Grand Rapids Ostomy Association "Call Us We're Here to Help 616 752-8317" "Twenty of the Most Frequently Asked Questions Following Ostomy Surgery*" by Ms. Lisa Whiteside --- Ostomy Association of Boston.

This is a list of some of the most common questions asked following ostomy surgery. We have provided general answers to these questions. As always, in order to obtain answers to your individually specific questions, be sure to consult with your doctor or enterostomal therapist (ET) for help. These questions are presented in random order, not in any specific order of importance.

1-Who should I tell? What should I say about my surgery?

First, you should tell those who need to know about your surgery, such as health care providers, your spouse or significant other, and people who are involved in your recuperative care. Beyond this, it is important that you do what is most comfortable for you. In most cases people will never know about your ostomy unless you tell them. For your boss and coworkers, depending on your relationship, you might choose to say that you had abdominal surgery. For your friends and family you might want to say more. If you want people to know, you should tell them, but it is also okay not to tell.

2- Will I be able to continue my daily activities once I recover from surgery?

Yes. Generally after surgery you can gradually resume the daily activities you were doing before. You may need to plan on doing certain things in a different way. For instance, ileostomates and urostomates need to take in a good amount of liquids. Unless there is a specific problem, your ostomy should not restrict daily living. With some people, such as those who have suffered from ulcerative colitis, an ostomy can greatly enhance the quality of that persons life.

3- Will I be able to resume or maintain an active lifestyle if I choose? Travel, camp, swim, etc.?

Most people with an ostomy lead active lives, indeed some are professional athletes. Unless you have a particular problem, you can look forward to traveling, swimming and most other activities. You may have to plan ahead more carefully, such as making sure you have extra ostomy supplies with you when traveling. Some doctors recommend avoiding contact sports to prevent injury to the stoma and may prescribe a plastic protector cap for the stoma during some activities. It is common for people to reinforce the edge of the wafer with waterproof tape and/or wear an ostomy belt during physical activities such as running or swimming.

4-What about showering and bathing? Should I bathe with or without the appliance? Will soap hurt the stoma?

People with ostomies shower and bathe both with and without their appliances according to their personal preference. Some people initially gain confidence for swimming by sitting in a tub of warm water to assure themselves that the appliance will not leak. Avoid using very hot water on the stoma as it may burn the sensitive tissue. Soap will not hurt it but try to avoid putting oil-based soaps and creams on the skin around it as they can cause adhesion problems with the appliance.

5-What about sex and Intimacy? Are there restrictions? Does the pouch get in the way?

Most people with colostoinies or ileostomies resume their active sexual lives soon after surgery. A period of adjustment is to be expected. in terms of restrictions, because surgeries vary, your doctor or ET is the best source of information regarding your personal situation. The pouch itself doesn't necessarily create any problems of being in the way. Some people use smaller pouches and cotton or silk pouch Covers for comfort and/or aesthetics. Some creativity with new positions might also be helpful. However some people may experience physiological problems with sex following surgery. For them there is still hope and your doctor is the best source of information. You may also consult the UOA publications "Sex and the Male Ostomate," "Sex and the Female Ostomate," and "Sex, Courtship and the Single Ostomate." They explain well the complexity of the sexual process, and a variety of ways to achieve sexual fulfillment. There are now a number of both surgical and non-surgical techniques for rehabilitation. In certain cases these options may even improve ones sex life. Please remember, if you experience such problems, you are not alone. Don't hesitate to talk to your doctor.

6-Will I be able to wear the same clothes as before? how about belts, pantyhose, girdles, tight clothes and swimsuits?

After ostomy surgery, many people wear the same clothes as before. Depending on your stoma location you might find belts uncomfortable or restrictive. Some people choose to wear higher or looser waistbands on trousers and skirts. Pantyhose, girdles, and tight clothes will not injure the stoma but they could inhibit the normal flow from the stoma to the pouch thereby breaking the adhesive seal and creating a leak under the wafer. Often people will wait a number of hours after applying a new wafer and pouch before wearing tight clothing or going swimming to make sure the paste or cement has set. As for swimsuits, steer clear of white ones as the outline of the pouch may be visible when wet. Many women prefer patterned suits with an inside panel for extra tummy control. Recently underwear and bathing suits that contain a provision for a pouch have been introduced for both sexes.

