The abcs of Ostomy Care



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The ABCs of Ostomy Care

From ConvaTec’s Health & Vitality publication, Summer 2004

The alphabet’s a handy thing. It helps us read, organizes our files, and gives us a song to sing. It’s also a great way to list this collection of facts that everyone with an ostomy should know.
A IS FOR ACTIVE

How important is exercise? Not very, unless you want to avoid diabetes, heart disease, osteoporosis, stroke, or high blood pressure. Your stoma is not an excuse to sit on the couch: people with an ostomy have run marathons and climbed mountains. If you’re just recovering from surgery, or haven’t been active for a while, talk with your doctor to come up with a fitness plan.


B IS FOR B12

If you’ve had an ileostomy, ask your physician about testing your levels of vitamin B12. This vitamin is absorbed at the tail end of your small intestine, part of which was removed by your operation. If you’re low, your doctor can give you supplements.


C IS FOR CONVEX

A pouching system with a convex faceplate or insert can help if you have difficulty with a short or retracted stoma. If you just need mild convexity, you can try an Eakin Cohesive® Seal.


D IS FOR DRUGS

Taking prescription medicine requires a bit of extra planning for ileostomy patients, since time-released or coated pills may not be properly absorbed by a shortened small intestine. Be sure to raise this issue whenever your doctor gives you a prescription.

E IS FOR EASY DOES IT

After your surgery, ease back into your job. Ask your employer if you can work part-time or at home for the first few weeks. Use the time to work out the details of working with an ostomy: Locate the closest private restroom, and make arrangements to keep spare pouches and a change of clothes (just in case) at your work site.

F IS FOR FIT

Today’s lightweight, low-profile, odor-blocking pouch systems are amazing, but only if they fit properly. Be sure to measure your stoma every time you purchase new supplies, especially when you’re recovering from your surgery. Also double-check the fit of your system if you lose or gain a significant amount of weight.


G IS FOR GROUP

As supportive as your friends and family are, it can be hard for them to completely understand what you’re going through. But finding others with an ostomy to talk, laugh, and share stories with is easy. Just contact the United Ostomy Association, 800-826-0826, www.uoa.org, for its list of local support groups.


H IS FOR H2O

To avoid dehydration, keep your tanks full: Drink at least six glasses of water and fruit juice every day. This will also help prevent constipation, help flush our your kidneys, and help your body maintain the proper levels of electrolytes like sodium and potassium.


I IS FOR INSURANCE

Shopping for an insurance plan? Before switching, find out if the new plan considers your ostomy a “preexisting condition,” and if that means coverage will be restricted.


J IS FOR JOURNAL

Sometimes specific foods can trigger gas, discomfort, diarrhea, or other problems. Add new foods to your diet one at a time, and keep a food diary. A written record of what you eat will help identify problematic foods so you can take them off the menu.

K IS FOR KRANBERRY

Okay, it’s really cranberry—but we used “C” already. If you’ve had a urostomy, favor cranberry juice over orange or other citrus juices. It helps keep your urine acidic, which is healthier (and less pungent).

L IS FOR LESS GAS

If flatulence is a problem, try avoiding these known gas-producers: beans, broccoli, cabbage, cucumbers, mushrooms, onions, and carbonated drinks. Some people are lactose intolerant, which means dairy foods cause gas and diarrhea. Gas production also goes up when you add more air to your digestive tract by drinking through a straw, chewing gum, smoking, or talking while you eat.


M IS FOR MEAL PLAN

Colostomy and ileostomy patients benefit from staying on a regular meal schedule, since skipping meals causes an uptick in gas and watery stools. Some people find that eating six small meals a day, instead of three large ones, works best.


N IS FOR NO HEAVY LIFTING

Since it can injure your stoma, heavy lifting is one activity prohibited to people with an ostomy. But who enjoys moving pianos anyway?


O IS FOR OPTIONS

You don’t have to use the same pouch system that you brought home from the hospital. Explore your options: You may want to use a drainable pouch on most days, and a closed-end pouch when traveling. If you have special needs, you might want to try out other ostomy systems or accessory products to get the best possible fit. Talk to your CWOC or ET nurse, who can make recommendations based on your situation.


P IS FOR POTASSIUM

This mineral is critical for health, and colostomy and ileostomy patients have an increased risk of running low — especially during bouts of diarrhea. Be sure to include high-potassium foods like bananas, fish, oranges, and yogurt in your diet.

Q IS FOR QUESTIONS

Wondering what keeps that flange attached to your skin? Not sure about the difference between a colon and a semicolon? Never be hesitant to ask your doctor or nurse any questions, big or small. Other great resources for information include the United Ostomy Association; the Wound Ostomy and Continence Nurses Society (888-224-9626, www.wocn.org); and ConvaTec’s Customer Interaction Center (800-422-8811). (Editor’s note: Don’t forget that much information can be gained by attending your chapter’s monthly UOA meetings).

R IS FOR ROMANCE

Yes, you can still get romantic with that special someone. Having an ostomy is no barrier to sexual intimacy. You will want to make some preparations for sex: Be sure your pouching system is odor-free, and empty it ahead of time. If the pouch or covering seems to get in the way, be willing to experiment with different sexual positions. And even if you’re just kissing or cuddling, reassure your partner that physical closeness won’t hurt your stoma or disturb the pouch. You may also want to try out a mini-pouch, so that the system is less obtrusive.


S IS FOR SKIN CARE

Cleaning the skin around the stoma is a must for preventing rashes, irritation, and infections. Wash the stoma and surrounding skin whenever you bathe or shower and every time you change pouches. Use simple soaps that are residue-free (soaps containing oil or moisturizers may interfere with the skin barrier you use). Be sure to clean the skin of any adhesive buildup.


T IS FOR TELLING

Most of the people who know you won’t know you have an ostomy unless you tell them. And who you tell is up to you. When you do decide to share your story, don’t overwhelm your listener with details. Just state the facts simply, and emphasize that your condition doesn’t stop you from living the life you want to live.


U IS FOR UNDERWEAR

You don’t have to buy a special wardrobe. Depending on the location of your stoma, you may find that underwear with a stretchy waist gives your pouch system a little extra support and security. If your stoma is near the waistline, choose underclothes that don’t put uncomfortable pressure on your stoma.

V IS FOR VACATION

You can travel wherever, whenever, and however you wish—camping trips and long plane flights included. Be sure to bring twice as many supplies as you need, in case there’s a change in your itinerary. Pack them in your hand luggage, since checked baggage might get lost or delayed. And always keep supplies in a cool place—so the adhesive won’t melt.

W IS FOR WATERPROOF

Your stoma loves water, so it’s perfectly fine to shower or bathe without a pouch or covering (just be sure to gently clean the stoma and surrounding skin with soap and water while you’re doing so). Swimming is also an option (and it’s a great way to get some exercise, too).


XYZ IS FOR EXCITEMENT, YOUTHFULNESS, AND ZEAL

By now you get the idea that living with an ostomy isn’t a sentence to a drab, isolated existence. Reach out to others with an ostomy, and you’ll be rewarded with stories of how they didn’t let their condition get in the way of their dreams. Then get out there and create some stories of your own!





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