Finding Humor in life with an ostomy and IBD

My name is LTC(R) Justin F. Blum and I had my initial ostomy surgery 29 years ago and my rectum removed six years later.  These surgeries were done because of an ulcerative colitis diagnosis that lead to colon cancer.

During the 1980s, I had many colonoscopies and a litany of medications, the Army assigned me to duty stations in Kentucky, South Carolina, Birmingham AL, and Fort Monroe VA. I started with 20mg of Prednisone per day and that went up to 240mg in the fall of 1992.  During that following winter, I made an appointment with an Army gastroenterologist at Eisenhower Army Hospital, Fort Gordon GA.  After the exam, he told me I needed to have ostomy surgery. I knew what an ostomy was, I raised

Still a tanker at heart!

my voice and said, “The only way I will have ostomy surgery is if my back is to the wall and I have one foot already in the grave”. Little did I know in one year I would be having that surgery. I was bleeding profusely while taking 240mg of Prednisone per day. My last colonoscopy showed that I had a large black spot on the transverse part of my colon.

My doctor immediately scheduled me for ostomy surgery at the end of February 1993. I was in the hospital for two weeks and proceeded to convalesce at home for 30 days. Three weeks into the leave, my wife and I tried having sex for the first time as an ostomate. My bag ended up going where no bag has ever gone before and probably had a better time than we did. After some maneuvering, life did get better! I reported back to duty in Birmingham AL after convalescent leave was over. I was eventually given a J Pouch which I had for four years.

My years with IBD and now an ostomy showed me that it takes a village to obtain a good quality of life.

The next few years living with my J-pouch were horrible. Despite taking 15 hospital strength Imodium per day, I was still defecating 20 times per day. I continuously was sore on my bottom. I would develop leaks and I ended up having to wear pantyliners in my underwear. When I retired from active duty in August 1996, I immediately started my second career as an Army JROTC Instructor in Bennettsville SC. I continued to go to the bathroom quite frequently and in the spring of the following year my daughter, who was six at the time, wanted me to play horsey with her and take her around the block. I bent down half in tears and told her that “daddy can’t play horsey because he is too sore on his bottom”. I immediately went to talk to my wife and we both agreed it was time to get back to having an ostomy bag. That summer at the Columbia SC Veterans Administration hospital, I had my third surgery to restore my ostomy due to my poor quality of life with the J Pouch. On the positive side, since I’ve had an external pouch, the veteran’s administration awarded me 100% total and permanent disability. I spent the next 23 years as an Army JROTC Instructor.

By the Fall of 1997, I was ready for my first formal engagement with my ostomy. The NAACP was conducting its annual scholarship banquet and I was one of the evening’s speakers.  I made a very big mistake on the Saturday morning of the event by eating two packets of oatmeal for breakfast. I then went to a local bowling alley with my 6-year-old daughter for a birthday party. At the party, I ate too much popcorn!   That evening my wife and children attended the dinner and I was dressed in my brand-new army dress mess uniform. I was sitting on the stage at the head table when it was my time to give remarks. Once I was finished with my remarks I looked down and I thought I had spilled some water on my lap. After a closer look, I realized that that was not water but wet feces seeping through my lap. I immediately got up and my wife and I proceeded to the nearest restroom. In the men’s room, my wife was straddling me with her body trying to clean off the feces from my pouch with one hand and trying to put on a new ostomy bag with the other. During this time three individuals came into the restroom and became startled because they thought we were having sex on the floor!

From 1997 to 2002 I would experience a lot of burning, stinging, and itching around my stoma. Unfortunately, I did not have access to an ostomy nurse at any of the two hospitals where I lived in Florence SC. To my good fortune, a new assistant WOC nurse was assigned to Carolinas Hospital. I called the nurse the next day and told her about the problems I was experiencing on my skin. She immediately asked if I could come in the next day for her to examine my broken skin. That next day she examined my skin and applied Nystatin Powder to the inflamed areas. Within two days the burning, stinging, soreness, and red skin started to heal very quickly.

Despite the ostomy pouch I worked very hard my first few years and to my happiness in 2003, was named the Army Junior ROTC instructor of the year for the entire worldwide JROTC system that consists of over 5000 instructors. In August of 2010 I received a letter from Cindy Norris, Carolina’s Hospital WOC nurse who enclosed an application for the ConvaTec sponsored Great Comebacks program. The Great Comebacks program identified ostomates that also accomplished acts in their lives of giving back to others. I mailed the application back for processing. The application highlighted my time with IBD and then in 1993 acquiring my ostomy while the whole time serving my country as an officer in the United States Army. In addition, in November 2009 I was promoted to the rank of full Colonel in the South Carolina State Guard. I received a phone call from former NFL Placekicker Rolf Benirschke with the great comebacks program. He told me I would be the recipient of the Tony Snow Award for Public Service. The Tony Snow Award was annually given to an individual who has an ostomy and performed years of public service to our nation.

In 2010 and 2011 I was honored to be recognized with several awards.  I was named the 2010 volunteer of the year for South Carolina, the Tony Snow award winner, and in the summer of 2011, I was named for the second time the Army JROTC instructor of the Year. South Carolina Representative the Honorable Jim Clyburn recognized me on the floor of the House of Representatives in the summer of 2011 for these mentioned achievements while having an ostomy.

