Enjoy a trouble-free transit with these travel tips.

If you’re traveling by airplane, car, bus, train, or cruise ship, you might be stressed about your ostomy needs during the trip. Don’t worry. With a little preparation, everything can go smoothly.

It’s also a good idea to start with short trips away from home to build up your confidence. Once you’re reassured that your pouching system stays secure during normal day-to-day activities, you can start to venture farther.

Here are a few tips to help you be fully prepared and comfortable, no matter how you travel.

Luggage weight limits: Are you traveling by air with a lot of supplies? Check with your airline and your country’s federal travel agency (e.g., the Transportation Security Administration in the United States) for the luggage weight limit. Weigh the luggage before you go. It may be helpful to use a portable luggage scale. If you’re over the limit, check to see if your airline has a special allowance for medical supplies.

Forbidden items: The International Air Transport Association (IATA) forbids dangerous items on board airplanes. For example, ether, methylated spirits, or flammable aerosol adhesives and removers are considered fire hazards. Scissors also may not be allowed in carry-on luggage – check with your airline or pre-cut all of your skin barriers before traveling.

Pre-boarding security checks: At airports, your carry-on luggage will be inspected at the security baggage check before boarding. If you have medications, get a card from your healthcare professional that explains why you need them. Some countries do not allow certain medications, such as codeine, to cross their borders. A travel communications card from an ostomy association in your country may also be available. United Ostomy Associations of America (UOAA) offers a travel card to help you be ready for searches or checkpoint questions.

Using airplane toilets: During a long flight, there can be long lines for toilets, especially after meals. Be alert for a chance to use the toilet when most people are in their seats. It’s also a good idea to request a seat near a toilet.

Car travel: Your car seat belt should sit across your hip bone and pelvis, not your abdomen and stoma. If you want to give your stoma extra protection from the strap, you can buy a seat belt pad. You can also use an extension bracket to lower the angle of the belt across your body.

Cruising with a stoma: Are you worried about taking a river, lake, or ocean cruise? Don’t be. If you’ll be away from land for a few days or more, just pack double the supplies you need. Plus, follow these simple precautions and you’ll have a trouble-free voyage.

View or print the full PDF booklet Living with an Ostomy: Travel from Hollister.com.

For similar articles on traveling with an ostomy and other topics, visit the Hollister Ostomy Care Learning Center.

Editor’s note: This educational article is from one of our digital sponsors, Hollister Incorporated. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

Whether Temporary or Permanent UOAA information and Support can help you Succeed in Life with an Ostomy.

By Ed Pfueller, UOAA

March is Colorectal Cancer Awareness Month. Colorectal cancer often has no warning signs or symptoms, and it affects more than 140,000 men and women each year. It is largely preventable with screening and treatable if caught early.

What can you do? Congress has introduced a bill Removing Barriers to Colorectal Cancer Screening Act (S668/H.R.1570). This act would fix a problem in Medicare that is a major deterrent to senior citizens getting screened. Currently, Medicare covers screening colonoscopies at no cost to the patient, but if polyps are removed during the screening procedure, beneficiaries are hit with unexpected costs.  Ouch!  This bill waives Medicare coinsurance requirements with respect to colorectal cancer screening tests, regardless of the code billed for a resulting diagnosis or procedure.

You can click here to help UOAA and other advocacy organizations advocate for final passage of this legislation in 2019.

You’ll also find that colorectal cancer survivors engage with United Ostomy Associations of America (UOAA) all year long.

If your cancer requires surgery you may have been told you’ll need an ostomy. In many cases, this is a temporary ileostomy (from the small intestine) or colostomy (large intestine). This may be required to give a portion of the bowel a chance to rest and heal. When healing has occurred, the colostomy can often be reversed and normal bowel function restored. A permanent colostomy may be required however when a disease affects the end part of the colon or rectum.

