Ostomy site Article 9, 15 Apr, 01.doc

From: KathFindlay (klfindlay@adhesions.org.uk)
Mon Apr 16 19:57:43 2001


http://www

Kath Findlay UK Adhesion Society mailto:klfindlay@adhesions.org.uk http://www.adhesions.org.uk

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The United Ostomy Association                         Article  9    15/4/01

http://www.uoa.org/

The United Ostomy Association is a volunteer-based health organization dedicated to providing education, information, support and advocacy for people who have had or will have intestinal or urinary diversions.

Frequently Asked Questions Following Ostomy Surgery Listed below are some of the most frequently asked questions following ostomy surgery. The answers are general comments. In order to obtain answers to your individually specific questions, consult your physician and/or an ostomy nurse.

You may also want to read the following Fact Sheets:

a.. Colostomy b.. Ileostomy c.. Urostomy d.. Sex and the Male Ostomate e.. Sex and the Female Ostomate f.. Sex and the Single Ostomate Note: Fact Sheets are in Adobe PDF format; to view and print PDF files, Download Acrobat Reader, if necessary

As always, in order to obtain answers to your individually specific questions, be sure to consult with your doctor or Ostomy Nurse for help.

1. Who should I tell? What should I say about my surgery?

You should tell those who need to know, such as healthcare providers, your spouse or significant others, and people who are involved in your recuperative care. You need not feel you have to explain your surgery to everyone who asks. Those who are just curious need to know only that you had abdominal surgery, or that you had part or all of your colon or bladder removed. If you are considering marriage, thorough discussions with your future spouse about life with an ostomy and its affect on sex, children, and family acceptance will help alleviate misconceptions and fear on the part of the spouse. If you have children, answer their questions simply and truthfully. A simple explanation will be enough for them. You may want to confide in your employer or a good friend at work because keeping it a complete secret may cause practical difficulties.

2. Will I be able to continue my daily activities once I recover from surgery?

As your strength returns, you can go back to your regular activities. Most people can return to their previous line of work; however, communicate with your healthcare team about your daily routines, so they can assist you to returning to maximum health as early as possible. An ostomy should not limit your participation in sports. Many physicians do not allow contact sports because of possible injury to the stoma from a severe blow or because the pouching system may slip, but these problems can be overcome with special ostomy supplies. Weight lifting may result in hernia at the stoma. Check with your doctor about such sports. There are many people who are distance runners, skiers, swimmers, and participants in many other types of athletics.

3. What about showering and bathing? Should I bathe with or without my pouch?

You may bathe with or without your pouching system in place. If you wish to take a shower or bath with your pouch off, you can do so. Normal exposure to air or contact with soap and water will not harm the stoma and water does not enter the opening. Choose a time for bathing when the bowel is less active. You can also leave your pouch on while bathing.

4. What can I eat? Will I need to change my diet?

There may be some modifications in your diet according to the type of ostomy surgery. People with colostomy and ileostomy surgery should return to their normal diet after a period of adjustment. Introduce foods back into your diet a little at a time and monitor the effect of each food on the ostomy function. Chew your food well and drink plenty of fluids. Some less digestible or high roughage foods are more likely to create potential for blockage problems. (i.e., corn, coconut, mushrooms, nuts, raw fruits and vegetables) There are no eating restrictions as a result of urostomy surgery. Urostomates should drink plenty of liquids each day following the healthcare team's recommendations.

5. Will I be able to wear the same clothes as before?

Whatever you wore before surgery, you can wear afterward with very few exceptions. Many pouching systems are made today that are unnoticeable even when wearing the most stylish, form fitting clothing for men and women. Depending on your stoma location you might find belts uncomfortable or restrictive. Some people choose to wear higher or looser waistbands on trousers and skirts. Cotton knit or stretch underpants or panty hose may give the support and security you need. Some men finds that jockey type shorts help support the pouch. Women may want to choose a swimsuit that has a lining to provide a smoother profile. Stretch panties (with lycra) can be also be worn under a swimsuit to add support and smooth out any bulges or outlines. Men may prefer to wear a tank shirt and trunks if the stoma is above the belt line.

6. What about sex and intimacy? Will I be able to get pregnant after surgery?

Sexual relationships and intimacy are important and fulfilling aspects of your life that should continue after ostomy surgery. Your attitude is a key factor in re-establishing sexual expression and intimacy. A period of adjustment after surgery is to be expected. Sexual function in women is usually not impaired, while sexual potency of men may sometimes be affected, usually only temporarily. Discuss any problems with your physician and/or ostomy nurse. Your ability to conceive does not change and pregnancy and delivery should be normal after ostomy surgery. However, if you are thinking about becoming pregnant, you should first check with your doctor about any other health problems. For more information a sexuality guide is available from UOA or check out the sexuality fact sheets on the web site under Ostomy Information.

