The Newsletter of The Winnipeg Ostomy Association

May/June 1997


Happy Summer!


Inside This Issue

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NOTICE

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
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Skin Cancer: How to Avoid It

by Bob White

With the prevalence of skin cancers growing daily, particularly in areas of high risk, such as our sunny Florida, the following article was felt to be timely. It is based, in part, on excerpts from a two-page article in a recent issue of the London Sunday Times Magazine. It's worthy of note that even in Britain, not especially known for long periods of intense sunlight, the subject is considered sufficiently important to devote costly space to it.

In explanation of some of the following, scientists talk of two particular types of ultraviolet [UV] rays - UV A and UV B. UV B rays cause the typical redness and, eventually, burning we associate with sun exposure. Sun screens typically address this type of hazard, and are rated by a protection factor [SBF]. These do not protect against UV A rays, which are responsible for the tanning process. Scientists now regard this type of UV as at least as harmful as UV B. It is graded by a system using stars, with four stars being regarded as complete protection against UV A. Skin protection agents combining protection against both types are now in production.

After discussing some of the ongoing research being done on the subject of benign and malignant skin cancers, a number of suggestions were made to help promote avoidance of growths that can easily prove fatal. They include:

Via S. Brevard (FL) OSTOMY NEWSLETTER 7/96
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From the President's Desk

I am nearing the completion of my first term as President of the Winnipeg Ostomy Association. There were many highlights over the past several months but two events, one yet to come, stick out. Last October we joined with ostomates around the world to celebrate World Ostomy Day. It was a good way for me to break in to my role and to share ostomates' concerns with the general public and hospital staff at the HSC and the St. Boniface Hospital. The other event hasn't happened yet. Next month I look forward with great expectations to meet and share with ostomates from across Canada and around the world at the 9th World Congress of the International Ostomy Association at the Coast Plaza Hotel in Calgary. No doubt, some of them had also been active in World Ostomy Day. Well over 100 Canadians have now registered for the annual general meeting of United Ostomy Association of Canada and the World Congress. At the annual general meeting, a delegate from each Canadian chapter will be asked to indicate their chapters decision regarding a separate Canadian organisation. Through previous editions of this newsletter and three of our general meetings, the membership has voted 98% in favor. It will be my privilege as your delegate to so indicate at the meeting.

This past April, WOA held their election of officers for the 1997-98 season. The following were reelected: President: Dave Page, 1st Vice-President: Eleanor Schmidt, Treasurer: Betty Friesen. Christel Spletzer continues as Visiting Chairperson as does Stan Sparkes as Past President. Mike Leverick and Gary Keedian did not seek reelection. On your behalf, I wish to thank both Mike and Gary for their work on behalf of the association. Personally, I thank them for their wise counsel and patience in breaking in a sometimes cantankerous new president. Harry Tucker was elected to succeed Mike as 2nd Vice-President. BUT NO ONE WAS WILLING TO STAND FOR ELECTION TO SUCCEED GARY AS SECRETARY. OOPS!!! TROUBLE!!! ONE SECRETARY ...URGENTLY REQUIRED!!! Job description: Required to take the minutes twice a month; 1. Executive meeting (this past year met the first Thursday of the month at the St. B 7: 30pm, longest meeting 1 hour, 59 minutes). 2. General meeting, third Wednesday of the month 7:30 p.m. at the St.B. The business meeting lasts about 3/4 hour . Required to keep the minutes and distribute copies of same to the Executive at the following meeting (either executive or general as the case may be). Without a Secretary, the business of the WOA will suffer greatly. I am confident that someone is more that willing to fill the position. Please contact a member of the Executive and indicate your interest.

As I write this, I hear the Red is dropping ( 2 feet in the last 24 hours), it is a smashingly gorgeous spring evening, the dog is itching to chase some squirrels and he's the boss! See you at the wind-up wine and cheese on May 21st and I look forward to seeing some of you in Calgary. Have a good summer! The first meeting next fall is September 17th. (Oops, before I get shot! Mike will carry on as Editor of Inside Out.)

Dave Page, President , WOA


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An Ostomate Needs a Sense of Humour

A sense of humor is certainly a needed trait when you are an ostomate. One of the highlights at our meetings is when we share some of those potentially embarrassing experiences that have occurred. One of the social problems of being an ostomate is noise made by the expulsion of gas from the stoma. Of course, the gas is captured by the pouch, but nevertheless, the noise can be at most inopportune times.

There are several options that an ostomate has if there happens to be a dog nearby, you can chastise him and shift the blame that way. Or, you might be as fortunate as I was last year when we were visiting a church where our daughter's family attends, near Birmingham, Alabama. We were on one seat and in front of us was a couple with a small baby. When my stoma "growled", the mother jerked her head to look at the baby. Then she began to laugh, thinking her baby had made that noise. Of course, my wife and I were amused by their idea as to the source of the sound. I took my finger and pressed on the stoma and prevented more noise as best as I could.