Eight years later I retired after 23 years as a JROTC instructor for a total of 44 years in uniform. My first act as a retiree was to apply to become a member of the United Ostomy Associations of America’s Board of Directors. To my good fortune, I became a board member and will have served a total of four years upon the conclusion of this tour of duty.

Justin at UOAA’s National Conference in Jacksonville , FL in August 2013. He now serves as a member of UOAA’s Board of Directors.

Over the four years, I was diagnosed and experienced neuropathy in conjunction with my ostomy. I was first put on a regimen of three 800mg tablets of Gabapentin per day which lasted six months. Not feeling any relief from the pain my doctor said we should try acupuncture. Apparently, the ears are where the acupuncture needles went because it was a central place for the pain sensors around my stoma.  I was on acupuncture for about 3 months and unfortunately, I did not see any relief. My doctor prescribed Lyrica, which is a derivative of Gabapentin. I started with one tablet per day now I am up to three tablets after two months. My pain levels have gone down considerably and fortunately I have been able to start exercising again in moderation.

My years with IBD and now an ostomy showed me that it takes a village to obtain a good quality of life. My wife Leah, who I refer to as my “Chief of Staff” is the most important person in my village. She stood by my side during four surgeries and all the years of total discomfort. In addition, if not for my caring and loving wife, I never would have gotten through the transition from non-ostomate to being an ostomate. She is my go-to person for any of my problems and she is both sympathetic and empathetic to those problems. She also stood by my side during countless tours of duty with the Army bringing her continually farther away from her home in New Jersey. Ten years prior to my initial surgery, in 1993, my father died at the age of 61 from colon cancer that spread to his liver. My ostomy surgery gave me a second chance to live because I was a prime example that ostomies save lives! If I did not have my proctocolectomy, my young wife would have become a widow with three children all under the ages of seven.

I am also most fortunate to have three WOC nurses in my life: Joy Hooper, Donna Sellers, and Joanna Burgess-Stocks. I can contact any of those three nurses at any time of the day or night, especially Joanna, if I am having problems with my ostomy/neuropathy. A healthy support system is needed for anyone inflicted with these lifetime conditions. I have learned to always look at the positive side of life throughout all those years I had IBD and now my ostomy. Today I counsel individual ostomates who are having problems adjusting to their ostomy and speak to UOAA Affiliated Support Groups around the country via Zoom and share my story and listen to theirs. Remember, you’re not alone!

There’s no bond more important than the one with your own body. ConvaTec helps you create a healthy bond with yourself, your stoma. And then, with the world around you.

We want to show the world that people living with Ostomies have deep, beautiful nurturing relationships with everyone and everything around them.

This is Kya’s story: Coming out of the hospital postpartum and post-surgery, I honestly never thought I could never go swimming again. I never thought that I could get back to my normal life, I never thought I’d be my normal self. Turns out, I’m a better version of myself. I’m stronger and with Healthy Bonds, I am doing so much better. This is my life now. I used to think once I got an Ostomy that date nights would be stressful and less romantic, but I couldn’t have been further from the truth. Happy anniversary, baby.

 

Editor’s note: This blog/video 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.

By Robin Glover

Oh no! An ostomy! You’re going to be pooping or peeing into a bag attached to your stomach?? Your life is over, right? No more dating. No one will ever like you. Children will run from you! It’s so gross!

Don’t worry. We’ve all been there. As great as they can turn out to be, the idea of getting an ostomy is never really welcomed news. Add on to that, you’re probably very sick and haven’t eaten well in weeks and you’re tired and worried and feel alone. You know nothing about ostomies and are wondering what life will be like with one.

Will having an ostomy bag eventually become second nature and you won’t even really think or worry about it? Yes.

First of all, life is going to be great! You’ll feel better. You’ll eat better. You won’t be bleeding out of unspeakable places and constantly panic-stricken about finding the nearest bathroom. Your life will become more consistent and routine and you’ll end up being happy you had a lifesaving, life-improving surgery.

It’s possible that you don’t believe that right now, though. And while it does turn out to be a good thing for most, there is an adjustment period and a lot of unknowns and myths. For instance, how do I change my ostomy bag? Will I stink? What if I have an accident in public? Can I ever play sports again? Or exercise? Or go swimming?

In short– is it easy? No. Will it be fine? Yes, yes and yes. But for a little expanded information and peace of mind, we can go into a little more detail.

How Do I Change My Ostomy Bag?

You gently peel it off, wipe things off a bit, and put another one on. It really does become as simple as that. But, at first, you’ll hopefully have a specialized ostomy nurse that will teach you how to do it. After your surgery, you likely won’t have to change it yourself the first several times. But, you should practice doing it and will be better off if you make the effort to know how before you leave the hospital. It also helps to know what the standards of care should be for ostomy patients and speak out before you are discharged and sent on your way.

If you did not have access to a certified ostomy nurse in your hospital be sure to seek one out. You can also find a Wound, Ostomy and Continence (WOC) Nurse or an Ostomy Management Specialist (OMS) through product manufacturers and telehealth services.

Will My Ostomy Bag Leak?

At first, Yes. It likely will. You might even get really frustrated in the beginning because you can’t seem to put it on as well as the nurse in the hospital. Even if you put it on “perfectly” and follow all the steps your ostomy pouch can still leak. You’ll get the hang of it, though. Every ostomy and everybody is different. You’ll learn what supplies you need, where to get them, and how to use them to make sure the fit is just right.

