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August
2010 Last Month’s Meeting (our 401th) Today was hot! Nevertheless, we had a cool time at our July meeting. Fred Shulak brought a delicious cake to celebrate his 54th Stomaversary. Moreover, we had excellent guest speakers. We were very fortunate to have as first time speakers Nancy Chaiken, CWOCN from Swedish Covenant Hospital along with Yvonne Stallard, CWOCN (who visited us a few years back when she was a student nurse) specializing in outpatient care at SCH. Nancy talked to us about managing our ostomies in hot weather. She mentioned a variety of skin issues that might occur especially during the summer, like skin rashes and candida (fungus) under the skin barrier. It was most interesting when she said that local fungal infections usually could be cured by simply keeping the infected area dry. Fungus needs a hot, moist environment to stay alive. Without these conditions, it cannot live. Nancy and Yvonne were pleased to answer the many concerns our members had about managing their pouching systems after ostomy surgery. Elaine Kosey made a moving presentation on the inspirational life of her uncle and WWII veteran, George C. Veverka. She dramatized the incredible life he lived especially his last 25 years with an ostomy. Northwest Community Hospital in Arlington Heights will be hosting a Vendor Fair on Saturday, October 2, from 9:00 AM until 1:00 PM, featuring the newest ostomy products from a variety of manufacturers. In conjunction with the Vendor Fair, WOCN nurses from the hospital will conduct a free Stoma Clinic to address individual concerns. There will be more specifics next month. To receive more details as they become available, please email uoa-nch@live.com. If you have a talent that you would like to share by participating in one of our many diverse committees, please let us know. Our offices and committees are listed in our bylaws via the link to OAGC on www.uoachicago.org . Are you parking in the underground garage for our meeting? Ask us for a pass to reduce your fee to $2.00! We are sad to announce the passing of one of
the original founding members of our ostomy association, Rhoda Gordon. Rhoda was active in our group for the
entire 35 years since its founding in 1975.
She attended more meetings and talked to more people about ostomy
surgery than anyone else in Chicago.
If you ever were a visitor to one of our monthly meetings, you would
have met Rhoda. She was always there
to greet people and offer a kind word of encouragement. Rhoda will be irreplaceable as one
providing inspirational leadership to our group. She kept us focused on our mission of being
an ostomy support group and primarily discussing ostomy issues. She was always concerned about dramatizing
to people with new ostomies the huge benefits of the gift of ostomy surgery. She focused our goals always to be advocates,
educators and supporters of people with ostomies. OAGC Meeting Dates for
2010 September 15—Bernie au
dem Graben, WOCN October 20—Jennifer Dore,
WOCN December 15—Our Gala
Holiday Celebration Southwest
Suburban Chicago 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
For information regarding this special ostomy group serving Chicago’s
greater southwest side, please call Edna Wooding, WOC nurse and association
president, at 708-423-5641. All meetings are held at Little Company of Mary
Hospital, Evergreen Park, Mary Potter Pavilion, Lower Level, 2850 W. 95th St. Northwest Community Hospital An ostomy support group was formed in 2008 at Northwest Community Hospital, 800 W. Central Road, Arlington Heights. They wish to extend a welcome to all of our readers to visit them. They meet at 1:00 PM in the Busse Center, B1 level, Room LC7-8 of the Learning Center. This building may be accessed from the garage at the west end of the Busse Center. It is easiest to enter from Central Road. The WOC nurses at the hospital lead the group. For more information, please contact Diane Davis-Zeek, RN at 847-618-3215, ddavis@nch.org .