Then, recently, again in a church, a family of five was in front of us. One, a small girl, was continually looking back. My stoma "growled" and she looked at me, curious as to what made that sound. Apparently, I had eaten too many gas-producing foods and even though I pressed against the stoma with my finger, noise occurred again. She looked and was totally baffled. Of course, we had a difficult time suppressing our laughter.

Sometimes, it seems that when you sit down to eat, the body gets ready to start the digestive process, and the stoma again lets its presence be known. The first time my nine- year-old grandson heard that, he looked at me. I said, "That's just my guts growling." He said, "I've heard lots of guts growl but l never heard anything like that!"

Well, as I said, you need a sense of humor! What are some other practical things you might do to reduce stoma noise? Certain foods produce more gas than others do. Experienced ostomates learn what causes the most problems. Also, an empty stomach tends to have more gas. Eating irregularly can be a factor. And I have found that usually the noise can be eliminated by pressing on the stoma. Sometimes, the sound may be muffled by placing something over the stoma area.

But, if you don't plan to keep a dog around that you can make the culprit, you need to develop a sense of humor and just accept the fact that this is a small price to pay for the quality life an ostomate can have.

Via Batesville (AR) Newsletter & S. Brevard (FL) OSTOMY NEWSLETTER (Feb/97)


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Annual Treasurer's Report

WINNIPEG OSTOMY ASSOCIATION INC.
Winnipeg, Manitoba, Canada.
STATEMENT OF CASH RECEIPTS AND DISBURSEMENTS
for the year ended December 31, 1996

RECEIPTS
Membership dues $8,127
Donations $4,564.81
Interest $690.82
Other receipts $582.38
$13,965.01

DISBURSEMENTS
United Ostomy Assoc. dues $5,274
Camp sponsorships $1,163.17
Newsletter $2,243.38
Literature $00.00
Meetings and Travel $2,489.41
Donations:
St. Boniface Hospital Research $350.00
Canadian Cancer Society $350.00
Party and coffee expenses $466.87
Office $1,003.87
Miscellaneous $1,062.21
F.O.A. membership $150.00
Total = $14,552.91

Cash receipts over disbursements $ -587.90
Cash on hand, beginning of year $15,996.70

Cash on hand, end of year $15,408.80

Cash on hand consists of:
Chequing account 4,514.40
Monthly Saving account $9,894.40
Term deposit $1,000
Total = $15,408.80


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Colostomy Irrigation

Irrigation is a choice for some, but not all colostomates. The lower in the intestines the colostomy is, the easier it is for irrigation training. The further away from the anus the colostomy is, and the more unpredictable the bowel movements before surgery, the less chance of any success with irrigating. The more regular and formed the stool, the easier the ostomy is to train.

Transverse colostomies behave more like ileostomies, with almost constant fluid output, and should never be irrigated.

Schedule time for irrigating when you won't be interrupted. The ET nurse or doctor should furnish you with an irrigation kit and train you in the procedure in the hospital, or as soon thereafter as possible.

Sit on the toilet facing the water closet, on a chair in front of the toilet, or on a special platform for this purpose. Some people put their coffee cup on the WC top, and catch up on the latest news with the newspaper, or radio. Others have a phone in the bathroom and do a bit of phone visiting or work, while waiting for the results. Always use body- temperature or slightly warmer water (NOT hot or cold). Hang the bag so the bottom is at shoulder level and time the delivery so it isn't too fast, which can cause cramping.

Some patients hook the end of the irrigation sleeve up over the top of the sleeve and after emptying the bag, wear a robe and go about their housework or other duties until the return is complete. Clean up and put on the cap or insert the plug in the ostomy. A tube from a paper towel roll, or a coat hanger, can be inserted in the sleeve to hold its sides apart and help it to dry after washing.

While traveling, never use water for irrigating that you wouldn't drink. In places where the water is contaminated or hard to get, save up drinking water from restaurant meals. Taking along an extra coat hanger or two, always comes in handy as do "S" type hangers and some clothesline rope. Some people forget about irrigating while traveling, and wear a drainable pouch.

Via Metro Maryland & GreenBay News Review 11/96


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Old Advice For New Members

An ostomy is not a rubber stamp. It is as individual as you are. It is patterned to your individuality and should be managed in a fashion best suited to your comfort and convenience. After all, we don't all wear the same shoe size any more than we all comb our hair the same way. Thus, when we are asked "What appliance do you recommend?" we don't. We can only point out the features of those that may appeal to you, or make suggestions to correct what you may consider a fault in the one you are wearing. "How long should my appliance stay on before changing?" is another moot question. An appliance should be changed when the need arises, whether it be after one hour or ten days. A well-fitted, well-applied, well-sealed appliance can be worn only as long as YOU can wear it. It is basically recommended, however, that you remove an appliance and look at your stoma and skin at least every seven days.

