OAGO The Picture Frame An Affiliate of A publication of the Ostomy Association of Greater Orlando Ostomy Association of Greater Orlando May/June 2015 Circulation 500+ TM www.ostomyassociationofgreaterorlando.com MEETING ANNOUNCEMENTS See the President’s Message on Page 2 Saturday, May 16, 2015 @ 10:30 AM NEWSLETTER CONTENTS TO BE ANNOUNCED Saturday, June 20, 2015 @ 11:45 AM Summer Luncheon Giovanni’s Italian Restaurant (Winter Park Corners) 1915 Aloma Avenue Winter Park, FL 32792 Please RSVP by June 10th if you WILL be attending, either by signing up at our May meeting or by email at [email protected] MEETING INFORMATION: Winter Park Memorial Hospital Library, 200 N Lakemont Ave. The Library is adjacent to the parking lot and has large black letters “LIBRARY” above the entrance. NORTH H LIBRARY P P Mizell Ave. Loch Lomond Dr. MEETING LOCATION: Aloma Ave. SR 426 N Lakemont Ave. Our fellowship meetings offer an exchange of valuable information offered by our speakers, members, and guests. All are welcome, especially supporting family and friends. Coffee is provided and donated treats are always welcome. H = Hospital P = Parking If you are not a member, please join us. Our low annual dues of $20.00 are not mandatory, but allow us to continue our programs to help others. Donations to the Ostomy Association of Greater Orlando, Inc. are tax deductible. FOR MEMBERSHIP INFORMATION PLEASE CONTACT Evelyn Vihlen, Treasurer 418 Tulane Drive, Altamonte Springs, FL 32714 407-862-6567 If not interested in receiving the Newsletter please call or write Evelyn Vihlen DO YOU HAVE INTERNET ACCESS? If you have internet access, you can help cut our costs by electing to receive the newsletter via email. If interested, email Pat Gessel at [email protected]. Thank You. PLEASE DONATE YOUR UNUSED OSTOMY SUPPLIES There are those who are homeless, unemployed, and without insurance. If you have unused supplies bring them to our meetings or call 407-862-6567 for information. Donated supplies are given to those without insurance. Page 1 OAGO Meeting Announcements and General Information. Page 2 What’s going on at OAGO? - President’s Message. - We Need You! Calling All Ostomates! - 2015 Youth Rally. - UOAA’s 5th National Conference. - In Memory of Mary N. Garrett and Donald J. Rudolph. Page 3 Article: Urostomy Review. Article: Ostomy Surgery and Depression. Page 4 Newsletter Ad Prices. Article: The Uncontrolled Colostomy. Article: Some ABC’s of Urostomy Care. Page 5 Article: Caring for Your Ostomy. Article: When to Call the Doctor or Ostomy Nurse. Travel Communication Card Information. Page 6 Outpatient Ostomy Clinic Information. Ostomy Supply Information. Page 7 List of 2015 OAGO Contributors. Article: Dehydration and the Ileostomy. Article: Ostomates Guide for Hospitalization. Page 8 List of OAGO Officers, Directors, and Advisors. About Us. Popular Ostomy Related Websites. The Ostomates Prayer. Note: Articles are approved by UOAA. Premier Online Version Get instant access to The Phoenix magazine by ordering the Premier Online Version. Read the magazine through any web browser on your computer, iPad, or any other device where you can browse the Internet. Annual Premier Online Edition subscription is $19.95. Annual print subscription is $29.95. 1 What’s going on at OAGO ? President’s Message Dear Friends, I hope this message finds everyone well! I would like to take a moment to thank the members that, despite ALL of our busy schedules, continue to come to monthly meetings and show their support! I greatly appreciate your dedication and that you choose to make OAGO an important part of your lives. Learning from each other is such a valuable component of our support group and it has been wonderful sharing and growing as ostomates, together. As spring approaches, it's a nice time to think about how each of us have blossomed or grown with the help of our ostomies. Personally, I was able to gain my independence and grow as a confident adult. My ostomy not only saved my life, but gave it back to me! I know that having an ostomy is not an easy adjustment, but I ask you to please take some time to think about and appreciate your life. Lori Cohen, President WE NEED YOU! CALLING ALL OSTOMATES! Ostomy Association of Greater Orlando needs your "Time and Talent.” We desperately need new faces on our "Board of Directors.” We all have busy lives, of course. So it is easy to just let someone else do the month to month work. But I for one really need our group, and have volunteered for twenty years! All the time, loving meeting and helping new ostomates. Every person has a different story and challenge. There are so many ways we can help the group. 