A colostomy is a surgically created opening in the abdomen in which a piece of the colon (large intestine) is brought outside the abdominal wall to create a stoma through which digested food passes into an external pouching system. A colostomy is created when a portion of the colon or rectum is removed due to a disease process such as colorectal cancer or a damaged area of the colon.

If you need lifesaving ostomy surgery remember-you are not alone. 725,000- 1 million people in the U.S. of all ages and backgrounds live with an ostomy. You too can do this, but it is critical to connect with UOAA resources. Especially seek out one of our almost 300 UOAA Affiliated Ostomy Support Groups in the U.S. before, or shortly after, your surgery. Peer support and preparation can put you on the path to success in what will be a challenging time both emotionally and physically.  Ask if the hospital has an ostomy nurse and insist on having your stoma placement marked before surgery. These and other self-advocacy tools are paramount and outlined in our Ostomy Patient Bill of Rights.

Our new ostomy patient guide is available to all who need it and is a great overview of what to expect. Our colostomy guide has even more in-depth information. You may feel too overwhelmed as you are discharged at the hospital to fully understand ostomy pouching systems and accessories and lifestyle considerations. If you have a question medical contact your doctor or nurse, in you have a quality of life question- UOAA likely has the answers.

Let’s clear up a few myths right from the start and learn some facts about living with an ostomy. After the healing period outlined by your surgeon you can swim, bathe, be intimate, travel, and embrace a new normal life. After some trial and error, you may also eat most of the foods you have been able to eat in the past.

Certified Wound Ostomy and Continent Nurse Diana Gallagher has outlined Tips for a Succesful Recovery After Ostomy Surgery for us that you should use as a roadmap for success.

Contrary to what it may seem from social media not everyone with an ostomy will be a candidate for a reversal operation. We also have a blog post to learn more Facts About Ostomy Reversals.

We do encourage you to read patient stories and tell your own story. People have ostomies for a wide variety of reasons and people with bowel diseases you may not have been aware of often have an increased risk for colorectal cancer. This includes ulcerative colitis, Crohn’s disease, pre-cancerous polyps, and hereditary syndromes such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC), or Lynch syndrome.

Celebrate Colorectal Cancer Awareness Month and connect with Fight Colorectal Cancer or the Colon Cancer Alliance on how to make an impact. And even if your ostomy is temporary, remember to speak out on Ostomy Awareness Day on October 5th, donate or join our advocacy efforts, or a support group to give back to the next cancer survivor in need.

UOAA is proud to be a member organization of the National Colorectal Cancer Roundtable (NCCRT). The NCCRT is a collaborative partnership with more than 100 member organizations across the nation, committed to taking action in the screening, prevention, and early detection of colorectal cancer.

Support Made the Difference Before Reversal

I was halfway through a 10-hour drive home to Lancaster County PA from Dayton, where I’d just finished a Relay For Life, when I felt the first pains in my lower left side. Thinking they were just cramps, I shrugged them off and kept driving. The cramps persisted though, so I popped a few Naproxen and tried to put my mind on something else.

Eventually I decided to stop at a hotel and sleep it off, then worry about it later. Whatever it was, I couldn’t do anything about it now, I’d call my doctor when I got home. A hospital “just happened” to be next to the hotel I chose, after bypassing 4 others.

When I checked in, though, I was so cramped up that I couldn’t even stand straight. I was sweating, weak, and had a bout of diarrhea. I had always been pretty healthy, so I had no frame of reference for what was going on with me. I figured I had a flu bug or maybe a cyst. I tried eating, taking a shower, more Naproxen, but nothing helped.

Finally at 1:23 am I felt a compulsion to go to the ER. I had no idea what was going on with me but I knew I needed to be checked out. After being checked in, I had a CT scan. The surgeon came back to me himself and announced that I had a ruptured colon and that I was going to have to go into emergency surgery. He could either sew it up or I’d have to have a colostomy.

I had never had issues with my colon and thought colostomies were for “old people”. Alone, still 4 hours from home, I had no clue what I was in for.