NW Comm Hospital Meeting Dates for 2010 August 12 October 7 December 9 Lake County
Ostomy Association The Lake County Ostomy Association (LCOA) meets on the third Saturday every other month. Meetings begin at 10:00 AM and end around noon. The LCOA meets at the corporate headquarters of Hollister, Inc., 2000 Hollister Drive, Libertyville (about one mile north of the Vernon Hills Shopping Center on the east side of Milwaukee Avenue., Route 21). For more information, call Carol Rhodes 815-459-2691 or Judy Gaughan, Hollister, Inc., 847-918-3451. LCOA Meeting Dates for 2010 September 18 November 20 Join
UOAA on Facebook at http:// www.facebook.com/#!/pages/United-Ostomy- Associations-of-America/169475247090?ref=ts Follow
UOAA on Twitter at http:// By Gail Wilhite, CWOCN An
ileostomy stoma should be at least 3/4” in length and some surgeons advocate
a longer length of 1” to 1 ½”. A
spout-like stoma is necessary to deposit the effluent into the pouch
preventing pooling of contents at the base of the stoma. Conversely, a stoma that
is too long is subject to external trauma and injury. Weighing the consequences, it is usually preferred
to have a stoma somewhat too long than one too short. There
is a difference between the creation of colostomy and ileostomy stomas. Frequently, when fashioning a left-sided
colostomy, the surgeon will create a flush stoma. The contents of the left colon are
relatively inert and may usually be regulated by those who choose to irrigate,
therefore, little or no functional problems occur with a flush colostomy
stoma. An
ileostomy stoma is never constructed as a flush stoma; nevertheless,
sometimes the stoma may retract for various reasons. The common cause of stomal retraction is
post-operative weight gain. Prior to
their operations, most people with ileostomies have lost considerable weight. Following surgery, weight gain can be rapid
and many times excessive. What once
was an adequate stoma now retreats within the expanding environment. Another
cause of retraction may be inadequate fixation of the opposing serosal layers
following eversion. If these layers
fail to adhere, healing and subsequent scarring may tend to draw the stoma
into the abdomen. Challenges resulting
from retraction is decreasing adherence of the skin barrier and skin
breakdown, the pooling of the excoriating intestinal contents cause the
loosening of the adherent skin barrier bond resulting in leakage of ileal
effluent on the skin. Effluent
that is contact with the skin for more than just a few moments will result in
skin breakdown and an acid burn. The
combination of irritated, weeping peristomal skin and continual pooling leads
to an unbearable situation, which must be remedied. One treatment for a slightly retracted stoma is the use of a convex skin barrier. The convexity applies pressure on the skin surrounding the stoma, thus pushing the stoma up. When using a convex skin barrier, it is important not to lose the convexity by applying thick washers or foam pads, etc. underneath it. The skin and skin barrier should suffice to maintain the advantages of both convexity and skin protection. If the use of a convex skin barrier proves unsuccessful or if the retraction is severe, then surgery may be advised to create a new, longer stoma.
By Rosemary Van Ingen, CWOCN It
is interesting that people with normal intact bowel tracts and urinary
systems manage odor problems in an acceptable manner in our society. However, when disease or trauma strikes and
a person is the owner of an ostomy, one big concern is the fear of offending
society with an odor.
What is an Ostomy? Basically,
an ostomy is a manufactured exit site that changes the point of exit
from the bottom or back of our body to the front. Our eyes and noses are obviously on the
front of our body, which leads us to be more aware of our changed body image
and our odor-producing products. I am sure
you have heard the statement, “You’ve come a long way, baby.” Yes, ostomy management has come a long
way-considering that as little as twenty-five years ago, we had very few 100%
odor-free pouching systems.
Ostomy Collecting Receptacles—when modern ostomy surgery was first
developed, people with ostomies wore anything to collect output. Tin cans, rubber gloves, cups of all shapes
and sizes, bread wrappers and plastic margarine cups just to mention a few. These were common, standard equipment for a
person with an ostomy. Not only the poor
feasibility, but also the odor problems this type of equipment produced, was
enough to give ostomy surgery and people who had ostomies a very deplorable
place in our society. Presently, virtually
all the ostomy pouching systems available to us today are made of
odor-barrier materials.
