Caring for Your Ostomy at Home

Transcription

Caring for Your Ostomy at Home
www.libertymedical.com • 1-877-812-7428
Welcome Home!
It must
feel good to sleep
in your own bed again.You
may be feeling anxious about
caring for your ostomy at home. You
and your family, most likely, have learned
basic ostomy education in the hospital.
Emptying your pouch is essential to learn
because this is what you will be doing most
often. As you continue to recover, changing your
pouch will become easier. Home care nurses may
be helping you practice ostomy care at home. If
you are feeling sad about the ostomy, keep in mind
that the surgery was necessary to correct or bypass
a medical problem, whether on a temporary or
permanent basis.
This booklet will provide you with information and
useful tips to ease your adjustment at home. Keep
a positive attitude and take one step at a time. You
will feel more confident once you care for your
ostomy by yourself. Keep practicing, and before
you know it, ostomy care will fit into your daily
routine and you will return to your
normal activities.
Let’s Review, What is a Stoma?
The stoma refers to the piece of intestine that you see on your
belly. No matter what type of ostomy you have, stomas have
common features.
A normal stoma is:
• Pink-red in color
• Moist like the inside of your mouth
• May slightly bleed when rubbed
• May move and change shape
• Without nerve endings for touch
picture of normal stoma
Even though a red stoma looks like it should hurt, it doesn’t! The
stoma stays red and may bleed slightly when cleaned because
of a rich blood supply within the tissues. After surgery, you may
see sutures (stitches) around the outside of the stoma which will
gradually dissolve. The stoma is also swollen after surgery which
will decrease in size over 6-8 weeks. You will not have control
over when the stoma will pass waste. When the waste is ready to
leave the body, it will pass through the stoma into the pouch on
your belly.
The stoma is unique to you, depending on your body shape and
the way the stoma was made. Your stoma may be:
• Round, oval, or irregular in shape
• Even with the skin, protrude above the skin level or pulled inward below the skin level • Located on either the left or right side of the belly
How was your stoma made?
• End stoma – The functioning end of the intestines is brought to
the belly, is turned back on itself (like a turtleneck sweater) and is
attached to the skin with sutures. There is only one opening to pass
waste. The other end of the intestines is either removed, sutured
closed, or is brought up to the belly as a second end stoma. Since
the second stoma is non-functioning, it will only
pass mucous.
• Loop stoma – A loop of intestines is brought to the belly
and usually a temporary device (rod or tube) holds the loop up
until healing occurs. An opening is made only in the top part of
the loop exposing two openings into the stoma. The functioning
opening will pass waste, the other will pass mucous. Usually
a loop colostomy or ileostomy is made when it is intended to
be temporary.
What Type of Ostomy do you Have?
• Colostomy – a portion of the large intestines (colon) is rerouted to the belly to allow stool to exit a stoma. This is performed
after a portion of the colon has been removed or bypassed.
• Ileostomy – the ileum section of the small intestines is rerouted to the belly to allow stool to exit a stoma. This is performed
after the colon has been removed or a section of the intestines
is bypassed.
• Urostomy – a passageway is made for urine to exit a stoma
on the belly. This is performed when the bladder is removed
or bypassed.
Colostomy
IIeostomy
Urostomy
Products
Products
You left the hospital wearing a pouch that was chosen for you
by the WOC Nurse or hospital nurse. There are many types and
brands of ostomy pouching systems and accessories on the
market. Once you feel confident with your ostomy care, you may
want to try other products. Sometimes, a change in products is
necessary due to allergies, body changes, or insurance coverage.
Let’s review some pouching options.
A pouching system consists of a skin barrier and pouch. The
skin barrier will be either a combination of a barrier disc and tape
border or contain a full barrier backing. There are 2 types
of pouching systems:
• One-piece system – The skin barrier and pouch are combined
and applied as one system.
• Two-piece system – The skin barrier and pouch are separate
pieces and can be applied separately or together.
