexity with ostomy skin barriers.
Gail had an exciting presentation last year, and we look forward to the addition
of Kathy this year.
You are welcome
to join us on the third Saturday of every other month from 10:00 AM until
12:00 noon. We hold our meetings in
the cafeteria at the world headquarters of Hollister, Inc. in
Southwest
Suburban
The Southwest Suburban Chicago Ostomy Support Group is an entirely
volunteer ostomy association dedicated to the mutual aid, education and moral
support of people with ostomies and their families. Meetings are held at 7:30 PM on the third
Monday of each month throughout the year, except July, August, December and
January.
2007
April
16—
May
21—
June
18—Little Company of
Potter
Pavilion
For information regarding this special ostomy group serving
Support
Your Ostomy Association
We are now offering free membership to our
Association. To provide for our few
expenses (mainly the publishing of The New Outlook) we need your
assistance. Please send a contribution
to help maintain our group’s viability.
Name & Address:
___________________________
__________________________________________
Send To:
Ostomy Association of Greater
Mr. Tim Traznik, Treasurer
The
Spring
Restorative Retreat
Saturday, April 28, 1:00 PM
Kathryn Heekin, Ph.D. & Deborah
Kronenberger
Please join us for our second retreat. This season we will quietly rejoice and
reflect new beginnings and new growth.
RSVP 847-509-9595.
The
Story of a Shipment
By Joan Loyd
The painstakingly slow process usually
begins with an e-mail asking for a donation of ostomy products from a new or
former recipient organization. We
request that the receiving organization communicate with us by e-mail in
English, if possible, until a shipment arrives.
Each recipient sends an address where to ship the products and the name
of the person responsible for receiving it.
We screen organizations to assure their
authenticity and that the request is legitimate. We evaluate answers to e-mailed questions
regarding their operation and distribution of ostomy supplies. We require that the supplies we donate in
turn will be donated to the people in need, without any “strings
attached”.
We contact the International Ostomy
Association and ask for demographic information on the requesting organization,
i.e., how many people with ostomies they serve, what is the proportion of
colostomy/ileostomy/urostomies, stoma size ranges etc. We can then plan a shipment of products
tailored to their specific needs.
We begin to select and pack boxes of
ostomy and/or medical supplies and arrange them on pallets. A loyal volunteer, board secretary and local
member, Sheryl Crook, collects the shipping data and arranges it into a
manageable Excel invoice. The invoice is
sent to our shipping agent, who begins arranging customs clearance and
transportation. Usually we must re-do
our documents to comply with the customs regulations of the destination
country.
When the paperwork is in order, the
pallets are wrapped in a plastic wrap and scheduled for pick-up. Shipments usually are pick-up by truck and
then go by sea to the destination country.
A truck will pick-up from the ship and deliver the precious goods. Our biggest issue is moving our shipment
through customs departments at the other end.
This sometimes delays the shipment to our consignee. At last, the organization receiving the
donation, a hospital, clinic or medical mission, obtains the most valuable
shipment—$25-50,000 at retail—and
manages the distribution of ostomy supplies to their people in desperate
need . . . free of any charges.
We received a request from
Mario Pardo
1933 - 2007
By Joan Loyd
On Wednesday, March 21 our support group,
FOW-USA and the world lost an important person.
Mario was important because he cared deeply for others and spent his
life making our world a better place.
In early 1990's Mario and Sharon, married
39 years on March 16 of this year, were responsible for mailing our
newsletter. Mario picked up the copies
at the printer. Mario and Sharon folded,
stamped, labeled and sorted by zip code over 500 copies. Then Mario took them to the post office. They did this every month for about five
years. When they gave up this chore as
Though not a person with an ostomy, Mario
was a loyal member of FOW-USA. When he
retired as a warehouse manager in 2003, he immediately became a volunteer at
the FOW-USA warehouse in
As treasurer of FOW-USA, Mario kept
accurate records. He successfully
challenged errors and stretched our budget to cover increasing costs for space
and shipping. All this was done
selflessly and with good humor. The
Velveteen Rabbit, a children’s story written by Margery Williams, is a
fitting allegory of Mario’s life.
“The Velveteen Rabbit was shy, made of
velveteen and stuffed with sawdust; and some of the expensive toys in the
nursery made fun of him. The mechanical
toys, like the model train, were very stuck-up and boasted they were real. Even Timothy, the jointed wooden lion, who
was made by disabled soldiers and should have had broader views, put on airs.”