Odor Detective Work--Therefore, if a person with an ostomy does
have a fecal or urinary odor about them, some detective work should be done. Review the procedure for applying the
pouching system to the body. Is it
leaking? Inspect the closure of the
pouching system. Is it closed properly
so that no fecal matter is oozing out after the closure? Do not put holes in the pouch as a way to
release gas because odor will escape as well as gas.
Urostomy Odor Cautions—The person with a urostomy should rinse or
wipe off the spout of the pouching system with a bathroom tissue after
emptying. Those few drops left in the
spout after closing the pouching system can cause a urine odor under clothing.
It is interesting to note that most
urostomy pouching systems on the market are odor-proof, but the connecting
tubing and bedside and leg bag are not. You must dispose of and replace these
products when they take on urinary odors, or else your entire living quarters
will smell.
Elimination with Ostomies—Emptying an ostomy pouching system is
comparable to a person with an intact bowel or urinary tract having a bowel
movement or emptying their bladder. How
does the non-ostomate handle the odor produced by the normal function of
their body? Room deodorizing sprays
are popular; a quick flush of the toilet when
defecation occurs, and opening a window are some acceptable methods that have
been used for odor management. Why Be Concerned with Odor? Somehow, those of us with ostomies are so uptight about elimination odors when our pouching systems are emptied. This constant complaint has encouraged ostomy supply manufacturers to create products to meet the need for odor control. Just remember, there is not a man or woman on this earth whose wastes do not smell. If someone tells you that their waste products are odorless, then a nose overhaul is in order for them. Rhoda Contributed By Joan Loyd So many thoughts—so many memories—so hard to put into writing—almost as if doing so would close the final chapter of a story that you do not want to end. Rhoda, so warm and welcoming. Rhoda, charming and beautiful. Rhoda, kind and helpful. Rhoda, giving of herself, concerned and genuinely caring about everyone she ever met. Rhoda, intelligent, funny, abreast of world events. Rhoda organized the ostomy support group. For 35 years, she rarely missed meeting. She gave wise steering to Board decisions. She filled in responsibly when job positions were without a candidate. She kept track of members, listened to individual problems, visited and sent flowers. Ostomates are told we need to show the world that we can “look good.” Rhoda lived this message, choosing a wonderful outfit and unique jewelry for each occasion. She was perfectly groomed and always looked good. Just seeing her was a treat. She was an inspiration for all of us to make the best of ourselves. Rhoda was helpful, actively stepping up to volunteer whenever she could help. She was respected for her intelligent solving of problems in innovative ways, and her persistent carrying through to satisfactory conclusions. She was a contributing team member who could be counted on to do what she said she would do - and do an excellent job. When she retired from her job, she enrolled in classes to expand her mind and spirit, keeping ever current with the world and all around her. Rhoda loved her family with all her heart. She was devoted to Mike’s mother. She was concerned about her boys. She was Mike’s anchor in life’s storms. When the bell tolled for Rhoda, truly that bell tolled for all of us. Our lives and the lives of all she touched were enriched and expanded by her presence. Rhoda actively made the world she lived in a better place. The beautiful song has ended. The melody will linger long. Coping with a New Diagnosis By David Swee, MD,
professor of family medicine and associate dean for education at UMDNJ-Robert
Wood Johnson Medical School in Piscataway, NJ. This is reprinted with permission granted
to the Green Bay Area Ostomy Support Group.
