Stoma Care

 

 

Living with a colostomy

Learning to live with a colostomy may seem like a big project. It is a lot like any other major change in your life. Starting a new job, moving to a new city, marriage, and having children are all examples of life changes that get easier over time. At first, you have to get used to the new aspects of these experiences and be open to the changes that are taking place. Having a positive outlook, patience, and a sense of humor are keys to adjusting to any life changes.

There may be times after surgery when you feel discouraged. You may feel alone andisolated. Because the whole experience is so new to you, you may feel awkward,frustrated, and uncertain. Feeling discouraged is real and normal. You might cry, be angry, and react in ways that are unusual for you. Talking to a trusted friend, nurse,clergy, and certainly another person with an ostomy may help you work through those feelings.

 

Your social life can be as active as it was before surgery. You can enjoy all the things you did before, such as travel, sporting events, and eating at restaurants. The first time you go out of the house after surgery, you may feel as if everyone is staring at your pouch even though it cannot be seen under your clothes. Remember, you may feel your pouch on your body, but no one can see it. You may also worry about your pouch filling with gas and bulging under your clothing. A quick trip to the rest room can take care of this problem. If you are worried about your pouch filling up right after eating at a social event, remember that people without colostomies often need to go to the rest room after eating. Nobody will think it unusual if you do the same. You will likely find that you need to empty your pouch less often than you need to urinate.

Telling others

You might be worried about how others will accept you and how your social role may  change.
It is natural to wonder how you will explain your surgery. Your friends and  relatives may ask questions about your operation. Tell them only as much as you want them to know. Do not feel as if you have to explain your surgery to everyone who asks. A clear, brief answer would be that you had abdominal surgery, or that you had part of your colon removed.

If you have children, answer their questions simply and truthfully. A simple explanation is often enough for them. Once you have explained what a colostomy is they may ask questions about it and want to see your stoma or the pouch. Talking about your surgery in a natural way will help get rid of any wrong ideas that they may have. They will accept your colostomy much the same way you do.

If you are single and dating, you can pick your time to tell a partner, but it might be better to do so early in a relationship. Stress the fact that this surgery was necessary and managing your colostomy does not affect your activities and enjoyment of life. This not only lessens your anxiety, but if there is an issue that cannot be overcome, the letdown isnot as harsh as it might be later. Do not wait until intimate sexual contact leads to discovery.

If you are considering marriage, talking with your future spouse about life with a colostomy and its effect on sex, children, and family acceptance will help correct any wrong ideas your partner may have. Going to an ostomy support group meeting together may also be helpful. Talking to other couples in which one partner has a colostomy will give you both an experienced point of view. See the section called "Intimacy and sexuality" for more information.

Clothing and appearance

You will not need special clothes. Colostomy pouches are fairly flat and hard to see under most clothing. The pressure of undergarments with elastic will not harm the stoma or prevent bowel function.

If you were sick before surgery, you may find you can now eat normally for the first time in years. As your appetite returns, you may gain weight. This can affect the clothes you choose more than the pouching system itself. Cotton knit or stretch underpants may give you extra support and security. A simple pouch cover adds comfort by absorbing body sweat and also keeps the plastic pouch from resting against your skin. Men can wear either boxer or jockey-type shorts.

 

 

Eating and digestion

Everything we eat and drink serves as building blocks for the body. To stay in good health ,the body

 needs carbohydrates, proteins, fats, minerals, and vitamins. Water is also a key part of good health. At least 8 to 10 8-ounce glasses of water a day is usually recommended. Having a balanced diet helps maintain good nutrition and keep the bowel'sac tivity normal.

There is no such thing as a colostomy diet. After healing is complete and the ostomy is working normally, most people with colostomies can return to foods they normally eat.Chew well and see how each food affects your colostomy. Those foods that have disagreed with you most of your life may still do so. If you are on a special diet because of heart disease, diabetes, or other health problems, you should ask your doctor about a diet that will work for you.

If you wear an appliance all the time, you will suffer no embarrassment if something you have eaten produces an unexpected discharge. You will soon learn which foods produce gas or odor, which cause diarrhea, and which lead to constipation. As you learn these things you can regulate the bowel's behavior to a large extent.
 

Returning to work

As your strength returns, you can go back to your regular activities. If you go back to work, you

may want to tell your employer or a good friend about your colostomy. Being open about it will help educate others. Keeping it a complete secret may cause practical problems.People with colostomies (sometimes called colostomates) can do most jobs. But heavy lifting may cause a stoma to herniate (the whole thing bulges outward) or prolapse (theinside falls outward). A sudden blow in the pouch area could cause the face plate to shift and cut the stoma. Still, there are colostomates who do heavy lifting, such as fire fighters,mechanics, and truck drivers. There are athletes who have stomas, too. Check with your doctor about your type of work. As with all major surgery, it will take time for you to regain strength after your operation. A letter from your doctor to your employer may be helpful should your employer have doubts about what you will be able to do.Sometimes people with a  colostomy find that their employer thinks the colostomy will keep them from doing their job. This also happens to some colostomates who are applying for new jobs.

