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May
2010 Last Month’s Meeting (our 398th) This night we had a truly great meeting that was completely fitting for our 35th Anniversary Celebration. Rhoda Gordon, one of the founding members and the person who has attended the most meetings ever, hosted the evening. Rhoda shared some of the history and sacrifices made by our members so our organization will benefit the many people with ostomies. We were very fortunate to have Jan Colwell, RN, MS, CWOCN, FAAN, from the University of Chicago and President of the WOCN Society as our guest speaker. Jan has visited us on many previous occasions and her talks have always surpassed our expectations. Today, she outdid herself. Jan custom-designed a very dramatic one-hour graphic presentation showing the history of ostomy surgery and the advancement of the pouching system. We were completely fascinated by the powerful pictures she researched that visualize how fortunate we are today with the quality of our pouching systems and ostomy care. We will have more details of Jan’s presentation in future issues. Jan mentioned that the most difficult part of her job is siting the location for a new stoma before surgery. The surgeon will endeavor to install a stoma on the site an ostomy nurse picks, if anatomically possible based on the internal physiology of a patient. Jan knows that a well-placed stoma will provide a patient with a high quality of life, while a poorly placed stoma can be difficult to manage. In placing a stoma, the main consideration is that the stoma works well with the pouching system. Placing the stoma in a body crevice to allow lower fitting fashions is not prudent because fashions change but one’s stoma location will not. Many people expressed how much they
enjoyed Jan’s presentation. Besides being interesting and informative, she
spoke with such warmth, which conveyed how much she cares for her work
with ostomy patients and being an advocate on our behalf. We were very proud and happy that a
person of her stature celebrated our 35th Anniversary with us. In the March 21 edition of the Chicago Tribune, Arts and Entertainment Section it was mentioned that the great artist Matisse had a colostomy in l94l following an intestinal infection and lived until l952. Does anyone know what the infection could have been? Congratulations are in order. The American Nursing Association (ANA) recently recognized Wound, Ostomy and Continence (WOC) nursing as a subspecialty within the ANA. This is a significant accomplishment with important ramifications for WOC nurses. We are updating our mailing/e-mail list every month. Please complete the form on the last page of this newsletter if your home or e-mail addresses change. Are you parking in the underground garage for our meeting? Ask us for a pass to reduce your fee to $2.00! July 12-17: Youth Rally – Xavier
University – Cincinnati, OH YouthRally@aol.com OAGC Meeting Dates for
2010 May 19—“How do you tell people you have an ostomy?” hosted by Joan Loyd with
Connie Kelly, WOCN, “Stomal and Peristomal Complications” June 16—Visitor’s Training moderated by Peggy Bassrawi, RN July 21—Nancy Chaiken, WOCN Swedish Covenant Hospital, “Hot Weather
Management” August 18—Surprise Ostomy Meeting September 15—Bernie au dem Graben, WOCN October 20—Jennifer Dore, WOCN 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 Mary Potter Pavilion, Lower Level 2850
W. 95th St. Evergreen
Park Northwest Community Hospital An ostomy support group 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. 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 . 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. NW Comm Hospital Meeting Dates for 2010 June 3 August 12 October 7 December 9 Mt. Everest Adventure By Carol Steedman, UOA of Canada At the age of nine, Carly Lindsay underwent a major operation, which propelled her to be a role model and spokesperson to encourage and educate others about a disease that is seldom discussed in public. Now,
the 16-year-old is reaching new heights in public awareness about intestinal
diseases. Next month, she will join a
special group of people to climb to the base camp of Mount Everest. This camp is located 5,360 meters above sea
level in the Himalayan mountain ranges in Nepal. This bright bubbly teenager has had quite a personal journey in the years since early December 2002 when she entered Hamilton's McMaster University Medical Centre with severe ulcerative colitis. Various medicines were used with limited success. Carly and her parents, Steve and Karen Lindsay, were presented with a choice to continue with the medication for her painful condition or consider surgery. Carly urged them to agree to the ileostomy. As
I sat with the Lindsay family in their Waterford home earlier this week, it
was hard to imagine that this slim attractive young woman had faced such an operation
as a child. She assured me many times
that the ileostomy was the best decision, and for her it gave back her normal
life of ballet, swimming and now even cheerleading at Waterford District High
School. I
had many questions about the procedure and the necessary changes for her. I spoke what came to mind, imagining what
you, the reader might ask. Carly and
her parents readily responded. To
understand the operation, it is necessary to know something about the
digestive process. In our bodies,
digested food from the stomach continues into the small intestine. The final, longest and narrowest section of
the small intestine is called the ileum.