So the new ostomate faces a period of gaining experience, and "shopping" for equipment, and usually puts these questions to use. As fellow ostomates and ETs, we are by no means in the "selling business." We can advise, suggest, and do our utmost to help in the selection for comfort and care. Our main objective is to help you to help yourself, and the final decision rests with you.

Source:Los Angeles Ostomy News; via Metro Halifax New, November, 1995


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Visitor's Report

By Christel Spletzer

1996 ANNUAL VISITORS REPORT

The Visiting Program of the Winnipeg Ostomy Association is dedicated to provide a valued service to patients that are faced with adjustments after surgery. I would like to thank all visitors that gave their time and compassion to this much needed service. The positive responses I get attest to the success of the program. In 1996 , a total of 91 visits were made..

These visits were as a result of the following types of surgeries:

Most visits were made at the Health Science Center and at the St. Boniface General Hospital. Phone visits continue to be beneficial to a good number of patients. The Visitor Training Program took place on April 26, 1997 together with the retraining program. The combined session gave the new trainees and re-trainees the benefit of some excellent speakers.

6 new visitors were certified
25 visitors were re-certified

The Visiting Program is the most valuable aspect of any Ostomy Association. Keep it alive and vibrant!

Christel B. Spletzer
Visiting Program Co-ordinator


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Stenosis

Stenosis of your stoma implies that there is a narrowing or stricture of the opening. This narrowing may make it difficult for your bowel to empty. The bowel must then expand, extra effort and force to drain through the narrowed opening, it is possible that you could experience abdominal cramping and/or diarrhea. If this occurs, I recommend that you contact your physician and report your symptoms in detail including when, how often, and how severe the cramping is and the frequency and amount of diarrhea.

Because I strongly believe that a doctor-patient relationship is a partnership based on sharing information, I urge you to make an appointment with your physician. Tell the receptionist or nurse that you need time to talk and ask questions about your stoma stenosis; she'll then be able to schedule you for an appropriate amount of the doctor's time. When you make your visit, you will want to ask your physician to explain the cause of the stenosis, and exactly what signs you should watch for and what to do if they occur. You need to know what he plans to do about the narrowing and how his plans involve you. Sometimes digital dilation or stretching the stoma by periodically introducing your (gloved) finger through the opening is recommended. But this must come from your doctor directly. He may refer you back to your ET for instructions, support and diet suggestions.

Source: Barbara McBride Schuck R.N ET; via Pittsburgh and Ottawa: via Metro Halifax News, March 1997


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VON logo

VON CENTENNIAL AWARD!

GAYE HORDIENKO BN. ET. WINS CENTENNIAL AWARD

The Victorian Order of Nurses is commemorating its 100th year in Canada. On May twelfth, at the Hotel Fort Garry, the Manitoba VON held their centennial celebration as well as 95 years for the local VON. President Dave Page was present representing the WOA. Thirty-six Victorian Order of Nurses Centennial Awards were presented across Canada in simultaneous ceremonies linked by telephone. Gaye Hordienko BN, ET was presented the award in Winnipeg as being representative of the type of person who has been the backbone of the VON throughout its 100-year history. Congratulations to Gaye! Winnipeg Ostomy Association members are not surprised to see Gaye get this recognition. We have been the recipients of her caring, expert, enthusiastic commitment to the Manitoba Ostomy Program for many years now!


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Travelling With an Ostomy

All methods of travel are available to you. Many people with ostomies travel widely, from camping trips to cruises to plane excursions around the world. Since you should prepare for travel, here are some suggestions.

Before going any long distance from home, ask your doctor for any information you may need to travel with your ostomy, especially in case of diarrhea or blockage. He may give you a prescription for diarrhea and advise on what to do if you need a doctor in a strange city.

Take along enough supplies to last the entire trip plus some extras. They may not be easy to get where you are going. Even if you don't expect to change your appliance, take along everything you need to do so. Leave home fully prepared. Find out if and where supplies are available for a long trip. A local UOA chapter may be helpful.

Try to obtain from your own chapter the name of the ostomy group in the country or area you will visit as the local chapter has information on ostomy and surgical suppliers, ET nurses, perhaps doctors. The local phone directory is a good place to look - check under "ostomy", or Ostomy Association. You may be able to telephone or fax your own supply source.

You can work out a way to change your appliance anywhere you travel, even in the woods or on a plane. If you use a reusable appliance, you can soak it in your favorite solution by putting both in a plastic container with a tight-fitting lid, or in a plastic bag that "zips" closed.

