ANNE ARUNDEL COUNTY MARYLAND OSTOMY ASSOCIATION, INC. P.O. BOX 847 GAMBRILLS, MD 21054 OFFICERS President: Stan Baker 410-672-5219 958 Fall Ridge Way Gambrills, MD 21054 Vice President Paul Rossi Secretary Mary Keller Treasurer Lyn Rowell 410-672-6983 Webmaster: Janice Winters BOARD OF DIRECTORS Allyn Mellits Joan Gardner Sandi Burnett Bob Keller OSTOMY ADVISERS: Joyce Onken BSN, RN, CWOCN Lead Inpatient Wound Ostomy Nurse AAMC We’re on the Web! www.annearundelostomy.com Volume 45 Number 7 April 2018 Thank you Anne Arundel Medical Center for printing our newsletter. 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 desk for the room number. If AA County Schools are closed due to inclement weather, there will be NO MEETING. UPCOMING MEETINGS April 5 th – WOCN Presentation May 3 rd – Cheryl Yiadom, Convatec Representative
Transcript
ANNE ARUNDEL COUNTY MARYLAND
OSTOMY ASSOCIATION, INC. P.O. BOX 847
GAMBRILLS, MD 21054
OFFICERS President: Stan Baker 410-672-5219
958 Fall Ridge Way Gambrills, MD 21054
Vice President Paul Rossi Secretary Mary Keller Treasurer Lyn Rowell 410-672-6983 Webmaster: Janice Winters
BOARD OF DIRECTORS Allyn Mellits Joan Gardner Sandi Burnett Bob Keller
We’re on the Web! www.annearundelostomy.com Volume 45 Number 7 April 2018
Thank you Anne Arundel Medical Center for printing our newsletter.
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 2nd 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 desk for the room number.
If AA County Schools are closed due to inclement weather, there will be NO MEETING.
UPCOMING MEETINGS April 5th – WOCN Presentation
May 3rd – Cheryl Yiadom, Convatec Representative
The Anne Arundel County, Maryland, Ostomy Association, Inc. (AACOA) is a non-profit, volunteer-basedorganizationdedicatedtoprovidingreassuranceandemotionalsupportforpeoplewhohavehadorwillhavesomekindofostomysurgery,suchasacolostomy,ileostomy,urostomy(urinarydiversion)oracontinentprocedure.ThegoaloftheAACOAistoprovidemoralsupport,information,andeducationtopeoplewithostomiesandtheirfamiliesandfriends.MembersreceiveTheRamblingRosebudnewslettermonthly.DUESare$15pleasemakecheckouttoAACOAandmailtoAACOA,POBox847,GambrillsMD21054-1454
Last FirstM.I.Address:_____________________________________________________________________________________________________________________StreetAddress Apartment/Unit#_____________________________________________________________________________________________________________________
Parastomal hernia is the most frequent complication following the construction of an ostomy. It is a type of incisional hernia that allows protrusion of abdominal contents through the abdominal wall defect created during ostomy formation. The construction of the stoma requires an opening that’s made through layers and structures that produce areas of weakness. This allows for the intra-abdominal contents to push forward and create a “bulge” around the stoma. Hernias are not reversible or self-healing. The incidence of parastomal hernia varies, is related to the type of ostomy constructed, and is reported as ranging from 0 to 50 percent. One review cited the rate of parastomal hernia formation is greater for colostomy than for ileostomy. There are many reasons for hernia development ie. strenuous activity , infection , trauma, poor or delayed healing. Other factors that contribute are obesity, steroid use, excessive coughing, and abdominal strain. Parastomal hernias are unfortunately very common. Some are small but others can become large and uncomfortable, creating an unsightly bulge and appliance failure. If the hernia size increases and becomes symptomatic, surgical repair may be considered and should be discussed with a surgeon who frequently (and successfully) performs this type of surgery. Efforts to help prevent a parastomal hernia include preoperative stoma site marking within the rectus muscle, and surgical fixation of the stoma to the fascia (wall). Use of abdominal support postoperatively for 6-8 weeks ie. “splinting” with the hands when coughing/sneezing is important. Also helpful are the many types of support belts and garments available today. They will not heal or eliminate a hernia, but are used successfully to prevent hernia enlargement and disfigurement. If you have additional questions about parastomal hernias, or are interested in learning more about support belts, contact the nurses at Austin Pharmacy & Medical Supplies at 410-773-0300. Schedule Your Ostomy Consultation Today!