I woke up hours later in a drugged daze. The surgeon came in to say that he’d had to do the colostomy. “The hole was so big I could put my thumb through it!” he said in amazement. I looked down at my left side to see this new, strange thing called a colostomy bag attached to me. How was I going to live with this?

At home, I connected with several different sources that I couldn’t have done without. A home health care nurse who showed me how to use and live with the bag, a WOC nurse who educated me, an online support group with fellow ostomates, who were always there for tips or to hear me vent.

I thought my life would be suppressed. But I was still able to swim, jog, bike, go out to eat, travel, and all the others things I did before.

I was fortunate to have a reversal three months later. I recovered quickly with no further health issues. I have a scar, but it reminds me to be thankful for the surgeon, nurses, and support group people who helped me along the way-I could not have done it without them.

Learn more about Jennifer’s story before and after her emergency surgery on her blog.

By Karin, Newbieostomy

Whether you’ve been a part of the ostomy community for 20+ years or joined it yesterday, United Ostomy Associations of America’s (UOAA) National Conference is worth attending. There are two main themes that come up time and time again when talking to people about their experiences at the conference: education and friendship. You can read about the bonds that are formed at the UOAA conference in the post Ostomy Camaraderie.

Regarding education, it doesn’t matter if you just got your ostomy or you’ve had it for years, there’s always something new to learn because technology advances and our bodies change over time. If you’re like me, you’ve scoured the internet looking for answers to all your questions and have probably found quite a few answers hopefully here on ostomy.org or on my blog newbieostomy.com, but you might still have some other questions that are left unanswered.

Queue UOAA’s National Conference. Held every two years UOAA does a fabulous job of bringing in professionals to share the most up-to-date research and information. At the last conference in Irvine, California they brought in doctors, surgeons, WOC nurses, nurses who also have an ostomy, a geneticist, a pharmacist, a psychologist, scientists, a dietician, TSA officials, and people with inspiring stories, and probably others that I’ve missed – all who are happy to answer your specific questions and share their knowledge. That’s quite a toolbox for us ostomates to have all in one place! Here is a tentative program of what to expect at the upcoming conference August 6-10, 2019 in Philadelphia, PA.

Conference attendees speaking directly to TSA agents about traveling with an ostomy.

This year there are even suggested sessions and reserved meeting space for people with similarities. There is a Young Adult Track (Discount if 25 and under), Pediatrics Track and a Caregivers Track, so feel free to bring your family or partner along as well.

As a first-timer it was great, so much info.” – Eric, first-timer

I lean toward the studious side, so I brought a notepad and paper to every session I attended to help me soak up and remember as much knowledge as possible. In addition to (or in lieu of) taking notes during sessions, I’ve taken pictures of the slides I thought were really valuable.

Don’t want to draw attention to yourself with your hefty notebook or by holding your camera up every time there’s a new slide? Some speakers might also be willing to share their powerpoint presentations with you if you reach out to them after the event, or they might let you record the sessions if you get there early enough to ask permission.

I have learned more in these few days than I have in the almost 6 years with my permanent ostomy. – Daniel, first-timer

Wow. Right?

That’s pretty powerful.

With dozens of sessions offered, it’s can be hard to choose which one to go to if a couple of them conflict with each other. Luckily, each person has their own needs and interests so it’s likely that someone you know will go to a different session from you, which gives you both an opportunity to share what you’ve learned.

You might think that the sessions are only useful to a first timer, but not so. Derek has gone to every conference and has had his ostomy for almost 20 years, yet he still chooses to attend the “Basic Colostomy” session because there’s always something to learn and the other people who attend might ask a question he hasn’t thought of. While there are many repeat (basics) sessions offered every conference, the UOAA does a great job of bringing in new speakers to talk on different subjects as well. This year UOAA is also highlighting talks that will be of interest to both the new and experienced ostomate.