While you might be hesitant to leave the house for a while, you’ll soon feel totally confident going anywhere you want, any time you want. And better yet? You won’t be constantly worried about being near a bathroom! There’s always the risk of a leak, though. But it won’t be a big deal. You’ll be able to detect it quickly and take care of it.

Will I Smell?

No. If the appliance is attached correctly, you should never stink. No one will be able to smell you. You can be as close as you want to other people. You can go out and be in a crowded bar and nobody will know you have an ostomy bag. There are also plenty of clothing and garment options to fit well with your pouch and conceal it from anyone ever knowing – if that’s how you choose to approach it.

If you do ever smell, that means you need to check your pouch for any leaks or openings allowing odor to escape. And if you happen to be in public, you can carry tape or any of a variety of things to sneak off into the bathroom and do a quick fix. Will it be uncomfortable or scary the first time it happens? Yes. Will having an ostomy bag eventually become second nature and you won’t even really think or worry about it? Yes.

(Quick note: The answer to a lot of questions about having an ostomy is that “you’ll figure it out” or “you’ll become comfortable” because everything will be new when you first have an ostomy bag. There’s no step-by-step guide. There will be frustrations. Maybe some tears. It’s an adjustment. Nobody just has ostomy surgery, learns to put on a pouch, and then goes about their business. You will have issues. You may have some stained clothes and probably need to change your bedsheets one or two times. But, you will figure it out.)

Can I Do Whatever I Want?

Generally speaking, yes. Of course, this depends on every unique situation, and only you and your doctor can accurately answer this question. But, in general, you’ll be able to do whatever you want. Simply having an ostomy won’t restrict you from doing anything. You might even be able to do a whole lot more than you could before.

You’ll be able to go swimming, play rugby, do mixed martial arts, teach yoga, travel the world, go on dates, and do anything you were physically capable of before having surgery. All without worrying about being in constant pain or eating the wrong thing or needing to run to the bathroom every five minutes. However, make sure to wait 6-8 weeks or until your doctor approves you for any strenuous physical activity before winning the local 5k again. (Perhaps you’ll even want to take part in UOAA’s own Ostomy 5k.)

Getting An Ostomy Is Totally Worth It

All the details about how to change your ostomy pouch where to get supplies, and when you can go back to doing the things you love will get worked out. But the important thing to remember is that having ostomy surgery is going to be totally worth it. Even if your head is spinning now about what life will be like, it will calm down.

And also remember that you’re not alone. One of the best ways to prepare is to call or visit an ostomy support and information group before you have surgery. Many others have been through the same process and are more than eager to offer a listening ear and emotional support. UOAA also offers a new ostomy patient guide and has tons of online resources to get you started on the right path.

You’ll get the hang of everything, then look back and be so grateful that you are a warrior. Countless other ostomates will tell you the same thing. That is, when they’re not busy living an incredible life they wouldn’t have otherwise.

You got this!

 

Robin Glover is a writer based in the Houston area. He has a permanent ostomy after being diagnosed with Crohn’s Disease in 2017.

I started my career as a surgical ICU and flight nurse providing care to the critically ill both on the ground and in the air. Flash forward 34 years, I now am the complex abdomen specialist at Regions Hospital, which is a Level I Trauma Center in St. Paul, Minnesota. As a wound and ostomy certified nurse, I specialize in complex abdominal wall injuries and enteric fistulas. I often see patients with abdominal disasters that require many levels of support including diverting ostomies and total parenteral nutrition (TPN).

A rare and serious condition called Short Bowel Syndrome (SBS) occurs in patients when part of their intestines are surgically removed or injured, and the remaining intestine may not be able to absorb enough nutrients from food and drink.

To learn more about SBS, visit https://sbs-whattoknow.com/. To join the community and talk with others who are living with SBS, check out https://www.facebook.com/TakedaSBS/.

In my experience, SBS doesn’t impact life early on in a trauma patient’s world while in the ICU. At that time, they often have little to no output of fecal matter because the body is working overtime to support the heart, lungs, brain, etc. Patients’ memories of the hospitalization usually begin once they reach our general care floor, which is when they start to mobilize, eat, and drink.

All this happening simultaneously with a patient awaking to learn that they now have an ostomy can often feel overwhelming to a patient and the family or friends who care for them. Patients and family caregivers may experience grief at the realization that they now have a temporary or irreversible ostomy. The emotional adjustment can take time. And since management of the ostomy and pouch is frequently paired with that of other injuries sustained by the patient, education is incredibly significant at this stage.

At our hospital, we have a stepwise program that involves the entire facility care team – dieticians, surgical staff, bedside nurses, patient care assistants, and other allied health professionals. We start by explaining what is happening with the patient’s body and why it requires management: SBS puts patients at risk for malnutrition, electrolyte disturbances, dehydration, and increased ostomy output. Additionally, patients and family caregivers often go through the stages of grief while mourning the loss of what they consider to be a normal lifestyle. Patient and caregiver education is incredibly significant at this stage. 