One-piece
Two-piece A
Two-piece B
Skin Barrier
The adhesive pectin disc is designed to fit closely around the
stoma. This tan disc protects the skin and provides a seal to
prevent leakage. It is essential for the barrier opening to be the
right size around the stoma. Skin barriers come in various styles:
cut-to-fit (you cut to the stoma size), pre-cut, and a moldable
option.
Here are tips to finding the correct size opening for the
cut-to-fit style:
• Use a measuring guide.
• Find the hole on the guide that fits closest to your stoma
without touching it.
• Trace with a pen the selected hole on the back of the barrier.
• Cut the barrier slightly larger than the traced hole. If your
stoma is oval, cut a oval shape instead of round.
If you are using a pre-cut or moldable skin barrier, follow the
manufacturer’s guidelines for sizing. Skin barriers also come in a
convex style. The barrier is shaped like a shallow bowl. Convexity
is mainly used for stomas that are below skin level or are even with
the skin to provide a better seal and increase wear-time.
Pouches
You, most likely, came home from the hospital with a basic postoperative pouch. The pouch is clear in order to observe the color
and amount of waste. Now that you are home, your needs will
change and more options are available to you. For instance,
if you have a colostomy, you may want to switch to a beigecolored pouch with a filter to release and deodorize gas. Let’s
review other options from various manufacturers:
Drainable Pouches (for colostomy and ileostomy)
• Pouch lengths 7”, 9”, 10”, 12”
• Clear (transparent) or beige (opaque)
• With or without filter
• Integrated pouch closure or separate clamp, wide-outlet
pouch tails
• One or two-sided comfort panels
• High output pouches with spout or integrated closure, 12”
• Pediatric sizes
Closed-end Pouches (usually for descending or sigmoid colostomy; 1-2 stools / day)
• Beige (opaque) or clear (transparent) with or without filter, lengths 8”, 9”
• Mini-Pouch with comfort panel, lengths 6”, 7”
• Cap with filter
• Pediatric sizes
Urinary Pouches (urostomy)
• Pouch lengths 7”, 9”, 10”, 12”
• Clear (transparent) or beige (opaque)
• Mini-pouch 6” length, transparent
• Minicap, opaque (1/2-1 hour use – 100 cc urine)
• Bendable tap or swivel tap
• Pediatric sizes
Accessories
There are many ostomy accessories available on the market.
These are products to aid in the care of an ostomy.
Some common ones include:
Pectin paste – Paste is used as an additional barrier to protect skin,
increase pouch wear-time, and to fill in uneven surfaces around
the stoma.
Pectin powder – Powder provides a protective barrier for
reddened, irritated skin. It also dries weepy skin or fills shallow
wounds around a stoma before the application of the skin barrier.
Powder can be sealed with water or a skin barrier wipe or spray.
Skin barrier rings and strips – These are a variety of moldable,
adhesive pectin rings and strips used as additional barriers to
protect skin, increase wear-time, and to fill in uneven surfaces
around the stoma.
Skin barrier wipes / gels / sprays – These products provide a
protective film on the skin under adhesives. These may also be
used to seal pectin powder used on irritated skin around the
stoma. Some brands contain alcohol which will cause temporary
burning if the skin is open. No sting formulations are available to
use without discomfort.
Adhesive remover wipes – These wipes aid in the removal of
adhesives and adhesive residue on the skin. Clean the skin with
soap and water after using so the new barrier will stick to the skin.
Belt – An ostomy belt provides additional security for those who
desire extra support and better pouch wear-time. The belt should
be worn at the level of the stoma.
Learning
Care
Pouch Emptying
You may wonder…how will I know when my pouch needs
emptying? The pouch should be emptied when it is 1/3-1/2 full. It
is important that the pouch does not become too heavy. It could
pull away from the skin causing leakage. Overfilling may also
create a bulge under your clothing. It doesn’t take long for you to
sense pouch weight and the need for emptying.
Pouches have various tail closures depending on the pouch type.
A pouch draining stool may contain a removable clamp or may
have a Velcro-like closure built into the pouch. Urinary pouches
have a bendable or swivel spout.
Here are some emptying tips:
• Place a piece of toilet paper in the bowl to avoid splashing of
pouch contents.