See these Fact Sheets for more information. Sex and the Male Ostomate Sex and the Female Ostomate Sex and the Single Ostomate

7. Is travel possible?

All methods of travel are open to you. Many people with ostomies travel extensively. from camping trips to cruises to plane excursions around the world. Take along enough supplies to last the entire trip plus some extra, double what you think you may need. Checked luggage sometimes gets lost, carry an extra pouching system and other supplies on the plane with you. When traveling by car, keep your supplies in the coolest part, and avoid the trunk or back window ledge. Seat belts will not harm the stoma when adjusted comfortably. When traveling abroad, take adequate amount of supplies, referral lists for physicians and medical centres, and some medication to control any diarrhoea and stop the fluid and electrolyte loss. When going through customs or luggage inspection, a note from your doctor stating that you need to carry ostomy supplies and medications by hand may be helpful.

8. What about medications? Can I take vitamins?

Absorption may vary with individuals and types of medication. Certain drug problems may arise depending on the type of ostomy you have and the medications you are taking. Make sure all your healthcare providers know the type of ostomy you have and the location of the stoma. This information will help your pharmacist and other healthcare providers monitor your situation. (i.e., time-released and enteric coated medications may pass through the system of ileostomates too quickly to be effective.)

9. Will I always be wearing the same size and type of pouch?

The type of pouching system that was used in the hospital may need to be changed as the healing process takes place. Your stoma may shrink and may require a change in the size opening of your pouch. Your lifestyle may necessitate a change of the pouching system after a recuperative period. Make an appointment with your ostomy nurse to evaluate your management system.

10. Got any tips on emptying the pouch?

Check the pouch occasionally to see if it needs emptying before it gets too full and causes a leakage problem. Always empty prior to going out of the house and away from a convenient toilet. Most people find the easiest way to empty the pouch is to sit on the toilet with the pouch between the legs. Hold the bottom of the pouch up and remove the clamp. Slowly unroll the tail of the pouch into the toilet. Clean the outside and inside of the pouch tail with toilet paper. Replace the clamp.

11. How often should I change the pouch?

The adhesiveness and durability of pouching systems vary. Anywhere from three to seven day is to be expected. Itching or burning are signs that the wafer should be changed. Changing too frequently or wearing one too long may be damaging to the skin.

12. What should I do if hospitalised again?

Take your stormy supplies with you since the hospital may not have your brand in supply. If you are in doubt about any procedure, ask to talk to your doctor. Ask to have the following information listed on your chart: 1) type of stormy or continent diversion, 2) whether or not your rectum is intact, 3) describe in detail your management routine and list the stormy products used. For urinary stomas, 4) do not take a urine specimen from the frostily pouch, use a catheter inserted into the stoma.

13. Where can I purchase supplies?

Supplies may be ordered from a mail order company or from a medical supply or pharmacy in your town. Check the yellow pages under "Stormy Supplies" or "Surgical Supplies", or "Hospital Supplies". (For more information, see the Stormy Product & Suppliers page on this site)

14. Does insurance cover the cost of stormy supplies?

Medicare Part B covers ostomy equipment. Medicare only allows a predetermined maximum quantity each month. Medicaid is the federal/state insurance of last resort for low income persons. Check with the state Medicaid office for specifics. Individual Health Insurance most plans typically will pay you 80% of the "reasonable and customary" costs after the deductible is met. For more information, see Insurance Issues.

15. When should I seek medical assistance?

You should call the doctor or ostomy nurse when you have: 1) severe cramps lasting more than two or three hours; 2) a deep cut in the stoma; 3) excessive bleeding from the stoma opening (or a moderate amount in the pouch at several emptyings); 4) continuous bleeding at the junction between the stoma and skin; 5) severe skin irritation or deep ulcers; 6) unusual change in stoma size and appearance; 7) severe watery discharge lasting more than five or six hours; 8) continuous nausea and vomiting; or 9) the ostomy does not have any output for four to six hours and is accompanied by cramping and nausea.

16. Where can I find help?

For medical assistance, seek help from your physician, surgeon, or ostomy nurse. Call theUnited Ostomy Association at 1-800-826-0826 for more information and referrals to local chapters and community resources. Contact the Wound, Ostomy and Continence Nurses national office, 1-800-224-9626 for information and local referrals for ostomy nurse specialists. Contact the American Cancer Society at 1-800-ACS-2345 for cancer information.

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