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Volume 33, Number 6 March, 2006
SELECTING UROSTOMY EQUIPMENT
Via: Hemet-San Jacinto, CA Stoma-Life Newsletter
Generally, your appliance should stick to your body for at least three days and three nights. Some urostomates prefer to change daily. Your appliance should be easily concealed under normal clothing and be comfortable in any position, despite the stress you place on it in your daily activities.
There are one-piece, two-piece, and custom-designed appliances. Appliances are made of various types of vinyl, plastic, and rubber. In hospitals where there are ET nurses, your personal needs will be evaluated and your appliance will be ordered for you. For some, this appliance is the style worn for a lifetime; for others, weight gain, normal growth, and other factors may later on require a new or different style appliance. Don’t continue using a recommended appliance if it is not satisfactory. Try different types until you find one that is both comfortable and convenient to use.
Sometimes a one-piece appliance might work better than a two piece unit when…
The patient’s eyesight is poor or if their hands are shaky.
The patient is a youngster who is just learning to care for himself or herself.
The new patient is a youngster who is just learning to care for himself or herself.
The new patient is depressed or uninterested and clearly will not be bothered with assembling anything.
The stoma is flush with the skin and a particular one-piece appliance offers the proper convexity in the face plate for obtaining the best seal.
Sometimes a two-piece appliance may be better when….
The patients want to put the face plate over the stoma first, which allows them to be sure that the stoma is correctly centered. (This is particularly helpful when the stoma is irregular in shape and the face plate opening has been tailored to fit.)
It is necessary to provide a very small face plate to avoid contours such as scarring, depressions, or high spots on or near the surrounding area. There are manufacturers who make appliances to meet those needs as well.
For situations where a particular two-piece appliance offers less silhouette or bulge under clothing.
The doctor or the patient wants the pouch to be changed daily for cleaning. With a two-piece appliance, this can be accomplished with ease while the flange remains securely in place on
place on the body.
CROHN’S MISTAKEN FOR ANOREXIA
Source: BBC News On Line, Via: Inside OUT & G.B News Review
Some children who are very thin are being misdiagnosed as anorexic when they have the gut disorder, Crohn’s Disease, a leading expert has warned. Child health specialist Professor Ian Booth told a conference that treatment can be delayed for months as a result. He said teenagers with Crohn’s, an inflammation of the digestive tract, could present with growth failure but no digestive symptoms. Professor Booth said doctors should be aware Crohn’s was a possible diagnosis
The diagnosis problems arise when children and teenagers are extremely thin and failing to thrive, he told a British Society of Gastroenterology meeting in Birmingham. Doctors may assume the patients have anorexia when they are actually having problems eating and digesting food because of Crohn’s disease.
Crohn’s usually affects the small intestine. People with the condition may develop obstructions in their bowel, making digesting food painful.
Punitive Treatment
Professor Booth told the BBC News website: “This is an issue which is numerically very small, but individually very important. “Growth failure in the absence of intestinal symptoms can be an important presentation of Crohn’s in adolescents. The other important presentation is in wasting, as in malnutrition—so much so—that presented this way in adolescence, it is sometimes confused with anorexia nervosa.”
He said concerns about misdiagnosing children had first been raised 40 years ago, but cases were still being seen.
Professor Booth cited the case of a girl who had suffered from low grade intestinal symptoms for several years. Her main symptom was a refusal to eat. She also had growth failure. “She was diagnosed by psychiatrists as anorexic and was admitted for in-patient treatment,” he said. “She was exposed to a fairly punitive style management of anorexia. It was eventually recognized after about six months in hospital that she had small bowel Crohn’s disease.”
Psyche Damaged
He added: Crohn’s disease can present as growth failure or sometimes masquerade as anorexia nervosa. “But mistakenly treating them for anorexia can cause damage to their psyche.”
Richard Driscoll, director of the National Association for Colitis and Crohn’s Disease, said his organization received several reports each year of patients being misdiagnosed as anorexic.
“Young teenagers may be losing weight and then stop eating because their condition makes it painful to eat. If they haven’t got any other symptoms, their condition can be classed as anorexia. It’s not something that happens frequently, but it does occur.”
EATING & DIGESTION AFTER ILEOSTOMY SURGERY
Via: Metro MD
There is no such thing as an ileostomy diet. An ileostomy is not a sickness, so there is usually no health reason for not eating the foods you ate in the past. If you have a special diet because of heart disease, diabetes, or other health problems, you should ask your doctor about a diet that will work with both the problem and your ileostomy.
You may wonder if you will be on a limited diet after surgery. Here are a few simple guidelines about your diet Doctors often have their patients follow a low-residue diet the first weeks after any abdominal surgery. This includes only foods that are easily digested and excludes raw fruits and vegetables. Be sure to find out when you can start a regular diet. Eat all foods that you like except those restricted by your physician.
Try one food a day that you have not eaten since surgery. Eat small portions at first, then gradually increase the amount. Chew well. If a small serving gives you cramps, diarrhea, or odor, eliminate that food from your diet temporarily and try it again in a few weeks. If it still bothers you, try it again in six months.