 

When it comes to SBS, I often quote nutrition support specialist, Carol Parrish, MS, RDN, “It’s not the length of the bowel, it’s the functionality.” In my opinion, following Ms. Parrish’s handbook for SBS is beneficial to the patient. You can’t prepare a patient for what comes with an SBS diagnosis, and no two situations are the same. When possible, we try to eliminate the need for long-term TPN for our patients and move toward management of SBS through strict meal planning and medication.

 

Weaning off TPN is a process that takes time, patience and commitment from patients and caregivers. It is important to educate and re-educate the care teams on medication choices and food and drink choices. I’ve seen great success from patients and caregivers that are diligent in tracking how certain food and drink affect them beyond their stay in the hospital.

 

SBS is a rare condition that is still not widely recognized in the medical community. More education for providers and access to care for patients is essential. Teamwork is key in managing the changes and challenges that come with an SBS diagnosis. There are resources available to help patients and caregivers as they navigate the journey with SBS and seek support.

 

Mary Anne Obst RN, BSN, CCRN, CWON, CWS is a complex abdomen specialist at Regions Hospital in St. Paul, Minnesota.

 

This article was created by Takeda.

 

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

By Robin Glover

No need to be alarmed, but if you have an ostomy you already have a hernia! When the surgeon opened your abdominal muscles to pull your intestine through, they technically gave you a hernia. But we’re not talking about that kind of hernia. We’re talking about parastomal (peristomal) hernias. That’s when more intestine than planned pushes through your muscles and causes a bulge at your ostomy site.

You can tell if you might have a parastomal hernia by a noticeable bulge or by placing your hand over your stoma and seeing if it protrudes out when you cough. (This doesn’t count as an official diagnosis. You’ll probably also want to talk to your doctor.)

What Is a Parastomal Hernia?

A parastomal hernia is like any other hernia. They happen when an organ pushes through a weak spot in the muscle. For people with an ostomy, the organ is your intestine and the weak spot is in the same area the surgeon created your stoma.

While every effort is made to close everything and ensure a tight, snug fit, some extra intestine can force its way through and push against your skin. (This is as opposed to a prolapsed stoma when extra intestine is actually coming out of your body.)

Parastomal hernias usually happen within the first one to two years after ostomy surgery, but can occur later. While people without a parastomal hernia will tell you they’re mostly asymptomatic, those with one will likely beg to differ. Parastomal hernias can cause discomfort and pain and make it difficult to keep your appliance on.

Dealing With a Parastomal Hernia

One of the most frustrating things about having a parastomal hernia is dealing with leaks. Every parastomal hernia is unique and they come in all shapes and sizes so finding the right pouching system is important. It can take some experimenting and ordering plenty of free samples from ostomy supply companies to get it figured out.

If possible, you should also consult with a Wound Ostomy Care nurse. In fact, you should probably do this first. It can save you plenty of time and frustration. Check out this link for resources on finding one. Ostomy nurses are out there and ready to help!

Preventing a Parastomal Hernia

The best way to prevent a parastomal hernia is to listen to your doctor. When they say to not lift anything over 10 pounds for 4-6 weeks after surgery, don’t do it! You should also always be careful about what you lift and use proper form no matter how long ago your surgery was. It’s also a good idea to wear an ostomy support belt or undergarment when you’re working out or doing any strenuous activity, and to apply pressure to your stoma when you cough or sneeze.

Strengthening the area around your stoma site can help, too. But, as always, check with your doctor before beginning any sort of exercise routine. (Also, as always again, quitting smoking and/or maintaining a healthy weight can make a big difference.)

How Do You Fix a Parastomal Hernia?

Well, there’s no simple answer. Like every parastomal hernia is different, so are our bodies and the surgeries we’ve had. It will take consulting with your doctor or a WOC nurse to find a plan of action that’s specific to your needs.

But something you can do right now is find support from the ostomy community. We are a tight-knit group (and just not our sutures!) of people always eager to help and offer a listening ear.

 

Robin Glover is a writer based in the Houston area. He has a permanent ostomy after being diagnosed with Crohn’s Disease in 2017.

Sponsored by Coloplast

Have you ever experienced skin issues under your barrier? While peristomal skin conditions are all too common, many are easily treated – and better yet, avoided – with the right knowledge, product fit, and support. Finding the right ostomy barrier to fit your individual needs can be a challenge and may involve trying a few different barriers to fit your unique body and stoma. Getting a nice snug fit between your stoma and ostomy barrier is key to protecting your skin, and helps you reduce the risk of experiencing a frustrating cycle of stoma leakage and resulting skin issues.

If you see an ostomy nurse – great! Every person’s situation is unique, so if you’ve worked together on a solution, or if you’re currently experiencing skin issues that may require a specific intervention, I highly recommend working with your ostomy nurse to find the routine that works for you. That said, below are some general tips that are relevant to anyone with an ostomy.

As the saying goes, “An ounce of prevention is worth a pound of cure” – meaning it’s preferable to take precautions than to suffer the consequences later. This is also true in ostomy care. So, what can taking precautions for peristomal skin health look like? While it may not be realistic to prevent skin issues 100% of the time (after all, things happen!) finding a well-fitted and comfortable pouching system for your stoma and body profile is a great place to start in reducing your chances of skin issues. I always like to explain proper fit like trying on shoes at the store. When buying a new pair of shoes there are different criteria to follow. For example, is this the right size? Is it too big? Too small? Does my foot move around too much or not enough? Does it chafe when I bend too much or too fast? All these questions can also be asked when selecting the fit of your ostomy barrier.