p. 410-773-0300 (x3) f. 410-773-0302
Austin Pharmacy & Medical Supplies Baltimore
6729 York Rd Towson
901 Dulaney Valley Hunt Valley
10757 York Rd
April 2018 The Rambling Rosebud
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PRESIDENT’S MESSAGE The last two months we’ve had two meetings with excellent speakers, Dr. Kahan in February and Dr. Tweed in March. Unfortunately attendance at the meetings was static, which is about 10-12 people. Although the interaction between speakers and audience in both cases was rewarding for the audience and the speakers seemed pleased, I’m not sure how long we’ll be able to attract speakers with such a small group. Time will tell. This month (April) the nurses from AAMC will be with us and in May the ConvaTec rep will be here. Then, over the summer, we will have open discussions before returning to speakers until the annual holiday party. With spring almost here (as I write this), I hope it is more traditional than winter. I’m not sure I can handle more snow and cold. See you at the meetings.
Stan
Items from this newsletter may be reprinted in other ostomy newsletters, provided proper credit is given as to source of material.
OSTOMY ADVISORS FOR STOMA HELP To consult with one of the ETs below, a physician’s referral is necessary and a fee will be charged. Call for an appointment.
BALTIMORE WASHINGTON HOSPITAL 410-787-4578
ANNE ARUNDEL MEDICAL CENTER Michelle Perkins, RN, BS, CWON
Joan M. Sullivan, MAS, RN, CNA, CWOCN 410-932-7312
The Ostomy Nurses at Austin Pharmacy 410-773-0300
No referral necessary ($40 consultative fee)
UPCOMING MEETINGS April - WOCN Presentation – Skin Management Rescheduled from January May – Cheryl Yiadom, Convatec Representative June, July & August – Group Discussion September – WOCN Presentation
“Everyone has a photographic memory. Some just don’t have film.”
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FDA Drug Watch Alert by Lyn Rowell, Rambling Rosebud Editor
One of our members recently received a notification that a common over the counter drug, Loperamide, sold as Imodium and used to treat diarrhea, may in the future be a little more difficult to get. If you have ever bought a small package of it at the drug store you probably noticed it came in a “blister” package – one where each pill is in a separate little plastic pocket covered by foil. It’s an expensive way to purchase it. But currently you can buy a generic version in a bottle where the pills are loose. For example Costco sells a double pack of 200 pills for less than the amount of 48 in a blister pack.
“Loperamide is a safe drug when used as directed. It acts on opioid receptors in the gut to slow the movement in the intestines and decrease the number of bowel movements. It is safe at approved doses, but when much higher than recommended doses are taken, it can lead to serious problems, including severe heart rhythm problems and death.” (www.drugs.com)
Apparently there are individuals who are abusing and misusing the drug. In these cases they are often using it with other drugs in an attempt to “increase its absorption and penetration across the blood-brain barrier…and enhance its europhic affect.” (drugs.com).
In response to this the FDA are working with manufacturers to only package it in blister packs with fewer doses in the package.
Why does it matter? Well, many ostomates who experience high volume output (which isn’t a large group) rely on this medication to help slow down the digestive tract. The over the counter directions say to take no more than 4 in a 24 hour period but my gastroenterologist prescribed up to 8 per day. If you have to take that amount for a long time you would go through a small package really fast. Purchasing in bulk obviously saves money but it is also easier to get shake them out
of a bottle instead of poking each small pill out of the “blister” packaging.
So it sounds like (but I haven’t been able to find anything confirming it) that it might soon only be available is small packets.
