BOARD OF DIRECTORS Dennis Fila Joan Gardner Ginny Gross Stan Baker Allyn Mellits
OSTOMY ADVISERS: Irene Repka, RN, BS, CWOCN Michelle Perkins, RN, BS. Were on the Web! www.annearundelostomy.com Volume 40 Number 8 May 2014
!"#$%&'( *++,&'(-. */0 12 3415 6 7$8'/ 98$:'+2 ;<=2 >/%&?0 /'@ A$'-B%+8 C#&+'#+- D@B#/,$8 EB'+ F2 3415 6 G8$B" =&-#B--&$' Note: Meetings are held at 7:30pm, the first Thursday of each month at the Belcher Pavilion at Anne Arundel Medical Center in Annapolis. From the 2 nd floor of the parking garage take the entrance into the Belcher Pavilion and once inside take the elevator to the 7th floor and check with the 7 th floor desk for the room number. If AA County Schools are closed due to inclement weather, there will be no meeting.
!"# %&&# %'(&)#* +,(&-./ 01'.*1&)/ 23-,4. %33,561-6,&/ 7&58 (AAC0A) is a non-piofit, volunteei-baseu oiganization ueuicateu to pioviuing ieassuiance anu emotional suppoit foi people who have hau oi will have some kinu of ostomy suigeiy, such as a colostomy, ileostomy, uiostomy (uiinaiy uiveision) oi a continent pioceuuie. The goal of the AAC0A is to pioviue moial suppoit, infoimation, anu euucation to people with ostomies anu theii families anu fiienus. Nembeis ieceive The Rambling Rosebuu newslettei monthly. 9:;< 1'# =>? please make check out to AAC0A anu mail to Stan Bakei, 9S8 Fall Riuge Way, uambiills NB 21uS4-14S4 0#4@#'3"6A %AA*651-6,& !"#$%# !'()* Full Name _______________________________________________________________________________________________________________________________ "#$% &'($% )*+* Auuiess: _____________________________________________________________________________________________________________________ ,%(--% .//(-$$ .0#(%1-2%342'% 5 _____________________________________________________________________________________________________________________ 6'%7 ,%#%- 8'0 69/- Phone: ( ) Bate of Biith: uenuei: Email Auuiess _____________________________________________________________________________________________________________ Reason foi suigeiy: ____ Ciohn's ____0lceiative Colitis _____ Cancei _____ 0thei__________________________ Emeigency contact if we aie unable to ieach you: ______________________________________________________________________ +,$* *-.# /0 %1'2#'- ,$3# -/1 ,$45 Colostomy 0iostomy SpouseFamily Nembei Ileostomy Paient of chilu with 0thei (please specify) 6 7/1"4 "(8# */ ,#". 7(*, *,# 0/""/7()2 9/::(**##;%< /' $9*(3(*(#%= Finance Bospitality Nembeiship Newslettei Piogiam Refieshments Sunshine visiting >/7 4(4 -/1 ,#$' $?/1* 1%5 Inteinet Seaich ETW0CN Nuise 0thei Bospital Physician
A WORD OF THANKS for their constant support of our Chapter to: The American Cancer Society, especially the office in Gambrills, for essential help with our newsletter; and Anne Arundel Medical Center for providing rooms for our regular meetings and special events. We appreciate their support and assistance. +%-1$ :(91 %;'$ 2-<$=-%%-( 1#7 >- (-0('2%-/ '2 9%;-( 9$%917 2-<$=-%%-($? 0(9@'/-/ 0(90-( A(-/'% '$ B'@-2 #$ %9 $9C(A- 9: 1#%-('#= REMEMBER!!! The entrance to the Belcher Pavilion is FROM THE SECOND FLOOR OF THE PARKING GARAGE. Once inside the building you will be on its second floor take the elevators inside up to the 7 th floor. When leaving, take the elevator the second floor and go through the doors onto the 2nd floor of the parking garage.