Intimacy and sexuality

Sexual relationships and intimacy are important and fulfilling aspects of your life that 

should continue after ostomy surgery. But there is a period of adjustment after surgery.

Your attitude is a key factor in re-establishing sexual expression and intimacy. Sexual function in women is usually not changed, but sexual potency of men may sometimes be affected. (If so, this is usually only for a short time.) Talk to your doctor and/or ostomy nurse about any problems or concerns you or your partner might have. Any sexuality concerns you have are best discussed openly between you and your

partner. A stoma on your belly is quite a change in how you look and can make you feel anxious and self-conscious. It is likely that your partner may be anxious about sex, too, and may be afraid of hurting your stoma or dislodging the pouch. Talk to your partner about the fact that sex is not likely to harm the stoma. Try to be warm, tender, and patient with each other.The first time you become intimate after surgery things may not go perfectly. Men may have trouble getting and keeping an erection and women sometimes have pain during sex.

These problems usually get better with time. Your interest in sex is likely to return as your strength returns and you get better at managing your pouch system. Body contact during sex will usually not harm the stoma or loosen the pouch. If the pouch or stoma covering seems to be in the way during sex, try different positions or use small pillows to take pressure off the stoma.If possible, empty the pouch beforehand. Women may consider wearing crotchless panties, "teddies," or a short slip or nightie. Men may consider wearing a cummerbund around the midsection to secure the pouch. There are many types of pouch covers that can be purchased or you can make your own. Ostomy surgery may present more concerns for single people. When you choose to tell that special someone depends on the relationship. Brief casual dates may not need to know. If the relationship grows and is leading to physical intimacy, your partner needs to be told about the ostomy before a sexual experience.

 

Pregnancy

Pregnancy is possible for women who have had colostomy surgery. But before you plan

to get pregnant you should talk about it with your doctor. The colostomy itself is not a

reason to avoid pregnancy. If you are healthy, the risk during childbirth appears to be no

greater than for other mothers. Of course, any other health problems must be considered

and discussed with your doctor.

Exercise, play, and sports

Everyone needs daily exercise to keep good health and body function. An ostomy should

not keep you from exercising and playing sports. But there are a few safety measures you

should think about. Many doctors do not recommend contact sports because of possible

injury to the stoma from a severe blow, or because the pouching system may slip. But

special protection can help prevent these problems. Weight lifting could cause a hernia at

the stoma. Check with your doctor about such sports. Indeed, people with colostomies are

distance runners, weight lifters, skiers, swimmers, and take part in most other types of

athletics.

 

Bathing and swimming

Water will not hurt your colostomy. You can take a bath or shower with or without a 

pouching system in place. Normal exposure to air or contact with soap and water will noth arm the stoma. Soap will not irritate it and water will not flow in.You can swim with your pouching system in place. For sanitary reasons, you should usea s tick-on pouch when you go swimming in fresh water or in the ocean. Remember these points:

 

If you use a support ostomy belt, you can leave it on if you want to.

• You may want to protect the barrier by taping the edges with waterproof tape.
• You may want to choose a swim suit with a lining for a smoother profile. Dark colors or busy      patterns can also help hide the pouching system.
• Women may want to choose a suit with a well-placed skirt or ruffle.
• Men may want to try a suit with a higher waist band or longer leg.
• Women may wear stretch panties made especially for swim suits.
•  Men may want to wear bike shorts or a support garment sold in men's underwear  departments or athletic wear departments under their bathing suits.

Travel

All methods of travel are open to you. Many people with colostomies travel just like everyone else, this includes camping trips, cruises, and air travel. Here are some travel tips:

Take along enough supplies to last the entire trip plus some extras. Double what you hink you may need, because supplies may not be easy to get where you are going.

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Even if you don't expect to change your pouch, take along everything you need to do

so. Plastic bags with sealable tops may be used for pouch disposal. Leave home fully

prepared. Find out if and where you can get supplies before a long trip. A local

ostomy support group may be able to help you find ostomy supplies and local medical

professionals.

When traveling by plane, remember that checked-in luggage sometimes gets lost.

Carry an extra pouching system and other supplies on the plane with you. Small cosmetic bags with plastic linings or shaving kits work well. These should be kept in your carry-on luggage. Air travel security will generally let you take on all medicalsupplies.

To avoid problems with customs or luggage inspection, have a note from your doctor

stating that you need to carry ostomy supplies and medicine by hand. Further problems might be avoided by having this information translated into the languages of the countries you are visiting.

Traveller's diarrhea is a common problem for tourists in foreign countries, whether

you have an ostomy or not. The most common cause of diarrhea is impure water

and/or food. It may also be caused by changes in water, food, or climate. Don't eat

unpeeled fruits and raw vegetables. Be sure drinking water is safe. If the water is not

safe, do not use the ice either. Bottled water or boiled water is recommended, even for

brushing your teeth. Your doctor can give you a prescription for medicine to control

diarrhea. Get it filled before you leave so that you can take the medicine with you just

in case you need it.