This is where the body absorbs the nutrients from food, before the
waste from the digestive process is carried by the large intestine out of the
body. With
a vertical incision, the surgeon removes the large intestine, and then makes
a small circular incision in the mid-abdomen, where a short length of the cut
ileum is put through the opening. It is
folded back to make a stoma, with the edges stitched onto the abdominal skin. After it heals, a permanent exit for the
body's waste is gathered in a compact pouching system, called an appliance in
the olden days. Wait
a minute! Appliance? I thought "toaster," and Carly
said she first thought "refrigerator!”
No wonder people who are contemplating surgery expect to see Carly
hauling some mysterious box along with her.
So, it was a relief to know that it is only the term used for the
small skin barrier and pouch used to dispose of the body's waste. The
skin barrier is a four-inch disposable square, with adhesive edges to stick
firmly to the abdominal skin, and fits snugly over the stoma. Using a sample, Karen Lindsay demonstrated
how the flat seven-inch by five-inch pouch fits onto the skin barrier. It is emptied and replaced as needed. This compact, hygienic pouching system is
undetectable under clothing and allows the person to lead a normal life
without the pain and medicines associated with intestinal diseases. Carly
Lindsay is well known in both the Brantford and Hamilton Ostomy Associations. She is the youngest member of the Brantford
Ostomy Association. She has
contributed articles to newsletters and made presentations to encourage
others. Her mother has also written
articles for the magazine Ostomy Canada. One of the recent publications highlighted celebrations for the 40th anniversary of the Hamilton and Brantford District Ostomy Society. Brantford's contact is Marie Winn, 519-752-5037, and Hamilton's is Roger Ivol at 905-387-6662. Carly
has participated in summer camp in Alberta for children and teens that have
ostomies. Camp Horizon is located near
Kanaskis and has doubled in size this year to accommodate 60 campers, aged 9
to 18. They enjoy swimming, white
water rafting, hiking, campfires and an opportunity to share stories and
learn about each other. Carly hopes to
become a camp counselor. While
at camp over the last five years, Carly met Rob Hill, who founded No Guts
Know Glory Seven Summits Campaign. His
personal challenge is to climb the highest peak on each of seven continents. At
the age of 23, Hill had Crohn's disease, which resulted in an ileostomy. It has not slowed him, and he still sets
goals and attains them. He encourages
others to do the same. This
year, Hill has his final summit to climb, and he has invited a group to join
him for IBD Adventures Mount Everest Base Camp trek. Carly and another 16-year-old, Clinton
Shard, will be part of the group that arrived in Kathmandu for the trek from
March 29 through April 19. Carly left
Waterford on March 22 and returned home April 24. She
has been busy training at the gym and following a regimen to prepare for the
trek, as well as gathering proper hiking apparel and gear. The Lindsays are grateful to the corporate
sponsors, ConvaTec and Abbott Laboratories, as well as numerous local
sponsors. Carly
has been chosen to speak on behalf of IDEAS (Intestinal Disease Education and
Awareness Society). Its purpose is to
provide opportunities for children and youth with IBD (inflammatory bowel
disease) to develop life and leadership skills. It also provides information and funds for
IBD research. While Carly was raising
awareness, Steve and Karen Lindsay were receiving pledges for IDEAS
fundraising. Check their web site at www.weneedideas.com. You can explore the journey that Carly took
by visiting her at www.nogutsknowglory.com/IBDadventures. The latest edition of the Social Security Update is posted online. You can read the newsletter by going to www.socialsecurity.gov/newsletter/. The Social Security Administration hopes that you find this newsletter informative and welcomes the opportunity to discuss these issues further. Ileostomies
and the Immune System By David E. Beck, MD, Ochsner
Clinic, New Orleans, LA In
response to a query about the possible effects of ileostomy surgery on the
immune system, the surgery by itself should have no long-term effect on the
immune system. Although there is some
