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Volume 29, Number 4 January, 2002
NEW TREATMENT FOR CROHN’S
By: Bob White, Via: S. Brevard (FL) Ostomy Newsletter
The Federal Drug Administration (FDA) announced, in a recent press release, that it has approved a new medication for the treatment of mild to moderate active Crohn’s disease, involving sections of the small and large intestines.
The new drug, Entocort EC, is an orally administered steroid that is released in the intestine, where it works locally to decrease inflammation. Because most of Entocort EC is not absorbed into the body, patients taking the medication
report experiencing fewer of the typical side effects associated with other steroids used to treat Crohn’s, such as prednisone or prednisolone tablets.
Prior to its approval, the new medication was studied in 651 patients with active Crohn’s. Those patients treated experienced significant improvement of their symptoms.
The most common reactions associated with the use of Entocort EC included headache, respiratory infection, and nausea. On the plus side, fewer patients receiving the medication experienced the facial swelling and acne common to those taking prednisone.
The source of the new medication is Astra Zeneca LP, of Wilmington, Delaware.
BLOCKAGE, MY HOSPITAL EXPERIENCE
By: Carol Ganje, “The Optomist”, Greater Seattle Chapter
I have an ileostomy, which means that if I get a blockage I can start loosing fluids quickly, and become dehydrated rapidly. This is exactly what happened to me on a Friday evening when I ate something, probably beans, and did not chew them well. But what I didn’t expect was what happened to me when I went to two different hospitals over the next two days.
Saturday morning, I knew I was in trouble, having thrown up all evening, with nothing but fluids coming through my ostomy. After first calling my doctor, my husband Barry took me to the ER at hospital # 1 at 11am. I discovered that ER personnel are not well trained in the handling of ostomy cases, something the ER nurse said she wished they had more training on. But she did have the foresight to ask how I normally handled a situation like this in the past. I said that it was imperative that I get started on an IV, in order to rehydrate me. By 12 noon, an hour later, I was hooked to an IV (before I saw a doctor), and was given pain medication to help relax me. In the past, this has also proven to help in relaxing my gut, and allowing food to pass. By 4 pm I no longer had cramps, and apparently no blockage, and was released from ER.
Sunday morning, the cramps started again, but not nearly as intense as Saturday. I was still rather sore and weak from my experience the day before. By evening, I was again in so much pain from cramps, that my husband took me to hospital # 2. This time we had gotten a hold of the back-up to my gastroenterologist, and he told us to go to a different hospital. We got there at 11 pm, to find that the doctor had already alerted the ER that we were coming. I thought, great, they will get me on an IV and some pain medication right away. Wrong!! At 11:15 pm I got into an ER room, so I could lay down. At 11:25 pm, the nurse came in and took my blood pressure. I asked about getting an IV, and the nurse said that they couldn’t give me one until the ER doctor saw me. It wasn’t until 1:40 am that the ER doctor saw me, and finally at 2 am, I was given an IV and pain medication. After x-rays were taken at 2:45 am, I was admitted to the hospital at 5 am, 6 hours after arriving at the ER. It wasn’t until 2 days later, that I found out that the ER doctor had prescribed a medicine for me that slows down secretions, or liquid output, a mistake in my case. I wasn’t released from the hospital until Thursday.
Lesson:
Not all hospital ER’s operate the same.
ER staffs need more education on treating ostomies.
Make sure you have a good GP doctor, gastrointestinal doctor, and colorectal surgeon involved in your care, and communicate what you need when you arrive at the hospital.
POUCH FALLOFF
Via: Ileostomist, & Spacecoast Shuttle Blast, FL & Metro MD.
One of the most embarrassing situations that can befall an ostomate is to have an accident with the pouch pulling loose, resulting in soiling of clothing and an instant loss of self assurance. Multiple reasons exist to explain the loss of a pouch, such as the stoma itself, the skin around the stoma, the cement, or the pouch. The stoma may be placed too close to a scar, crease or bodily prominence, so that the twisting or bending loosens the appliance. There is no single solution for a misplaced stoma. A different faceplate may be tried, one with a soft and pliable surface to fill in irregular areas, rather than a hard faceplate that pries off with motion. A regular area may be built up with tissue and cement. The stoma may have to be moved, if leakage continues. A prolapsed stoma will push the pouch off. Conversely, a flat or recessed stoma will cause pooling of intestinal contents around the stoma eroding the adherent and eventually lifting the faceplate from the skin. Convex pouches or convex inserts help this situation.