Also be advised that SOME individuals who take even small doses of Loperamide on a continued basis, have experienced increased blood pressure and swelling of legs and ankles. I use it when I am traveling and on vacation (and other times when I am concerned about bathroom access) and have found that after I take a dose of 4 the first day and wean down to 1 pill within a few days, and even half a pill, I still can have swollen legs and slightly elevated blood pressure. So I try to minimize my use of it. However, it does work at slowing things down so I am not ready to completely abandon it.
INFECTION IN UROSTOMIES Via: Johnstown UOA Newsletter
Germs are all over the world, but when they are in the urinary tract, either in the conduit, the urethras or the kidneys, they’re in an abnormal location and that is what promotes an infection. What causes the infection? The reasons are sometimes unclear. Why do some people get more colds than others? Infections can be caused by an obstruction, kidney stones, tumors, cysts or scar tissues. Almost synonymous with obstructions is infection and then too often comes stone formation. You can’t get rid of the infection. It’s kind of a cycle that goes around and around.
Infection can be caused by urine being forced back to the kidneys through the conduit. This could be done by falling asleep with the appliance full of urine and accidentally rolling over on the pouch, causing urine to be forced back into the stoma, through the urinary tract with tremendous pressure. Invariably the urine in the appliance will be contaminated. In general, to prevent and treat infections, you need a good flow of urine much like a stream. This means
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DRINK fluids (water is best)! Extra fluid not only dilutes the bacteria in the urine, but also helps wash out the bacteria. Two and one half quarts of liquids daily is required for the average adult.
Spring Allergies: Nothing to Sniff At
While some people are planning family picnics, trips to the ballpark and other ways to enjoy the warm weather, 35 million Americans will also be preparing to deal with spring allergy symptoms, including congestion, sneezing, runny nose and itchiness in the nose, mouth, throat, eyes and ears. Here are some tips for spring allergy season:
♦ Minimize outdoor activity on days when it’s windy or the pollen count is high. To find out the pollen and mold count in your area, check out the National Allergy Bureau’s latest report for both the United States and Canada at www.aaaai.org/nab. ♦ Take a shower after being outdoors to remove pollen and mold from hair and skin.
♦ Use a filtering mask when mowing and raking. ♦ Avoid hanging clothes and sheets out to dry since they can collect pollen and mold. ♦ Close your windows at night to keep pollen and molds out of your home.
♦ Roll car windows up when driving in your vehicle. ♦ Take vacations to the beach or sea where pollen is usually less prevalent.
WHAT WOULD YOU DO IF? By: Ellice Feiveson, Metro MD. Via: Dallas Ostomatic News
Trust me, every ostomate has had or will have an “ostomy accident.” By accident, I mean a pouch leak of some kind. The question is, “are you prepared in case an accident occurs away from home?” Not so much prepared as far as having a
change of clothes and extra pouches, but prepared emotionally to deal with the unexpected mishap. The reality of it is that every ostomate must think of what he or she would do if at a party, in a restaurant, work or anywhere else, your pouch leaked because it wasn’t on securely, or the clasp came off and the contents were spilling out. The question is, “What do you do if you feel your pouch is not on securely or you feel wet around your pouch?
First of all, you think that everyone is noticing you and knows what’s happening. Stay calm. Go to the nearest bathroom and take care of business. Most likely, your friends are continuing their conversation in the restaurant or in your workplace and no one knows you are temporarily missing. When I encountered an accident while I was in a group situation, I just removed myself and took my time in freshening up and rejoined my friends. No explanation was necessary! The more outings you take and the more public situations you are in, the more confident you will be as time goes on.
STOMAS via Semi-Colon and Cheers & Tears; via Santa Barbara (CA)
Side Exit
I think that I shall never see a stoma well-behaved like me. A stoma that will understand
when restrooms aren't near at hand. A stoma that will quiet be
when the room is full of company. A stoma that will really rest
when I change at a time I think is best. But let's not dream and let's not pray;
a stoma is not built that way. A stoma is built to work, not to play;
and work it does, both night and day. A stoma has a head, but not a mind;
it sometimes can be so unkind. Yet thankful we must always be that surgeons work so skillfully.
Sure, God can make an anus perk, but only man can make a stoma work!