The right barrier?

While you might sacrifice comfort for a number of reasons when you’re picking a new pair of shoes, your ostomy barrier should be treated more like your favorite go-to shoe no matter the occasion – going out on the town, running on the trails, or enjoying a quiet night in. If your shoe doesn’t fit and move with your foot just right, you may find that you have blisters on your heels from walking in them for too long. Similarly, if your barrier doesn’t move with your body while you sit, stretch, and go about your day, you may also find blisters or painful sores underneath your adhesive. That’s why the adhesive of your product is also important to consider when finding the right barrier for you – there are a lot of options out there! For instance, there are options for more stability around your stoma, more flexibility, special sizes and shapes to better fit your body’s contours, more resistance to breakdown from stoma output, and a host of other options that your WOC nurse can help you navigate. No matter which option you choose, an ostomy barrier should move comfortably with your body and shouldn’t limit your activities or range of motion.

Does this fit just right?

A great question! Let’s continue referencing trying on shoes. If the shoe is too large, your foot slides around and can create some friction in some places like your heel or your toes. Ouch! If the shoe is too small for your foot, it’s too tight and is quite uncomfortable, which can also create some friction and maybe some sores, much like when the shoe is too big. So, how do we relate this to an ostomy barrier? Let’s discuss! An ostomy barrier needs to be snug to the stoma and measured properly. If the barrier size is cut too big, the risk of stool or urine on the skin from the fit not being appropriate can create irritation or even sores. If the barrier is too tight, the proper seal may not be achieved, and the improper fit could lead to irritation on the skin or even to the stoma if the fit is far too tight. Just like you would use a previous shoe size as a reference or a foot-measuring size guide at the store, utilizing a stoma measuring guide to size up your stoma may be key to getting the right fitting barrier. You want to make sure that the measuring guide fits snug around the stoma, but not too tight, and just close enough to the stoma so the skin doesn’t show through.

For illustration purposes only. Performance and experience may vary. Talk to your healthcare professional about what may be right for you. Please refer to product ‘Instructions for Use’ for intended use and relevant safety information.

What is a solution?

Finding the right solution may take a few tries to find the right fitting barrier for your body type and your stoma size. When finding the right fit, the goal is to reduce any peristomal skin irritation or issues you could experience from improper sizing. Utilizing a size guide or template that you created is helpful with each pouch change to stay consistent. If the fit of your barrier changes, like after surgery when your stoma swelling goes down, creating a new template may help reduce potential peristomal complications.

Making a routine for fit

Don’t forget to do a body assessment when you perform a stoma assessment. What is a body assessment? Let’s reference shoes again. Just like when you try on a pair of shoes from many years ago that used to be your favorite to wear, you may find that when you try them on, they no longer fit, and it’s time to go up a shoe size. Similarly, it’s important to observe your stoma and skin over time to make sure that the barrier you’re using still fits right. All bodies change over time, especially our skin. Fluctuations in weight and differences in skin texture may impact the fit of your barrier. One way to stay on top of your body assessments is to do an online check. Coloplast’s BodyCheck tool is a simple way to check in on your fit and assess your body and stoma profile. If you feel it has been a while since the last time you checked in with your WOC nurse for a barrier fitting, I’d certainly recommend scheduling an appointment, too. Current guidelines recommend an annual checkup with a WOC nurse, and this is a great way to get back on track with your fit.

 

Mackenzie Bauhs, CWOCN, is currently an employee and Ostomy Clinical Consultant for Coloplast. She obtained her bachelor’s degree at Carroll University in Wisconsin. She has worked with ostomy patients in the post-operative period at the University of Wisconsin Hospital and Clinics in Madison, Wisconsin as well as outpatient ostomy care at Rush University Medical Center in Chicago, Illinois.

The materials and resources presented are intended to be an educational resource and presented for general information purposes only. They are not intended to constitute medical or business advice or in any way replace the independent medical judgment of a trained and licensed physician with respect to any patient needs or circumstances. The information presented or discussed may not be representative of all patient outcomes. Each person’s situation is unique, and risks, outcomes, experience, and results may vary. Please see complete product instructions for use, including all product indications, contraindications, precautions, warnings, and adverse events.

Editor’s note: This article is from one of our digital sponsors, Coloplast. 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.

By Ed Pfueller, UOAA Communications Manager

Beverly Dabliz is ready to celebrate a monumental 60th anniversary but even her closest friends do not all know what it is for. Recently she decided it was finally time to share the news. “Just last week I told a close friend I’ve known for 66 years – I’m the godmother of her twins, but even they did not know I have an ostomy. It was just not something people talked about,” Dabliz says. She adds “People are surprised to learn the news, but it does not matter to them one bit.”

Dabliz had ileostomy surgery in 1962 at Ferguson Hospital in Grand Rapids, Michigan. Ferguson was one of the first clinics in the world to perform such surgeries. By the time she turned twenty she was suffering from ulcerative colitis and by twenty-four ran out of treatment options. “After sixty years I have never regretted it, it has allowed me to live a great life,” Dabliz says.