“The only one kind to him was the old skin
rocking horse who had lived longer in the nursery than anyone else. He was so old that his brown coat was bald in
patches and most of the hairs in his tail had been pulled out. He was wise, for he had seen successions of
mechanical toys arrive to boast and swagger, then by-and-by break their springs
and pass away.”
“‘What is real?’ asked the rabbit. ‘Does it mean having things that buzz inside
you and a stick-out handle?’ ‘Real isn’t
how you are made’, answered the skin horse.
‘It’s a thing that happens to you.
When you are loved for a very long time, not just to play with but
really loved, then you become real.’”
“‘Does it hurt?’ ‘Sometimes’, said the skin horse, ‘but when
you are real, you don’t mind being hurt.’
‘Does it happen all at once like being wound up, or bit by bit?’ ‘It doesn’t happen all at once. You . . . become. It takes a long time. It doesn’t happen to people who break easily,
or who have sharp edges, or who have to be carefully kept. Generally, by the time you are real, most of
your hair has been loved off, sometimes your eyes drop out and you get all
loose in the joints and very shabby. But
these things don’t matter at all, because once you are real, you can’t be ugly,
except to people who don’t understand.’”
“Time passed in the nursery. The little rabbit became the favorite toy of
the little boy. He slept in the boy’s
bed. They spent long days outside,
riding on the wheelbarrow, playing in the grass. The little rabbit grew very old and shabby,
but the little boy loved him just as much.
He loved him so hard that he loved all his whiskers off, and the pink
lining to his ears turned grey. He even
began to lose his shape. He scarcely
looked like a rabbit any more, except to the boy. To the boy he was always beautiful. Nursery magic had made him real, and when you
are real, shabbiness doesn’t matter.”
“And then one day the boy fell ill. His body was so hot that it burned little
rabbit when he held him close. Strange
people came and went in the nursery, and a light burned all night. Through it all, the little Velveteen Rabbit
sat guard. It was a long weary time, but
he knew the boy needed him. While the
boy lay half asleep, the little rabbit crept up close to the pillow and
whispered all sorts of delightful plans for when the boy would be well again. They would go out in the garden and play
splendid games among the flowers and butterflies.”
“At last the fever broke, and the boy got
better. Then the room had to be
disinfected. All the books and toys the
boy had played with in his sick bed must be burnt. And so the little rabbit was put into a sack
and carried out to the end of the garden.
While the little rabbit lay among the old picture books, he remembered
the long sunlit hours in the garden and how happy they were. He felt very lonely and sad, and a tear . . .
a real tear trickled down and fell to the ground.”
“Then a wonderful thing happened. Where the tear had fallen grew a mysterious
flower. It was so beautiful the little
rabbit forgot to cry and just sat there watching it. Suddenly the blossom opened, and out stepped
the loveliest fairy in the whole world.
She came close to the little rabbit.
I am the nursery magic fairy. I
take care of all the playthings children have loved. When they are old and worn out and the
children don’t need them anymore, then I come and take them away and turn them
into real.”
“‘Wasn’t I real before?’ ‘You were real to the boy because he loved
you. Now you shall be real to everyone.’ She gathered him up in her arms and flew with
him into a beautiful forest. In an open
glade between the trees, wild rabbits danced on the grass. When they saw the fairy, they stopped dancing
and stood in a ring to stare at her.”
“‘I’ve brought you a new playfellow. You must be very kind to him and teach him
all he needs to know, for he is going to live with you for ever and ever.’ The fairy kissed the little rabbit, and
suddenly instead of dingy velveteen, he had brown fur, soft and shiny. His ears twitched by themselves, and his
whiskers were so long they brushed the grass.
Instead of sawdust, he had legs that could spring, and leap and
jump! She kissed him again and said,
‘Run and play, little rabbit! Run and
play!’”
UOA-C at
CCFA Symposium—2007
By Renard Narcaroti
For the eighth year in a row, we have participated in the CCFA Educational Symposium held here in Chicago (Marilyn Mau as well as Dave Rudzin arranged and managed our initial participation in this event.) We are invited to set up an educational booth where the people attending the symposium may stop by and talk to us about ostomy surgery. This was CCFA’s best-attended conference with over 1000 people registering.
Our active participation was managed through the efforts of: Vera Miller, who after suffering with uc, is our best example and an outstanding role model of a person with a successful j-pouch: Judy Svoboda, with has an ileostomy due to Crohn’s disease—who dresses impeccably wearing spandex type pants, which shows off her flat tummy. We notice people stealthily looking at her trying to see her ostomy—which is virtually impossible to notice. Judy introduces herself as a person with an ostomy right away or else nobody would believe it: and, of course, myself.