1. Help with decision making. 2. Speaker and meeting committee. 3. Refreshment committee. 4. Supply committee - picking up donated supplies and bringing them to meetings. 5. Welcoming committee. 6. Membership committee. 7 Marketing to doctors and nurses. 8. New officers! Lori is not going to devote the rest of her life to being President. She too has a life! All these jobs would not take up great amounts of your time. Come on kids! Always remember! "Many Hands Make Light Work" We need your hands! Call us to let us know what you can help us with. Shelley Dittmer - 407-929-3668, Lori Cohen - 407-399-8371, Evelyn Vihlen - 407-862-6567 Thank You, Shelley Dittmer, Director and Past President 2015 YOUTH RALLY The 2015 Youth Rally will take place July 13th - 18th at the University of Colorado in Boulder, Colorado. The annual rally allows youths, with ostomies or facing ostomy surgery, the chance to meet others with the same physical condition so they know they are not alone. This year, through the generous support of our members and friends, the Ostomy Association of Greater Orlando Inc. is again proud to support the Youth Rally with a donation of $1,000.00. This donation will cover camp costs, airfare, and spending money for one youth. For more information contact Stephanie Crane, Youth Rally Director, at 612-669-9990. Go to www.rally4youth.org to see the inspiring photos and videos of past rallies. - UOAA's 5th National Conference will be held at the Hyatt Regency in St. Louis, MO from September 1-6, 2015. For Conference details go to www.ostomy.org/2015_National_conference_page.html - World Ostomy Day - Saturday October 3, 2015 - World Ostomy Day is recognized on the first Saturday in October. Meeting Refreshments We greatly appreciate the kindness of people who bring food to our meetings for all to enjoy. If anyone is planning to bring food, please call Evelyn Vihlen at 407-862-6567, so we don’t have more than needed. In Memory Of We regretfully announce the passing of members Mary N. Garrett and Donald J. Rudolph. Our heartfelt condolences go out to their family and friends. “If you want to lift yourself up, lift up someone else.” Booker T. Washington 2 UROSTOMY REVIEW Via GAOA Newsletter: UOAA Update March 2015 Diet: There are no eating restrictions as a result of Urostomy surgery. (If the kidneys have been severely impaired, your physician will monitor your protein and salt intake, but the functions of your kidneys are not affected by the surgery.) The urinary tract and digestive tract are separate. A few foods and certain medications may cause urine odor or a change in urine color (such as asparagus, fish and certain spices). Drink plenty of liquids each day following the health care team's recommendations. Mucus: You normally have some mucus shreds in your urine. If the amount increases, if the urine changes color and has a strong odor, it may signal that you have a urinary tract infection. Be sure to drink six to eight glasses of liquid a day, unless your physician instructs you otherwise. Drinking fluids helps to decrease the amount of mucus in your urine. Acidic Urine: Drink cranberry juice in place of orange juice or other citrus juices which tend to make the urine more alkaline. Take vitamin C daily (if approved by your physician). Keeping your urine acidic may help to: (1) prevent urinary tract infections, (2) prevent damage to your skin, and (3) decrease odor. Check the pH of your urine about twice a week to be sure the urine is acidic, with a pH of less than 6.0. Most fruits and vegetables actually give an alkalinized ash and tend to alkaline the urine. Meats and cereals will usually produce an acidic ash. Unless otherwise indicated, the urine should be maintained in an acid state. Fluid & Infection Management: People with urinary diversions no longer have a storage area, a bladder, for urine. Urine should flow from the stoma as fast as the kidneys can make it. If your urinary stoma has no drainage after even an hour, it is of serious concern. The distance from the stoma to the kidney is markedly reduced after urinary diversion surgery. Any external bacteria have a short route to the kidney. Since kidney infection can occur rapidly and be devastating, prevention is essential. • Wearing a clean pouch and frequent emptying are vital. • Adequate fluid intake, particularly fluids that acidify the urine, will decrease problem odor. • In warm weather, with increased activity or with a fever, fluids should be increased to make up for body losses due to perspiration and increased metabolism. • It is important that you be