The skin around the stoma might be too oily or too irritated. Bath oils and creams should be avoided. Liquid antacids, such as Maalox, help protect sore skin and, if properly dried, do not interfere with seal of the faceplate. The cement may be too thin. Leaving the can open for a short time will allow some of the solvent to evaporate, thickening the cement. If the can is not shaken sufficiently to mix up the dense cement that settles on the bottom, the thin mixture will not be strong enough to support proper adherence. Not enough time may be given to allow the cement to dry properly.
Finally, a well-fitting pouch that is suited to your needs and lifestyle is essential. If your pouch keeps coming off, have your entire management evaluated by an ET Nurse—No need to suffer!
IMPROVISING...or fixing a leak in a hurry
Via: The Right Connection & Southern Nevada’s Town Karaya
If you do spring a leak, especially when away from home, it can be a cause of panic. Being prepared can help you keep your cool. Wearing an appliance cover provides extra protection. One person noted that when they had a leak near the seal he was able to stuff several folded tissues between the pouch and cover. This absorbed the leakage and kept him going for 90 minutes until he was able to get back home and change.
A pouch cover has the advantage of soaking up perspiration on a hot day. Perspiration can quickly undermine the best adhesives. A good ostomy powder can help soak up moisture too. Lacking this, corn starch or baby powder is equally effective. Some people always carry Band Aids with them. She said she used the tape to mend a small tear in the pouch. It worked so well that she forgot about the makeshift repair until her regular time to change pouches!
One ileostomate told about his pouch filling with gas while he was hurrying to catch a plane and he didn’t have time to stop in the restroom. He used a pin to poke a hole in the top of his pouch. By pressing his arm against his body, he was able to avoid an emergency until he could safely use the restroom on the plane.
Another ileostomate told about Using a disposable diaper to wrap around her appliance. It kept her safe until she could get home and change.
Individually packaged alcohol wipes or towelettes are easily carried and are great helpers in cleaning up an emergency.
Best of all though, take precautions to try to avoid having an emergency.
HOW TO BOOST YOUR IMMUNE SYSTEM
By: Diann Daniel GB News Review
Your immune system is a quiet hero, working behind the scenes to protect your body against illness and disease. The immune system is made up of certain organs and white blood cells that work together to protect your body from harmful substances, cells and viruses. Here are some things you can do to help strengthen your immune system:
GET REGULAR EXERCISE. Being under a lot of stress can damage your immune system over time. To help your body cope with stress better, exercise for 30 minutes at least three times a week. This also may help lower your risk for conditions such as heart disease, obesity, osteoporosis, back pain and depression.
GET ENOUGH SLEEP. There is evidence that people who are sleep deprived may have a weakened immune system. To be sure that you get the amount of sleep you need, avoid alcohol for at least two hours and caffeine for at least six hours before bedtime. Also, early in the evening, plan your activities for the next day so that you won’t have to think about them until then. Spend the last two hours of your evening relaxing.
EAT WELL. Eating a variety of fruits, vegetables and grains can help your immune system fight disease and infection. Also limit the amount of sugar, salt and alcohol in your diet.
SEEK HELP FOR DEPRESSION. It’s normal to feel sad sometimes. But if you suffer from depression, it not only harms your emotional and social life, it also can weaken your immune system and affect your appetite and sleep patterns. If you are depressed for more than two weeks or if your depression interferes with your daily activities, talk with your doctor.
Taking these steps can help boost your immune system, which can keep you healthy and strong.
MORE HINTS AND TIPS
Eating bran muffins is a simple and delicious way for colostomates to solve constipation problems.
Carry an extra tail closure or rubber band with you in case yours “goes down the drain.” It could prove critical to your entire program.
Why not empty your pouch each time you urinate? No need to wait until it is full. While in the neighborhood, do it. Travel on “empty.”
Sometimes, Micropore tape will adhere better if you apply the heel of your hand over the taped area for a few minutes.
Don’t be afraid to take a shower without your appliance. Soap cannot hurt the stoma. Just rinse well.
If your stoma bleeds during cleaning and appliance changes, don’t panic. A healthy blood supply is what gives your stoma a bright red color. If bleeding continues long after the appliance has been changed, check with your doctor.
Increase your intake of fluids during the cold and flu season!
GROWING THREAT IN THE HEALTH INSURANCE FIELD
By Linda Aukett
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