Like Derek, I also found value in the sessions from this conference even though I went to a ton of sessions at my first conference in 2015. I was happy to see new sessions offered, and to be able to attend a couple sessions that had conflicted with something else I’d prioritized hearing. I went to at least one repeat session that I noticed was really similar, but even there, I felt like I gained new knowledge and perspective because my brain can only hold so much information (even if we take notes).

In addition to attending the educational sessions and exploring the ostomy product exhibit hall, there was a hospitality area open every day where you could put a pushpin in the map of the United States to show where you’d come from, ask questions of local volunteers, and talk to members of the UOAA Advocacy and Communications team. There was also a free stoma clinic where attendees could sign up for an appointment to meet with a WOC nurse to troubleshoot pouching and skin troubles. On top of that, there were great speakers at the opening and closing ceremonies, and a really fun closing night party complete with dessert, dancing, and a perfectly executed fashion show.

This year the conference is at the Philadelphia 201 Hotel in the heart of the city and there are even more social events such as a free improv comedy show and music act, a Roaring 1920s Casino Night, and plenty of free time to explore an awesome city with new friends.

Living with 2 Ostomies Since 1974

Jearlean Taylor has never known life without an ostomy. She has had two ostomies (colostomy and urostomy) since she was just two years old. But with the support of her family and her own inner drive, she triumphed to become a successful model, author and businessperson. Here she shares her story and offers ostomy fashion tips that work—both on and off the runway.

Dressing Up and Looking Great

Maybe you don’t want to be a fashion model. Maybe you just want to look good at your friend’s party this weekend. Here are some practical fashion tips Jearlean learned from the modeling business that work in everyday life, too.

When in doubt, try it on.

“Maybe not every outfit will work for your ostomy, but something will. If you like something, try it on. You may be surprised.”

You can make anything fashionable.

“Sometimes I throw on a scarf with an outfit. I might put a belt around my waist. Even when it may seem strange or crazy, I put an outfit on to see if it makes me feel confident.”

Find the right jeans.

“A lot of people want to get back in their jeans again. If you’re anxious to get back into jeans right after surgery, try maternity jeans; they stretch and put less pressure on your pouch as you get comfortable with your ostomy.”

Fashion-friendly wraps.

“Some ostomy wraps have a pocket on the inside that securely fits your pouch and keeps it flat against your abdomen to help relieve the pressure of your pouch filling. This is helpful when you’re wearing certain kinds of clothes.”

Feel good about yourself.

“No matter who you are, you’re beautiful. You’re carefully and wonderfully made. You’re a designer original. There’s nobody like you.”

 

Have questions about living with a colostomy, ileostomy or urostomy?

ConvaTec’s expert team of me+™ ostomy nurses and product specialists is only a phone call away.

Call: 1-800-422-8811 (M‍onday-F‍riday, 8‍:30am-7:‍00pm ET)

Email: cic@convatec.com

Editor’s note: This educational article is from one of our digital sponsors, ConvaTec. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

Learn how to spot peristomal skin irritation and damage.

 

After your ostomy surgery, your healthcare team likely taught you how to care for your peristomal skin and what it should look like when it is healthy. Ideally, it should be intact without irritation, rash, or redness. The skin around your stoma should look just like the skin on the other side of your abdomen, or anywhere else on your body, free of redness, irritation, or damage. Healthy skin should be the rule, not the exception.

However, if your peristomal skin is irritated or damaged, there may be some signs of a peristomal skin complication (PSC), such as:

  1. Discomfort, itching, soreness, or even pain around the stoma
  2. Recurrent leakage under your pouching system or skin barrier
  3. Excessive bleeding of your stoma – it’s normal for your stoma to slightly bleed after you wash it, but the bleeding should resolve quickly
  4. A bulge in the skin around your stoma
  5. Skin color changes from normal pink or red to pale, bluish purple, or black
  6. A rash around the stoma that is red, or red with bumps – this may be due to a skin infection or sensitivity, or even leakage
  7. Wart-like, pimple-like or blister-like bumps under the skin barrier – this type of irritation can happen any time, even if you’ve used the same product for months or years
  8. Any type of wound or scratch on the peristomal skin

Peristomal Skin Complications — Potential causes and what to do

Irritated and damaged peristomal skin can occur for a variety of reasons. It can be caused by anything from a poor-fitting pouching system, to frequent skin barrier changes, to an allergic reaction to anything that contacts the skin, such as soaps or products used to prepare the peristomal skin. Some studies report up to 75 percent of people with an ostomy experience a PSC.* Although it is a common issue, it should not be ignored.

