UOAA UPDATES are our way of communicating to our members what is happening throughout the organization. It is our hope that that this information will be passed on to your members by including it in your newsletters or by discussing it at your local support group meetings. We continue to look forward to working with you and to being an active resource to ensure your success.

 

ARTICLES TO SHARE

MAY 2015

• Caring for your Ostomy

• Camping

• Wisdom from a Pharmacist

• WHEN TO CALL THE DOCTOR OR OSTOMY NURSE

• VITAMIN B-12 REPLACEMENT THERAPY

• SPECIAL CLOTHING FOR THE OSTOMATE

• TAP WATER vs. BOTTLED WATER: 

  DEPENDS ON THE SOURCE

• SOME ABCs OF UROSTOMY CARE

• "LIFE WITH LUKE"

• ON THE SHORT SIDE

 

 

CARING FOR YOUR OSTOMY

By Pat Murphy, RN, CETN, Middle GA, Ostomy Rumble

UOAA Updated May 2015

 

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. You may, however, notice some pink skin under pressure points when you first remove the skin barrier from your body. This is the same as when you take off your watch or a pair of stockings and 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 to help seal the area.

 

Remember: a new stoma can change size for up to a year. Re-measure your stoma every time you change the skin barrier for the first six months after surgery and every month thereafter. Always re-measure 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 of a one-piece pouching system, no skin should show when it is in place. However, making sure the skin barrier doesn't touch the stoma unless it is an extended-wear skin barrier manufactured to be able to touch the stoma (these skin barriers are designed to "turtleneck" where they touch the stoma). Since it can be tricky to cut the opening to the correct shape without leaving gaps around the stoma, manufacturers have developed skin barrier seals and ostomy paste that can be used to fill the gaps.

 

If your stoma is not perfectly round, do not trace and cut a round circle. Instead, make the skin 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.

 

 

CAMPING

I'd Like to Buy A Bowel Please! By Brenda Elsagher Reprinted with permission

UOAA Update May 2015

 

Back in the days when patients were in the hospital for longer stays, ten days to two weeks was normal for a colectomy/colostomy. You really got a chance to get to know your patients and see their progression of dealing with their medical issues. A forty-four-year-old patient and mother of four had a diagnosis of cancer and her prognosis was not good. Initially, like most, she really had trouble with the whole cancer deal, but unlike many, she was very open about her feelings.

 

We were in the hospital room bathroom during the irrigation procedure one morning when she asked, "Will I be able to continue camping with my family?" I assured her with some planning and adaptation, she should be able to join her family and resume their good times together. I'll never forget her light-hearted response when she looked up and said, "In other words, have bag will travel!" I just about lost it. It marked the beginning of a new outlook for her. She was over the hump with self-care after that.

 

The next day I slipped into her room to find her sleeping; at least I thought she was asleep. Before I could turn to leave, she opened her eyes, smiled mischievously, and reported, "I have already been up, completed my irrigation and bag change, and am done for the day." It never ceases to amaze me how the human spirit rises to meet the challenges of life.

 

Brenda's book, I'd like to buy a bowel, please! is available through Amazon.

 

WISDOM FROM A PHARMACIST

 

By Florian Norwicki, Rph: Snohomish County WA,  Insights

UOAA Update May 2015

 

I find ostomates with the least problems are those who become acquainted with other ostomates with a similar surgery. The best method of acquaintanceship is to become involved in your local ostomy chapter.

 

We constantly her of organizations being formed for many types of bodily  dysfunctions, such as paraplegics, epileptics, bypass cardiac club, diabetes, etc. These peer groups perform invaluable services, especially to new members when the trauma is often more psychological than physical. I encourage each and every one of your to attend meetings regularly. If you come away with one new fact or idea per meeting for your self-help, you know it is worth the time and effort.

 

Your best medicine is preventive medicine. Whatever your procedures are, or your diet is, think of the problems you encounter if you deviate from your norm. Spices, alcohol, caffeine and some vegetables which cause flatulence are to be used moderately or not at all.

 

Again, it is pertinent to your well-being that you know what is best for you. A good idea is to keep a diary or log of your diet so you may determine what food it was that caused a problem for you then steer yourself away from that problem.

 

Your UOAA Chapter is the way to go. Ask questions - get answers. The members have already been in your shoes!

 

 

WHEN TO CALL THE DOCTOR OR OSTOMY NURSE

The Right Connection, Ostomy Assn. of San Diego

UOAA Update May 2015

• If cramps last more than two or three hours.

• If you get a deep cut in the stoma.

• Excessive bleeding from the stoma opening or a moderate amount in the pouch after several emptyings.

• Bleeding at the juncture of the skin and stoma.

• Severe skin irritation or deep ulcers.

• Unusual change in size or appearance of stoma.

• Severe watery discharge lasting more than five or six hours.

• Strong odor lasting more than a week.

• Any other usual occurrence regarding the stoma.

You can find an Wound Ostomy Continence Nurse at the following web address:

http://www.wocn.org/?page=Nurse_Referral

 

Fill in the sections that ask for "Zip Code" and "Zip Code Within" ONLY.

 

 

VITAMIN B-12 REPLACEMENT THERAPY

By Bob Baumel, Ostomy Assn of North Central OK

UOAA Update May 2015

 

Vitamin B-12 is, under normal conditions, absorbed in only a small section of the terminal small intestine (ileum), raising the possibility of B-12 deficiency if that section of the ileum has been removed surgically or damaged by disease. People who may have lost that portion of their ileum include some ileostomates, people who had a failed J-pouch or Kock pouch, and some people with urinary diversions (especially continent urinary diversions) made using the terminal ileum. A condition such as Crohn's disease may have damaged the terminal ileum, even if it hasn't been removed surgically.

 

Vitamin B-12 is necessary for many metabolic processes, including development of red blood cells and maintains normal functioning of the nervous system. Deficiency causes anemia (reduced oxygen carrying capacity of the blood resulting in fatigue) and can also cause nervous system damage. It's worth noting that folic acid (another B vitamin) can correct the anemia caused by vitamin B-12, but will not correct the nerve damage caused by B-12 deficiency. So it's important to get enough vitamin B-12.

 

If you think you are at risk for vitamin B-12 deficiency, you can ask your doctor to check your serum (blood) B-12 level. This test can be added easily to routine blood testing. If your ability to absorb vitamin B-12 by the normal pathway involving the terminal ileum has been impaired, you can supplement the vitamin by three basic methods:

• By Injection: This method bypasses the normal gastrointestinal process of B-12 absorption by inserting it into the body by intramuscular or subcutaneous injection. B-12 injections may be self-administered in the same way that diabetic patients can give themselves insulin shots. Maintenance therapy may require only one B-12 injection per month.

• Nasally: This method also bypasses the normal gastrointestinal absorption process, as vitamin B-12 can be absorbed through nasal mucous membranes. The nasal form of B-12 was developed first as a nasally applied gel and later a true nasal spray (brand name Nascobal®). This product is marketed by the Strativa Pharmaceuticals, who promotes it as the only FDA approved form of vitamin B-12 besides the injectable form. Nasal B-12 can be effective, but because one company has sole rights to distribute it in the U.S.A., it can be an expensive way to get your vitamin B-12.

• Orally: Until recently, doctors believed that B-12 taken orally was useless to people who lack the normal absorption mechanism involving the terminal ileum. That opinion has changed, however, as research has revealed that even in such people, when a large dose of vitamin B-12 is taken orally, a small fraction (typically around 1%) gets absorbed by mass-action transport across the gut.

Note: Time Released medications should, in general, be avoided if you have an ileostomy as they may pass through your gut without getting absorbed adequately.

 

 

SPECIAL CLOTHING FOR THE OSTOMATE

Tulsa Ostomy Association Newsletter

UOAA Update May 2015

 

Having a stoma does not mean you need to have any special clothing; you should be able to dress just as you always have. High-waisted clothes are more comfortable and hide your pouch.

 

Many people find that tucking their pouch into their underwear makes them feel more secure, but with a belt, you can let it hang outside if you prefer. A large capacity appliance shows less than a small one when full, handy to remember when away from home. Lycra type clothing provides excellent and effective support so look out for these in the stores. Support wear is available often on prescription.

 

If you wear an appliance belt, make sure it is at the same level as the stoma to avoid an upward drag. Make sure that your belt or trouser waist lines do not rub on your stoma as this can be very uncomfortable. A sports protector can be worn to protect the stoma while playing physical contact sports.

• Patterned swim suits mean our pouch is less visible.

• A tankini with a high waist can be quite discrete.

• A 2-pc with boxer shorts is a good choice for women.

• A one-piece suit can have gathers horizontally or crisscross.

Emphasize again - you do not need special clothing. Dress as you always have. Even jeans if they are not tight. However, sometimes switching to elastic waist bands is the way to go.

 

 

TAP WATER vs. BOTTLED WATER: 

DEPENDS ON THE SOURCE

Metro Maryland: UOAA Update May 2015

 

Many ostomy newsletters are sharing an article entitled "Water" By Prometheus T. Peabody, NNBH. In it he states "Tap water should be used in moderation. It contains toxic chemicals that in large quantities are poisonous to our bodies. Bottled water should not contain these toxins."

 

Despite marketing claims by the bottled water industry, bottled water is not safer than tap water. In fact, tap water is subject to more stringent regulation than bottled water. In 2009, almost 50% of all bottled water came from municipal tap water supplies.

 

According to a 2010 survey, only three companies provide the public with the same level of information available for tap water, including:

• where the water came from,

• how it was treated, and

• what the results of the water quality tests were.

Independent testing of bottled water by the Environmental Working Group in 2008 found that 10 popular brands of bottled water, from grocery stores and other retailers in 9 states and the District of Columbia, contained 38 chemical pollutants with an average of 8 contaminants in each brand.

 

Bottled water has negative environmental impacts, frequently ending up in landfills, lettering our streets and/or our streams. It takes 17 million barrels of oil per year to make the plastic water bottles used in the U.S. alone. That's enough to fuel 1.3 million cars for a year. For more information, check the website:  www.foodandwaterwatch.org

 

 

SOME ABCs OF UROSTOMY CARE

Philadelphia Newsletter: UOAA Update May 2015

 

Adherence: Urinary appliances adhere well with cement Stomahesive® and Colly-Seel™. The urinary stoma drains continuously. The urine may be mildly irritating to the skin and may be odorous.

 

Bleeding: Often blood is noted in the appliance and its origin isn't immediately clear. One source may be irritation of the stoma by uric acid crystals. These can be formed in the appliance or on the skin around the stoma if the faceplate if too large. This may be indicated by small white spots on the stoma upon removal of the appliance. The crystals have an abrasive effect on the stoma. The crystals may be readily dissolved and the bleeding relieved by bathing the stoma and the surrounding area with a half-strength vinegar solution. Do this three or four times a day while the appliance is being worn.

 

Changing Appliances: Usually the best time to change a urinary appliance is in the morning before drinking anything.

 

Closed Bottom: Only drainable pouches should be used on urinary stomas. Closed bottom pouches should never be used.

 

Face Plate: A convex face plate may be extremely useful with the flush urinary stoma.

 

Fluid Intake: Two to three quarts of fluid daily provide adequate "traffic" through the urinary system to prevent an increase in bacterial growth. (This can occur in a slow moving system.) Increased bacterial growth may lead to urinary tract infection.

 

Leaking: Urinary pouches that are allowed to get too full will tend to leak. Connecting the pouch to the leg bag will be helpful if you're unable to empty often enough. Attach the strap of the leg bag loosely to allow good blood circulation.

 

Night Drainage: Bedside drainage bag or bottle, probably similar to the type you used in the hospital, may be used for children and adults. This is how you can avoid getting up during the night to empty the pouch. The average urinary pouch won't hold the amount of urine that may be excreted during the night.

 

Odor: Drinking cranberry juice is helpful in deodorizing urine.

 

Plugging: You should NEVER use anything to plug your stoma while cleaning, changing or emptying your bag. This could cause problems with your stoma.

 

Showers: You may shower with your skin barrier on and removing the pouch or you may take a shower with the entire appliance off. It is found that if you chose to leave your skin barrier on, using Pink Tape (available through your supplier) around the edges helps prevent water from seeping in and compromising the seal. This also allows you to keep the skin barrier on longer causing less stress and irritation to your skin. This applies to colostomates and ileostomates as well.

 

"LIFE WITH LUKE"

An ongoing saga by Michelle Rogan, Printed with Permission

UOAA May 2015

 

Picture a 7 year old boy with a beautiful long stem, plastic rose in pink with red tips in his hands. He has the flower end facing his older brother and sister, who are seated on the couch watching television. 

 

Luke:   "Pow"  "Pow"   "Pow"

Mom:   "Luke, what are you doing?"

Luke :  "I'm a soldier fighting the enemy."

Mom:   "You're using a pretty rose as a gun, Luke?!!!"

Luke:   "FLOWER POWER, MOM!"

 

 

ON THE SHORT SIDE

By Kathy Ward: UOAA May 2015

 

The UOAA's 5th National Conference will be held in St. Louis MO, from September 1st through 5th and the closer the event gets the more calls I get. Here are a few questions I've been receiving about the upcoming Conference:

 

Question:

 

Are there rooms still available at the Hyatt for the UOAA's 5 th  National Conference?

 

Answer: 

Yes, there are still rooms available and it looks like this year's Conference is going to be spectacular.  So don't miss out!  You can register for the Conference and make your room reservations with the Hyatt for the event by going online at www.ostomy.org or you may call the office and I would be happy to assist you. Remember the date is September 1 st through 6 th.

 

Question: 

What kinds of events and/or workshops will be available at the Conference?

Answer: The list is long, but here are just a few from each day:

Tuesday, Sept. 1st

Conference Open Registration

UOAA President's Reception

 

Wednesday, Sept 2nd

Yoga & Meditation

Ask the Docs

Pain Management

 

Thursday, Sept 3rd

Basic Ileostomy

Male Spouses of Partners Meeting, Non Ostomates Only

Coloplast Medical Chair, motivational speaker by Dr. Katherine Jeter

 

Friday, Sept 4th

Exhibition Hall with continental breakfast sponsored by Shire/NPS Pharma

Meet with UOAA President followed by Support Group Chatter

The "Barrier" Cooking Show

 

Saturday, Sept. 5th

Nutrition and the Ostomate

Have Ostomy Will Travel

Closing Ceremonies

  

We look forward to seeing you there!

 

United Ostomy Associations of America

PO Box 512

Northfield, MN 55057

  Phone: 1-800-826-0826 

Web site: www.ostomy.org