This article first appeared in Health Monitor at Home, Vol. 2, No. 3, spring
2010. Q. How difficult is it for people to cope with
a new diagnosis? A. A person’s ability to cope
generally depends upon his or her health condition and personality. For instance, if someone has symptoms but
is unsure of the cause, a diagnosis, especially if it is minor, can come as a
big relief. However, a diagnosis of a
very serious condition often triggers a grieving process. People morn for the healthy person they
once were, while learning to accept their new condition. Learning to live with long- and short-term symptoms can be very overwhelming for some people. Others, though, find they can manage with the same skills they have used to start a new job or move to a new neighborhood. Still, it is challenging to everyone to manage a new condition, especially if it involves taking prescribed medications or regular doctor visits. Stigmas about certain conditions—like HIV, cancer and diabetes—make a diagnosis much harder to accept, and that makes health management much more difficult. It can take years for people affected by stigmas to fully accept their illness and assume the responsibility to care for them. No matter what the diagnosis, the most common emotional responses are anger, guilt, sadness, hopelessness, disbelief, anxiety, fear and depression. It is best if the patient is able to let the doctor know about these feelings so they can make a team effort to work through them—especially depression. Q. What are some signs that a
diagnosis may be causing depression? A. If your normal functioning is disrupted—you are unable to get out of bed, eat, sleep or concentrate, or you are crying all day long—you need to see someone. If it is clinical depression or a mood disorder, your doctor may recommend meeting with a professional counselor. Medication may also help make symptoms more bearable. Anxiety and depression are not signs of personal weakness. People need to know this. They are in fact very common reactions to coming up against a life-changing diagnosis. Q. What coping strategies do
you recommended for people struggling to accept a diagnosis? A. Generally, I tell patients that coping is all about choice. You can choose to be angry, you can choose to feel guilty but you can also choose to use that energy to learn about your condition and become your own health advocate. At the same time, it is equally important to collaborate up with your doctor and set small, realistic health goals. You do not need to go through this period alone. Your physician is there to coach you through it. Newly diagnosed people can also open up to a friend or family member about their concerns or join a support group. Either option is great, as it promotes healing by helping people shed a few fears. Exercising can help you work through emotions, boost your health and even serve as a good distraction. To ease nerves, I often recommend deep, slow breathing. Another technique is to tighten then quickly loosen all your muscles at once to release tension throughout your body. What is a CWOCN? Adapted from an article by ReRoute, Evansville,
IN CWOCN is an abbreviation for a Certified Wound-Ostomy-Continence Nurse. A CWOCN is a Registered Nurse (RN) who has received extensive training in managing conditions related to complicated wounds, ostomies, or problems related to fecal and urinary incontinence. Some RNs choose to become specialists in only one area. A CWOCN has at least a Bachelor’s degree in nursing. In addition, the CWOCN has received extensive training in anatomy and physiology; wound ostomy, and continence management, patient teaching, prevention of complications; appliance fitting and refitting; evaluation and consultation. The CWOCN must pass a certifying examination for each area of specialization and then become certified by the national organization. The CWOCN must also attend relevant continuing education sessions each year and be re-certified every five years. Here is how a CWOCN can help. The CWOCN § Consults with the physician to recommend treatment for complicated wounds § Can teach the patient and family how to manage wounds, ostomies, and continence after they leave the hospital § Can evaluate and fit pouching systems. This is helpful for new people with ostomies and for people owning ostomies for a long-term who can no longer find the pouching system they have been using. § Has received training to assist the surgeon in locating the best site on the abdomen for the ostomy to be placed during surgery. This is important to make certain the ostomy is not put in a location, such as a crease or fold that could complicate pouch system management. § Can help identify the causes of incontinence, and help manage it effectively while in the hospital and at home. § Is an expert at preventing skin irritation and pressure ulcers, and consults with doctors and other nurses to recommend the best approach for each individual situation. CWOCNs are available not only in hospital, but in outpatient settings, and when appropriate, in the home such services are usually covered by insurance, but normally only when referred by a physician. Home services are not provided by hospital CWOCNs, but if the patient is covered, some home health agencies have CWOCNs on their staffs. Helping Patients Adjust Forward by Ostomy Highlife The patient
