The Newsletter of The Winnipeg Ostomy Association

March/April 1997

Independent Canadian Ostomy Association?

Inside This Issue

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Articles and information in this newsletter are not necessarily endorsed by the Winnipeg Ostomy Association and may not apply to everyone. It is wise to consult your E. T. or Doctor before using any information from this newsletter

Independent Canadian Ostomy Association?

The Winnipeg Ostomy Association has been asked by UOA Canada Inc. to poll our membership regarding the formation of an independent Canadian ostomy association separate from UOA Inc.

This issue has been raised at our past two monthly meeting and further discussion and the vote will take place at the March 19th meeting.

There is a mail-in ballot on page nine for those who will be unable to attend the meeting. This is a weighty issue and therefore I have included a series of questions put to UOA Canada by the Ottawa Chapter on page 7. One should also be sure to read the "Open Letter to All Canadian Members" on page 4 of the January 1997 Ostomy Quarterly. Come out on March 19th and make your vote count!

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From The President's Desk

Well, the longest period of below freezing temperatures Winnipeg has ever recorded is over, 108 days! Now I look forward to the disappearance of the eight foot snowbanks on the front street which will become the largest lake that has ever formed in front of the house, I would imagine.

In the Jan/Feb 1997 newsletter I wrote of the possibility of the closure of the Home Care Depot on Regent Avenue and the transfer of the distribution of ostomy supplies to another facility. You will, by now, have received a mailing from Manitoba Health outlining details of the change, i.e. name, address and telephones of the facility, the date of the change, and a request from the manager of the present Home Care Depot not to order supplies the last two weeks of March as during that period the move to the new facility will be taking place. In case of an emergency the Home Care Depot will be open, but for emergencies only. I would suggest those who would be planning on ordering the latter two weeks of March do so earlier in the month.

On January 24, 1997, three representatives of Winnipeg Ostomy Association along with VON ET's Gay Hordienko and Karen Spencer met with the Manitoba Health officials responsible for the move and toured the Church Ave. facility. It is a large warehouse supplying everything the Government could possibly need or want. The ostomy supplies distribution area is right next door the main office, with a separate entrance, washroom facilities and a waiting area. It is much larger than the current facility and looks more like a waiting area in a doctor's office. We were all quite encouraged by what we saw and heard. The Manitoba Ostomy Program is to remain as it is now, except for the move of location.

Tracey Danowski, Chief Operating Officer of the Materials Distribution Agency will be our guest speaker at the March 19th chapter meeting, She will give a presentation on the Materials Distribution Agency and answer any questions we may have.

In early January of this year you received via mail, a packet from United Ostomy Association of Canada outlining the evolution of UOA Canada and the relationship with UOA Inc. in the United States. I do hope that you read and digested the information contained therein, as the implications will change greatly the future of UOA Canada.

Elsewhere in this newsletter you will find further information about this proposed change which will be voted on at the Annual General Meeting of UOA Canada, June 15, 1997, in Calgary. It is very important that you respond, as it is very important that the wishes of all the membership of the second largest ostomy chapter in Canada, and the tenth largest in North America, (that's us), are heard. I believe the United Ostomy Association of Canada will receive a strong mandate to become an independent organization serving Canadian ostomates to the year 2000 and well beyond. I strongly endorse this move.

After the discussion at the March 19th meeting the membership will vote by ballot. If you are unable to attend the meeting but still wish to vote, please use the enclosed ballot on page 9 and return to our box address to arrive no later than Friday, March 21, 1997.

Dave Page
President, Winnipeg Ostomy Association.

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St. Boniface Hospital Research Center Tour
January 15th Meeting.

On January fifteenth, the Winnipeg Ostomy Association held its monthly meeting at the St. Boniface General Hospital Research Foundation. After a multimedia presentation on the history of the Centre we were given a tour of many of the research labs.