• Sit on the back of the toilet so the pouch tail easily fits between
your legs or you can stand or lean over the toilet.
• After emptying, clean the pouch tail or spout before closing to
avoid odor.
Changing the Pouching System
The first step in changing your pouching system is to gather supplies and place within easy reach. The bathroom is a logical place to perform ostomy care. It is important to see the
stoma site by looking down at your belly or by looking in a mirror.
Then carefully:
• Empty your pouch before proceeding.
•
Gently remove the barrier from your belly by lifting the edge with one hand and pushing down on the skin with the other
hand. It may work best to begin at the top of the barrier and work downward so you can see what you are doing. Water or adhesive remover wipes can assist with pouch removal.
•
Wipe the stoma and skin with toilet paper to remove waste.
Gently wash the stoma and skin with warm water and a
washcloth or paper towel. If using an adhesive removal wipe,
clean the skin with mild soap and water to remove residue.
• If needed, carefully shave unwanted hair around the ostomy
site, using an electric razor.
•
Look at the stoma and skin to make sure all is healthy.
Sometimes there will be temporary redness on the skin when
you remove your pouching system. Pay attention to any areas
that are sore.
•
If the skin around the stoma is irritated, apply pectin powder.
Dust away excess powder and dab lightly with water or a
skin barrier wipe and allow to dry. If the skin is normal, you
can apply a barrier wipe if you have been instructed to do so.
Allow the skin to dry well.
•
Re-measure the stoma. Make sure your skin barrier (two-piece)
or one-piece pouch is ready to apply. If using a cut-to-fit
system, cut the barrier or pouch slightly larger than the
stoma size.
• If using a second barrier, such as paste, adhesive ring or strip,
apply either around the stoma or around the opening on the
back of the barrier after removing the paper lining.
•
Apply the skin barrier or one-piece pouch over the stoma
(after removing paper lining) and spend a few minutes
pressing down around the stoma and the barrier. Apply the
pouch onto the barrier if using a two-piece system. Cover
the pouch with the warmth of your hand to increase the bond
between the barrier and the skin.
• Secure the pouch tail with a clamp or built-in closure, or close
the spout on a urostomy pouch.
The Do Not’s of Ostomy Care
Don’t use gloves or gauze as in the hospital.
Don’t use soaps with oils, creams, or fragrances.
Don’t use baby wipes or towelettes with lanolin, oils,
or fragrances.
Don’t use alcohol or other chemicals to clean the stoma site.
Don’t flush ostomy products in the toilet.
Don’t forget to discard used products in a small plastic bag.
The Do’s of Ostomy Care
Do measure your stoma weekly for 8 weeks, then as needed.
Do change your pouch when the stoma is least active, usually
before eating and drinking.
Do change your pouch at least 1-2 times each week.
Do change your pouch promptly if itching, burning or
leakage occurs.
Do talk to your WOC Nurse if you are changing your pouch
more often than expected.
Do store ostomy supplies in a cool, dry place.
Colostomy
Colostomy
To better understand your colostomy, let’s review the normal
digestive system. Basically, the digestive tract is one long tube
from the mouth to the anus. The organs that make up this tract
have various sizes and functions.
Mouth – starts digestion
Esophagus – carries food to stomach
Stomach – churns & turns food into liquid
Small intestines – digests & absorbs nutrients; about 22 feet long
Large intestines – (colon) absorbs water & stores stool; about
5 feet long; divided into sections:
• Cecum – about 3 inches; appendix present
• Ascending – right side belly
• Transverse – extends across belly
• Descending – left side belly
• Sigmoid – lower left belly; s-shaped
• Rectum – stores stool until passed
• Anus – body exit for stool
A colostomy (colon + ostomy) can be located anywhere in the
colon. A colostomy is named for the section where the ostomy is
present. For example, if the colostomy is located in the sigmoid
part of the colon, it is a sigmoid colostomy. The more right-sided
the colostomy is, the looser the stool will be. It will also require more
frequent emptying of the pouch. Pouch emptying usually ranges
from 1-3 times each day.