transient reduction in a patient’s immune response right after major surgery,
this usually returns to normal in a couple of days. However,
the diseases that cause patients to need a stoma, such as inflammatory bowel
disease, and the medications used to treat the diseases, such as steroids, or
malnutrition associated with the disease may all affect the immune system. If you are concerned, there are several
tests that a doctor can perform to test your immune system. One of these involves placing chemicals or
allergens into the skin to see how the body responds. Others involve blood tests. We
are continually learning more about the human immune system from our
experience with HIV infections. Most
efforts are directed towards identifying and then treating the cause of the
immune dysfunction. Although good
nutrition and some supplements, such as vitamins, are necessary for the
immune system to work, little has been proven to improve immune function. Join UOAA on Facebook at
http:// www.facebook.com/#!/pages/United-Ostomy- Associations-of-America/169475247090?ref=ts Follow UOAA on Twitter at
http:// Build Muscles . . . Now By The New Outlook You should start
strength training now. Do not wait to
start losing weight first. The average 25-year-old woman has 25% body
fat. The average 65-year-old woman is 43% body fat. As we start
to lose muscle over the years—everyone losses muscle as they get older—our body
fat increases. The good news is that we do not need to be average.
We can build muscle and burn fat, while gaining strength, balance and
confidence, and lose weight in the process. A Dieter’s Dream Cutting calories can
help us lose fat, but unless we exercise, we will also lose muscle. In
fact, when we lose weight, we lose muscle first. That is one of the
reasons why we feel a bit weak after ostomy surgery. It is not unusual
to lose 25 to 35 pounds that week in the hospital, but it was mostly
muscle. Strength training
exercises, done three or four times every week, dramatically alter the ratio
of bulky body fat-to-fat-burning muscle tissue. The more muscle you possess,
the more calories and fat you burn, even when sitting down because exercising
increases your metabolism. Strength training has
several benefits for the body, but it produces different results than aerobic
exercise. Do not consider skipping your daily walk—it is a great
cardiovascular workout. Do regular stretching exercises also. You
need to combine these different types of exercise for optimal fitness and
weight loss. More Than Muscles Besides building
strength and aiding weight control, weight lifting also improves the ratio of
LDL (bad cholesterol) to HDL (good cholesterol), relieves arthritic symptoms
and helps prevent diseases such as diabetes and hypertension. Studies
show a direct link between resistance training and increased bone
density. Strength training to prevent weight gain as we age can also
help lower cancer risk. Let us repeat strength-building exercise
benefits: ·
Helps lower cholesterol ·
Reduces joint pain and swelling ·
Better controls your blood sugars ·
Lowers your blood pressure ·
Builds stronger bones ·
Helps prevent osteoporosis ·
Lowers cancer risk Dumbbell Basics Before getting
started, consult your doctor and perhaps a strength-training
instructor. Always let them know that you have an ostomy and require special
body building workouts. Strength training exercises must be done
properly to prevent injury and effectively to build muscle strength. Once you learn proper
technique, exercises can be done on your own. If you cannot meet with
an expert, a good introductory video or guidebook can teach you basic
movements. Do exercises in front of a mirror at first to be sure your
form matches that of the images you are learning to perform. Begin a program of
strengthening the largest muscles in the body: those in the legs, back
and chest. As a person with an ostomy, you may want to modify your
weight training from that of methods that are more traditional. Most
weight-training guides suggest lifting a weight that is heavy enough to make
you feel fatigued after eight or nine lifts. That may be too heavy for someone
with an ostomy. It is surely too heavy for anyone that is just
beginning weight training. If you cannot lift a
weight at least 20 times without straining, it is too heavy for you.