I think it would serve us well if I let you know of some of the stories people relayed to us while working there. As a preamble, Judy reminded us that although we are smiling, happy and healthy, people there observing our attitude do not know how to take us. You see, they are usually very sick, scared to death about the possibility of having to live with an ostomy, yet, here we are excited about life. They think, “How can they be so cavalier about on ostomy, when I am so scared about it? Don’t they know how serious this is for me?”
Of course, we know how serious it is. However, we have the advantage of seeing past the fear of what it is like to live with an ostomy because we know firsthand that will we actually be able to leave our house . . .. This ostomy business is old news to us, we have too many other interesting things that we are involved with in our lives but they are just beginning the journey. They just do not realize the great opportunity from the pain of disease ostomy surgery will provide them. We are there to help communicate the potential future it is possible for many of them to possess.
Not all the stories are so good. One woman, in her late 50’s, near death in 2001 due to uc, was told by her doctors that she needed to have her colon removed. Her husband told her that if she had an ileostomy that he would stop having sex with her. She chose the j-pouch surgery as her alternative.
However, the surgery produced some serious side effects, like is usually does. Besides the customary issues, like pouchitis, butt burn, etc., she had constant pressure on her anus. This caused her pain continuously for five years. Her husband died last year and soon afterwards, she had her j-pouch excised. She is very happy with her new ileostomy—translated no pain—and she controls her own body now.
Another young woman, who by the way was beautiful enough to be a movie star, came by asking us about some ostomy issues. She had a temporary ileostomy, due to uc, that she was keeping, while she and her husband tried to have a baby. Her doctor told her that a baby is easier to conceive and deliver with an ileostomy than a j-pouch. However, she questioned Vera quite intensely on her quality-of-life with a j-pouch. She will have to ultimately decide whether to have her remaining colon and anal parts removed and make the ileostomy permanent or to convert her temporary ileostomy into a j-pouch. She has a few years yet to decide. We presented a case viewing both sides of the issue.
One woman, who stopped by with her son who is in his early 20’s and is being ravaged by uc, told us how terrified they are of colon surgery. They were desperately seeking the least visible evidence of colon surgery. They were sure the alternative surgical procedures would make him “normal” once again. We explained the benefits and downsides of a j-pouch, Kock pouch and ileostomy. Judy and Vera explained their feelings so positively and compassionately that the young man was not as panicked about having ostomy surgery.
Another lovely young woman in her 20’s, who had a j-pouch due to uc in 2000, stopped by to talk to us about her surgery. Although she was happy to be rid of the uc and had a good life, she was concerned that she would have to continue her entire life living on anti-diarrhea drugs as well as a whole plethora of antibiotics, while still going to the toilet about 20 times a day. Vera, who was a popular speaker this day, gave her some tidbits on improving her life. This young woman also came to realize that maybe she still has other alternatives if carrying a j-pouch proves too costly in terms of quality-of-life.
Another young woman, Sabrina, was very enthusiastic about all the interesting things she has done since obtaining her ileostomy due to uc. She told us how she swims all the time and the type of bathing suits she wears to hide the ostomy; like wearing suits with printed patterns, the new two-piece suits where the top overhangs the bottom by just a touch and the fashionable body wraps that the young girls all wear. She also scuba dives. She said being in water 60 feet deep is a pleasure with an ileostomy; i.e., no worries about having to make an emergency toilet visit.
Dozens and dozens of people came to us showing off that they have had ostomy surgery and felt better than ever. (Studies have shown that people with ileostomies due to inflammatory bowel disease have better quality-of-lives than regular, healthy people do in the general population!) Many who come to the symposium, live in areas over an hour away from the nearest local ostomy association. They seem to look forward to seeing us each year as a way to keep in contact with the ostomy community.
We were able to experience first-hand the
benefits people receive from our local ostomy association. In addition, we leave with the gratitude of
having all that pain and suffering behind us.
We are grateful for our new life after ostomy surgery. We hope you are too.
“Spring Into
Exercise” Carefully
Adapted By The New Outlook
Spring is the time in
People with ostomies should start out at
very basic activity level. Increase your
exercise only gradually. For instance,
if you took walks in the spring and summer last year of about three miles a
day, start off this season at one mile, and then increase a little each
day. In addition, you may find that you
cannot perform at the same level that you did last year. Just take it slow at a level in which you
feel comfortable. Never strain yourself.