If you experience any signs of a PSC, contact your stoma care nurse. You should work with your healthcare team to determine the exact cause and the appropriate solution.

For more information on maintaining healthy skin and other topics, click here to visit the Hollister Ostomy Learning Center.

 

* Rapp CG, L Richbourg, JM Thorne. Difficulties Experienced by the Ostomate After Hospital Discharge. JWOCN. 2007;34(1):70-79.

The information provided herein is not medical advice and is not intended to substitute for the advice of your personal physician or other healthcare provider. This information should not be used to seek help in a medical emergency. If you experience a medical emergency, seek medical treatment in person immediately.

Editor’s note: This educational article is from one of our digital sponsors, Hollister Incorporated. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

You may have questions about your ostomy, how to care for your stoma, and how to keep living the life you want to live – but you don’t have to figure it out on your own. Hollister Secure Start services offer free support for people living with an ostomy, regardless of the brand of products used. Below are five common questions we are asked from people in the ostomy community like you.

I’m having leakage under my pouching system.

To help solve the issue, we would ask several questions including the current pouching system being used, and the frequency of it being changed. Other questions that would assist us in problem solving might be—How are you preparing your skin before putting on your pouch? If the products are not being properly applied, it could cause adherence issues. Are you cleaning out your pouch or do you put anything in it? Most important, where is the leakage occurring? If it’s always in the same area, evaluate the area for any creases or uneven surfaces such as scar tissue, incisions, or your belly button that may cause an uneven surface under the barrier. If this is the cause, you might try a barrier ring as a filler to even out the surface area. However, make sure that the stoma size is correct in the barrier. You’ll know it’s a correct fit when the barrier fits where the skin and the stoma meet. There should be no skin exposed between the stoma and the opening of the barrier.

 

My skin is irritated and weepy.

This can be a problem for many people with an ostomy. A person should not have skin breakdown, open wounds, or a rash under the barrier. Where exactly is the skin breaking down? How long has it been going on? Is there a situation that may have led to this irritation, such as leakage or was your barrier removed too quickly? What product are you using to prepare your skin for the barrier? Try using stoma powder to absorb moisture from broken skin around the stoma, which may help allow the skin barrier to get better adherence. The cause of the skin irritation needs to be addressed in order to find solutions.

 

I am noticing an odor and I’m concerned others will too.

There can be an odor associated with emptying your pouch versus odor caused by leakage and we need to determine which one you are experiencing. A lubricating deodorant is a great choice for neutralizing the odor of the stool when the pouch is emptied. You might also consider a pouch that has a filter, which neutralizes odor caused by gas in the pouch. Make sure that no stool drainage gets on the outside of your closure system. If neither of these situations is the issue your barrier might be starting to lift off the skin, which can allow odor to escape and can be the beginning of a leakage.

 

My pouching system is not staying on. What can I do?

It may be a problem with your barrier seal. Make sure you have one that you can count on. Everybody is different when it comes to wear time. A good rule of thumb is to determine how many days you can rely on the product to provide a secure seal without experiencing leakage. Monitor the back of the barrier when you change the pouching system. If you see stool or urine from the stoma that has leaked under the barrier, it’s a sign that the barrier seal is compromised and the barrier can begin to lose adherence to the skin. If this occurs then the barrier should be changed. It’s important to change your product on a routine basis, which can be determined by the lack of stoma drainage under the barrier as well as the condition of your skin.

 

It is important that my pouching system is discreet. What can you recommend?