When traveling by car, keep your supplies in the coolest part. Avoid the trunk or back window ledge.

Seat belts will not harm the stoma when adjusted comfortably. You may place a clothes pin near the retraction slot to relieve tension on the belt. Shields are available to guard the stoma.

Travel by plane - Checked luggage sometimes gets lost. When you travel, carry an extra appliance and other supplies on the plane with you. Be sure your adhesive remover is non-flammable. Small cosmetic bags with plastic linings or shaving kits work well. These should be carried in your carry-on luggage.

Traveling Abroad - Before traveling abroad, get a copy of the current directory of English-speaking physicians in the various foreign cities who charge a standard fee. The International Association for Medical Assistance to Travelers (IAMAT), 417 Center Street, Lewiston, NY 11 092, (716) 754-4883, publishes lists of English-speaking physicians in over 1,400 cities around the world. The IAMAT is a non-profit association and its service is free. A donation is appreciated, however.

To avoid problems when going through customs or luggage inspection, have a note from your doctor stating that you need to carry ostomy supplies and medications by hand (something like "Medically Necessary - Ostomy Supplies"). By having this information translated into the language or languages of the country(s) you are visiting, further problems might be avoided. The note could be written in several languages, on one piece of paper, and carried with your passport.

In foreign countries, traveler's diarrhea is a common disease of tourists, whether you have an ostomy or not. The most common cause of diarrhea is contaminated water and/or food. It may also be caused by mere changes in water, food or climate. Your physician can give you a prescription for medication to control diarrhea and rebuild stamina. It should be filled in your home state, since the prescription may not be valid elsewhere. Be sure drinking water is safe. If the water is not safe, do not use the ice either. Bottled water or boiled water are recommended. Also avoid unpeeled fruits and raw vegetables.

Don't let any of these suggestions stop you from traveling. All travelers must plan carefully and be careful about food and drink. So travel to your heart's content and join the many thousands of ostomates who travel extensively in North America and abroad.

Source: Metro Maryland, via Los Angeles Ostomy News, via Metro Halifax Chapter, May, 1996.


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Controlling Alkaline Urine

Odorous urine is usually caused by a high alkaline condition created by bacteria in the urine. Irrigation of the pouch with a solution of water and vinegar will help but will not correct alkaline urine coming from the stoma. The more bacteria present in the urine, the higher and stronger becomes the alkaline condition and odor. Incidentally, it only takes 20 to 30 minutes for the bacteria to double its count in the pouch.

Indications of alkaline urine: Usually it has a darker yellow color. Sometimes calcium deposits are seen on the appliance or skin.

Additional problems caused by this condition: 1. Irritated skin pebbled with what appear to be tiny warts. 2. Closing of stoma opening. 3. Tendency of stoma to bleed easily. 4. Calcium deposits that collect inside the appliance opposite the opening (these can scratch and cause the stoma to bleed.)

Tips for good body chemistry: If only a slight overbalance of alkali is indicated, Vitamin C (ascorbic acid) may do the job. The dosage depends on how alkaline the urine is. Two to four grams of Vitamin C per day may be taken for a week, backing off to about 500 mg to 1 gram per day as a regular maintenance dosage. Check this with your doctor. Adding cranberry juice to your diet may also help balance the urine chemistry if it is not too heavily alkaline. Sufficient daily intake of water .is always important (in hard water regions distilled water may be recommended). Mixing of "Electrolytes Plus" to the water will not only make this a very satisfying thirstquenching drink hut will also replenish vitamins, minerals and electrolytes needed to maintain proper body chemistry.

Treatment of skin irritation: Use soft cloths to apply "Soaks" with a 50/50 solution of warm water and distilled white vinegar. Apply gently to affected area for 10 to 15 minutes. This will remove calcium deposits and help neutralize any Ph imbalance of contacting urine. Allow warm air to circulate over the area. Sunlight or the heat from a 60-watt lamp held about 12" from the skin will provide the preferred temperature. After drying, apply a skin care product such as Stoma Care or Sween Skin Care. If a skin irritation continues, consult your enterostomal therapist and he or she will suggest additional treatment to meet your individual needs.

Maintain proper appliance hygiene: It is good hygiene to irrigate the pouch daily with a 50/50 solution of warm water and distilled white. A deodorant may then be used in the pouch. However, keep in mind that the use of a deodorant - while providing a pleasant scent - should not be misconstrued as a solution to continuing urine odor. When the infection or body chemistry condition is corrected, a few drops of deodorant can be added to the pouch daily after irrigation.

Via NU-HOPE & Kankakee Ostomy Assn., via GB News Review (March 96).


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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.

LETTERS TO THE EDITOR & SUBMISSIONS

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