If your anus has not been removed, it is normal for you to pass
mucous at times through the anus. It may be watery or thick,
varying in color from white, yellow or brown. You will get an urge
to have a bowel movement and will pass mucous. Sit on the toilet
and satisfy the urge.
Stool Consistency
Cecostomy - fluid stool
Ascending colostomy - fluid to semi-fluid stool
Transverse colostomy - mushy stool
Descending colostomy - semi-mushy to formed stool
Sigmoid colostomy - solid stool
It is important to be aware that stool consistency will also vary
depending on diet & fluids, medications, and activities. Once
you are eating a well balanced meal and back to your routine
activities, you will get a better sense as to your “new normal” stool
consistency and frequency.
Constipation and diarrhea can still occur with a colostomy.
Reasons why constipation may occur include certain
medications, not drinking enough fluids or eating enough fiber,
just like before you had a colostomy. Increasing fluids and
taking a mild laxative recommended by your doctor, may be
helpful. Diarrhea can occur for a variety of reasons, such as viral
or bacterial infections. Eating foods which thicken stool may be
helpful, as listed in a later food table. Be aware that diarrhea can
lead to dehydration. Increase your fluid intake during this time.
Colostomy Irrigation
Irrigating a colostomy is a method of control for those with a
descending or sigmoid colostomy. Basically, a colostomy irrigation
is an enema given into the stoma. The goal is to remove stool that
would be passed that day. It takes time and patience to learn.
Some people are controlled enough to only use a stoma cap
instead of a pouch. If you are interested in this option, talk to your
surgeon and WOC Nurse. It is important to be properly trained in
the procedure.
Ileostomy
Ileostomy
To better understand your ileostomy, let’s review the digestive
system and how it has been altered with your surgery. Basically,
the digestive tract is one long tube from the mouth to the anus.
The organs that make up the digestive tract have various sizes
and functions.
Mouth – starts digestion
Esophagus – carries food to stomach
Stomach – churns & turns food into liquid
Small intestines – absorbs nutrients;
about 22 feet long; consists of 3 sections:
• Duodenum – about 10 inches long
• Jejunum – about 9 feet long
• Ileum – about 12 feet long
Large intestines – (colon) absorbs water & stores stool; about
5 feet long
Anus – body exit for stool
Usually an ileostomy (ileum + ostomy) is located in the lower part
of the ileum near where the small intestine attaches to the large
intestine. Because of this location, an ileostomy is usually located
in the right lower part of the belly. Ileostomy stool will vary in
consistency from liquid to pasty. It is normal to empty the pouch
4-6 times each day.
If your anus has not been removed, it is normal for you to pass
mucous at times through the anus. It may be watery or thick,
varying in color from white, yellow or brown. You will get an urge
to have a bowel movement and will pass mucous. Sit on the toilet
and satisfy the urge.
Conditions Unique to an Ileostomy
• Stool from the small intestines contains digestive enzymes
which are irritating to skin. It is very important to protect the skin
around the stoma with a good pouching system.
•
Diarrhea can still occur. It is normal for ilestomy stool to be
unformed, however if the stool volume increases and turns
liquid, you may have diarrhea. Become familiar with foods that
thicken stool, as listed later in the food table. It is also important
to drink plenty of fluids (10-12 eight oz glasses daily) to avoid
dehydration. Keep sport drinks available to help replace fluids.
The symptoms of dehydration include:
- Increased thirst
- Dry mouth
- Decreased amount of urine, darker urine
- Muscle cramps, abdominal cramps
- Weakness
If symptoms of dehydration occur, increase fluids and notify your
doctor. Sometimes, IV fluids are necessary.
•
Food blockage is possible with an ileostomy due to the smaller diameter of the small intestine. This can occur when high fiber foods have trouble passing through the stoma. Stool output will decrease, stop or turn liquid. Cramping, belly swelling, and stoma swelling are other symptoms. Actions to take if food blockage occurs:
• Quit eating; drink warm fluids.
• Apply larger opening pouch for stoma swelling.
• Take a warm bath to relax belly muscles for blockage
to pass.