OSTOMY ADVISORS FOR STOMA HELP To consult with one of the ETs below, a physicians referral is necessary and a fee will be charged. Call for an appointment. BALTIMORE WASHINGTON HOSPITAL Carol Canada RN, BSN, CWOCN 410-787-4578 ANNE ARUNDEL MEDICAL CENTER Michelle Perkins, RN, BS, CWON Email: mperkins@aahs.org Laura Alberico-Klug, RN, BSN, CWON Email: lalbericok@aahs.org 443-481-5508 / 442-481-5187 Fax: 443-481-5198 Private Consultants Joan M. Sullivan, MAS, RN, CNA, CWOCN 410-932-7312 Foi those seiving on the boaiu, the next boaiu meeting is Nay 19th at 7:Supm BC>DEBC>F
Live Well ! Live Independent ! Live Active
T0WS0N 6729 Yoik Roau Baltimoie, NB 21212 Phone: 41u-S77-SSuu Fax: 41u-S77-SSu2 B0NT vALLEY 1u7S7 Yoik Roau Cockeysville, NB 21uSu Phone: 41u-77S-uSuu Fax: 41u-77S-uSu1 Toll Fiee: 1-8SS-A0STNEB
The waimei weathei lenus itself to spiing cleaning anu ieoiganizing piioiities. So while you'ie setting new goals anu getting things 'tuneu up', why not scheuule a yeaily exam with youi ostomy nuise anu visit youi ostomy specialists at Austin Phaimacy.
As we age, oui skin unueigoes changes anu we may auu oi loose a few pounus which lenus itself to changes in abuominal contoui anuoi skin sensitivities. This coulu have an affect on the fit, weai oi comfoit of ostomy appliances oi piouucts that have been suitable foi yeais.
Youi ostomy nuise can assess youi skin anu iegimen in accoiuance with youi cuiient lifestyle anu bouy shape. A simple change like auuing oi iemoving a skin baiiiei might significantly impiove youi 'system's peifoimance'. Youi ostomy specialists at Austin Phaimacy can guiue you to newei piouucts oi pie-cut items which might save time oi eliminate the neeu foi unnecessaiy steps oi supplies.
Even if you aie not expeiiencing any conceins with youi ostomy, it is impoitant to scheuule youi yeaily 'check up' anu exploie new oi aujunct piouucts that can allow you to be moie active anu enhance youi uaily life.
Bon't live with the woik aiounus. Nake it a piioiity to 'optimize youi system' this spiing!
May 2014 The Rambling Rosebud
4 PRESIDENTS MESSAGE Dont forget our next board meeting is on May 19 th I know I have mentioned this before but wed love additions (or replacements) to the board! Anyone fancy being Board President?? I know we are all glad to see the back of winter and welcome the warmer weather. Over the summer we will have group discussions instead of speakers so please give us your suggestions for topics for those discussions. Paul THE S-LOW DOWN ON EATING Vicki Rackner, MD , Via: Gainseville GA, Arizona ICU Bulletin & S. Brevard (FL) Ostomy Newsletter Do you find yourself slamming down a sandwich or dashing through the drive-up window? Take time to take healthier bites, and youll get the most nutrients from the foods you choose. Slowing down means chewing each bite well and taking time between bites. The digestive process breaks down food mechanically and starts in your mouth, mostly with chewing. Teeth are the original food processors. Saliva starts the digestive process that continues in the stomach, where powerful digestive enzymes release the nutritional gifts found in food. HOW TO SLOW DOWN: *Sit down when you eat. *Turn off the TV so you focus on the pleasure of eating. *Chew, chew, chew. The more you chew, the less work is left for your stomach, and the more nutrients can be absorbed. *Be conscious of the taste and texture. *Make eating a social event with a family dinner or lunch with a co-worker. *Ask yourself, What do I want now? Am I full? If youre full, stop eating. The bottom line: Slowing down helps you enjoy your food, enjoy your meals, enjoy better nutrition, and enjoy weight loss while eating less as you give your body time to tell your brain that you are full.
