Allergy to Appliances – April 2019

Question:

Perhaps you can shed some light on how I should handle this ongoing problem.

I have an allergic reaction to the adhesive on most appliances.
How am I to handle this? Not wearing a bag is not an option.

Any thoughts?

Thank you

Response:

My first recommendation is to contact a NSWOC (Nurses Specialized in Wound, Ostomy and Continence), in your area. If you do not already have a NSWOC, you can find a nurse closest to you by the following instructions:

Go to Ostomy Canada Society official website – OstomyCanada.ca
When the webpage opens you will notice the banner at the top of the page, look for “Support”, and click on it.
Another window page will pop up on the screen.
Click on “Find a NSWOC”
A subsequent page will pop up on the screen indicating – “Find a NSWOC”, click.
A “search form” page will show, follow the instructions on the form.

When you have a consultation, the NSWOC nurse will examine you to determine if in fact you are experiencing an allergic reaction, or if you are experiencing a yeast infection for example, and so on. Depending on the outcome of an examination, the NSWOC professional will then provide you with recommendations such as; skin prep products that may help you.

If you are taking particular medications they can cause side effects such as itching, this could be another potential source of your skin sensitivity issue.

Use plain soap and water (no perfumes), to clean the area. Also, make sure the area is dry before applying the appliance wafer. You may want to try keeping it simple around the stoma sight until you have researched your options, and change your wafer every few days until the problem is under control.

The various ostomy equipment manufacturers are very helpful in providing free samples of their products and will ship them to you free of charge. When you contact the companies they will provide you with a knowledgable professional who will discuss your sensitive skin issue with you. Depending on the outcome of the consultation, they will then recommend various appliance samples that you can try. Possibly they have an appliance that you will not be as skin sensitive to.

Wishing you the best in finding the most effective approach for supporting the health of your sensitive skin.

Jo-Ann

Jo-Ann L. Tremblay
THE OSTOMY FACTOR Blog-joannltremblay.wordpress.com
FACEBOOK – Author Jo-Ann L. Tremblay
TWITTER @joanntremblay
Author of “The Self-Coaching Toolbox”, “Better With A Bag Than In A Bag” & “Another BAG Another DAY”
amazon.com, amazon.ca, amazon.co.uk
Member OstomyCanada /Medical Advisory Committee Member-
Ostomy Lifestyle Expert
Member Arteast – www.arteastottawa.com
Website: jo-annltremblay.com

Support Groups – April 2019

Question:

Hello,
Please help me find an ostomy support group in my area of Stouffville. I am about to undergo the surgery and would like to talk to other patients like myself.
Thank you.

Response:

The Ostomy Canada Society is pleased to assist in all ostomy Chapters and Support Groups inquiries, by providing a very useful support web page.

Instructions:

Go to Ostomy Canada Society official website – OstomyCanada.ca
When the webpage opens you will notice the top banner, now look for “Support”, and click on it.
Another window page will pop up on the screen.
Click on “Find Your Local Ostomy Support Group”
A subsequent page will show on the screen titled – “Ostomy Chapter and Support Groups”

The information on this page will direct you to the Chapter and Support Group details throughout Canada. Look for the information details that will direct you to your Province, click, and then a more detailed list and the map will pop up. You will then be able to identify and contact the Chapter/Support closest to your home location.

Your local Support Group members will be pleased to assist you, and we all wish you a speedy recovery.

Jo-Ann

Jo-Ann L. Tremblay
THE OSTOMY FACTOR Blog-joannltremblay.wordpress.com
FACEBOOK – Author Jo-Ann L. Tremblay
TWITTER @joanntremblay
Author of “The Self-Coaching Toolbox” , “Better With A Bag Than In A Bag” & “Another BAG Another DAY”
amazon.com, amazon.ca, amazon.co.uk
Member OstomyCanada /Medical Advisory Committee Member-
Ostomy Lifestyle Expert
Member Arteast – www.arteastottawa.com
Website: jo-annltremblay.com

Ileostomy – diarrhea after reversal – April 2019

Question:

I had an ileostomy for 9 months. Then, in January 2018 it was reversed. Still diarrhea every single day. I’d like to ask if there is any rehabilitation for people in the same situation?

Response:

Managing Changes in Bowel Function

The first recommendation would be to discuss your bowel movement concerns with your physician. They may prescribe anti-diarrhea medication that you can take as directed, and possibly suggest rehabilitation.

Our rectum is the storage tank for stool (poop). Depending on what was required during your original surgery, your storage tank (rectum), may be smaller. If this is the case, over time, your rectum will stretch and be able to hold more stool. This process can take months to years. After surgery, you will have a lot of bowel movements. This is because the lower part of your colon hasn’t been used in a while. It will take time for your body to recover.

The following are some suggestions and tips

You need to drink a variety of liquids, not just water. Water does not contain potassium or sodium that your body loses when you have diarrhea and when you sweat.

There are foods that you may want to limit or avoid such as; dairy products, including milk, cheese, and ice cream. Coffee, chocolate, spicy foods, fried foods, gravies and cream sauces, high-fat deli meats, greasy meats such as sausage/bacon, fruit juices.

Following the BRAT diet can also help control frequent bowel movements. The BRAT diet is made up mostly of:

Bananas (B)
White rice (R)
Applesauce (A)
Toast (T)

Drinking black tea can also help.