When a pouch fills with gas or drainage it will start to balloon out and might show under clothing. A pouch with a filter can help release the gas. Also consider emptying your pouch when it’s a third to a half full. When a pouch is full it could cause weightiness on the barrier, which might lead to leakage. When it comes to discretion, it’s important that you find the right pouching system for your body. Hollister offers both one- and two-piece systems. For a person with a colostomy or ileostomy, there are drainable and closed-end pouches in various lengths and options of transparent, ultra-clear and beige pouch films. Those with a urostomy can also choose from pouches with transparent, ultra-clear or beige film depending on the product they are using.

 

As always, it’s important to follow up with your healthcare professional or Wound, Ostomy, and Continence Nurse for clinical or medical advice.

 

Have a concern that wasn’t mentioned here?

Check out the helpful tips from Hollister Incorporated, Routine Care of Your Ostomy or go to Hollister.com and navigate to the Ostomy Care Resources to find accessory sheets, helpful brochures and videos.

 

Need someone to talk to?

Hollister Secure Start services is here to help! Call us today at 1.888.808.7456.

 

Nothing contained herein should be considered medical advice. Medical advice can only be provided by an individual’s personal doctor or medical professional.

Editor’s note: This educational article is from one of our digital sponsors, Hollister Incorporated. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

UOAA Supports the Survivors of Colorectal Cancer

 

Colorectal cancer is the third most common cancer diagnosis among men and women combined in the United States. There is currently no cure, but it’s 90 percent treatable if caught early with a screening. American Cancer Society estimates there will be over 140,000 new cases and over 50,000 deaths this year.

Recent research has confirmed what many have long suspected–more young people are dying of colorectal cancer. Ten percent of all new colorectal cancer patients are under the age of 50 and are too often misdiagnosed.

People with other bowel diseases have an increased risk for colorectal cancer. This includes ulcerative colitis, Crohn’s disease, pre-cancerous polyps, and hereditary syndromes such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC), or Lynch syndrome.

If you need to have lifesaving ostomy surgery because of colorectal cancer or any other reason, education and peer-support is available from the approximately 300 affiliated support groups of United Ostomy Associations of America. Ostomy patients of all ages and their families, friends and caregivers are welcome. Find a meeting near you today. You are not alone.

UOAA is proud to be a member organization of the National Colorectal Cancer Roundtable (NCCRT). The NCCRT is a collaborative partnership with more than 100 member organizations across the nation, committed to taking action in the screening, prevention, and early detection of colorectal cancer.

Basic Tips for Changing your Ostomy Appliance

 

By Wendy Lueder

 

If you feel overwhelmed by changing your appliance, please know that your feelings of anxiety will diminish over time. I know it can be difficult at first but it will become more routine with practice. Knowing just what you’re going to do can be helpful so here are some basic guidelines that you may wish to use.