IS YOUR POUCH TOO FULL? Via Evansville ReRoute, The Pouch, Coos Bay & Cincinnati chapters Avoid letting your pouch too full, either of water or gas. Normally you should empty your pouch when it becomes 1/3 to 1/2 full and before trapped gas makes it firm. As the pouch becomes fuller, it places a greater strain on the snap fasteners holding the pouch onto the flange for two piece wearers, and increase the tendency for the adhesive part of the appliance to pull away from the skin around a stoma for a one piece pouching system. If it is not convenient to empty a filling pouch, get somewhere where you can discreetly pop the seal, releasing the gas pressure. This trick can buy you a little more time before emptying it is absolutely necessary. Also, for the ileostomates, if you know that you are going to be traveling or in a situation where easy access to a rest room is not available, adjust what you eat to avoid high residue food. Instead of eating bran muffins and a bowl of Raisin Bran for breakfast, consider pancakes which have much less residue. Be aware of how fast your body response to eating. If you know that you can expects lots of stoma activity about two hours after eating, time your meal so that you wont have to deal with a pouch approaching its capacity at an importune moment. Similarly, urostomates may want to consider temporarily adjusting their rate of fluid intake for a short time. The caution here is that urostomates should consume plenty of fluids during the day. This technique is not advisable for periods of more than a couple of hours. Ostomates should not skip meals before going out socially. In general, the less an ostomate eats, the more gas he or she will produce with its attendant problems. Actually, a quick arm across the stoma will usually silence it if it is operating at the wrong time. Adversity introduces you to yourself. THE MI D-ATLANTI CS LARGEST OSTOMY DEALER We have a dedicated group of Ostomy Supply Consultants that are committed to keeping you in your active lifestyle. Northern Pharmacy and Medical Equipment has an attentive staff that cares about your quality of life. Make us your first step in getting back to life as it was meant to be. After all
Weve been here for over 75 years, there must be a reason! Our Ostomy Department provides a full range of comprehensive services and quality products from trusted brands you can rely on. WE OFFER: Delivery anywhere in the United States Free delivery available Next day delivery is available Large inventory of ostomy & wound care supplies in stock (we stock an inventory of over 5,000 boxes of supplies) Customized hospital and clinic service plans available In-house Medicare and insurance billing specialists Personalized pharmacy/medical supply specialist available Easy ordering by fax, phone, online, or in-person. Toll Free 24 hour hotline Acceptance of all major credit cards Northern Pharmacy and Medical Equipment 6701 Harford Rd, Baltimore, MD 21234 Harford Rd & Northern Parkway www.NorthernPharmacy.com SPEAK DIRECTLY TO OUR OSTOMY SUPPLY CONSULTANT: KEITH CAPPS Phone: (410) 254 2055 x249 Fax: (443) 740 9297 kcapps@northernpharmacy.com May 2014 The Rambling Rosebud
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BLEEDING AROUND THE STOMA Lyn Rowell As a new ostomate I was changing my pouch and alarmed to see fresh blood as I cleaned the skin frightened I called my neighbor who was a nurse. It turned out that I had bumped the stoma as I removed the old pouch, and caused it to bleed. I was reminded of this recently when during a pouch change it happened again. So why does a stoma seem to bleed rather easily? To begin with, we need to remember that the stoma is created from the intestinal tract. When it is formed, the surgeon folds it back, like folding back your sleeve thus the inside of the tract is now outside. This is then sutured to the muscle wall. The nutrients from food are absorbed into the blood stream as it passes through the digestive tract requiring there be plenty of blood vessels and consequently even a small bump can cause a bleed. If a bleed happens, apply pressure with a dry cloth or tissue to help the blood coagulate. It should stop within a few minutes. If it doesnt stop within 10 minutes call for medical assistance. Once the bleeding is stopped, a powder such as Stomahesive powder can be lightly applied to help seal it before putting on the new pouch. Make sure that if you are using a cut-to-fit pouch that you make sure to cut the opening an extra 1/8 so that it doesnt rub against the stoma. If using a pre-cut pouch, make sure that nothing has changed and you have the correct size. Some medications such as Coumadin or Aspirin make an individual more prone to bleed so if you have a regular problem with your stoma bleeding at pouch change, ask your doctor if it might be medication related. Occasionally a cut can be caused by the pouch moving during a physical workout in those cases