aware of the symptoms of kidney infection. Elevated temperature, chills, low back pain, cloudy bloody urine and decreased output. If you experience these symptoms, see your physician. • Urine samples should never be collected from an existing pouch. The best way to collect a urine specimen is for a medical professional to obtain it by catheterizing the stoma under sterile conditions. OSTOMY SURGERY AND DEPRESSION Edited By Bobby Brewer: UOAA Edits and Update March 2015 Sleeplessness, loss of appetite, feelings of guilt or worthlessness, and/or irritability are some of the symptoms of depression. It can be triggered by the inability to participate in normal daily pleasurable activities by a sense of helplessness and lack of control over your body. Medications, stress, malnutrition, anesthesia or metabolic imbalance can also cause depression. Other patients who have a harder time dealing with their ostomy are those who: (i) base their self-esteem on their physical appearance, (ii) those with a take charge or "always in control" character (iii) the good Samaritan behavior (always the helper or solver). Their ostomy, or lack of control over their bodies, and their need to depend on others for help, even if only temporarily, can make coping difficult. Constantly tired from efforts to cope with daily household or work routines, while learning to adapt to physical requirements to this unpredictable new addition to your body, leaves little energy for enjoyment of leisure activities or romantic involvement. It takes us some time to return to our normal lifestyle. So relax-do what you are capable of doing at this time and do not try to rush things. You have had enough pain and deserve a vacation. Give yourself a year for a good recovery and if it should happen to take a lot less time, consider yourself a very lucky person. In the meantime, do what you have to do in whatever way you are capable of doing it. But do not give more than a passing thought to the things you cannot do right now. You might have to take some shortcuts, do some improvising, or indulge in some healthy neglect. Do not be bashful about asking for and accepting help. You would do the same for someone else if they needed help. Some patients conceal their ostomy from their spouses, families or lovers because they fear rejection, feel shame or embarrassment, are modest or have noticed evidence of disgust. This results in feelings of isolation, depression and chronic anxiety. Most ostomates need a few months before they feel secure about being accepted. Join the crowd! You are not alone! We all go through this. Signs of Depression: • Physical - aches or pains, or other physical complaints that seem to have no physical basis. Marked change in appetite; change in sleep patterns, and fatigue. • Emotional - pervasive sadness; anxiety; apathy; crying for no reason and indifference. • Changes in Behavior - neglect of personal appearance; withdrawal from others; increased use of alcohol/drugs; increased irritability and restlessness. • Changes in Thoughts - feelings of hopelessness/worthlessness; inappropriate or excess guilt; forgetfulness and inability to make decisions to take action. NOTE: There are some cases of depression which can benefit most from professional help. Do not hesitate to ask your doctor. “All that I am, or hope to be, I owe to my angel mother.” Abraham Lincoln 3 Your Ad Here Available Ad Sizes: 2 x 2 @ $15/Issue 4 x 2 @ $30/Issue 4 x 4 @ $50/Issue 4 x 6 @ $70/Issue 4 x 8 @ $90/Issue 8 x 5 @ $100/Issue Call 801.558.3074 for details and specials on yearly rates Happy Birthday to those born in May and June!!! THE UNCONTROLLED COLOSTOMY Montreal, Canada & Ostonoma News, CA: UOAA Update March 2015 Some people in the medical and nursing professions are under the impression that people who have colostomies have very little difficulty in managing them, in comparison to people with ileostomies or ileal conduit. Very often a patient is told that in time, he can learn to train the bowel to evacuate once every 24 to 48 hours. This, they are told, can be achieved by either irrigation of the colon or by diet, and then all that is required is a dressing over the colostomy or a piece of colostomy equipment if more protection is desired. While the above situation is true in a large number of cases, there are those who find it an impossibility to regulate the bowel no matter what method they try. These people often become discouraged, especially after hearing other colostomates report how well they manage with a minimum amount of care, with no problems at all. Usually the person who had an irritable colon