• Massage muscles gently around the ostomy or get in a knee-chest position and rock back and forth.
• If the blockage does not pass over the next few hours or
if you have nausea or vomiting, notify your doctor or go to the emergency room.
• An abdominal x-ray will most likely be done.
• Blockage can be relieved with a lavage procedure. The doctor or nurse will instill saline solution into the stoma through a catheter until the blockage is dislodged.
• The belly may be sore for several days after the blockage
is resolved.
How to avoid?
• Increased risk during the 8 weeks following surgery due
to stoma swelling.
• Avoid high fiber foods – see later food table.
• Chew food well.
• Eat potential problem foods in small amounts.
•
• Drink plenty of fluids.
What to do?
There are medications that may not be completely absorbed with an ileostomy. These include enteric-coated (hard) pills and time or extended release capsules. Discuss with your doctor and pharmacist. Laxatives should not be taken when you have an ileostomy.
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Urostomy
Urostomy
To better understand your urostomy, let’s review the urinary system
and how it has been altered with your surgery. The urinary tract
consists of the kidneys, ureters, bladder and urethra. Urine is made
in the kidneys and travels through small tubes called ureters to
the bladder. Urine is stored in the bladder until it passes out of the
body through the urethra.
When the bladder is diseased or damaged, it may be removed,
and a new system is created for urine to exit the body. The most
common urostomy is called an ileal conduit. After the bladder
is removed, a piece of small intestine (ileum) is isolated from the
digestive tract to serve as a passageway (conduit) for urine. The
ureters are attached to the ileal segment and one end is brought
up to the belly as a stoma. The other end is sutured closed. The
urine passes from the kidneys, through the ureters, out the conduit
stoma into a pouch on your belly.
After surgery, you may see small tubes called stents coming out of
your stoma. These tubes are threaded through the stoma into the
ureters to protect the surgical sites. Usually the tubes are removed
in the doctor’s office several weeks after surgery. The urine from
the ileal conduit will drain constantly. The urine will look cloudy at
times due to mucous. The ileal conduit is made from small intestine
and its job is to make mucous for lubrication. Over time, you may
see a decrease in the amount of mucous in the urine. The ileal
conduit stoma is usually located in the right lower part of the belly.
Conditons unique to a urostomy
•
Dietary changes are not needed, other than drinking plenty
of fluids, especially water (at least 8-10 eight oz glasses each
day). There are foods that increase urine odor such as
asparagus, seafood, and some spices.
•
A primary goal is to prevent urinary tract infections which can
lead to kidney problems. Fluids flush the urinary system which
decrease bacteria overgrowth. Urinary pouches contain an
anti-reflux device to keep urine from bathing the stoma.
Emptying the pouch regularly and using a night drainage
system can also help.
A night drainage system is a large urine collection bag or bottle
with tubing that is connected to your pouch while you sleep at
night. This keeps you from having to get up at night to empty your
pouch. The collection bag or bottle must be emptied, rinsed, and
allowed to dry every morning. Every few days the bag or bottle
should be cleaned with a commercial urine cleanser or with a
water-vinegar solution. Mix 3 parts water to 1 part white vinegar
and allow the solution to soak for 1 hour. Make sure the drainage
collection bottle or bag thoroughly dries.
The symptoms of a urinary tract infection are:
• Cloudy, dark urine (remember, mucous strands may also make the urine appear cloudy)
• Strong smelling urine
• Fever
• Back pain in the area of the kidneys
• Nausea and Vomiting
• Fatigue
Notify your doctor if these symptoms occur. You may have a urine
culture done and be placed on antibiotics.
Diet/
Activities
Diet/Activities
You can live an active lifestyle with an ostomy. You just have to
believe that you can! It will take time and some adjustments, but
you will be able to do normal things, like going out to eat, working
and enjoying leisure activities. Let’s review how the ostomy will fit
into your activities of daily living.
