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4 days ago · Intimacy with an Ostomy in Ostomy

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written by D. Fechner RN, CWOCN

Intimacy and an Ostomy

Let’s talk about one of the things that no one wants to bring up…..but what everyone is thinking! Am I right?!? One of the biggest concerns for new ostomates is how the ostomy will affect their relationships.  It’s natural to feel stressed about possible relationship issues related to your ostomy.  Some common questions are: Will my partner look at me differently?  How will it affect my dating life and/or sexual relationships?  How will the pouch affect my sex life?  The good news is intimacy and sex is still possible after having ostomy surgery!

The most important thing to remember is there is more to intimacy than just sexual relationships. Being intimate with your partner is about a deep level of familiarity, closeness and trust between two people.  Being open and honest with your feelings will help your partner understand what you are going through and create a deeper bond.  It’s very important to talk and share about your feelings and not hold them inside.

If you are dating and you anticipate things getting more serious, make sure to be open and honest with your partner. Be upfront about what they can expect with your body.  Explain why you had the surgery and why you need to wear a pouching system.  Explain to them how this has changed your life and situation for the better so your partner understands.  This will create a level of trust and intimacy.

If you are in a committed relationship, make sure to include your partner as soon as possible. Bring them to all your pre-op appointments where the topic will most likely get brought up.  You can talk to the surgeon about how it will affect your body together.  Most couples feel this actually brings them closer.   Involve them early in pouching changes in the hospital so they know what to expect.  Attend a pre-op education class to learn about all the information upfront.  If you learn all this upfront, it lessens the shock and fear that comes with the unknown.

Here is a list of suggestions to make intercourse more comfortable following surgery:

  • Empty the pouch prior
  • Make sure all connections are secure and locked
  • Buy special clothing options to make yourself feel more comfortable such as silky tops, wraps, cummerbunds, and/or specialized underwear
  • Consider a fabric pouch cover to prevent rubbing on your partners skin
  • Smaller pouches and pouches with opaque covers will conceal contents in the pouch
  • You don’t need to change anything with positioning-do what you are comfortable with
  • Take things slow and remember sex is about your comfort level
  • Never use the stoma for intercourse

Remember, the most important thing is to be proactive, open and communicate. Support groups are also available after surgery and a good place to share your concerns.   Your WOC RN is also a great resource to help with clothing and accessory options.  The United Ostomy Association of America (UOAA) has wonderful written information and resources about intimacy and sexuality on their website: http://www.ostomy.org.

Meet other people talking about living with an ostomy on Mayo Clinic Connect. Join the conversation, share experiences, ask questions, and discover your support network.

Tue, Apr 30 1:51pm · REDUCING RISK OF COMPLICATIONS: Recovering after surgery in Ostomy

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written by Mary Famorca MAN, RN, COCN

REDUCING RISK OF COMPLICATIONS: Recovering after surgery

After a major surgery, it is necessary to recognize that each individual have different levels of energy and strength to meet the physical demands of their job, school or life in general. It is important for a person to listen to their own body and be guided by how you feel. It is important to be patient and don’t expect too much of yourself too soon. However there are a few gentle activities that you can do to aid in your own recovery.

Appropriate gentle activities to do in the early phase of your recovery might include:

  • Walking – adopt a more upright posture and think about “standing tall”
  • Gentle core and abdominal movements – breathing & relaxation and pelvic floor muscle exercise
  • Mobility, balance and coordination exercise

The suggested activities need to be balance with appropriate amounts of sleep and rest in order to recover. Remember to always consult with your provider when you can start increasing your activities and exercise. For further information please go to the United Ostomy Association of America or you can also look up the Me+ program by ConvaTec.

REDUCING PARASTOMAL HERNIA

Parastomal hernia is an abnormal bulge around the stoma. This is technically an extra loop of bowel that squeezes through between the stoma and abdominal wall and sits between the skin and the muscle of the abdominal wall. There are things that you can do to reduce your risk:

  • Speak to your surgeon about parastomal hernia prevention
  • Stop smoking
  • Wear a light support garment
  • Manage your weight
  • Strengthen your abdominal muscles
  • Stay active
  • Maintain strong arm muscles to help you lift and move more safely
  • Try to “breathe out” as you lift and make sure to hold the object close to your body
  • Be cautious when you push, twist or pull any objects or doing any kind of physical housework and gardening-it is better to avoid this type of activities for a first few weeks until you feel you are ready

Tue, Apr 16 3:11pm · Cleanliness and Odor Control in Ostomy

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written by J. Morris RN, MSN, CWOCN

Cleanliness and Odor Control

One of the biggest concerns for new Ostomates is the fear of odor from their new ostomy.  Whether you have a urostomy, ileostomy or colostomy, this can be a legitimate concern.  But there is great news: ostomy products are odor-proof when worn correctly!  The only time there should ever be an odor is when you are emptying /changing your pouch.

Remember certain foods may cause an increase in odors.  But only when emptying!

Here are some quick guidelines to keep you and your pouch clean:

  • For drainable pouches, keep the bottom couple inches free of stool
    • After emptying use a damp paper towel or toilet paper to wipe out the bottom of the pouch.
    • This prevents stool from getting on the outside of the pouch when closing it
  • For 2 piece systems, always check the connection between the flange and the pouch, these should be tightly sealed.
    • This prevents stool/urine from getting on the wafer or outside of pouch.
    • Keeping the outside of your pouch clean is essential.
  • Consider using a liquid deodorant such as Adapt lubricating deodorant in your pouch. There are also deodorants that can be taken by mouth. Your Ostomy RN can speak with you about these options.

Wed, Mar 6 6:07pm · Is your current pouching system right for your body type? in Ostomy

Pouch

Our bodies change and with that sometimes our ostomy pouching system may need to change too.  There is no one size fits all for everybody or every stoma.  Gaining or lose of weight, abdominal surgery or even natural changes from aging can change our stoma and surrounding skin which can lead to a poor fit of a pouching system.  It is advised to have periodic reviews of your pouching system with your ostomy nurse to ensure consistent wear time and maintain intact peristomal skin.

There are many pouching systems available including one- and two-piece systems.  Skin barriers (the part attaching to the skin) comes in both flat and convex.  As your body changes due to weight, surgery or aging, the skin barrier you choose may make a difference in your wear time.

There are several considerations when deciding between a flat or convex skin barrier.  Your ostomy nurse can help.  He or she will start by examining your abdomen for the presence of creases or folds.  If the area is flat in all positions, a flat barrier may provide a good fit.  If there are creases or folds in the area, a convex barrier can help to flatten the creases providing a good fit.  A second consideration for a convex barrier would be when a stoma does not protrude above the skin and the waste leaks under the barrier.  Finding the most appropriate type of skin barrier and amount of convexity depth can be overwhelming.  Your ostomy nurse will help with this.

If you have any questions or concerns about the fit and wear time of your pouching system, please see your local ostomy nurse for help.

Tue, Jan 8 12:58pm · Patient Story: Improved Quality of Life in Ostomy

Jeff

written by J. Stanhill

My Ostomy Improved My Quality of Life

My story goes back to 1974. I had just graduated from culinary school in Los Angeles. I was having digestive issues, and on the advise of my parents, went to see a gastroenterologist. I was diagnosed with ulcerative colitis. A year later, after many prescriptions, the diagnosis came in with Crohn’s disease. At that time not much was known about Crohn’s, only to treat it with diet and medication. At one time I was taking thirteen pills three times a day. The worst of it was prednisone. 50 MG a day. For those that have been on it, you know what it does to you. Not pleasant!.

For three years, I saw my doctor monthly and stayed on the meds as I was told. I stayed on the diet (no fresh fruit or fresh veggies, no milk as they thought I was lactose intolerant. I was a regular at the local hospital. At least once every two months from bad cramping and spasms. Demerol was the only thing that would ease the pain.

Finally in April of 1978, I went in for a colectomy. In those days, the surgery took 7-8 hours and left me with a twelve inch scar from below my chest to my groin. A year later the Crohn’s reappeared. The rest of my large intestine was removed and an ileostomy was put in place. Fortunately I have not taken any medication for Crohn’s since then.

During my illness I was blessed to have met my beautiful wife. We actually met before my first surgery. I must tell you that there is no way I could have made it without her. She was my rock then and is still today. This August we will celebrate our 40th wedding anniversary. We have also been blessed with two beautiful children and now two amazing and loving grandkids.

Fast forward 35 years. I had a few visits to the hospital due to adhesions, but managed to only be in for a few days each time.

I have been dealing with bowel obstructions and a Stomal hernia for the past four plus years. Twice the hernia has been repaired. Since the obstructions started, I have had to remove items from my diet. The doctors at Mayo have been amazing. And I can’t say enough about the nurses and the quality of care that I have received each time I had to be admitted. They are the BEST! Each time, my wife would stay with me. It is so important to have an advocate with you while you are a patient.

During my recent visit, one of my nurses was Teddy. He also has an ileostomy. He shared with me about a support group that was being formed at Mayo for Ostomy patients. I was very excited to hear this and told him that I wanted to be part of it. To say the least, I look forward to helping other Ostomy patients with their issues and just being there to listen to what they have to say.

I am currently a culinary arts teacher the Peoria Unified School District.

Thank you for letting me share my story.

Meet other people talking about living with an ostomy on Mayo Clinic Connect. Join the conversation, share experiences, ask questions, and discover your support network…

 

Dec 13, 2018 · Finding Your Support in Ostomy

MCC Support

Many patients undergoing ostomy surgery find that surrounding themselves with support can aid in their recovery. This support can be found through caregivers, family, friends, medical professionals and others facing the same surgery.  There are many caring people that can help you to manage life with an ostomy.