with an ostomy is apt to foresee a life of ostracism. Even though
he/she may have been ill and limited in activity for a long period, it will
be difficult for him/her to acknowledge the inability voluntarily to control
his/her bowel or urine function. As his/her
family doctor, you may be able to handle the patient's questions and
emotional difficulties better than the consultant may, who is a stranger to
the patient. However, the best medicine is a visit by a healthy, happy,
fellow person with an ostomy. It is also important that the patient is
associated with a WOC nurse. If the patient
is a woman, the sight of a person with an ostomy in a slim sheath without a
telltale bulge can provide assurance. In addition, the visitor will
answer the type of questions the patient might be reluctant to ask
others. The following are typical questions new person with an ostomy
asks and the answers a fellow person with an ostomy may provide. Can I have
intercourse? When the patient asks about the potential for sexual
intercourse, it is a harbinger of a successful adjustment. A man will
be concerned about his ability to perform, a woman about her ability to
attract and satisfy. All too often, the subject is skirted or, even
worse, is handled negatively with, "What difference does it make at your
age?" or "This operation is going to save your life—isn't that
enough?" According to
the United Ostomy Associations of America, it is estimated that approximately
10-20 per cent of males with ileostomies suffer temporary impairment of
sexual function and potency. However, fortunately, this is only
temporary in most cases. About 1% of
men are permanently impotent after fecal ostomy surgery. Males who have
had urinary ostomies early in childhood can usually perform sexually, but
they may be sterile. More than half of the males who have urinary
surgery as adults for bladder malignancy are impotent. The average age
for this surgery is 74. Males with
colostomies vary in their degree of potency from full potency to complete
impotency. In many instances, potency is retained, but in these cases,
the patient is sometimes sterile. In some patients, potency is lost due
to the extent of the surgery. In a few cases, regardless of the type
ostomy, it may take as long as two years to regain potency. Is marriage
possible for me? Many people with ostomies are married. An
ostomy is not a barrier to getting married. The first ostomy nurse,
Norma Gill, was married after her ostomy surgery. Moreover, usually, no marriage breaks up
solely based on the ostomy, although it may put added pressure on an already
weak relationship as will any serious illness or emotional event. In
fact, a remarkable 82% of people with ostomies are still married to the same
spouse a year after surgery. This compares to 76% of the normal
population. Can I have
a child? A patient contemplating pregnancy should consult her
physician for evaluation of her individual situation, but an ostomy in a
woman does not preclude a successful pregnancy. In addition, an ostomy
is not an indication for a caesarean section. Many ostomy women have
normal vaginal births. There is a
need, however, for close medical care during pregnancy. The ostomy may
tend to enlarge or protrude. This may require a temporary change in her
pouching system management to permit the modifications to the size and
location of the stoma. An ostomy woman may also require more careful
monitoring of her diet and fluid needs. However, on the other side,
ostomy women never worry about constipation or hemorrhoids like their
continent friends. Can I
travel? The patient can go anywhere in any type of vehicle.
An ostomy alone does not stop someone from climbing mountains; riding
horseback; flying in airplanes; driving in autos; riding bicycles; taking
cruises; etc. All ostomy
patients should buy a copy of the book, Yes We Can! by Barbara Kupfer. It is
currently the best resource on traveling, and offers all types of valuable
advice on traveling with an ostomy and tips for everyday living. Will I be
able to sleep at night? Any comfortable position may be assumed
with a correctly applied pouching system. Having an ostomy will
probably improve the sleep of a patient who has previously been sick. Can I
participate in sports? People with ostomies report enjoying many
types of sports—water skiing, body surfing, skin diving, tennis, golf,
baseball, football, hockey, weight lifting, running, bicycling, hiking . . .
you name it. Rough contact
sports require special protection for the stoma. However, there are
professional athletes in all types of sports with stomas. An ostomy
alone is not a reason not to participate in sports. You can assure your
patient that he/she will be back on the golf course, hitting them as good as
always. We assume that for most people with ostomies that there is a
strong desire to return to his/her normal way of life and there is every
reason he/she will do just that. The Ostomy Trap Forward by the Tulsa Ostomy Association One trap we
must avoid is letting our whole life revolve around our ostomy.