Diet
It is generally recommended eating a low fiber diet for the first 6
weeks after intestinal surgery. The intestines are swollen and it may
be harder to pass high fiber foods. Gradually add foods back into
your diet. Eat slowly and chew food well. Those with colostomies
will later be able to eat what they want. Those with ileostomies will
always need to be cautious with high fiber foods.
High Fiber Foods
Popcorn
Celery
Nuts
Meats with casings (hot dogs, sausages)
Fruits & vegetables with skins and seeds
Mushrooms
Coconut
Dried fruits
Chinese vegetables
Cabbage family
Become aware of the effects of food on your stool. There are
foods that loosen stool, thicken stool, and those that cause gas
and odor.
The Effects of Food
Foods that loosen stool
Foods that thicken stool
Foods causing gas and odor
Fruit juices
Applesauce
Asparagus
Baked Beans
Bananas
Cabbage family
Spicy foods
Boiled rice
Dairy: Milk / Eggs / Cheese
Cabbage
Creamy peanut butter
Fish
Broccoli
Tapioca pudding
Corn
Milk
Potatoes without skins
Dried beans and peas
Raw vegetables & fruits
Cheese
Spicy foods
Chocolate
Pasta
Carbonated drinks
Fried foods
Marshmallows
Beer
Gas & Odor
It is normal to pass gas and have stool odor. If you have an
ostomy that drains stool, you can no longer control when the
gas will be released from the stoma. What causes gas can differ,
however there are some general tips to know.
• Gas can occur from swallowed air, such as drinking through
a straw, chewing gum, talking while eating, sucking on hard
candy, and smoking.
• Get to know which foods cause YOU to have gas. Use the food
table as a guide, but it can differ from person to person.
• If you feel ready to pass gas through the stoma, place you arm
over the stoma to muffle the sound.
• Talk to your doctor or pharmacist if you need medication to
reduce gas.
• Get to know which foods cause odor, using the food table as
a guide.
•
Pouches are made of odor-resistant material. You should not
have odor when the pouch is properly in place. Odor will be
present when emptying the pouch in the bathroom. The place
where everyone has stool odor!
• You can use a pouch with a filter which deodorizes and
releases gas.
• A pouch deodorant can be used in the pouch to reduce
odor. There are also deodorants to take by mouth to eliminate
stool odor.
• Gas and odor are more bothersome for a colostomy
than ileostomy. There is more gas forming bacteria in the
large intestine.
Bathing and Swimming
Water will not harm or go inside the stoma. You can return to
taking baths, showering, and swimming. Here are some water tips:
• You can bathe with your pouch on or off.
•
One method is to bathe without a pouch on your change day and keep the pouch on for other days. If your skin barrier has a
tape border, blot this dry with a towel or a use a hair blower on
a cool setting.
• If bathing without a pouch, use mild soap that does not leave
a residue.
• Check your pouch seal before swimming. Waterproof tape
may be helpful on the barrier edges.
• If enjoying a hot-tub, your pouch wear-time may decrease
because of the heat.
Clothing
You will be able to wear your normal clothes after ostomy surgery.
No one will know that you have an ostomy unless you tell them.
Pouching systems are designed to be as flat as possible. Women
can wear tight garments, such as pantyhose and panty girdles.
Just be cautious about pressure from belts or tight clothing
rubbing the stoma. You can wear your pouch inside or outside
your usual underwear depending on your preference. There are
companies that make specially designed ostomy underwear to
provide fuller coverage and pockets for the pouch.
Exercise/Sports
Having an ostomy should not keep you from returning to exercise
and sports you love. A few tips:
• Ask your doctor when you can return to sports.
• Return slowly to exercise until your strength returns.
• Empty your pouch before starting an activity.
• Pouch wear-time may be decreased with heavy exercise
and perspiration.
• If you engage in a contact sport, such as karate, talk to your
doctor or WOC nurse. There are coverings on the market which
can protect your stoma during such activities.
Intimacy
In time, you can return to a satisfying sexual relationship. It will
not be the ostomy, but your attitude toward your ostomy that will
affect your relationships with others. It is normal to feel sensitive
about the change in your body image. Some surgical procedures
can affect sexual function, which is usually discussed prior to
surgery by your doctor and WOC Nurse. Some helpful tips when
you feel ready:
• Talk with your surgeon about when it is safe to resume
sexual activities.
