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Volume 32, Number 5 February, 2005
CRANBERRIES — FOR
AND AGAINST FOR UROSTOMATES
Via: Snohomish county, WA & S. Brevard FL Newsletter
FOR– The secret ingredient in cranberries that is pivotal in preventing urinary tract infections (UTIs) is concentrated tannins in the juice, called proanthrocyanidins. In a Boston study published in the Journal of the AMA, cranberry juice was found to be effective in reducing the incidence of UTIs and the need for antibiotic treatments.
This has important implications for persons with ostomies and continent diversions. Recurrent UTIs can be common in persons who catheterize frequently. These can be more evident if proper hand washing and cleaning of catheters is not done routinely. In addition, a large proportion of women over age 65 will experience at least one UTI per year.
How does this special ingredient in cranberry juice work? The tannins from cranberries simply prevent E-coli bacteria, the main culprit in urinary infections, from adhering to cells that line the walls of the bladder and kidneys. The bacteria thus will “wash out” before infection can develop.
Scientists in the Boston study believe that the routine addition of cranberry juice to dietary regimes in circumstances where UTIs have a high incidence, would be sensible.
AGAINST—An article from the Mayo Clinic says drinking cranberry juice to prevent recurring bladder or urinary infections is an “old folk” remedy. Does it work? Maybe—but don’t count on it.
A key to preventing a bladder infection is blocking the growth of the bacteria that cause the infection. Researchers have two theories about how cranberry juice makes urine more acidic, discouraging the growth of bacteria. But scientists don’t know whether a realistic amount of cranberry juice can produce enough change in urine acidity to affect bacteria.
The second theory is that cranberry juice keeps bacteria from “sticking” to the bladder wall where they multiply and cause infections. This theory was confirmed in the laboratory and in mice, but results vary in humans.
We do know that taking 500mg of vitamin C (ascorbic acid) twice a day along with cranberry juice can cause acidity of urine. Still, if you think you have a bladder infection, don’t try home remedies. See your doctor. The usual treatment is antibiotics and lots of liquids.
SELF-CONCEPTS AND OSTOMIES
by Dr. Sue Bergman, Johstown, PA Via: Hemet-San Jacinto, CA
Self-concept can be viewed as being made up of several components:
Work Self-Concept: How we see ourselves as workers.
Family Self-Concept: How we see ourselves as parents, spouses, sons or daughters.
Sexual Self-Concept: The view we have of ourselves as sexual
sexual men or women.
Physical Self-Concept: How we see our bodies.
Ostomy surgery certainly affects the sexual and physical parts of how we see ourselves. It can also have an overlapping effect on the other parts of our self-concept. We have to see everything in this new light and the adjustment process may take as much as one to two years—sometimes longer. The better we adjust, the more comfortable we will feel ourselves and the better others will feel with us. This adjustment process after ostomy surgery takes the form of several major factors:
First, learning how to use the appliance and to find the right combination of equipment. If things don’t fall into place and we don’t get the “knack” of it and if we are misguided by the wrong information, we can be thrown into a tailspin. This in turn, can lead to a state of depression which might be difficult to overcome. But, once we’ve mastered the appliance, we can go on to the incorporation of it to our entire body image and self-concept—how it looks on us with or without clothes, how it feels in the swimming pool or during sexual relations and what we need in order to feel more comfortable with it, such as special covers, etc.
The next step is the adjustment to the day-to-day aspects of having an ostomy. We have to get used to the appliance’s presence as a constant part of our lives. For me, this was the hardest part. I had some really rough times putting it on and feeling like a mess. But somehow
I got over those feelings once I mastered the process. For me, the part was the realization that this would be with me for the rest of my life. I particularly had difficulty waking up with a full puffy bag every morning to remind me of the everlasting presence of this thing that was now an intricate part of my self-concept. However, as time passed, this became a smaller and less important part of my life.
With each day, I felt more comfortable about my new self-image and everything fell back into a clearer perspective. It was certainly a slow process for me, as I am sure it is for most people.
IS YOUR PRESCRIPTION TOO HOT?
UOA Website & Greater Cincinnati Chapter
Getting your prescriptions filled by mail may subject your medicine to extremes of temperature, especially during the summer months; say researchers at the US Pharmacopoeia. They sent test packages with temperature recording devices through the mail and found that only 8% of the parcels stayed at room temperature during shipping. More than a quarter of the packages were subjected to temperatures of 100 or higher.
“We don’t know yet what effect these high temperatures could have on medications,” say lead researcher Claudia Okeke, Ph.D., “But, it could be a problem.” Until we have more information, you can take these protective steps:
Don’t let your mail set in your mailbox. If you’re expecting medications to come while you’re away, arrange for someone to pick it up or have it forwarded to you.
Compare the date on the package to the date that it arrived. “The medicine should not take more than four days to get to you,” says Dr. Okeke. If it does, it may have been exposed to high temperature conditions.
Inspect the medicine and make sure it’s not discolored or damaged. If it is, call the pharmacy and tell them.
Ask your doctor or pharmacist if your prescription is particularly heat-sensitive. If so, ask the mail-order pharmacy if they have temperature-protective packaging or consider getting it filled locally, especially during the summer months.
NEW TEST SAVES LIVES
Via: The Pouch & UOA Website
Bladder cancer, a killer disease notoriously difficult to diagnose, can now be detected with 95 percent accuracy by a new test for abnormal genetic material in the urine. The test could mean early treatment for thousands of patients, say researchers. Dr. David Sidransky of Johns Hopkins University School or Medicine said, “The simple urine samples can be analyzed for the presence of abnormal DNA, a telltale sign of cancer.”