Almost no one with the exception of her doctor understood the procedure and how to care for it. She knew she was on her own on how to carry on and reach her full potential.
Even if you have a great support network Dabliz recommends, “You have to own it and take care of it.” Ostomy supplies of that time bear little resemblance to the lightweight, contoured appliances of today. “I wore a heavy two-piece rubber appliance held on with an ostomy glue,” she recalls. It was not until the 70s that pouching systems began to evolve into something similar to the one and two-piece systems commonly used today.

“It was just not something people talked about,”

Over the years Dabliz has helped other ostomates in need through the Detroit Metro Ostomy Support Group. While doing hospital visits she would always appear in fitted clothes and enjoyed how grateful the patients were to hear from someone else living with an ostomy. She is happy about the recent return of in-person support group meetings. At meetings, Dabliz is sometimes surprised by some of the concerns new ostomates have regarding things like food, “I just tell them to be sure you chew your food very well, in the beginning, I tried it all without being scared but I’m still often the last one eating. I chew my food so well I’ve worn down teeth.”

Beverly Dabliz, right, works during a mission trip to Costa Rica with her Michigan church group.

Dabliz worked in the accounting department of a computer company in Detroit and Plymouth, Michigan for 45 years before retiring. Her boss was aware of her ostomy and supportive. “I never missed a day of work because of the ostomy,” she says.

Six years ago Dabliz had a fight with kidney cancer and three years ago a shoulder replacement surgery. But she has otherwise been fortunate to live a healthy life since the ostomy surgery six decades ago. She still makes it a point to get out of the house almost every day. “I have always been very active and really have not had any ostomy issues,” Dabliz says. In her eighties now, she still enjoys golfing and was in a bowling league for many years.

Beverly Dabliz working as a volunteer at the Eagle River Methodist Camp in Juneau, Alaska.

Dabliz can also still be found tending to her yard and is reluctant to give up shoveling the Michigan snow – though neighbors have started beating her to it. With the exception of some subtle changes, her ostomy regiment remains routine. She consistently uses the same products.

Dabliz is an active member of her church and has gone on many mission trips over the years in countries such as Jamaica and Costa Rica. “I’ve had to use outhouses in Alaska and done mission work after Hurricane Katrina,” Dabliz says. Even in these tight living quarters, nobody knew she had an ostomy.

An ostomy has never gotten in the way of her passion for traveling and cruising the world with her older sister. The pair have even circumnavigated Australia and New Zealand. Her advice; “I take extra supplies and always bring some on carry-on and have never had any trouble flying. Just do it. Go swimming, do whatever you want to do,” she says.

In celebration of her 60th Stomaversary and 85th Birthday, Dabliz is hoping to take a Holland America cruise around Iceland with her sister. Her minister and family have known of her ostomy but she hopes to tell more friends about what this landmark occasion means to her. Dabliz is confident they will take the news in stride as they help her celebrate a life that could have been cut way too short if not for that long ago ostomy surgery.

By Robin Glover

The recovery process for a j-pouch is just that. It’s a process. It takes time and patience and is different for everyone. For some, it can be relatively easy. For others, it can be a winding path with twists and turns just like the colon that was removed for it.

But one thing is the same for practically everyone: j-pouch surgery offers hope for a return to a life that’s less encumbered by the alternatives. Seriously, who doesn’t want to poop out of their butt again if given the opportunity? Oh, and getting rid of that disease-ravaged large intestine is a plus, too.

What Is A J-Pouch?

In case you’re reading this to research information for yourself, friend or family member, here’s a quick explanation of what a j-pouch is:

Medically known as Ileal Pouch Anal Anastomosis (IPAA) surgery, it involves removing the entire colon and rectum and then connecting the small intestine directly to the anus. The term j-pouch refers to the shape of the “pouch” that’s created when the surgeon folds the small intestine on itself and creates a reservoir to hold waste until it is passed through the anus. It can also be known as an s-pouch or w-pouch based on how it’s surgically constructed. J-Pouch surgery is most often done in cases of ulcerative colitis where there is no disease in the small intestine or as a result of FAP, colorectal cancer or a bowel perforation.

The surgery for a j-pouch almost always involves two or three steps. The first step, and usually the more major surgery, is to remove the large intestine. At the same time, an ileostomy is created that will be used until the small intestine is reattached. This will be a temporary external pouch.

Stages of J-Pouch Surgery

Depending on individual circumstances, the first surgery can also involve removing the rectum and creating the internal j-pouch. However, it can also be its own separate procedure. But either way, the final step is to reverse the ileostomy and connect the small intestine to the anus. At this point, no external pouch is needed and the traditional route of passing stool can resume.

Be aware that the patient has the right to decide between a J-pouch or keeping the ostomy and should know not all temporary ostomies are able to be taken down and not all J-pouches are able to be connected.

Early Recovery From J-Pouch Surgery

It’s an exciting experience when you wake up from the final surgery and see that there’s no longer a need to have a pouch attached to you. What was once your stoma is now a still pretty nasty wound, but one that will heal and become just another proud scar.

Things won’t be working quite yet though. It will be a few days before you actually have a bowel movement. Sometimes it can take longer, but that’s not a big deal. When you’re in the hospital you’ll be monitored and well taken care of. You likely won’t go home until your doctors are sure everything is working correctly, including being able to eat and pass solid food.

Everything that comes out will still be liquid, though. It will be a little bit before you start passing anything even semi-solid. And you might not ever get to that point or only have it happen on rare occasions. There’s nothing unusual about that.