• Be honest and talk with your partner about each others’
feelings and concerns.
• Empty your pouch and check the pouch seal before
proceeding.
• Mini pouches are available to use for short periods of time,
known as “passion pouches”!
• Pouch covers and specially designed underwear and lingerie may enhance your comfort.
• Seek professional help if you are unable to physically or emotionally return to a satisfying sexual relationship. Ask your doctor or WOC Nurse for assistance.
Travel
The most important thing about traveling is to not forget your
supplies! Other tips include:
• Carry extra supplies for unexpected events.
• Carry a list of supplies with product names and Liberty
Medical’s numbers in your purse or wallet.
• Watch what you eat and drink in other countries.
• If you are flying:
– Pack your supplies in carry-on luggage.
– Pre-cut your skin barriers to avoid scissors on the plane.
• If you are driving:
– Do not put supplies in the trunk where they will get overheated.
– Make sure the seatbelt does not rub the stoma. You can protect the stoma with a small pillow or towel if needed.
Skin
Problems
Skin Problems
The skin around the stoma (peristomal skin) should look normal,
without redness, rash or irritation. The skin will usually feel sore if it
is damaged, but not always. Be sure to look at your skin at each
pouching system change. There are various reasons why skin
problems occur, some common ones are listed.
• A pouching system that does not fit right may lead to leakage
and skin problems. People with ileostomies have a greater
risk for skin damage due to small intestinal enzymes in the stool.
However, those with colostomies and urostomies can
experience skin problems too. Skin damage may be redness,
irritation or open, weepy skin. Some tips to prevent and treat
skin problems include:
– Re-measure the stoma regularly the first 8 weeks to
down-size your barrier opening as your stoma shrinks.
– Change your pouching system regularly before leakage.
– Consider other pouching systems or accessories for a
better fit.
– Use pectin powder to treat skin until healed.
– Contact your ostomy nurse or doctor if the skin does
not heal.
•
Allergies can develop to any products you are using. This can
occur anytime, even if you have been using the same product
for a long time. The skin may itch, blister, develop a rash, or
become weepy. The skin problem may match the shape of the
product, such as under a tape border. Ostomy tips include:
– Patch test products on the other side of your belly to check
for redness, itching, and irritation after 48 hours. Change to
another product if needed.
– Talk with your WOC nurse or supplier for alternate products.
– Contact your WOC nurse or doctor if the skin does not heal.
•
A skin infection can occur. Moisture at the ostomy site may
contribute to a fungal infection (yeast) especially if you have
recently been on an antibiotic. Symptoms include itching,
redness, and rash with white or red bumps that continue to
worsen without treatment. Tips include:
– Treat the skin with antifungal powder prescribed
by your doctor.
– Change your pouching system more often during treatment.
– Continue to treat the skin for a couple of weeks after the skin
is normal.
– Contact your doctor or WOC nurse if the skin does not heal.
If any of the following problems occur, call your doctor:
• Stoma turns darker in color
• Stoma becomes longer
• Excessive bleeding from the stoma or at the stoma-skin margin
• No stool for 48 hours for colostomy; or 6 hours for ileostomy
• Abdominal pain, cramps, severe diarrhea, and/or nausea
& vomiting
• Bulge that develop under or around your stoma
• Peristomal skin problems that do not resolve.
Support
Resources
This is All About ME
ThissectionistobecompletedbyyouwiththehelpofyourWOC
nurse,homenurseordoctor.Astimegoeson,youmayforget
details.Youcanusethissectionasareference.