Eat a balanced diet. You need protein, fats, carbohydrates, vitamins and minerals, just as you did before your illness. Your diet should include dairy products, vegetables and fruits, meats, fish, or legumes high in protein and cereals, bread, and liquids every day.
Watch for foods that cause watery discharges with cramps or partial obstruction of the small bowel. Some foods may tend to clump together to form a mass difficult to digest or expel. If this occurs, the ileostomy may squeeze out the water and retain the pulp. Nut, kernel corn, popcorn, coconut, Chinese vegetables, coleslaw and celery are among the trouble makers if eaten in large quantity. Many ileostomates find that these foods can be tolerated in small amounts if chewed well and eaten in combination with other foods. Experimenting is the only way to find out for sure.
Eat regularly. Skipping meals to avoid gas or discharge is unwise because your small intestine will be more active, and more gas and watery discharge might result. Some people find it best to eat a lesser amount of food four of five times a day.
Drink plenty of liquids. A minimum of one quart a day is recommended. Dehydration and loss of electrolytes are possible if not enough fluids are consumed in a day.
Foods which are difficult to digest such as whole corn, Chinese foods, skins or seeds, may appear in the pouch, undigested, if not chewed well. Medication in the form of coated tablets or time-release capsules may also come out whole in the pouch and be of no benefit at all. Beets will make ileostomy output turn a reddish color rather like blood, but there’s no harm done. Tomato juice and food dyes may change the usual color of ileal discharge as well. Tomato skins can also appear in the pouch. For some ileostomates, milk or large quantities of beer can cause a watery discharge, as can iced beverages.
How long is it before intestinal contents flow through the stoma after eating?
This varies with each individual. It may take anywhere from 20 minutes to several hours after eating. Some ileostomates find their movements occur regularly after eating; others find their movements are irregular. What you eat or drink, your mood, and your health may affect how long it takes, as does the length of the remaining ileum and many other personal characteristics of your digestive system.
CALCIUM AND VITAMIN D: BEYOND THE BONES
Via: Consumer Reports: On Health, Via: Great Falls MT, Bib Sky Informer & S. Brevard FL Ostomy Newsletter
A flurry of recent studies has strengthened the case for getting enough calcium and vitamin D—not just to bolster your bones, but possibly to fend off colon cancer, premenstrual syndrome (PMS), and other health problems.
In a four-year clinical trial involving people with colon polyps or precancerous growths, calcium supplements reduced the risk of new polyps 19%. Five years after that trial ended, researchers found an even greater reduction of 36%. A separate trial, published in 2003, found that calcium cut the polyp risk only if people consumed enough vitamin D, which boosts absorption of the mineral.
Women who ate or drank at least four servings a day of low-fat dairy products or fortified orange juice—good sources of both nutrients– were significantly less likely to develop PMS than those who seldom or never consumed them, according to an observational study from the University of Massachusetts in Amherst. Previous studies have shown that calcium supplements can relieve PMS.
Based on the results of eight clinical trials in older volunteers, average age 81, talking 700 to 800 international units (IU) of D– roughly twice the government’s recommended dose for that age group—reduced the risk of hip fracture by 26%, while the standard dose provided no protection. That finding supports our long-standing position that the need for vitamin D rises with age.
In addition, previous research has shown that adequate amounts of vitamin D may reduce the risk of several cancers and that calcium may help lower blood pressure. But despite the evidence of multiple benefits, most Americans fail to get enough of those vital nutrients.
At age 60, everyone should have 1500mg of Vitamin D. At age 55, we need more sun exposure or 600 to 1000 IU.
HELPFUL HINTS FROM HERE AND THERE
Zip-lock sandwich bags are useful and odor proof for disposal of used ostomy pouches.
Don’t get hung up on odors. There are some great sprays and internal deodorants…. Remember: everybody creates some odors in the bathroom. Don’t feel you are an exception.
Hydration and electrolyte balance is of vital importance. Be sure to drink enough fluids to maintain good hydration (ileostomates, especially).
Read and learn all you can about ostomies. You never know when you may find an opportunity to educate someone about the life-saving surgery that has extended so many lives. Learn to be matter of fact about this and never embarrassed.
In the beginning after surgery, almost everyone experiences some depression. If you fit into this category, you certainly are not alone. But, it need not be a lasting condition. Try something as simple as walking—long walks. If the depression seems to linger, don’t be afraid or ashamed to seek help. There is help out there!
Never wait until you’ve used your last appliance before ordering new ones. Keep a list of your equipment, complete with order numbers, sizes and manufacturers. Let a number of your family know where you keep the list so that they can get the necessary supplies in the event of an emergency.
Do not spread paste on the entire back of a barrier—it will produce less than satisfactory results. Use paste only sparingly to fill uneven areas and around the stoma. Paste is a great filler, if used correctly.
Use a round clothespin to roll up your tube of paste. (works for toothpaste tubes too.)
If you still have your rectum and have pain or a full feeling, you may have a collection of mucus which should be washed out. Check with your doctor regarding this.
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