Preoccupation with managing an ostomy can sometimes make us fail to realize
how unimportant it is to other people. Our families
and friends are only concerned that we join them again in our usual
activities of work and play. Sure, we have challenges managing our ostomies
on occasion. However, people without we think back, we can ostomies
have elimination problems at times, and if we can think back we can probably
remember when we had more than our share. Now, we can
enjoy a freedom not possible before our operation. We will continue to
have upsets from time to time, but so do those who never had an ostomy.
Our own experience together with the shared knowledge of our fellow ostomy
members along with the advice of our doctors and WOC nurses will see us
through these infrequent and unpleasant episodes. Traveling with an Ostomy Taken from Stuart Online The stoma should not prevent you from
traveling. However, one should pay attention to the following points to
avoid any problems: §
Take enough supplies with you! You might
even spread it into two pieces of luggage. The most required material
for the first few days should always be in your hand baggage. §
Notice, warm temperature and sports reduce the
wearing time of your pouching system. So take more material with you as
it may be necessary. This means
double, triple or more times the supplies you usually use. §
Write down the precise product with their
associated product number of the ostomy supplies you use. It may be necessary for you to make a
purchase while away from home. Be
prepared just in case you do not have access to resources where you will be
traveling. Other types of makings are sometimes used in different countries
for your habitual material. §
Obtain the address where your supplies are
available in the foreign country. §
Be careful with unusual food try small pieces. You must purchase Barbara Kupfer's book,
Yes We Can! It is one of the best current resources available for
advice on traveling with an ostomy, and tips for everyday living.
The intent of this book is to serve as a useful and practical guide for
the person who has as ostomy, and wishes to travel. Whether you have recently had ostomy
surgery, or are a veteran; whether a seasoned traveler or a new
adventurer, whether traveling across the state, or out of the country, the
pages of Yes We Can! are filled with
valuable tips for traveling. Barbara Kupfer is a world-traveled person who has never let her ostomy slow her down. Traveling has always been part of her life, and when surgery for colon cancer was performed, she was determined to continue to see the world. She had many questions about traveling with an ostomy, and although the ostomy associations, and the medical community were helpful, she felt there was a need for a definitive resource. She realized that if she was asking questions, then other people were also looking for answers. Her book offers us the opportunity to read the stories of others who travel, as well as the best advice yet, when preparing for travel. The Nerve of Those
Stomas By Mike D’Orazio on UOAA
Discussion Board The question or comment about stomas lacking sensory nerves or the more broadly stated claim that stomas have no nerves is a myth that dies very hard. Allow me to borrow from one of my presentations that partly address this issue, which is that most of the information carried by gastrointestinal primary afferent neurons is not consciously perceived. “This is nicely demonstrated by tests on fistula patients who report no sensation when the healthy stomach is probed or in patients that have had the intestinal lining cut to take a biopsy.” Please referenced from Am J Physiol Gastrointest, Liver Physiol 277:922-928, 1999, John B. Furness, Wolfgang A. A. Kunze and Nadine Clerc, page G924. Additionally, we have: “There are more than 100 million nerve cells in the human small intestine, a number roughly equal to the number of nerve cells in the spinal cord. Add in the nerve cells of the esophagus, stomach and large intestine and you find that we have more nerve cells in our bowel than in our spine. We have more nerve cells in our gut than in the entire remainder of our peripheral nervous system.” Please reference from The Second Brain by Michael Gershon, M.D. page Xiii. Alas, stomas do have nerves! So, now let us put to rest the misstatement about the bowel and nerves, and bother to reeducate those who have misspoken early on. There are nerves but the sensory nerves of the bowel between the esophagus and the rectum, for certain types of painful stimuli, such as cutting or cautery, are either very low in number and caliber or the brain is not readily able to perceive the pain. Of course, one can still be a pain in the a**; however, this is a topic for other times and places. You Are Special and Important Contributed By Rhoda Gordon One day a teacher asked her