My Surgery
Ostomy Type:
Colostomy___ Ileostomy______Urostomy______ Other____________
Stoma Type:
End__________Loop__________ Twostomas____ Other____________
Name of Surgical Procedure:___________________________________
DateofSurgery________________________________________________
Hospital___________________________Phone#____________________
Address_______________________________________________________
Surgeon____________________________________________________
Phone#_________________________Fax#_________________________
WOC Nurse____________________________________________________
Phone#_________________________Fax#_________________________
Home Care Nurse______________________________________________
Agency________________________________________________________
Phone#_________________________Fax#_________________________
StomaSize___________Date_______________________
StomaSize___________Date_______________________
StomaSize___________Date_______________________
StomaSize___________Date_______________________
7/7/11 8:26 AM
My Ostomy Supplies
Name_________________________________________________________
Phone Number________________________________________________
Website_______________________________________________________
Medicare Monthly Product Guidelines
Quantity
An Ostomy product listing with Medicare allowables is on the adjacent page.
My Medications
Primary Care Doctor____________________________________________
Phone #___________________________Fax #________________________
Address________________________________________________________
Allergies _______________________________________________________
Name of Medication
Dosage
Frequency
Prescribing Doctor
7/7/11 8:26 AM
Quick Reference Guide
Ostomy Products Listing with Medicare Allowables
Ostomy Product
Quantity Allowed/Duration
Pouches (closed)
60 per month
Pouches (drainable)
20 per month
Pouches (urinary)
20 per month
Wafers (4 x 4)
20 per month
Wafers (6 x 6)
20 per month
Wafers (8 x 8)
20 per month
Stoma cap
31 per month
Lubricant
4 oz. per month
Irrigation cone/bag
1 every 3 months
Irrigation sleeve
4 per month
Stomahesive paste
4 oz. per month
Adhesive
4 oz. per month
Adhesive remover (liquid)
8 oz. every 3 months
Adhesive discs
10 per month
Convex inserts
10 per month
Ostomy belt
1 per month
Appliance cleaner
16 oz per month
Tape (depending on tape width)
1-2 rolls per month
Skin barrier wipes
3 Boxes/50 every 6 months
Ostomy deodorant, liquid or tablet
No set allowable amount
Drainage bottle
1 every 3 months
Drainage bag
1 per month
Ostomy absorbent packets
90 per month
Medicare allowables may change. Liberty is not responsible for typographical errors.
7/7/11 8:26 AM
Support Resources
United Ostomy Association of
America (UOAA)
This is an association of affiliated,
non-profit support groups committed
to improving the quality of life for
people who have, or will have an
intestinal or urinary diversion.
The Phoenix magazine, their official
publication, is an ostomy patient
magazine that is published four
times a year.
1-800-826-0826
www.uoaa.org
Wound, Ostomy, and Continence
Nurses Society (WOCN)
The professional organization of
nurses who specialize in wounds,
ostomies, and continence issues.
Most hospitals have WOC Nurses
(previously known as ET Nurses) to
assist ostomy patients. For information
regarding WOC Nurses in your area,
contact national headquarters.
1-888-224-WOCN (9626)
www.wocn.org
American Cancer Society (ACS)
An organization committed to fighting
cancer through research, education,
patient service, advocacy, and
rehabilitation.
1-800-ACS-2345
www.cancer.org
Crohn’s and Colitis Foundation of
America, Inc. (CCFA)
This is a non-profit, volunteer driven
organization dedicated to finding the
cure for Crohn’s disease and ulcerative
colitis.
1-800-932-2423
www.ccfa.org
Liberty Medical
Ostomy Supplier
1-800-921-9131
www.libertymedical.com or
www.bestostomy.com
Educational Content: Sally Matson, RN BSN MS CWOCN
An ostomy nurse for 29 years, Sally has extensive experience both in adult and
pediatric care. She has practiced in hospital, home health and skilled nursing facilities.
7/7/11 8:26 AM
Visit us on the web at
www.libertymedical.com
© 2010-2011 Liberty Medical Supply, Inc. All rights reserved. Reproduction in whole or part without express written permission from the publisher is
prohibited. Liberty Medical Supply, Inc., a Medco Health Solutions, Inc. company. This communication is not affiliated with Medco client programs or
communications. Liberty and We Deliver Better Health are registered trademarks of PolyMedica Corporation.
Ostomy back cover Rev.indd 1
7/7/11 8:23 AM

Caring for Your Ostomy at Home

Transcription

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