A good place to start is with a visit to
your doctor, especially if your exercise program was non-existent during the
winter. He/she will check your health
and work with you on the best exercise regimen.
Before any type of exercise, slowly . . .
warm up and stretch. This means let your
body adjust with some easy, low-stress movements. Move into some basic stretches before doing
your main exercises. End your exercise
session gradually and end with more stretches.
Stretching helps to prevent injuries and
enables your muscles to perform better.
A strained back, pulled muscles or tendonitis may be avoided by careful
stretching or warming-up. When you stretch,
hold the stretch for at least 10 seconds.
This helps avoid “bouncing” which tears muscles and tendons. Holding a stretch allows the muscles the time
they require to overcome natural tension.
Bouncing pushes the body too fast and makes muscles tend to guard
themselves against that movement.
Stretch as far as you can comfortably and
then hold that stretch. If there is
pain, you are going too far. Experiment
on the positions best for you.
Your do not have to be an Olympian to reap
the benefits of exercise. It is never
too late to start getting in shape. We
tend to lose about one-third of a pound of muscle per year after the age of 30,
and our bones become weaker—if not subjected to weight-bearing exercise. So, in addition to aerobic exercises such as
walking or swimming, doctors recommend people—especially seniors—to do some
degree of strength training.
If your body is in pain two hours after
exercising, back off a bit. You may
experience some minor soreness later in the day or in the next day or two—this
is normal. You should not have intense
soreness or pain at anytime, especially shortly after doing the exercises. If any exercise causes you pain, try doing it
more gradually or do not do it at all.
Also, you should never increase your rate of exercise by more than 10
percent a week.
Facts about Convexity
By Bob Baumel
A
convex pouching system is designed to improve the peristomal seal by increasing
the depth of the skin barrier. This is
done in order for the ostomy system to conform to the peristomal skin contour
more continuously. The following are
indications for use:
Æ
A flush stoma
Æ
A retracted stoma
Æ
A stomal at or near skin level
Æ
Peristomal creases and wrinkles
Æ
Liquid drainage getting on the skin
Æ
A high output stomal effluent
Æ
A protruding or flabby abdomen
Æ
Frequent pouching system changes caused by
leakage
The
following are contraindications for use:
Æ
Pyoderma Gangrenosum, a chronic non-infective
eruption of spreading undermined ulcers showing central healing, with diffuse
dermal neutrophil infiltration; often associated with ulcerative colitis
Æ
Caput Medusa (peristomal varices), varicose
veins radiating from the umbilicus, dilated ciliary arteries girdling the
corneoscleral limbus in rubeosis iridis
Æ
Pressure ulcers, a lesion on the surface of
the skin caused by superficial loss of tissue, usually with inflammation,
which may be cause by an ostomy belt or
convex insert putting stress on the skin causing ulceration
Æ
Mucocutaneous separation, relating to mucous
membrane and skin; denoting the line of junction of the two at the orifice . .
. in our case the separation of the skin from the stoma
Æ
Crohn's ulceration, ulceration caused from
Crohn's disease
Æ
Malignant ulceration, ulceration caused from
cancer
Products
and devices to achieve convexity include:
Æ
Convex Insert:
A pre-sized plastic ring for use in the flange of a two-piece system
Æ
Barrier Rings or Strips: A moldable product used to create convexity.
Æ
A Convex Skin Barrier: A skin barrier manufactured with built-in
convexity
It
should be noted that an ostomy belt is usually worn to provide additional
support when using any convex product.
There are also differing degrees of depth available in convex products
such as, shallow, normal and deep.
The
person who has a need for a convex product should be able to maintain his/her
peristomal skin in excellent health; comfort and satisfaction with the pouching
system; increased pouching system wear time; a more cost effective stomal
management system. There are certain
considerations when using a convex system:
Æ
Convex pouching systems are best fitted by a
WOC nurse and evaluated regularly
Æ
Convex products leave an imprint on the skin
Æ
Convex barriers may be less flexible
Æ
Convex products generally cost more, but
should be a better value because of the increase wear time leading to less
frequent pouch changes
Patients
are encouraged to see their WOC nurse if there are any stomal changes, bumps,
cuts bruises or bleeding; if peristomal skin changes occur such as irritations,
rash, color changes, bleeding, pain, itching or lesions; if there is continued
and frequent leakage of the pouching system.