J-Pouch Guide

Diet Right After Going Home

The diet you follow after getting home from the hospital will be communicated to you by your doctor and you’ll probably go home with many guides and resources. Mainly, staying hydrated is very important and avoid raw fruits or vegetables, nuts, whole grain, seeds, or anything else that doesn’t digest in around two hours. Since you no longer have a large intestine, food has much less time to be processed and if you eat a handful of nuts they’re going to come out the same way they went down.

Check the Eating with an Ostomy Guide for a much more complete diet guideline.

But, even worse, it can cause a blockage. Blockages are the bane of a j-pouch’s existence. You need to be careful about what you eat (typically called a “low residue” diet) and chew your food thoroughly. Chew extra. And then some more. Take small bites and don’t take any risks right away. Introduce new foods slowly.

NOTE: Your doctor or dietician will know the best foods to eat and what to avoid for your specific needs. Always follow their directions before anything you read on the internet.

Getting To Know Your J-Pouch

It can take a while after surgery to completely adjust to your new plumbing. You’ll learn what foods are “safe foods” and which to avoid. You’ll also learn about how your j-pouch behaves and how it affects your daily life.

For example, you’ll start to get an idea of how many times per day you’ll go to the bathroom and what consistency you can expect. You’ll also learn what each sense of urgency means and when you need to go to the bathroom right away and when you can hold it. It will feel like you need to go to the bathroom a lot and you’ll probably actually need to at the beginning. But, over time, your j-pouch will stretch and grow to be able to hold more before needing to be emptied.

Ideally, after everything settles down, you will only go to the bathroom 4 to 8 times a day and it will be a simple and quick emptying process.

You’ll Experience Butt Burn

Speaking of going to the bathroom a lot, you may experience what is known as “butt burn.” This is because, on top of going to the bathroom more often, without a large intestine your stool will be much more acidic from digestive enzymes.

It’s necessary to take special care and make sure everything is extra clean. A bidet is a great idea because rubbing with toilet paper can also cause irritation. There are also many creams and lotions you can use to soothe and protect. Zinc-based lotions are a good place to start. And get some disposable gloves while you’re at it.

You may go to the bathroom up to 20 times a day (or more) and experience irritation from going so much. But, it will get better as you learn more about your j-pouch and develop processes that work best for you. In the end (no pun intended), you’ll get to a point where you’re comfortable and know how to manage it like an expert.

Ideally, after everything settles down, you will only go to the bathroom 4 to 8 times a day and it will be a simple and quick emptying process.

It’s Not Always Easy

As mentioned, j-pouch recovery is a process. At the beginning, there will be accidents (typically nighttime) and discomfort. It’s a whole new way of digesting food and your body needs time to adjust. And you will need time to adjust to it too. It’s a major change.

Be aware of possible complications such as pouchitis and tell your doctor if you have more frequent or blood in your bowel movements.If you have a j-pouch or need one, you’ve already been through a lot. You know you’re resilient and can make it through almost anything. This is just another step in your journey.

Don’t let any of this discourage you. There’s a reason you decided to get a j-pouch and there’s a wealth of resources and support out there to help. Everything you will experience has been experienced before and the j-pouch community is always ready to help. But keep in mind that social media is often a place to vent so you might see more negative than positive posts.

So focus on the good, be patient, and look forward to enjoying pooping out of your butt again!

 

 

Robin Glover is a writer based in the Houston area. He has a permanent ostomy after being diagnosed with Crohn’s Disease in 2017.

By Makeda Armorer-Wade

Who knew that having an ostomy would be such an enlightening journey?

I was terrified. But my ostomy was just the beginning of this new experience for me and my entire family. When I received my first ostomy, it was an emergency surgery. There was no time to prepare, learn or even have a voice. It was life or death, and since I spent the previous three decades fighting for my life, I chose the ileostomy. Up until that point, I knew nothing much about an ostomy, other than I didn’t want one. When I considered that point, I realized it was because of the cavalier attitude of a medical professional, who told me,“what’s the big deal, a lot of people live with ostomies.”

I quickly learned that I had to live that Possibility Lifestyle. I learned that I was in charge of my mindset and could change it at any time with a little motivation. I don’t want to give the impression that it was easy, because it wasn’t. But I would need to learn because I was being discharged. When I got home, I decided to take myself to ostomy school. I did as much research as I could, in order to be able to function and live some quality of a life.

It was very difficult and took about 90 days to get accustomed to my new best friend. By the time I was beginning to accept my ostomy, I was given the date for my takedown. I still had a month to go and I had already lost 100 lbs. I was already counting down. I believe that my biggest challenge with my first ostomy, was the fact that Crohn’s Disease had ravaged my body. So, it wasn’t just the ostomy, but I was so weak and depleted, and unable to absorb any nutrients. At one point, I had a TPN line to feed me.

When the day came for me to go to the hospital, I celebrated and gave away all of my ostomy products to patients that I thought could use them. Simply said, I was done and over it. My recovery didn’t happen as quickly as I wanted, which required me to be patient and work my P.L.A.N.© I needed to Prepare and figure out what my diet would be to help me put some weight on. I was down to 98 pounds. I had to Let go of the shame that I was feeling, realizing that all of this was out of my control. I had to ask for help, because I just didn’t have the strength to do it myself. And I vowed to Never give up, because I desperately needed to live The Possibilities Lifestyle.