You need to build up slowly. Let me repeat . . . I mean very
slowly. Never strain yourself and obtain adequate rest in between
sets. For a person with an ostomy, it is better to lift light weights
20 to 40 times instead of lifting heavier weights 8 to 12 times. Lifting
lighter weights builds well-defined muscle shape, while lifting heavier
weights builds strength and bulk. Guess if Angelina Jolie lifts heavy
weights or light ones? If you keep up your
regular weight-training regimen, you will be able to increase the weights you
lift. The key is consistency, month after month, year after year, and
you will be lifting more than you ever thought possible. Just so you know,
the American College of Sports Medicine says that single sets are just as
effective as multiple sets for beginners. So begin weight training this
week. We will see you at the club. Adjustments with an Ostomy Adapted by The New Outlook Apparel Diet Undergarments—for women Girdles are not necessary for the ostomy, but most women who use them prefer the lightweight stretch type. A girdle that does not stretch may cause pooling of the drainage around the stoma, making the seal loosen. An old girdle, or one that is a size too large, may be more comfortable at first. If the girdle covers the pouch, it is not necessary to cut a hole in the girdle for the pouch, because the girdle will help support the pouch and the pouch will be even less noticeable with the girdle. A little air in the pouch around the stoma will often prevent the girdle from being too tight and improve drainage. In addition, cotton knit or stretch underpants may give you more support and security. Some women find a maternity garter belt suits them best in the first weeks after surgery. Panty hose are also comfortable. Undergarments—for men Men can wear a girdle designed especially for them. Jockey-type shorts or a wide-belted athletic supporter with the crotch cut off may be helpful. Many men after ostomy surgery prefer to wear boxer briefs. They are more comfortable because they provide more room for the pouch. Physical labor People with colostomies, ileostomies and/or urostomies can do most jobs; however, heavy lifting may cause a stoma to prolapse or the intestines to herniate around the stoma. A sudden blow to the skin barrier could cause it to shift and cut the stoma. There are people with ostomies who do some lifting, such as, firefighters, mechanics and truck drivers. There are athletes who have stomas. Check with your doctor about how you should prepare yourself for your type of work. As with all major surgery, it will take time for you to regain strength after your operation. A letter from your doctor to your employer may be helpful should the employer have doubts about what you can do. A stoma is never an excuse not to do anything. Fair employment rights Sometimes a person with an ostomy finds his/her employer thinks the ostomy will impair one’s ability to do the job. This also happens to some people with ostomies who are applying for new jobs. You should know that your right to work is protected by sections of the US. Rehabilitation Act of 1973, by the Americans with Disabilities Act, and by sections of your state laws. If you feel you are being treated unfairly because of your ostomy, check with a local legal resource about protecting your rights. However, as a practical matter, it would be strange for you to mention that you have an ostomy at a job interview. If one talks to personal managers across America, you would be hard pressed to find one that questions a potential employee about his/her bowel habits. An interviewee mentioning his/her bowel habits would usually in itself be reason not to hire someone because of the absurdity of the discussion. Other people, especially employers, are not interested in your bowel habits. Sports participation An ostomy should not limit your participation in sports. Many physicians do not allow people with ostomies to participate in contact sports because of possible injury to the stoma from a severe blow or because the skin barrier may slip, but these problems can be overcome with special equipment. Weight lifting can result in a hernia at the stoma if the lifting is done without proper instruction and proper body preparation. Check with your doctor about such sports. Some people with ostomies are distance runners, skiers, swimmers, weight lifters, football players, boxers, wrestlers and participants in most other types of athletics. Many of us play golf, hike, mountain climb and swim. Bathing
