The Stigma of a Stoma

It is an inevitable thing that people will stereotype other people who are different. It happens all the time and in many ways those stereotypes are correct, but it is a shame that it happens so often to those who have an ostomy.  The immediate thought is that they are untouchable or you shouldn't be close to them.  It really does hurt me on the inside to think about it and it is really only because of a lack of education on the general public.  My goal has always been to enlighten and not shun those who are ignorant or who follow their misconceptions.  Kindness when explaining and kindness when teaching a newcomer to the ostomy world is also a big part of the movement. For family members, this is extremely important.

When a person in your family goes through a surgery for an ostomy the family is part of it.  They need to be educated on how to keep their loved one safe and really most of all they need to be educated on the fact that their loved one is still the same person with really the same capabilities.  Yes, you are a more prone to hernias now that you have a stoma, but in general, with some training, most individuals live their life almost the exact same as before.  So letting the family know that vacations are still on, and beach time is still a go is not only important to the family dynamic but also to the individual who just had surgery.  Now I will say always listen to your healthcare provider because everyone's needs are different but in general, most people with an ostomy are fully capable of doing great and even crazy things.

Athletics are not off the table for people with a stoma.  In fact, there are even Iron Man finishers who have done it with a stoma.  That is an incredible feat as they are running a marathon, swimming several miles and biking 100 miles or so.  All in one day. That is incredible and if you can train your body to do that with an ostomy then truly anything is possible.  So take heart and have hope that all is not lost.  Now, most Ostomy Doctors and Nurses are amazing and give such good information on care and how you go about living a happy life.  I suggest listening to them and soaking up all the information even though it may feel a bit overwhelming.  Learn, take your time, and jump into how your stoma works and all the gear that you will use and then master it.  The faster you find what works best for your body the sooner you get to literally get back to doing your normal life.

For the most part, it is a big learning curve and then it is over.  The learning more about gear that will help you be more athletic and get in the water is a bit of a learning curve, but I suggest youtube and of course, your doctor first is a good source of information.  Follow people who live the lifestyle you have or want.  They can give you amazing tips on how to do the things you are interested in and to do them without your own personal fail curve.  Failing is a great part of life, but reinventing the wheel when the information is readily available is simply silly. So be safe and have fun!

Caring for an Ileostomy

Caring for an ileostomy is different than caring for a person with Crohn's Disease or Ulcerative Colitis. A person with one of these disorders does not have the typical bowel movements. 

Therefore, they do not produce the same amount of waste as someone with a normal healthy colon. When dealing with someone with one of these ailments, you need to consider their symptoms and what their colon is like. This can help you determine if you should be performing the surgery or not.

An ileostomy is a medical term meaning "at the opening." It is a permanent affliction where part of the small intestine is removed from the body. The pouching system that functions to keep bacteria and other toxins out of the body's large intestine is located here. The pouch is attached to the abdominal wall via the skin. When undergoing surgery, the doctor will cut a small hole in this area. They then connect this hole to a smaller opening on the abdominal wall to remove the pouch.

When a patient has an ileostomy due to Crohn's Disease or Ulcerative Colitis, their doctor may recommend removing part of the small intestine so that bowel movements can be more frequent. When dealing with a patient with one of these diseases, it is important to note that bowel movements can become very painful during this surgery. This pain usually comes from the area that is being removed. For this reason, a doctor may recommend surgery, even though it is not necessary. In addition, if the patient's condition worsens or does not improve after three to six months of the healing process, then surgery may be recommended.

Patients that have undergone a Crohn's Disease or Ulcerative Colitis procedure usually suffer from diarrhea, abdominal bloating, and/or constipation. Because of the nature of these diseases, it is possible to develop an intestinal obstruction (enteritis) after surgery. The area causes this intestinal obstruction that the intestines are attached to (the ileum). An ileostomy will make it possible for the doctor to create a large enough opening to remove the stools without the risk of infection easily. A large opening is also created so that the doctor can remove the stool from the small intestine.

After the colon is opened up via an ileostomy, the surgeon will use drainage techniques to clear the colon of feces. If these methods do not work, then the surgeon will make a small incision in the abdomen and insert a long tube (that looks like a small camera) that has a camera on the other end. This tube is hooked up to special tubing that empties the waste material from the colon via the ileum. This process happens very quickly, so the patient needs to follow the surgeon's instructions regarding bowel frequency after the surgery.