Sometimes separating food from liquids when you eat can help to slow the bowels and passage of stool. If you drink large amounts of liquid with your meals, food may move through you more quickly. While you are eating, try to take only a few sips to help you swallow, and then drink the majority of liquid 30 minutes later.

Other helpful hint:

When you have the urge to have a bowel movement, use deep breathing and sphincter tightening (Kegel exercises). Kegel Exercises – Tighten your anal muscle or sphincter as if you are trying to prevent a bowel movement. Hold for a count of 10 while squeezing tightly. Then relax for a count of 10. Repeat each step 10 times to make one set of exercises. You can do up to 4 sets a day or more.

Jo-Ann

Rectal Leakage

January 2019

Question:

Hello. On April 24, 2018, I had surgery to section my upper rectum due to cancer. I have had an ileostomy, since then surgery to re-sect has been delayed by slow healing at the surgical site. Initially after surgery I had a lot of mucous leakage through the rectum … several months but by the fall, it became very sporadic. There were a couple of bouts of a week or so and then it would stop. In Dec it virtually disappeared. About three weeks ago it came back with a vengeance. I now try to empty it 5 or 6 times a day but it has greatly restricted my activities because I’m never sure when it will occur other than it happens when I get up from sitting or lying. I’m wondering if this is common. My specialist has no answer for why the stops and starts have occurred. Thinks it may be gathering where the section hasn’t healed?? But why now and not two months ago. I am told there is no food intake … type of food etc… connection. Wondering about meds. It started around the time I went on a new antibiotic but that ended a week ago. I take a sleeping pill but have since the start. I am hoping this is a come and go thing but starting to wonder this time. Any advice or history you can relate to assist me.

Response:

Discharge from the rectal stump is normal. The intestine is not connected, but it still keeps producing mucus. In some cases, a person will have a stoma but will also still have their rectum, and there will still be a discharge where the rectum and the anus are. How often there is a need to empty some fluid out of the rectum, and why, will vary from person to person. This is a normal expected occurrence, and is nothing to be worried about. However, if the discharge is bloody or smelly, this should be discussed with a Doctor.

The rectum is living tissue, and it will continue to produce mucus even though a person has a stoma, and stool is not currently passing through it. Mucus is a liquid produced by the lining of the bowel that acts as a lubricant, helping the passage of stools, and is a normal part of stool. It’s still produced even though it no longer serves any purpose. In the absence of any stool, the mucus passing through the rectum becomes readily apparent. The mucus can vary from a clear “egg white” to a sticky, glue-like consistency. The amount and frequency of mucus discharge is individual to each person.

Some people feel that they can relieve mucus output from the rectum by sitting on the toilet and passing it as one would pass stool. Some people suggest using gauze or a sanitary napkin worn in the undergarments to help catch unexpected leaks. It may also help with leaks to periodically sit on the toilet and try to expel the mucus, even before feeling the need to pass it.

If the mucus has a foul odour, or is green or yellow in colour, you will want to have this investigated by a physician. In addition, call your Doctor if you find that you are experiencing any pain or other symptoms connected with the rectum or the passing of mucus.

As the amount of and frequency of mucus discharge varies from person to person, and from time to time, you have investigated this with your Doctor and so, this is a come and go thing for you.

Jo-Ann

Pancaking

January, 2019

Question:

I have had surgery on November 20, 2018, to remove rectal cancer. I am now dealing with a colostomy, the removal of my rectum, the reconstruction of my vagina and skin grafts. The recovery is slow. I am having issues because my stools are very dense and heavy which leads to pancaking and leaking. I have tried lubricants and baby oil to no avail. I am having a very hard time emptying the bag as well because it is so very compact. I am not sure what to do to deal with this. Any advice would be appreciated. Thank you.

Response:

I often have to deal with the issue of pancaking, and it is frustrating. Pancaking is a situation when the output collects around the stoma and can squeeze between the flange and the skin instead of going into your bag. One of the reasons this happens is because there isn’t enough air in the bag and so the output doesn’t take a downwards turn.

It is often recommended and as you have indicated, for some people the lubrication of baby oil or one of the many products available from the various supply companies can help. Some ostomates squirt a little oil or gel in their bag and give it a good rub around before they stick it on.

Another possible approach is to check to see if you’re wearing cloths that are tight fitting in the stoma area as this can also cause pancaking. You may want to try to wear looser fitting clothing in order to prevent a vacuum forming inside the bag. Also, in terms of clothing, make note of where your waistband or belt sits. Does it allow the stool to drop into the pouch or does it restrict the stool so the stool gathers only at the top. Monitor your body positions. If you are sitting for long periods for example driving or at the computer, does the pouch fold onto itself not allowing the stool to drop but remain in the top part of the pouch?

If the pouch has a filter in it, block the filter by either using waterproof tape or the ” tabs” that come in the box of pouches. This will leave air in the pouch, preventing the vacuum effect and allow to stool to drop into the pouch.

Another reason for pancaking is that your output is thick. Each person is an individual and so, each of us has trigger foods that can cause digestion processing issues, and stool issues. It would be helpful to consult your physician for a referral to a nutritionist or dietician to assist you in identifying foods that will work best for you.

Jo-Ann