7- Will I he able to get pregnant after surgery?

Many women have had full term pregnancies after ostosny surgery but this question is best discussed with your doctor. If you are a man, this surgery will do little to improve the odds of your getting pregnant. 8- What can 1 eat? Will I need to change my diet? There may be some modifications in your diet but in most instances you should be able to eat a varied and well-balanced diet. Any dietary restrictions are highly individual. It is important to introduce foods a little at a time with plenty of liquids. For ileostomates, some less digestible or high roughage foods; such as corn, coconut, mushrooms, nuts, popcorn, dried or raw fniits and some vegetables are more likely to create potential blockage problems. People with colostomies and urostomies generally have fewer or no restrictions. It is important to drink lots of liquids and to chew your food thoroughly before swallowing. Ask your ET for a list of recommendations before or soon after you leave the hospital.

9-What about medications? Can I take vitamins?

Time-released and enteric coated medications may pass through the system of ileostomates too quickly to be effective. Remind each of your doctors that you have an ostomy. Checking with your doctor is a good idea before taking any medication, vitamins included.

10- WIll there be odor coming from the pouch?

Generally there should be no odor coming from the pouch as it is designed to be odorproof. Depending on the type of ostomy you have and what you have eaten, you may have gas and odor when emptying the pouch. There are a lot of products that can be taken orally or placed in the pouch to combat odor. Some people like to use room deodorizers preventatively before emptying.

11- The appliance provided to me In the hospital after surgery is very large and long. Will I always be wearing this size pouch?

After surgery, your initial output may be greater than it is a few months later. Pouches are available in many different types, styles and sizes. Check with your ET or supplier to learn about your choices.

12- how many times a day mill empty the pouch?

It depends on the type of ostomy, what you eat and how quickly it passes through your system. For most ostomates two to six times a day is to be expected. Ileostomates must empty more often than colostomates. Urostomates will empty even more frequently

13- Is there a correct way to empty an ileostomy or colostomy pouch?

Most people with a colostomy or ileostomy find the easiest way is to sit on the toilet with the pouch between the legs, although there is no right or wrong way. Make sure to hold the closing clip and bottom of the pouch firmly before opening. It is a good idea to place some paper in the bowl before emptying to prevent backsplash.

14- how long can I or should I wear one appliance between changes?

The adhesiveness and durability of systems vary. Anywhere from three to seven days is to be expected or whatever makes you and your skin comfortable. Specialists say that changing an appliance unnecessarily frequently, or wearing one too long may be damaging to the skin. After a few months most people learn how long a single appliance will last.

15- Where can I purchase supplies?

Check the yellow pages under Ostomy Supplies, Hospital Equipment and Other Supplies, or other listings for a more complete list of local suppliers.

16- Does Insurance cover the cost of equipment?

This varies. Usually. but not always, a quantity of supplies are covered, but you must always check with your insurer. Remember, whenever in doubt, get a prescription for your ostomy supplies.

17- My stoma looks large. Will it always be this size?

A colostomy stoma is larger than an ileostomy stoma and a urostomy stoma is smaller yet. In the first few months after surgery the stoma will shrink in size. It is very important that you make sure your appliance accommodates this change by reducing the opening. Check with an enterostomal therapist (ET) if you have any question or problem

18- OccasIonally the stoma bleeds. Is this harmful?

The stoma bleeds easily when touched as the blood capillaries are close to the surface of the tissue. Usually this is normal and it stops within a short period of time. If the bleeding is prolonged or if you are concerned, contact your ET.

19- If I have any questions or difficulties about how my appliance or my stoma is functioning who should I call?

Call an ET or other caregiver who has been specially trained in ostomy care. If you believe the problem is medical in nature you should not hesitate to contact your doctor.

20- Is there someone I might speak with who has had this surgery? Where can I get support? Where can I meet other people with ostonsles?

Contact the United Ostomy Association (UOA) at 800 826-0826 for information, resources and support.