  1. To start, wash your hands!
  2. Set out your equipment within easy reach on your bathroom countertop. You will need: an old bath towel on the floor and Kleenex tissues (without any lotion!) to catch any unwanted output while changing; plastic bags for clean-up; a washcloth if you don’t shower; clean bath towel; pencil and stoma measuring guide; scissors or x-acto knife if you don’t use the new “moldable” skin barrier wafers; a skin barrier wafer; Stomahesive or HolliHesive paste or product such as Eakin Cohesive Seals (preferred by this writer) a new pouch; a tail closure if you use a drainable pouch that doesn’t have the built-in Velcro closure ; hair dryer and finally, a swivel make-up mirror.
  3. Empty your pouch as normal. DO NOT rinse your pouch out when emptying. This only reduces adhesion. If you get this advice, ignore it. Rinsing out pouches is an obsolete suggestion that is totally bothersome and no longer valid for modern ostomy equipment. Empty your pouch while sitting comfortably and normally on the toilet. Put some toilet paper in the bowl first to avoid any splashing. If you use a tail clip, carry an extra one with you in case you accidentally flush yours down the toilet
  4. While holding a corner of the tape that holds your appliance to your body, gently push your skin in toward your body to remove the appliance. Pushing your skin inward is far less harsh on it than if you pull the appliance off and away. Try it and feel the difference. You only need to use an adhesive remover if: A) you have worn the skin barrier wafer a very short time and the adhesion is still very strong and/or B) your skin is irritated or tender and can be easily damaged. I personally prefer the spray adhesive removers as they leave less residue. However, I only use them if I have worn the barrier for less than two days between changes.
  5. Put the old pouch, wafer and other waste (not the tail clip!) into a plastic bag for disposal. Sealable sandwich bags work great. My favorite product is Ostaway x-bag which is a black, opaque, leak-proof, odor-proof zip-lock bag made just for this purpose. See www.bagitaway.com or call 1-800-774-6097 (Mon-Fri 9 a.m. to 5 p.m. Eastern).
  6. Clean the skin around the stoma with a washcloth and warm water or by getting into the shower and using your hands. Be gentle. Do not use scented or cream soaps as they will diminish adhesion of your skin barrier. Any waste coming out of the stoma will merely wash down the drain.
  7. Pat your skin dry with Kleenex and for best results use a hair-dryer on low setting to complete the job. The cleaner and dryer your skin is the better your skin barrier will adhere.

Measure your stoma with a measuring guide (usually supplied in the box with your skin barrier wafers) using the make-up mirror placed on the countertop to get a better look. This is especially important if your surgery is recent as your stoma will become smaller over a period of months.

For all Skin Barriers except StomaHesive Wafers measure right up next to the stoma. For StomaHesive Wafers add an eighth of an inch space between the stoma and the wafer hole. Only this brand of wafer is “stiff” and could damage your stoma if it is too close. All other types of skin barrier wafers are more flexible and won’t damage the stoma if placed right up next to it. If your stoma is oval take two measurements, one each of the larger and smaller diameters.

  1. Trace the correct size and shape onto the back of the wafer with the starter hole in the middle. Cut out the hole either with your scissors or more easily by using an x-acto knife.

There are new moldable skin barrier wafers that you do not need to cut but merely manipulate to create the correct size opening. This is especially helpful if your stoma is oval and is highly recommended by this writer. Follow the manufacturer’s directions to create the perfect size opening for your unique stoma.

  1. If you use paste, peel the paper from the wafer and apply the paste only by the width of the tubes opening around the cut circle in the wafer. Allow alcohol to evaporate for approximately thirty seconds. Unfortunately paste is poorly named. Paste is really merely caulking and has no adhesive property.

If greater protection is needed than paste can afford (such as for ileostomates who have a caustic output), try using an Eakin Cohesive Seal or similar product instead of paste. these seals have the consistency of silly putty, and lasts far longer and will not wash away from heavy output.

Small dabs of paste or small pieces of Eakin Seals are great to fill any dimples in your skin that you may have. The flatter the surface of your skin around the stoma, the better the seal. Do fill in those dimples if you have them.

  1. While leaning slightly backwards to smooth out your skin, remove paper backing from the skin barrier and apply it slowly and carefully over the stoma. Use the magnifying side of your mirror to see that you are correctly setting it in place. Remove the paper backing from the surrounding tape and smooth it out on your skin being careful not to create any wrinkles as they may latter dig into your skin.
  2. If you use a two-piece system, snap the new pouch onto the wafer. Never tug down on the appliance to see if it is secure. Instead, feel with your finger all around the “Tupperware” closure to make sure the pouch and wafer are as close to each other as can be. If you detect any space, push the pouch toward your body until you feel it close the gap. You may hear a series of clicks as you apply the pouch.
  3. If you use a tail clip, apply now. Hold your appliance in place with your hand for a full five minutes to ensure a secure seal. All skin adhesives are more effective if held in place after first application as the heat from your hand improves adhesion. If your stoma is flush to your skin, use a skin barrier wafer with built-in convexity. The convexity will gently push the skin toward your body around the stoma giving it some extra length. When the stoma thus protrudes a bit more, its output goes more easily into the pouch. The new adhesives and skin barrier wafers stay put well for days.