Ileostomy
Lavage
By: Dianne Garde
When someone with an ileostomy encounters a blockage, it is important to know how this should be treated. The term “Lavage” is used rather than irrigation. In the ostomy realm, the term irrigation generally refers to someone with a colostomy who gives themselves an enema on a daily basis to clear the colon of stool. The amount of water used is probably between one and one half liters. Trying to instill this amount of fluid into an obstructed ileostomy could be potentially dangerous as the pressure could cause a perforation.
The generally accepted method of treatment of ileostomy obstruction is to use saline (sodium chloride) to prevent dehydration and to utilize a bulb syringe with an open-ended whistle tip, 24Fr or 26Fr, catheter. The solution is sucked into the bulb syringe and gently instilled into the catheter and the contents sucked back into it again in an effort to break up a food bolus.
This should be done a number of times until the saline comes back clear. I would not recommend that a patient try this procedure unless he/she possesses the proper equipment and has been trained by a well- educated WOC nurse. This should not be attempted until an x-ray has been taken to determine that it is a food bolus and not a mechanical obstruction.
I would also recommend that if you feel
you have an ileostomy blockage that you try to get to a major centre where
there are qualified personnel familiar with the proper procedure to deal with
the problem appropriately. About the author: Dianne Garde is a
certified ostomy nurse that may be reached at wcet@on.aibn.com.
Living with Your Ileostomy
By
This article is from a talk about, The Surgeon's Responsibility to You
and Your Responsibility to the Surgeon. The
talk was on what a physician expects of an ileostomy patient.
"Being a person with an ileostomy myself, I have jotted down things
I experienced, and what I expect of you as you learn to cope."
Immediate post-op care . . . the most important thing the doctor expects
is the patient's acceptance of the change in body image. He/she must accept the fact that he/she has
been changed for the better in most cases.
One of the biggest hurdles with patients who will not even look at the
stoma is to have him/her take care of it.
This is the beginning of the road to recovery and complete
recuperation. The patient should and
must be independent by the time he/she leaves the hospital. The patient should have a satisfactory ostomy
system with resource available for follow up care.
Motivate the patient to look at the positive effects of his/her
operation. He/she is free of the
disease; of contracting colon cancer; urgent diarrhea; cramping and pain. Most people with an ileostomy say they happy to
be rid of 20 or more trips to the bathroom, while sometimes getting there too
late. Most ileostomy surgery is due to
inflammatory bowel disease. Make him/her
aware that he/she has not been mutilated, but changed for the better.
The next big challenge is "bagging the stoma." It is most important to find the best ostomy
system for the patient. The patient
needs to know that his/her stoma is going to change. After surgery, he/she will gain weight again
resulting in additional adjustments to one's pouching system. The WOC nurse should be the primary resource
for patient consultation. A WOC nurse is
an expert on post surgical ostomy care and should be fully utilized.
It
is very important to understand the challenges a surgeon faces. Keep in mind that the individual's health
problems dictate the surgeon's techniques.
Depending on the exact anatomy of each patient, he/she will have a
different stoma located in a slightly or more dramatically different area on
the abdomen than someone else. One does
not swap dentures or eyeglasses, therefore one should not unfairly compare
stomas. Patients should attend meetings
at their local ostomy association; learn all he/she can about ostomy care. The caring and sharing will help more than
anything else will.
Usually, the person with an ileostomy has been on or tried special diets
for years. After surgery, he/she is
desirous to move onto his/her post-surgical life. However, there are foods that may cause
concerns, gas or odors. The patient must
be aware of correctly introducing foods into his/her diet once again. The patient should also be instructed on what
procedures to implement in case of problems like food blockages, dehydration or
injury to other parts of the body.
A
correct routine in handling these concerns will provide the patient with the
best quality-of-life after surgery.
Urostomy Complications
Forwarded
by our friends in
People with urostomies may have complications developing as far as after
10 to 12 years after surgery. Most
complications are gradual. Probably an
ill-fitting pouch causes the most common challenges. Urine that accumulates on the skin around the
base of the stoma may become reddish-brown with raised, thick, leather-like
areas. It is important to have a skin
barrier that fits right up to the stoma to prevent this and other long-term
complications.