Suppose the patient feels any pain while passing bowel movements, or if there is something inside the anus that they are unsure about, they may need to have a colonoscopy. The colonoscopy is a non-invasive test that allows the surgeon to look inside the rectum to see any abnormal material present. An ileostomy nurse will be present during the trial to assist the surgeon with whatever they are doing. They may also be asked to empty the bowels while they are on the toilet. 

How IBD is Treated

Inflammatory bowel disease is a condition that needs to be managed to help with symptoms. 

There is no cure at the present moment, but there are good options for treatment, which include medications, changes to lifestyle, and surgery. 

Treatment also usually falls into two categories of IBD, Chron’s disease and UC. If you have what’s called indeterminate colitis, they may give you different treatments. 

The Prescription Treatments 

There are drugs that are used to be treated for IBD. 

The goal of these drugs is to help control the flare-ups, and also to keep the condition in remission so you don’t experience further flare-ups. 

Some drugs that are out there do involve 5-ASA drugs. Antibiotics, biologics, and corticosteroids. 

Usually, you can talk to your doctor about this. 

OTC therapies 

Over the counter treatments are also used. 

First, you’ve got fiber supplements, which is used for chronic moderate and mild diarrhea, and usually, this is Metamucil, or Citrucel, to help make the stool firmer. 

There are also anti-diarrheal medications, including Imodium A-D and others. 

If there is pain in your intestines and stomach, you may take OTC pain relievers to help with this, or even NSAIDs that can help with this condition. 

Another thing is iron, since intestinal bleeding does cause anemia, and you may need to take an iron supplement. Talk to the practitioner, and try to find liquid iron options, since this is non-binding to the intestines as well. 

And finally, IBD treated by steroids does need to have a calcium and vitamin D supplement.  Corticosteroids for Crohn’s disease does increase the risk for osteoporosis in women, and supplements will improve the bone density as well. 

Talk to your doctor before you take these in order to treat IBD in yourself. 

Lifestyle 

There are lifestyle changes that you can do too, which is basically your diet. 

You may need to eat a low residue diet for those who have structures in bowels or stenosis, since this can prevent intestinal blockage. 

You also may need to have a special diet through enteral nutrition, or interveinal nutrition. 

The feeding tube may be surgically placed or through the nose for a bit, and then after it’s placed, you can then just have this fed through a tube at home. 

There is also parenteral nutrition which is a liquid formula that you get through an IV, where it passes through the GI tract, and then goes into the bloodstream, where a catheter is placed on the vein by the heart, and then, you’re given nutrients. 

Surgeries 

Finally, there are surgeries that you can get if the medication is not working, or if there are complications for the condition. 

Crohn’s disease and UC are treated in different ways since this does affect the digestive tract differently. It eventually depends on the type of disease, the location, and how this is spread. 

It’s not a cure, and it may cause inflammation down the line. 

There are ostomies you can get, which is where they redirect the bowels out and away from the impacted area, but also a resection which is where they remove part of the inflamed area, and then he healthy tissue is then put together. 

They may even do a structureplasty, which is where scar tissue increases, and then, they usually remove the bad structure, and they open this up again. 

And of course, there is also a proctocolectomy, which ix what people get where they remove the large intestine, and then the connect the small intestine to the anus, to prevent needing a stoma in most typical cases. 

How likely is Crohn’s disease after a J Pouch

People who have IBD sometimes get treatment with J pouch surgery, where they have their colon partially or fully removed, and replaced with a pouch that’s attached to the anus. 

J pouch surgery is normally done for those with UC who struggle with this, but usually, it isn’t done for Crohn’s in particular.  That’s because they use the ileum for this, and it might become inflamed, to the point of pouch failure, and you might need an ileostomy to fix this, impacting your life quality. 

When Chron’s Gets Found 

In a few instances, those who are dealing with ulcerative colitis eventually are found to have Crohn’s, and usually, it can happen after they get a J pouch., albeit not common. The patients with Crohn’s disease may deal with this from the onset, even though tis was not part of your original diagnosis. Part of this because Crohn’s disease usually affects your large intestine, and the diagnosis may change over time. 

How common is Diagnosis? 