Caring for Your Ostomy By Pat Murphy, RN, CETN, Alexian Brothers Hospital Here are some simple pointers for ostomy care. They may not be new, but sometimes it is good to be reminded of them. Good ostomy care habits can catch and nip problems in the bud—the rosebud that is. Inspect your stoma and skin each time you change your skin barrier. Your stoma should be bright red, smooth and shiny. Inspect the lower edge especially well. Use a mirror if necessary. Look for any signs of irritation or bleeding. These signs may mean your skin barrier is rubbing there. Your skin should not be pink, purple or gray, even right next to the stoma. Although when you first remove your skin barrier you will notice some pink skin under pressure points, this is the same as when you take off your watch or a pair of stockings. This is normal. Inspect your skin in a sitting position to see if creases or low areas form around the stoma. This will tell you where to take special steps to even out the area when you put on your skin barrier. Stretching the skin to make it smooth may be all you need to do, or you may need a dab of ostomy paste or a skin barrier seal. Remember, a new stoma changes size for up to a year. Remeasure your stoma every time you change the skin barrier for the first six months after surgery and every month thereafter. Always remeasure if you are having a leak. Measure the stoma at the base from side to side and from top to bottom. Many stomas are oval. If you are cutting a skin barrier or a one-piece pouching system, no skin should show when it is in place. However, make sure the barrier is never touching the stoma, unless it is an extended-wear barrier manufactured to be able to touch the stoma. This is a bit tricky to do; thus, manufacturers developed skin barrier seals and ostomy paste to fill in any openings when the skin barrier is cut. If your stoma is not perfectly round, do not trace and cut a round circle. Instead, make the barrier fit exactly. Your ostomy nurse can show you how. It should just miss the stoma, sealing down on the skin right next to it. Your skin barrier should not go over any red, wet mucosal tissue, the kind that forms the stoma. If you wear a pouch with a karaya ring on it, the ring should gently touch the stoma all around. Even an "old" stoma can change size temporarily. It can change from round to oval if you are experiencing some abdominal distention or if you have gained weight. Be sure you know the steps involved in treating sore skin. Many people use too much powder. This may interfere with the adhesion of the skin barrier and cause skin problems to worsen. A tiny amount of powder should be placed on the sore area and then wiped off with a dry tissue. It will stick where you need it; i.e., if you have wet, irritated skin, powder will protect it so the skin barrier will stick to it. A skin barrier will not stick to a wet surface. The skin barrier will then protect the skin against the output, and the skin will heal better under the skin barrier. Skin heals better under a bandage than when left open exposed to the air. If you use a liquid skin barrier—never with extended wear barriers, like ConvaTec's Durahesive or Hollister's Flextend—it should be applied over the powder until you can no long see any powder. Quickly, fan the liquid dry quickly and then put on your skin barrier as usual. When treating any skin problem, always change your skin barrier more frequently than you usually do until the problem is solved. This is so you may examine the progress of the healing, and prevent any additional damage from occurring. Be sure you are not over-cleaning either your skin or the pouch. The skin around your stoma is best washed with plain water. A mild soap may be used for particular circumstances, but is not recommended for regular use for most people. When rinsing out a pouch—like a one-piece—while it is on your body, do not use too much agitation or you may loosen the skin barrier. Being too aggressive may loosen the skin barrier by making the inner seal wet. The skin barrier may pick up too much moisture too soon, and wearing a moist barrier may cause a yeast—fungus infection—rash under the skin barrier Do not
try to set record for wearing-time. Change your skin barrier before the part next to your skin is washed away or gets soft and mushy. It usually is not wise to wear any type of pouching system more than seven days. Most people change two or three times a week. The Wound, Ostomy Nursing Association (WOCN) recommends changing the skin barrier no less than twice a week. When you inspect your stoma and skin; you have a question about what you are seeing and what you should do about it, you may want to call your WOC nurse and arrange an appointment. If you can describe the situation well, the WOC nurse may be able to advise you immediately right over the phone. If not, have the WOC nurse look at it before it becomes a bigger problem. You should have an ostomy nurse examine your stoma and peristomal skin every few years.