If
the reddish-brown growth is extremely bad, it may be treated with soaks of
white vinegar three times-a-day for three or four days. Vitamin C, taken according to instructions
through the advice of one’s doctor, may also be helpful to acidify the
urine. Alkaline urine on the skin is
irritating. If these measures are not
successful, a revision of the stoma is an alternative. Encrustation's
or sand-like deposits on or around the stoma are another complication. When these deposits are noticed, it is
sometimes beneficial to start to increase your intake of cranberry juice. Vitamin C is also good and your physician may
order Mandelamine to increase urine acidity even more. Orange juice is not recommended because of
the high alkaline ash residue.
One part vinegar to two parts water sloshed over the stoma may help if
done once or twice a day. This
encrustation can clog up the stoma and eventually cause a closure of the
stoma.
Recurrent urinary tract infections are prevalent in most people with
urostomies. Most of you know the
symptoms, fever, a strong urine odor, decrease output, amber-colored urine with
a large amount of white sediment. You
may need more fluids. You should be
drinking at lease 64 ounces (two liters) of water each day . . . make sure you
discuss this with you doctor to make sure you are not one of those rare people
who should not drink excessive amounts of water. This will reduce infections and prevent
kidney stones. Cleanliness is also very
important.
People with urostomies should empty the pouch before it passes the
half-full level. There is a chance that
the pouch will pull away from its seal because it is too heavy. There is also a
higher chance of urine backing up into the conduit if the pouch if full.
Certain brands of pouches are affected by certain cleaning
solutions. For instance, United
Surgical's quality control laboratory has determined that using a vinegar and
water solution to rinse United pouches changes the vinyl. They recommend their Uri-Kleen or Uni-Wash or
other approved products to clean their pouches.
Discuss this with your WOC nurse or contact a manufacturer directly.
The use of a small wastebasket at the side of the bed provides a handy
storage place for your night drainage unit.
It also prevents kicking it over in the middle of the night. Also, when connecting your pouch to your
night drainage container, do not completely empty your pouch. The collected urine will run down the tubing
into the container and produce a siphon effect, which will facilitate keeping
your pouch empty during the night—a good thing.
How to go on a Doctor's Visit
—
Have you ever gone to a medical appointment only to find yourself unable
to remember the details of your health history or struggling to recall your
questions for the doctor? If so, you are
not alone. It can be tough explaining
your symptoms, understanding your doctor’s advice, especially if you are
anxious, or not feeling well. Medical
professionals offer this advice when for making the most of your doctor visits:
Organize a health file: It is always useful to have
information about your history on hand.
Bring a detailed list of previous medical issues; i.e., the dates you
had surgery and what was done; medications taken and any reactions.
Also, bring pertinent information about your family's health history and
records of immunizations. Ask your
doctor for copies of your medical records and any relevant test results to keep
in your personal files. Do not forget to
keep a list of previous doctors' names and addresses.
Schedule your appointment wisely: Plan ahead for your appointment
by getting your medical records from laboratories or previous physicians
transferred to your doctor's office.
When scheduling appointments, ask if there are certain days of the week
less busy than others are. Also, ask
about the expected length of the appointment so you can plan you time
accordingly. If neither of you feel
rushed, you are more likely to cover all the issues you want to discuss.
Bring your medication bottles: Your doctor will want to know
about the medications you are taking, their dosage and frequency, how long you
have been taking them and possibly contact the prescribing physician. Having the actual bottle provides all this
information. Do not forget the
over-the-counter remedies, vitamins and herbs you are taking. All of these can affect your diagnosis and
your treatment.
Make a list: It is easy to feel tongue-tied, especially if
it is your first visit with a new doctor.
To ease some of this anxiety, write down your thoughts ahead of
time. Having this information on hand will
keep you from forgetting any questions you have. A list is particularly helpful for those with
multiple health needs. It gives your
doctor a complete picture of your concerns and helps prioritize issues that
need to be addressed.
Be
Prepared for questions about your symptoms:
Before your appointment,
take a few moments to think more intensely about your condition. When did you first notice the problem? Have you had the problem before? What are your symptoms? How often do they occur? If you are in pain, do you describe it as a
dull ache or a stabbing pain? What have
you done for it? Does anything make it
worse? Have there been changes lately in
your life related to stress, medications, food or exercise? The more clearly you can define the health
problems, the more likely your doctor will be able to find the best possible
solution.
Bring your diary with you: At your appointment, having a diary is
helpful for many reasons. Write down
when the doctor thinks you will start noticing improvements in your health
condition, the dates and directions for receiving any lab test results and the
date and time of your next visit. You
may also find a planner useful for jotting down your doctor's advice for taking
prescribed medicines or preparing for lab tests.