students to list the names of the other students in the room on two sheets of paper, leaving a space between each name. Then she told them to think of the nicest thing they could say about each of their classmates and write it down. It took the remainder of the class period to finish their assignment, and as the students left the room, each one handed in the papers. That Saturday, the teacher wrote down the name of each student on a separate sheet of paper, and listed what everyone else had said about that individual. On Monday, she gave each student his or her list. Before long, the entire class was smiling. "Really?" she heard whispered. "I never knew that I meant anything to anyone!" and, "I didn't know others liked me so much" were most of the comments. No one ever mentioned those papers in class again. She never knew if they discussed them after class or with their parents, but it did not matter. The exercise had accomplished its purpose. The students were happy with themselves and one another. That group of students moved on. Several years later, one of the students was killed in Viet Nam and his teacher attended the funeral of that special student. She had never seen a serviceman in a military coffin before. He looked so handsome, so mature. The church was packed with his friends. One by one those who loved him took a last walk by the coffin. The teacher was the last one to bless the coffin. As she stood there, one of the soldiers who acted as pallbearer came up to her. "Were you Mark's math teacher?" he asked. She nodded "yes." Then he said, "Mark talked about you a lot." After the funeral, most of Mark's former classmates went together to a luncheon. Mark's mother and father were there, obviously waiting to speak with his teacher. "We want to show you something," his father said, taking a wallet out of his pocket. "They found this on Mark when he was killed. We thought you might recognize it." Opening the billfold, he carefully removed two worn pieces of notebook paper that had obviously been taped, folded and refolded many times. The teacher knew without looking that the papers were the ones on which she had listed all the good things each of Mark's classmates had said about him.
"Thank you so much for doing that," Mark's mother said. "As you can see, Mark treasured
it." That is when the teacher finally sat down and cried. She cried for Mark and for all his friends who would never see him again. The density of people in society is so thick that we forget that life will end one day. We do not know when that one day will be. So please, tell the people you love and care for, that they are special and important. Tell them, before it is too late.
THIS MONTH’S
MEDICAL EXPERT IS: Ellen Ladowski, RPh., Pharmacist for
Shopko Pharmacy & Examiner for the Wisconsin Licensing Board forwarded by
the Green Bay Ostomy Association QUESTION: I have an ileostomy, with a transit time
of only a few hours. I have heard that
because of this, many of my supplements and meds might not be absorbed
completely. Generally, which
supplements (calcium, multi-vitamins, vitamins C & D, folic acid, etc.)
or meds (Nexium, fexofenadine, prednisone, antibiotics) can be safely crushed
instead of being taken whole? If they can be crushed, can they be just
taken that way with water or should they be mixed into food? Many tablets do lose their integrity by crushing them. The question is a little vague because, for example, fexofenadine 180 mg cannot be crushed, but the 60 mg would be OK. Prednisone can be crushed, but tastes extremely bitter, so sometimes it is a good idea to sprinkle it in pudding and swallow it whole without getting much on the taste buds. Antibiotics can be tricky. Usually, if they are dosed 2-4 times a day, they can be crushed, but nothing that is dosed once daily usually can be crushed. Each medication has such different dissolution rates that I encourage everyone to ask the pharmacist each time something new is prescribed. Many products now have liquid alternatives; can be made into a liquid form by the pharmacist, or come in a "solutab", which is a tablet that is made to dissolve in the mouth instead of swallowed. Nexium, for example, is available in capsule form only, but Prevacid, a medication in the same therapeutic class, has a prescription solutab made to dissolve in the mouth, not the gut. Vitamin supplements I would encourage in the liquid or chewable forms. If you cannot find liquids or chewables in the discount chains, the specialty vitamin stores may have a larger selection. Searching the internet for reputable drug info from a trusted source is hard to know unless you have a background on the source/study. Your pharmacist can help determine reputable vs. irrational.
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 Chicago Mr. Tim
Traznik, Treasurer 40
Fallstone Drive, Streamwood, IL
60107-1079 |