Questions & Answers By Angela Kelly, RNET, Vancouver General Hospital Q When I take off my skin barrier, there is a red circle around my stoma. It is about the distance to the round inner circle of my skin barrier. It is not painful or sore, but I am wondering if I should be worried about this. A The main reasons for red skin around the stoma are incorrectly cutting the skin barrier opening, leakage, moisture irritation or sensitivity to the ostomy products. (Note that we are talking about red skin and not the pink skin caused by the pressure of the skin barrier or paste. This is normal and expected.) From what is described in the question, the red skin is the result of the most common problem, an improper opening in the skin barrier that when measured correctly turns out to be too large, thereby exposing the skin between the stoma and the seal. To check this, measure your stoma—there is usually a paper stoma guide in most boxes of skin barriers—with a measure guide, then check the size of the opening in the skin barrier that you are using. If the skin barrier opening is more than one-eighth of an inch larger than your stoma, this probably would account for the red skin. The fact that the condition described is not painful indicates that the stoma under discussion is probably a colostomy. People who have an ileostomy or ileal conduit can get very irritated sore skin from using too large an opening in the skin barrier because the drainage from these is much more corrosive to the skin. To correct this problem, measure the skin barrier opening and if there is a gap between stoma and seal, choose a barrier with a smaller opening; i.e., one that fits to 1/8th of an inch around your stoma and this will eliminate the red skin. If the problem persists, make an appointment to see your WOC nurse and have your pouching system procedures reviewed. Q I have come across faulty pouches lately. Three to five pouches out of a box have small pinprick holes in them. Is this a common problem with pouches? A In a word, no. This is not a common problem, although I did hear of someone who had a cat as a pet and discovered that when this kitty sat on her lap, it would knead its claws into her clothing to show its pleasure at being stroked. Unfortunately, its claws would sometimes dig through the clothing and make small holes in her pouch. There may be a message here somewhere. Let us go back to the question. The manufacturers of ostomy equipment maintain very high standards in the production of their supplies. In fact, Hollister, Inc., inspects and tests every pouch before it is sent to patients. This is a remarkable undertaking to insure 100% customer satisfaction. However, the machinery used is very complex and sometimes if not calibrated properly, the seams on the pouches will not bond correctly. This would soon be detected by the numerous checkers of the machine and finished product. However, in the thousands made, it is possible that some faulty pouches do slip through and end up in the packages. If you do come across faulty pouches, call up the manufacturer. They will gladly replace them. They will want to know the stock number on the box. This will help them track down any manufacturing errors. If you are nervous about putting on a pouch that is faulty, check it before you wear it. A good way is by filling it with water. If it does not leak, it is good. Using this test, you can be guaranteed that you are putting on a sound pouch. Q I have an ileostomy and when I have a blockage should I perform an ostomy lavage? A A fecal ostomy blockage is most commonly caused by food. Sometimes the opening becomes narrow where the stoma comes through the muscle of the abdominal wall. Sometimes, undigested food particles can become stuck in this narrow place causing an obstruction. The best way to prevent this from happening is to be sensible about what you eat and chew your food well. The way it goes into your stomach is usually the way it comes out the stoma. However, if you just could not resist that extra bran muffin or raw carrot and you do get a blockage, stomal lavage stoma is not always the best solution. Rather, remove the skin barrier—give that stoma a chance to stretch—let the stoma be freely exposed or at least apply a skin barrier with a larger opening. Step into the bath or shower. Often the warm water will relax your abdominal muscles and allow the obstruction to pass. Another suggestion: Sipping warm tea without cream or sugar will cause the bowel to increase peristalsis and push out the offending blockage. If things do not resolve in a matter of hours, then seek advice from your physician or WOC nurse. Possibly a gentle irrigation with normal saline solution will be required to remove the blockage. Only a professional familiar with this procedure should perform this. A word I want to say on ostomy lavage. Be gentle. Insert your well-lubricated little finger into the stoma until you feel the blockage. Push it back a bit. This should help loosen the blockage and allow it to release. Rough dilation can cause accidental perforation or injury to the stoma, which may produce scarring when it heals compounding an already tight situation worsening the obstruction. Q What is a good way to hide or conceal your pouching system during sex? A First, make sure your pouching system is clean. The pouch can pick up body odors over a few days. A well-fitting pouching system will not dislodge during lovemaking, and if you use a two-piece system, a smaller pouch may be exchanged for a larger one at these special times. There are now available many different and attractive pouch covers. If you are good with the sewing needle, how about making your own fashioned out of soft sensual material. Also available in the stores is attractive underwear designed to come up to the waist so covering the pouching system with wider legs for women. If you want to be especially daring, how about trying "Anticipants" (crotchless panties) available in specialty stores or seen in advertisements in the Phoenix Magazine. Some folks prefer to drape a cummerbund around their middle. May I recommend for further ideas, the excellent pamphlets available through the UOAA entitled Sex and the Single Ostomate, Sex and the Female Ostomate, and Sex and the Male Ostomate available at www.uoachicago.org on the Tips page. You should know that once one has tried
all these alternatives, most people with ostomies simply have sex like anyone
else. The pouch simply becomes part of
the process like an arm, leg or butt.