Some bleeding is normal when touching your stoma, but report any unusual color, size, shape, or bleeding to your Ostomy nurse. Try different products. Call your Ostomy nurse or ostomy supply companies and ask for free samples. You may have to shop around to find products that leave you feeling comfortable and secure. You should be no more aware of your appliance than you are of your underwear. Always follow any special instructions provided by your health care professional as they know your specific situation better than any general guidelines an article such as this could provide

If your abdomen is very hairy, you may want to gently shave off the hair under your skin barrier wafer. Be careful not to cut or damage your skin.

These suggestions are gleaned from years of helping ostomates cope and are just that, suggestions. They come from over thirty-five years of experience, but are in fact just the input from a layperson. I’m not a nurse, I’m an ostomate. Your healthcare professionals always know best and you need to follow their advice, not mine.
Bottom line: Your appliance should be comfortable, stay on for at least a few days between changes, odor-free (not odor resistant) and leak extremely rarely. If not, go see an ostomy nurse and change your routine until you find the products that work well for you. Best of all, studies done at Duke University verify that the longer you’ve been an ostomate, the better it gets. Problems do diminish with time and experience. You should be able to forget you’re an ostomate and get on with doing the things you really enjoy. There’s no stopping you.

Additional Tips for ileostomates only:

Try changing first thing in the morning when output is at its slowest. Many ileostomates report that eating four to five marshmallows right before changing stops all output from the stoma for several minutes. I personally have found this to be true. As marshmallows are pure sugar, please don’t try this if you’re a diabetic.
As the output for ileostomies is far more caustic than for colostomates and urostomates, don’t put off changing your appliance when needed. There are two indications you need to change, one is “itching” and the other is a “burning” sensation. If you itch, it may be merely dehydration. Drink a glass of water. If the itching continues, you need to change. If you feel a burning sensation on the skin around the stoma, change as soon as possible. The output from your ileostomy is caustic and will damage your skin. Avoid the vicious cycle of damaged skin -> poor adhesion due to damaged skin -> leakage -> damaged skin.

 

Colorectal Cancer: Be informed if you are a candidate for an ostomy reversal 

 

By Joanna Burgess-Stocks, BSN, RN, CWOCN

 

  • Not everyone who has an ostomy as a result of colorectal cancer and other diseases will have the option of having their ostomy reversed.  Some people will need to keep their ostomy for life.

 

  • Your surgeon will determine when an ostomy will be reversed. There are many factors that determine a reversal such as the extent of the disease, a patient’s overall health and treatment process (radiation and chemotherapy).  Most patients with temporary ostomies will have the ostomy for about 3-6 months.

 

  • Surgery for reversal of an ostomy is usually much less involved than the surgery that you had to create the ostomy. So if you are feeling nervous, keep that in mind. A typical hospital course is 3-4 days on average.

 

  • For some patients, interrupting bowel function with a temporary ileostomy increases the chances that you will experience alterations in bowel function after reversal of your stoma. These symptoms can include rectal urgency, frequency, fragmentation of stool and incontinence. It is important that you notify your surgeon as soon as possible with these symptoms. Treatment includes behavioral strategies based on the symptoms and includes dietary modifications, incontinence products, skin care (use of barrier creams such as zinc oxide) and medications such as loperamide. More involved but helpful recommendations are pelvic muscle retraining (PMR) to regain sphincter strength and biofeedback. This therapy is done by a highly trained physical therapist.

 

  • Some physical therapists recommend PMR prior to surgery or radiation to assess muscles and teach strategies for ongoing muscle strengthening that can be carried over after surgery. This helps to address any coordination or existing weakness prior to radiation due to chemo or post-operative recovery. If PMR is recommended after surgery, it is best to wait at least 6 weeks and with the surgeon’s approval.