an ostomy belt or additional framing using tape can help. However alarming it may be to see blood when you change your pouch, dont panic but take the appropriate steps to stop it. And if you are concerned, make an appointment to see your ET nurse. COMMON OSTOMY PROBLEMS AND POSSIBLE SOLUTIONS Excerpted from an article in the Huntsville, Alabama Re-Route Food blockages. Symptoms may include no output from the stoma for more than 4 hours, cramping in the abdomen, nausea or vomiting and high watery output. Solution: Drink hot tea and increase your fluid input. Take a warm bath or shower and massage your abdomen. Have a glass of wine. This will help relax your abdominal muscles. Get down on all fours with your backside in the air. An undignified position, but it does help some people move a blockage. If the blockage persists for more than a few hours, seek medical advice from your nearest hospital. Mucous and bleeding from the rectum. Solution: This is completely normal if your rectum is still intact, although annoying, since the mucosal lining of the rectum is still working. Try wearing a sanitary napkin to save soiling your underwear. If the bleeding is profuse, see your doctor. Odor. Solution: Simple solutions that work for some ostomates are to place mint tic tacs or mint mouthwash into your bag. Deodorants, A mature lady ordered two shots of whiskey and one drop of water. The bartender promptly obliged. After she ordered a duplicate drink, his curiosity became aroused. Maam, he said, I couldnt help but notice the odd mixture of your drink. Why so light on the water?
Young man, she replied, I dont have any trouble holding my whiskey, but I do have trouble holding my water. May 2014 The Rambling Rosebud
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either taken orally or placed in your bag, are available from your ostomy supplier. DO NOT place aspirin in your bag in an attempt to eliminate odordoing so can cause damage to your stoma. Bleeding. Solution: First, determine if the bleeding is coming from the surface of the stoma or from internally. If it is internally, then its wise to seek medical advice. If the bleeding is from the surface of the stoma, it should stop quite quickly. Stomas are made from the same type of skin as the inside of your cheeks and you know how easily they bleed. Even the slightest little nick can cause it to bleed. If bleeding is profuse or doesnt stop quickly, seek medical help. Cuts to the stoma can also be caused by the wafer riding off center. Try picture framing the wafer with some tape to stop it from moving. Phantom rectal pain, ie., you get the urge to go to the toilet in the old way, even though you know you cant. Solution: This pain is because your body needs time to adjust to its new plumbing and still thinks it needs to go to the toilet in the old way. Try going and sitting on the toilet anyway, even though you know its pointless. A lot of people find this alleviates the pain. The good news is that over time, phantom rectal pains become less frequent and eventually disappear altogether. Stoma is placed on or above the beltline. Solution: This is more common in men than women for some reason. DO NOT let them site your stoma on or above the beltline if at all possible. Belts will stop the stool from flowing into the pouch so try wearing trousers a size bigger than you would normally wear and wear braces or suspenders to keep them up rather than a belt. Seatbelt of cars ride right over the stoma site and are uncomfortable. Solution: Try using a clothes peg at the top of the seatbelt where it slides into the door. This will enable you to wear the seatbelt looser than normal but still protect you in case of an accident. Use a small cushion or pillow between you and the seatbelt. Remember, a broken stoma is much easier to put back together than a whole person! Stoma shows through a tight dress. Solution: Try wearing bike pants or similar lycra pants under your outfit that will smooth out the line of the bag. Empty frequently.
PREVENTING SKIN IRRITATION Via: Metro Maryland & So. NV. Town Karaya You do not have to put up with irritated skin. A properly fitting pouching system changed as needed will prevent skin irritation in most instances. Irritation right around the stoma can be a sign of poor adhesion which permits leakage of body waste. Your skin barrier should be changed as soon as it starts to leak. The time you can wear it comfortably will vary depending on your activities. You may need to change it more frequently when you exercise strenuously or when the weather is hot and you are perspiring. Itching, redness, or rash may be caused by constantly pulling the adhesive away from the skin. It may also indicate that you are allergic to the adhesive. Report any such reaction to the doctor, nurse, or ET nurse immediately. There are several types of skin barriers available. You should be able to use at least one of these with no problem.