Never allow having a pouch on your tummy stop you from having
enjoyable sexual activity. Q My stoma seems to protrude more one day than another day. Is this OK or should I worry? A The contents of the bowel are pushed along by progressive, simultaneous contractions and relaxations of the muscles in the bowel wall. This is known as peristalsis. This wave of movement can sometimes be seen traveling through the ostomy itself, causing the stoma to wiggle, swell a little and contract. All this is perfectly normal. A stoma that is flatter when one is lying down but protrudes significantly when sitting or standing may indicate a prolapse. This is often associated with a peristomal hernia or excessive weight gain after surgery. Although there is no urgency to this, it is a good idea to have it checked out by your physician or WOC nurse. Sexual Functioning with an Ostomy From Sexual Counseling for Ostomates, By:
Ellen A Shipes, RN, MN, ET, & Sally T. Lehr, RN Fear and misunderstanding often result in the assignment of unnatural or supernatural qualities to that which is unknown. This article will present factual information about ileostomies and urostomies that will dismiss the fear and dispel the misunderstanding. Ileostomies do not possess the extensive attributes of colostomies. They are more uniform in size and shape. Like the individuals they are a part of, however, no two are exactly the same. Ileostomies are usually temporary. They are most often performed to treat diseases such as ulcerative colitis and Crohn’s disease. Since ileostomies are made in the small bowel, they are usually smaller than colostomies but have the same red color. Urostomies are the most varied of all the ostomies in name, location, size and color. Urostomies are done because of trauma, congenital defects or disease, but the ultimate reason is to protect the kidneys by removing or bypassing the affected or diseased portion of the urinary tract. Verbal and mental exclamations of “Gross!”, “Ugly!” “Monstrous!” “I can’t stand it!” “It’s a sore!” and the like may be expressed by people with ostomies and their partners following surgery. Indeed, only members of the medical profession can truly gaze upon a stoma and its accompanying incision and state, “How nice! It looks great!” Although a person with an ostomy and partner may react poorly to the initial results of surgical intervention, the stoma itself should produce no physical change in sexual functioning once the individual has recovered from the surgical procedure. Since the stoma is often bright red and appears sore, it is commonly thought that sexual activity will cause stomal damage and pain. Because the bowel and stoma have no nerve endings, even vigorous sexual activity should not result in pain. Slight stomal bleeding may be noted following an especially energetic lovemaking session because of the fragile nature of the stomal blood vessels. There is no cause for alarm as long as the bleeding remains minimal and does not persist for several hours. The maintenance of sexual functioning varies widely following surgery. In men, the scope of physical change depends solely on the degree of damage to the nerves controlling erection and ejaculation. The radical resection required for removal of malignancies of the bladder and rectum imparts a high degree of erection difficulty (impotence). Concerning surgery performed for colon cancer, studies cite the frequency of impotence as ranging from 24 percent to 75 percent. Since a major part of sexual functioning depends on the desire, expectation and motivation of the individual and partner, it is unwise to assume that erection failure is a foregone conclusion. For women, the physical damage is not so
extensive. Removals of the vagina or persistent coital pain are the
only physical conditions that should preclude normal lovemaking. Each person
with an ostomy must be considered individually and all people with ostomies
and their partners should have sexual counseling incorporated in their
pre-and postoperative teaching. This will aid in reducing both fear and
psychological difficulties, which frequently accompany ostomy surgery. For our liability disclaimer and
privacy policy visit http://uoachicago.org/liability.htm. Emergency
Room Information If you ever need to visit a hospital emergency room, you will be asked a routine list of questions. You should complete the following list and have it with you at all times just in case it is needed. You can provide this to the hospital staff even if you cannot speak. Personal Information Name_____________________________________ Address___________________________________ __________________________________________ Phone_____________________________________ Date
of Birth_______________________________ Medicare or Insurance #s __________________________________________ __________________________________________ __________________________________________ Physicians __________________________________________ __________________________________________ __________________________________________ Medical History / Type of Ostomy __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ Medications, Vitamins & Herbs __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ Allergies __________________________________________ __________________________________________ __________________________________________ __________________________________________ Emergency Contact __________________________________________ __________________________________________ __________________________________________ Current Medical Conditions __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ |