Opus 2014-225: Healthy Insights: Stoma Saga, 5 of 7, Our Problem

Now for the reason for these posts.

For the first three weeks nothing seemed to work for us.  The seals would never hold.  The bags would always leak.  We could watch the progress of brown material through the barrier.  The pain kept up constantly as the skin around the stoma was attacked by the acid. 

If the seal is not good the material, scientifically called poop, pumping out of the stoma comes in constant contact with your skin.  If you have ever had heart burn and felt the way it seems to be eating away at your throat and mouth, picture that on the skin of your abdomen.  The skin gets red.  It gets redder and begins to bleed.  You keep changing the bag and it just gets worse.  You consult the professionals and they come up with all kinds of solutions but nothing works.

Finally, no thanks to the professionals, we began to figure it out. 

Most stomas in the videos stand at attention or at least pretend to do so.  Ours acted like a short snake that was trying to burrow back into the ground.  You had to get real close with a bright flashlight and move the stoma around to discover this.  What we thought was a large stoma that was leaking from the side was actually a stoma of normal dimensions that was bent over.  The stoma is a muscle.  It flexes.  Our stoma had a kink and every time it flexed it put downward pressure as it would emit the acidic contents.  It did not take long for it to work its way down under the barrier, disrupt the seal, eat away the adhesive and begin to attack the skin.

If you are having problems or know someone who is having problems, get down real close with a bright light.  Don’t be afraid to touch the stoma.  Lift it gently.  Move it from side to side.  See if it is bent over.  If not, then I can’t help you.  If it is I can tell you what worked for us.

To be continued...

homo unius libri

Opus 2014-224: Healthy Insights: Stoma Saga, 4 of 7, The Making of a Stoma

When the colon is removed it is still necessary to get rid of body waste.  This is done through constructing a stoma.

The stoma is the end of the small intestine that is extended through the muscle and skin and sutured in place.  It becomes a combination rectum and anus but without the sphincter muscles that allow control.  It puts out feces whenever it feels like it and there is nothing you can do about it.  Modern medicine has developed technology, commonly called bags, to contain and control the output.

The stoma is a short section of the small intestine which, in the ideal circumstances that are used in the teaching videos, protrudes from 1/4 to 3/4 of an inch through the wall of your lower abdomen near your belly button.  The exact placement on right our left depends on the type of surgery.  Picture a jumbo hot dog that has been peeled sticking out of your side and you get the picture.  It is red, glistening and rough, just like the tip of a hot dog would look without the skin.

The bag consists of a barrier, sometimes called a wafer, that sticks to your skin and a bag to contain the waste.  They come in two piece and one piece.  They come in different shapes sizes and materials.  The difficult part is finding what works best for you and learning how to apply it.

In a perfect world you come home and are able to do the whole process of applying and changing the bags yourself.  Life goes on.

We were not in a perfect world and from my reading on-line, neither are others.

To be continued...

homo unius libri 

Opus 2014-223: The Morning Dig Out

I am sure you have all been there.

Every normal morning starts the same for me.  I get out of bed and shuffle to the kitchen, start the coffee, visit the water closet for the first session, stumble to my Lazy-Boy and read a chapter in Proverbs.  By that time I am awake enough to realize where my day is going.  On week days that means the ritual of the working class:  Wash, dress, fix, drive. 

Today I became awake enough half way on my journey to realize that I was one car among millions, all jockeying for position.  I was one of the washed masses.  I was a spear carrier in the play of life.  I was a loose wire in the cosmic computer.  I was one Republican vote in California.  We are talking insignificant here.

As I started the feel sorry for myself God had pity on me.  He tapped me on the shoulder and reminded me that I had a job and the car showed no indication of breaking down.  Sure I was acting as a full time nurse always on call but I was one of those who had insurance that seemed to be doing its job.  I am healthy enough to help instead of needing help. 

Best of all, as a Christian, I have an assurance of eternal life.  I am reminded:

(Lamentations 3:22-23 KJV)  It is of the LORD'S mercies that we are not consumed, because his compassions fail not.  They are new every morning: great is thy faithfulness.

The compassion of the Lord has been made new again.  It is morning.  He is here.

homo unius libri

Opus 2014-222: Healthy Insights: Stoma Saga, 3 of 7, An Anatomy Lesson

First, a description of the digestive system.  This is important because it is the body system we are dealing with and you probably did not listen in high school.  Now you need the information and wish you had paid attention.  This is anatomy 101.  If you listened then you can skip it now.

Your digestive system is a long tube that starts at your lips and ends at your anus.  Not a very pretty picture but simple and clear.  Food enters the mouth, descends through the esophagus and passes through the stomach, small intestine and large intestine to exit through the anus.

The mouth starts the digestive process by chewing and mixing with saliva.  It breaks down the large units of food into smaller pieces so that digestion will proceed more efficiently.  Think of how much easier a powder dissolves than a pill.  This is why we are told to chew our food well.  The saliva begins to chemically break down the food.

The esophagus simply pushes the food down into the stomach.  What you eat and drink does not fall by gravity but is forced down by muscle action.  This will be true from this point on.

At the top and bottom of the stomach are sphincter muscles (circular like a camera iris) to keep food in the stomach while the muscles of the stomach churn the food for digestion.  The lining of the stomach excretes acid and mucus to make a smooth paste that will pass on into the small intestine.  Contrary to popular belief, your stomach is not located behind your belly button.  It is high up, under your rib cage.  The lower part of your body houses your intestines.  Think of your stomach as a balloon that stretches and contracts as needed to contain varying amounts of food.

When the mixture is right the stomach relaxes the lower sphincter muscle and pushes the ooze into the small intestine.  The small intestine is about the width of a polish sausage and about 20 feet long.  Muscle contractions squeeze the food down the tube.  This muscle action is like you trying to get tooth paste out of a tube.  As it move along the small intestine extracts the substances needed to keep you alive and functioning:  Carbohydrates, protein, vitamins, minerals, salts. 

By the time the remains reach the large intestine there is little but waste and water.  The job of the large intestine is simply to remove water.  As the waste moves through it thickens until it comes out the anus.  Too little water removed causes diarrhea.  Too much result in constipation.

Wasn’t that exciting?

To be continued...

homo unius libri 

Opus 2014-221: Healthy Insights: Stoma Saga, 2 of 7, The Quest Begins

Are you still with me? 

We received lots of well meaning DVD’s about how to care for the stoma.  There were You Tube videos offering advice.  They were interesting in general principles but our problem was that everyone in the DVD’s and on the internet had a trim body and a normal stoma.  Think about it.  If you had rolls of fat on your stomach you would not want to make a video to show the world.  In our case we have layers of fat that denied us a firm foundation for attachment.  We had a stoma that had a mind of its own.  Where most stomas stand tall and firm, ours layed over on its side and kept trying to dig its way back into the body.

I remember going to discussion chatrooms and reading people who were totally frustrated.  No one seemed to offer them any hope except “hang in there.”  Maybe I didn’t look far enough but I found no answers.  We eventually put it together.  We learned by failure and were motivated by pain. 

I will try to share what we learned.

To be continued...

homo unius libri 

Opus 2014-220: Healthy Insights: Stoma Saga, 1 of 7, Stoma? What’s a Stoma?

Do you know what a stoma is? 

If not, count your blessings.  You may also want to skip this series of posts. 

If you do know, are you slender, with little extra body fat?  Is your stoma standing straight and at attention?  Then most of what I am going to say will not be necessary for your happiness and comfort.

If you are having trouble with your stoma or know someone who is, I offer this in hopes that our journey may give you some insights on your own rough road.  The stoma I will be addressing is the result of the removal of the colon.  People with a stoma are on a bag.  It is technically called a “ileostomy” since your small intestine is labeled the ileum.  You can read about it on Wikipedia is you want.

We have moved to the second stage of our journey which produced a new type of stoma.  We are going through struggles on how to work with this one because it is totally different.  This made me think of the lessons we learned by trial and error on the first stoma and my attempts to get help in dealing with it.  Looking back I find that I either ran across answers for standard, low maintenance stomas or frustration with struggles with difficult stomas.  The first I didn’t need.  The second was a matter of sharing pain, not results.

The journey begins.

To be continued...

homo unius libri 

Opus 2014-219: On the Street: Spoon Feeding

The modern family is interesting to watch. 

I am sitting at breakfast in the local Panera.  As I get up to get more coffee I notice a lady and her teen age daughter.  What a study.  The daughter is working her smart phone.  The mother is eating from a plate between them.  Suddenly the mother forks a bite and raises it to put it in the mouth of the girl.  The mouth opens and the girl chews.  Her eyes never leave the phone.

Is it any surprise that when the baby chick was fed that they left and did not clean up after themselves. 

In a few years the girl will be old enough to vote.  There are two of them.  I am already outnumbered.

homo unius libri