Family members and caregivers play a vital role in the life of a person with an ostomy. They can offer support and encouragement.  Encourage family members and caregivers to educate themselves in order to understand and accept this new life.  Adequate information and a positive outlook is the basis for recovery and acceptance.

You may also seek support through your medical professionals. Your ostomy nurse, physicians and other healthcare professionals can help with education and skills needed for everyday life with an ostomy.  They can also connect you with others who have had ostomy surgery to build friendships with those experiencing the same feelings you may be having.

Your new life with an ostomy takes time to adjust. Talking with someone who has faced this same experience helps you to share your feelings.  Many find it helpful to talk with others about these new struggles and share success stories.  There are many ways to find support from others sharing your experience.  Online and in-person support groups are offered throughout the United States.  Talk with your ostomy nurse for more information.

Many people with ostomies feel alone in the world. According to the United Ostomy Association of America, there are between 725,000 to 1 million Americans living with an ostomy in the United States.  You are not alone.  Together, we can live a happy and fulfilled life with nothing holding us back.

Meet other people talking about living with an ostomy on Mayo Clinic Connect. Join the conversation, share experiences, ask questions, and discover your support network…

Oct 23, 2018 · Traveling with Your Ostomy in Ostomy

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The holidays are about family. Seeing our families sometimes means travel.  Are you nervous about traveling with your ostomy?  Don’t let your ostomy get in your way of your fall travel plans.

Preparing for travel can help put your mind at ease. Create a checklist of supplies.  Ensure you have packed enough supplies for your trip.  The best way to do this is to count the number of pouches you would normally need and double that.  This way you will ensure you have enough supplies for anything you need.  Some other considerations for your packing list may include disposal bags, cleansing wipes and other ostomy accessories such as stoma powder and skin protectant.  Bringing a handheld mirror is a good idea, just in case you need to change your pouching system on the go.

When packing supplies, make sure to pack some supplies in your carry-on bag. The remainder can be put into your checked luggage.  It is a good idea to pack some supplies in your companion’s luggage.  That way, if a bag is lost, you will still have supplies in the other bag.

If traveling abroad, it is a good idea to know where you can buy supplies if needed. The United Ostomy Association of America has information on suppliers abroad.  This list includes ports of call for cruise ships.  It is a good idea to have a travel communications card when going through customs.  This card explains why you need pouches, ostomy supplies and medications as you pass through checkpoints.

Maintain your normal diet while traveling. It is tempting to eat and drink less to lower your output.  This is not recommended.  To ensure confidence and prevent leaks, change your pouching system right before departure.  During travel make sure you are staying hydrated.  Drinking plenty of fluids is important for any type of ostomy you may have.

Some air travel restrictions may not allow scissors or adhesive removers. Plan ahead for this by checking with your airline or pre-cutting your wafers.

Car travel and seat belts should not cause any problems with your ostomy. Ensure you are taking frequent stops to get out the car and stretch.  Try to not place your seat belt across you stoma.  Lower the angle of the seat belt to ensure proper fitting.  You can purchase optional accessories to make seat belts more comfortable.

When you travel this fall, you want to relax and enjoy yourself. Preparation before travel can lead to a very confident and enjoyable time.  What are some of your tips for traveling with an ostomy?

Oct 18, 2018 · Peristomal Skin Care in Ostomy

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The skin around your stoma is called your peristomal skin. Maintaining healthy skin in this area is very important.  Most people do not think about skin health when they think of ostomies.  However, the skin surrounding your stoma can have a great impact on your quality of life.  Healthy peristomal skin should be intact with no signs of redness, warmth, itching or pain.

Poor skin health surrounding your stoma can lead to leakage, odor, additional healthcare costs, pain and discomfort.   Prevention is the key.  There are many things you can do to keep you peristomal skin healthy.

Skin Care Tips

  • Less is better. Water alone is enough for cleaning your peristomal skin. If soap is preferred, use a mild soap without added lotions or creams.
  • Ensure your pouching system has a secure seal. To protect the skin, the opening in the skin barrier should fit snugly around the stoma.
  • Change your pouching system when needed. Talk to your ostomy nurse for guidance on how often you should change your pouching system.
  • Urostomy patients should connect pouch to overnight drainage system to prevent urine from undermining the skin barrier and causing leakage on the skin.
  • If concern for allergic reaction, talk with your ostomy nurse to find appropriate pouching system.
  • Remove pouching system gently to avoid adhesive skin injury. Pouching system without tape borders can also be considered.
  • Consider permanent hair removal for ostomies that are problematic or permanent for persistent folliculitis (inflammation of the hair follicles).

Peristomal skin complications are not a normal part of life with a stoma. You do not have to accept the pain of peristomal skin complications.  If you have red, broken or irritated skin, seek the assistance of your healthcare professionals.