The DNA abnormality appears at a very early stage— a time in the disease process when there is a high likelihood of cure. Researchers report the pilot study using the new test detected 19 to 20 patients with the disease. Dr. Carlos Cordon-Cardo, a bladder cancer expert at Memorial Sloan Kettering
Cancer Center in New York said, “the new test is very important in saving lives. Labs now find only 20-30 percent of bladder cancers in the early stages.”
FINDING THE POSITIVE
by Mike Florak, Via: Greater Cincinnati Ostomy Association
“In this sad world of ours, sorrow comes with bitter Agony. Perfect relief is not possible, except with time. You cannot now believe that you will ever feel better. But this is not true! You are sure to be happy again. Knowing this, truly believing it, will make you less miserable now. I have had enough experience to make this statement.”
-Abraham Lincoln-
President Lincoln overcame many maladies during his life, including depression. I have come to know that his words are true. I have tried to live my life by this creed since being diagnosed with Crohn’s disease more than 10 years ago.
For a long time after I was diagnosed, I lived in denial. I told myself that I would return to being the person I was before I became ill. The irony was that I really didn’t like that person.
I had everything a young person could want when I was in my early 20s. I had been a good enough athlete to be an all-state football player and was drafted by baseball’s Seattle Mariners in high school. I did okay in school and earned a college baseball scholarship. I had a lot of friends and lived a life of excess, like many people I knew in the 1980s. I never seemed to be happy, however, and my persona was clouded by self-loathing and alcohol abuse.
My negative attitude and lack of confidence kept me from fulfilling my potential in every aspect of my life. Then, during my senior year in college, I started to feel weak and tired all the time. Poor eating and sleeping habits, stress, drinking excessively and using tobacco were much more likely to be causing the symptoms than a debilitating intestinal illness.
About six weeks after finishing my college baseball career, I learned that there was another reason for my feeling this way. After having had 12 to 15 bloody stools per day for a while, I woke up one day with a stabbing pain in my abdomen. Several miserable weeks at home were sandwiched between a 35-day stay in a Pittsburgh hospital and a 20-day stay in a Cleveland hospital. After seeing three teams of doctors, it was clear that I had a bad case of Crohn’s disease.
For the next few years, I managed to keep coaching baseball and earned a master’s degree. Unfortunately, despite these accomplishments, my disease never went into remission. I experienced dramatic weight loss (of up to 70 pounds), diarrhea, dehydration, severe abdominal and joint pain, and abscesses. Before it was all said and done, I would also endure unsightly skin disorder pyoderma gangrenosa, four blood transfusions and eight surgeries. Every doctor who examined me said that I was a perfect candidate for an ileostomy, since my disease was confined only to the lower part of my digestive tract.
Despite all the physical pain and discomfort, the worst part of the illness was the depression that set in after my denial ended and the fight with the disease was several years old. After seven years, the ups and downs of the disease and being on prednisone nearly broke my spirit. I simply did not want to live. I fought the urge to buy a gun every day, and it was not going to be used for deer hunting. I prayed to God to make the decision to have the surgery easy for me.
In the fall of 1996, I suffered the mother of all flare-ups. My Pittsburgh gastroenterologist said the severity of my case of Crohn’s was a nine on a scale of one to ten. Also, a team of doctors at the Ohio State Medical School said that I had the worst case of Crohn’s disease they had seen in 30 years. I was 60 pounds underweight, severely dehydrated and needed a blood transfusion. The peri-rectal abscesses nearly infected my reproductive organs. God had finally made the decision to have surgery clear for me.
Since my ileostomy, the changes in my life and my overall outlook have been nothing short of miraculous. I am able to have fun and get along with my family, friends and associates better than I ever had before.
In 1997, I was named head baseball coach, professor of communication, and sports information director at Waynesburg College in Waynesburg, PA. Our baseball team earned national recognition for having the highest team batting average (.382) for all NCAA Division III colleges. In my second year, we won the league title, and I was named President’s Athletic Coach of the year.
In 1998, I became one of only 275 NCAA Division I college head baseball coaches –and one of its youngest at age 31-when I was hired at Youngstown State University. All of the suffering was worth it and has made me a better person and a better coach. In hindsight, I would not change most things I have experienced.
There are many things that I should have done differently immediately after my diagnosis. I should have gone to support groups. I should have seen a psychologist earlier. I should have watched my diet and been more dedicated to the exercise program that now keeps my weight at a healthy 220 pounds. Most of all, I should have fostered better relationships with my doctors and kept in constant contact with them.
I did do some things that I thought were good during my fight. I used prayer and meditation to strengthen my faith and relieve stress. I sought opinions from homeopaths, psychologists, nutritionists, dieticians, massage therapists, allergists, and other healthcare practitioners. I learned about the possible effects of food and environmental allergies, stress, and other factors that can possibly exacerbate IBD symptoms. I learned what being tough is all about. It takes a lot of trial and error and desire before most people learn to cope with IBD.
Above all, I learned important things about life. I learned how much God, strong support from family and friends, and a strong will can help human beings conquer adversity. We can do anything we want if our determination, faith, and resolve are strong enough. People can live productive lives and learn what the important things in life really are when they learn how to battle inflammatory bowel disease...I have had enough experience to make this statement.
OSTOMY TIPS
Via: Indian River Ostomy Association
Diet for a colostomate is usually pretty normal. New colostomates will want to try different things a little at a time. If something doesn’t agree, leave it alone for a while and then try it again if you wish.
For constipation, try drinking a glass of apple juice once or twice a day.
When to change your pouch, is strictly up to you. Whether it is three days or more, or a little less depends on what works for you.
If the skin in only slightly red around the stoma, this is usually caused by pressure from the pouch and no treatment is required.
Remove your appliance gently. Don’t “rip” your appliance off! You may clean the skin with water and pat dry before applying your pouch.
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