Many researchers were still hard at work after 8 p.m. when we took the tour and explained their research activities to us. Canada's number one heart research program resides within the Centre and many of the labs are doing various forms of cardiovascular research. The Sleep Disorders Lab looked fascinating and you aren't paranoid if you think someone's watching you while you sleep. High tech cameras and sensors keep track of one's every move and heartbeat. It looked like they could watch your dreams if they wanted to!

One of the highlights was a prototype pharmaceutical robot. The only one of its type in the world, it's being developed by a U.S. firm right here in Winnipeg. It is to be used by pharmacy departments in hospitals to measure medications for patient IV bags. It is completely automated and takes instructions from an on-line computer system and spits out the bags, filled with the correct medication and labeled with the patients' information. It takes up a floor area of about 4 meters by 6 meters. With its robotic arms grabbing syringes and IV bags, it must be quite the sight when it is running at full steam.

The fourth floor is under development and will become the Centre for Health Research on Aging. The Foundation hopes to raise $10.5 million over the next five years to accomplish this. Areas of future study will include Alzheimer, stroke and dementia.

The Research Centre includes so many varied areas of study that they could not all be listed here, even if I could remember them. Some of these include Surgical Research, The World Health Organization Quality of Life Centre, Infectious Diseases and Microbiology and Magnetic Resonance Imaging.

Those 24 of us who braved the January weather to take part in the tour were all very impressed and eager to repeat the tour next year. Dave Page was suggesting a Sunday afternoon tour in the Fall as a possibility. I would not hesitate to go again as my brain could not absorb all that fascinating information in one tour. Everyone is encouraged to attend and support their research.

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Pelvic Pouch Procedure: Dr. Yaffe
February 19th Meeting

Dr. Clifford Yaffe gave a presentation on the pelvic pouch procedure at our February 19th meeting.

There have been over 200 pelvic pouch procedures done in Winnipeg. The procedure is being constantly improved and is now the "Gold Standard" surgery for treatment of Ulcerative Colitis and Polyposis. The surgery is being done on patients up to their seventies now and results are generally excellent.

The procedure was first done in Winnipeg in 1983 by Dr. Yaffe. At that time it was at least a two stage procedure and involved a temporary ileostomy for about 3 months. It involved a six to seven hour surgery and was not generally recommended to patients over 55.

In the past two years a newer procedure is now in place resulting in a single stage operation. Through the use of titanium staples instead of sutures, using a J' pouch instead of a S' pouch, and leaving one or two centimeters of rectal mucosa, the surgery has been much improved. It now is about a three and half hour procedure, no temporary ileostomy is needed and leakage problems have been virtually eliminated. Dr. Yaffe stresses that the pelvic pouch procedure should only be done after thorough consultation with the prospective candidate. He spends extensive time explaining the procedure and possible outcomes with the patient and has previous patients discuss their experiences with the candidate as well.

He quotes a less than five percent failure rate with the newer procedure and people can revert to a regular ileostomy if the pelvic pouch procedure is unsuitable for them. The end result? After 12 to 18 months normal bowel function is reached. This involves 4 to 6 stools a day, good control, minimal food restrictions and occasional night time leakage. Pregnancy is no problem although cesarean section is recommended to avoid damaging the rectal muscles.

The procedure offers an alternative to an ileostomy for suitable patients. It is great to know that such advanced "cutting edge" surgery is being done in Winnipeg and that excellent doctors like Dr. Yaffe choose to practice here.

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Don't Let Depression Keep You Down

Depression can disable a person's functional abilities as much as a chronic medical problem like diabetes, research studies show. In the elderly, depression is often misdiagnosed as being a normal part of aging. But while older adults do experience many losses as they age, including the deaths of family and friends, the loss of "roles", and declining health and abilities, it's not "normal" to be depressed all the time. Most older adults, in fact, feel satisfied with their lives.

Depression is not an uncommon illness in the elderly. Vicki Schmall, Ph.D., formerly of the Oregon State University Extension Service, found that approximately 15% of independent older adults and 25% or more of nursing home residents suffer from depression. More than 60% of depressed older adults aren't being treated for this illness. The suicide rate for older persons is high, with males over age 65 committing suicide at three to four times the rate of the general population.