Because there are multiple surgeries for J pouches, there is always that concern of Crohn’s disease in a lot of cases. But it actually can be as low as about 1% to as high as about 13% in some cases, and usually, this isn’t as high as others expect it to be. Most of them is about 10% or lower in a lot of cases. Right now, the percentage is near 5%, but that’s because they can diagnose this before the IBD surgery in order to make sure that you get found. 

Is there a Way to Predict it? 

You may wonder if there is a way to predict it. Right now, there isn’t at the moment, but there is one study that shows patients who had ulcerative colitis at a younger age may have complications and have a Crohn’s disease diagnosis later on down the line, usually after they have a J pouch surgery. 

For young patients, it is actually more common to have “pouch failure” and eventually getting it removed, especially if there is a Crohn’s disease diagnosis later on. However, those who can have their pouch still will find that it does function well, and there is a difference in your quality of life between those who dealt with the surgery and those with ulcerative colitis still. 

So at the end of the day, it is something that could happen, but if your doctor takes care of the problem and gives the proper prognosis later on, you’ll be able to make sure that the IBD does improve over time, and usually, with the way surgeries are done, unless you’re young or have complications from surgery, you probably don’t have to worry about this. 

But that doesn’t’ mean you shouldn’t talk to the gastroenterologist, or your colorectal surgeon before this is completed, since it is important especially those who are young and have these kinds of complications. Usually, patients ask the surgeons before they start the amount of surgeries that they’ve had, and how many have ended up with a rediagnosis over time. 

But you should, even if the answer isn’t’ what you want to hear, fret be cause this actually isn’t as common as one may thing, and the cool thing about this is that over time, this is starting to improve as time goes on, and you’ll be able to, with this as well, improve your life, and the chances for this developing when you have IBD is starting to get less and less common, and it definitely does need to be talked about a little. 

OSTOMY POUCHING SYSTEMS

From the condition of having a conditionally wrecked biological system in your body like the bladder, there is the creation of stoma under your skin hence leakages of body waste are resultant. Therefore taking care of your skin condition involves taking extremely acute care in the use of the pouching systems in a bid to prevent skin problems that may come from leakages being in contact with the skin. These are the commonest and in a considerable way, quite effective in dealing with such kinds of body complications.

The use of these pouching systems should be carefully laid down, starting with knowing the correct sizes for use according to the skin stoma. Having a bigger pouching system gives a massive room for leaks to occur quickly and still a smaller one, may constrict your skin stoma hence digging it out and squeezing out leakages of the waste. Having the perfect fitting size, as advised by your medical professional, ensures all body wastes have a direct output in the ostomy pouching systems preventing resultant fat leakages.

The areas upon which the pouching system is to be placed upon should and must be clean and very dry and this is ensured by using relatively warm, clean water and later on, drying thoroughly after the clean-up to ensure the pouch healthily sticks around the stoma. It prevents skin irritations due to moisture from any leakages. Any moisture much irritates the skin and loosens the pouching system which provides room for leakages. This process is entirely vital and healthy for all patients with this kind of condition to ensure the pouching system does its work effectively.

 

When placing the pouch, you should ensure you do so in a way that will avoid any leakages under the skin, bringing about fatal results and irritations. For some specific skin conditions, the stoma is situated below the skin level and hence the obligation to use a convex pouching system that pushes it outwards and allows the extracted body waste to be dropped right into the bag and not trickling below the skin. Use of this convex pouching system without its prescription may be quite dangerous and fatal, especially if your condition does not require its use. Without any other prevailing conditions, the use of a standard pouching system should be useful in its work.

 

Since these pouching systems get used over a short period since waste removal is a continuous biological process in the body, they often need renewal. The pouching system, during removal, should involve the use of an adhesive remover to avoid damages to the areas faced with the skin condition. The adhesive remover should and must be prescribed by your health professional to ensure they assist you in any questions and clarifications needed for their use. The removal of the pouching system is a very key, and critical process as careless dealing with it may lead to fatal results from leakages.

 

Without forgetting leakages that may occur under your pouching system and as a result bring about adverse effects to the skin, a way has been sought to seal this problem. The use of a paste or rather a barrier hoop may be used to fill out any edges on your skin and uneven cracks around the stoma area of the skin. These go a long way to ensure the output of body waste is done correctly and deposited in the right place.

 

Managing Your Recovery From Stoma Surgery

A stoma is any hold that opens into the human body; the plural form of the word is stomata. Occasionally artificial stoma is used surgically to treat different health conditions. Recovering from stoma surgery can take a little while, but as long as you do what is necessary, it should not be a problem.