I knew that the possibilities for my life were endless, if I could just hold on. I just had to believe.

It took me about 12 weeks to be strong enough to go back to work. I had to believe, that just maybe my doctors and nurses were right. Everyone couldn’t be wrong. The messaging was consistent. “God must have something special for you to do”. Every time I met a new medical provider who reviewed my record, they would say, “Wow you have some story. You must have something important to do, with all that you have been through.” The Residents would ask permission to interview me.

I truly believe that when you receive an assignment from God, you will have the necessary experiences and pressure to become masterful. Just like the pressure needed to produce a diamond. I have learned so much with each surgery and recovery.

Fast forward six years. And here we go again. Crohn’s disease was causing significant problems with my health. After a conversation and encouragement from my gynecologist, I called my surgeon and made an appointment. After numerous tests, we made the decision to move forward with another Ostomy. This time a colostomy. (A colostomy is a surgical opening in the large intestine that is brought through the abdominal wall). This surgery was different, in that I initiated the conversation. I was armed with information and I had some semblance of control. This all matters in your perception of your ostomy.

Climbing the valley after this surgery started like the others, on a walker and a liquid diet. And the determination needed to propel myself forward was there as well. I was looking up knowing I had made the right decision. I began sharing and supporting other ostomates in monthly meetings at the hospital.

The more I encouraged others the better I felt about my own situation.

I began working with a life coach who encouraged me to be kind to myself and set goals that continued to positively impact my recovery and healing. This was the best thing that I could do. I knew from my conversations with ostomates that they needed an adjustment period and continuous support. With everything I shared, she continued to reinforce that my story was no longer mine. She said “do you think you went through all that you did, just to suffer?” My answer was no. I already knew what I had to do. It was all in the Value of the Valley. If you want to know how that turned out, stay tuned.

Your Ostomy is Just the Beginning Part 1

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.

What is more important: fit, flexibility, stretch capability, or adhesion?

If you cannot decide, or there are two or more that are just as important, you are not wrong. Why not have all in one for your barrier selection? You can have fit, flexibility, stretch capability, and adhesion in one pouching system!

Fit

When selecting a barrier, many considerations can come into play. When considering fit, proper application and sizing is important to help reduce leakage and create a seal around the stoma. Utilizing a stoma measuring guide or template with each pouch change is beneficial to help obtain the proper fit. Stoma size can change after surgery, so measuring is key.  Deciding between a precut or a cut-to-fit barrier is also important to consider, as it depends on which option provides the best fit to your body.

Flexibility

A flexible barrier will move, bend, and stretch with your body allowing you to be comfortable as you go about your daily activities. Flexibility with stability helps achieve a seal around the stoma along with the proper fit. In day-to-day movements like, getting in and out of your car, vacuuming, getting a spice off the top shelf, or even a sport you enjoy playing, flexibility is important to move with your body.

Stretch capability

Can you have flexibility without stretch capability and vice versa? What if these two worked hand in hand to create the best seal and optimal comfort to help you with your daily activities? Think back to reaching to get a spice off the top shelf in the kitchen. You need to have flexibility in the barrier to obtain the stretch, but then when back in a normal standing position the ability for the barrier to go back to the original shape after completing the stretch—how is that obtained? Teamwork!

Adhesion

Lastly the ability for the barrier to have adhesion to the skin. This can be a challenge outside of the barrier itself. For example, what if there is a small area of irritation, moisture, or the landscape is not perfectly flat (which is very common)? The adhesion is important to provide the tact to the skin so that the barrier has all the capabilities: fit, flexibility and stretch! Good adhesive security is obtained by gentle warmth using the body heat of your hands, and a nice gentle pressure with application from the inside (near the stoma) all the way to the edges of the barrier. This helps activate the adhesive into those small nooks and crannies that our skin has even if we can’t see them with the naked eye.

Essentially, there are many questions that may come up when deciding on the best barrier fit for you. Let’s go back to the original question that was posed: What is more important: fit, flexibility, stretch capability, or adhesion? The answer can be any of the above, and it all depends on your own lifestyle and personal needs. Things to keep in mind when you are considering your barrier options are, “Does this barrier have a good fit to my body?”, “Does the barrier allow me to stretch without compromising the seal?”, and lastly, “Does this barrier give me the security to enjoy my activities?”. There are options available for many body types and challenges. Reach out to your WOC nurse so they can help you answer the questions that are important to you!

 

Mackenzie Bauhs, CWOCN, is currently an employee and Ostomy Clinical Consultant for Coloplast. She obtained her bachelor’s degree at Carroll University in Wisconsin. She has worked with ostomy patients in the post-operative period at the University of Wisconsin Hospital and Clinics in Madison, Wisconsin as well as outpatient ostomy care at Rush University Medical Center in Chicago, Illinois.

The materials and resources presented are intended to be an educational resource and presented for general information purposes only. They are not intended to constitute medical or business advice or in any way replace the independent medical judgment of a trained and licensed physician with respect to any patient needs or circumstances. The information presented or discussed may not be representative of all patient outcomes. Each person’s situation is unique, and risks, outcomes, experiences, and results may vary. Please see complete product instructions for use, including all product indications, contraindications, precautions, warnings, and adverse events.

 

Editor’s note: This article is from one of our digital sponsors, Coloplast. 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.