In a booklet titled, Depression in Later Life: Recognition and Treatment, Dr. Schmall published the signs of depression, printed here. Recognizing these symptoms is very important, because depression is considered to be one of the most treatable emotional disorders.

If you're concerned about someone you love, or feel depressed yourself, a good first step is to talk to a physician. (S)he can help develop a plan of action which may include medication, counselling, or both.

Signs of Depression
Check each sign exhibited. The more signs checked, the more likely the person may be suffering from a serious depression and may need help.


Emotional Changes in Thoughts Changes in Behavior

Via Tacoma (WA) Newsletter, & S. Brevard (FL) OSTOMY NEWSLETTER

In Winnipeg, contact
The Society for Depression and Manic-Depression of Manitoba Inc.,
4-1000 Notre Dame Ave. Wpg. R3E 0N3
Phone: (204) 786-0987

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Hernia and the Ostomate

If you've noticed an unusual bulge around or under your stoma, you may have a hernia. A hernia essentially is a separation in the muscle through which the bowel was brought when the stoma was created. This separation allows a loop of bowel to slip into the area next to the stoma and puts pressure on the abdominal wall, causing a bulge that can be relatively small, or about the size of a grapefruit or larger.

Why do hernias occur? Usually they form after a person has done heavy lifting or straining, thus putting pressure on the abdominal muscles. Other causes could be coughing excessively without supporting the abdomen, or a weakened abdominal muscle not repaired unless there are problems resulting from the hernia. The surgeon would either repair the hernia and leave the stoma in the same location or if the hernia is excessively large, the surgeon may decide to relocate it. In either case, it would be wise to use a support belt to prevent a hernia from reforming.

Another problem with a hernia, especially with colostomates who irrigate routinely is that the person begins to notice that the irrigation does not work as well as it used to. It may take longer to run the water in, or maybe it does not enter at all. There is a major problem to consider if you irrigate. If you use a catheter, be very careful not to push it too hard if it does not slide in easily. It is probably up against the bowel wall and can not turn sharply to accommodate the new route of the bowel, and you could perforate the bowel wall. A cone is better to use, however, the sharp curve of the bowel may not allow the water to flow in easily. Sometimes pressing the area around the stoma may open up the kinked area to allow the water to flow. I would recommend holding off on the irrigation procedure and try to control the colostomy by diet.

There are support belts that are available for ostomates to wear. They are made to accommodate the pouch through a front opening, and they usually have a Velcro close. They are available in several widths. It is important for all ostomates to be careful in lifting or straining post-operatively, as well as years later. There is always the potential for a hernia to occur due to the opening made in the abdominal muscle for the creation of the stoma. This does not mean that every ostomate should wear a support belt. Just remember that if you lift something over 10 pounds, be sure to use the proper techniques. Use your upper thigh muscles instead of your abdominal muscle. Common sense goes a long way.

Ostomy Highlife; Jill Conwill, RN ET, Corpus Christi, via Metro MD

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Visitor's Report

By Christel Spletzer

Patients with the following ostomies were visited in January and February:
Colostomy - 9
Ileal Conduit - 2
Ileostomy - 6
Pelvic Pouch - 0
Continent Urostomy - 0
Total = 17

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Editor's Comment

This is the electronic version of The Winnipeg Ostomy Association's newsletter, Inside Out. The newsletter includes articles from other United Ostomy Association chapter newsletters and these are credited at the end of each article. Please credit the source as well as Inside Out if you wish to use any of this newsletter.


Submissions and Letters to the Editor can be mailed to:
The Editor, Inside Out,
130 Woodydell Ave,
Winnipeg, Manitoba,
Canada. R2M 2T9.
All submissions are welcome, may be edited and are not guaranteed to be printed (but I'll make every effort).
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Last updated June 15, 2001. Comments to: Mike Leverick