Stoma Appearance And Pain Management

The first few dozen days after your surgery, the stoma will be swollen and large. It could even start to use bodily fluids. Over the first couple of months after your stoma surgery, it will reduce in size significantly.

Most patients are given control over analgesic medication after their surgery with a patient control button.

These allow you to control the painkillers' level in your body to manage pain post-surgery effectively.

Immediately After Your Surgery

When you wake up from your surgery, you can expect to be in the hospital for 1 to 2 weeks recovering. You will be discharged once your new stoma is functioning correctly. During the time you are at the hospital, the nurses and doctors will help teach you how to take care of yourself.

Learning How To Take Care Of Yourself

Eating and drinking need a bit of relearning after stoma surgery. Immediately after surgery, you will likely only be able to digest liquids.

Over a few days, your gastrointestinal system will come back online. Some foods that are difficult to digest are essential to avoid if you have a stoma. These can include things like popcorn or potato skins.

Moving Around Again

Avoid the temptation to just lay around in bed all day after your surgery. The quicker you get up and moving again, the faster your recovery will be. It is normal to feel a little weak after your surgery, but you should regain your strength quickly.

What To Expect Once You Arrive Back Home

When you get back home, expect to still feel soreness around your stoma and bowels. Do not live over actively for the first few weeks after leaving the hospital. Eight weeks is the typical length of time for a full stoma surgery recovery.

Exercise Precautions

Lifting heavy weights is important to avoid for at least the first eight weeks after your surgery. If you raise more than 10 pounds, your chances of creating a hernia at the stoma site are extraordinarily elevated and can cause future issues if the stoma ruptures.

Showers And Baths

When you take a shower or a bath, it is your choice to leave your stoma back on or off. You do need to make sure that any bath products you use do not leave any remaining fits behind on your skin, or it could interfere with the functioning of your ostomy wafer.

Changing Your Stoma Bag

It would be best if you had been taught how to change your stoma bag at the hospital. Make sure to regularly take measurements during your first few weeks home to monitor the size changes. Ensure you have an excellent hermetic seal around your stoma to prevent your banks from leaking when you change them.

 

Going into regular office work with your new stoma

I have been a fan of working in all kinds of locations and doing lots of different things.  I now enjoy the fact that I have a great office view and that I am able to walk around and simply enjoy my day how I want.  But most people don't have that luxury.  In fact, most people work in a cubicle in a dark damp place.  That is in the United States, so what kind of life do you want to live. I don't want to ever spend 9 to 12 hours a day in a closet.   For most of us we will say some sort of America Dream jargon and always say live life to the fullest. That is not possible for many or at some times in your life.  I would absolutely agree that you should be able to live the life you want to no matter what that is and not let the fact that you have a stoma get in the way.  If you have a stoma then some medical conditions can in some ways really limit your life but for most people who have had an ostomy their lives are normal, active, and fulfilling.  I always try to give people positive news and a good outlook on their future.  To me having a stoma has not hurt my regular workings of life.  Unless you are told by your healthcare provider that you shouldn't be out and active, then you should find ways to live life to the best of your ability.  Don't let a simple thing that has an insanely good gear in 2021 keep you from living your best life.

The research I have done has allowed me to live a wild and adventurous life outside of work.  It has also allowed me to enjoy my office and go play a game of pool and not have to worry about my ostomy bag.  I have found that by using quality gear you are able to not worry about your stoma nearly as much. To me, this is because you have less anxiety rather things will go wrong.  There are a ton of companies I buy gear from. 

Each of them is for different reasons and before I sound like a marketing commercial just know that I like to use multiple companies and mostly because they have nice customer service and good quality control.  In my life, most companies live and die in my mind off those two areas because those areas are what can cause conflict.  If something goes wrong and gets taken care of is what drives my opinion on a company.  So if the product has great quality control then it is likely I won't have to deal with Customer Service in a negative light and only contact to ask questions. But if something goes wrong and customer service is fast, polite and understanding thanI won't have a negative feeling and will continue to use the company.  I have found both to be outstanding and that is why I am a loyal customer to the companies who treat me the best.

This matters when I need gear every second of the day.  I want to know I am safe and now going to work is a daily thing and to me being comfortable is a big deal. I generally work at a desk now and I like to make sure my body won't be in pain during the day.