prior to surgery will experience problems post-op. Irrigations are recommended in these cases, to help regulate the colon. Persons in this category should consider being measured for a good appliance, one that will keep them clean, dry and odor free. This is a possible solution to this particular problem at the present time. Note: There are some cases where a large amount of the colon and or ileum (small bowel) has been removed. In that case, a colostomy can act more like an ileostomy, therefore CANNOT be controlled. Best to check it out with your doctor. SOME ABCs OF UROSTOMY CARE Philadelphia Newsletter: UOAA Update May 2015 Adherence: Urinary appliances adhere well with cement Stomahesive® and Colly-Seel™. The urinary stoma drains continuously. The urine may be mildly irritating to the skin and may be odorous. A group of 4 to 8 year olds were asked, “What does love mean?” See what you think: “If you want to learn to love better, you should start with a friend who you hate.” Nikka - age 6 “Love is when your puppy licks your face even after you left him alone all day.” Mary Ann - age 4 “Love is when my dad makes coffee for my mommy and he takes a sip before giving it to her, to make sure the taste is OK.” Danny - age 7 Wound, Ostomy, Continence Department Bleeding: Often blood is noted in the appliance and its origin isn't immediately clear. One source may be irritation of the stoma by uric acid crystals. These can be formed in the appliance or on the skin around the stoma if the faceplate if too large. This may be indicated by small white spots on the stoma upon removal of the appliance. The crystals have an abrasive effect on the stoma. The crystals may be readily dissolved and the bleeding relieved by bathing the stoma and the surrounding area with a half-strength vinegar solution. Do this three or four times a day while the appliance is being worn. Changing Appliances: Usually the best time to change a urinary appliance is in the morning before drinking anything. Closed Bottom: Only drainable pouches should be used on urinary stomas. Closed bottom pouches should never be used. Face Plate: A convex face plate may be extremely useful with the flush urinary stoma. Fluid Intake: Two to three quarts of fluid daily provide adequate "traffic" through the urinary system to prevent an increase in bacterial growth. (This can occur in a slow moving system.) Increased bacterial growth may lead to urinary tract infection. Leaking: Urinary pouches that are allowed to get too full will tend to leak. Connecting the pouch to the leg bag will be helpful if you're unable to empty often enough. Attach the strap of the leg bag loosely to allow good blood circulation. Night Drainage: Bedside drainage bag or bottle, probably similar to the type you used in the hospital, may be used for children and adults. This is how you can avoid getting up during the night to empty the pouch. The average urinary pouch won't hold the amount of urine that may be excreted during the night. Odor: Drinking cranberry juice is helpful in deodorizing urine. Plugging: You should NEVER use anything to plug your stoma while cleaning, changing or emptying your bag. This could cause problems with your stoma. 601 East Rollins Street Orlando, FL 32803 407-303-5600 extension 110-9271 Showers: You may shower with your skin barrier on and removing the pouch or you may take a shower with the entire appliance off. It is found that if you chose to leave your skin barrier on, using Pink Tape (available through your supplier) around the edges helps prevent water from seeping in and compromising the seal. This also allows you to keep the skin barrier on longer causing less stress and irritation to your skin. This applies to colostomates and ileostomates as well. “I don’t feel old, I don’t feel anything until noon. Then it’s time for my nap.” Bob Hope 4 CARING FOR YOUR OSTOMY By Pat Murphy, RN, CETN, Middle GA, Ostomy Rumble UOAA Updated May 2015 Here are some simple pointers for ostomy care. They may not be new, but sometimes it is good to be reminded of them. Good ostomy care habits can catch and nip problems in the bud-the rosebud that is. Inspect your stoma and skin each time you change your skin barrier. Your stoma should be bright red, smooth and shiny. Inspect the lower edge especially well. Use a mirror if necessary. Look for any signs of irritation or bleeding. These signs may mean your skin barrier is rubbing there. Your skin should not be pink, purple or gray, even right next to the stoma. You may, however, notice some pink skin under pressure points when you first remove the skin barrier from your body. This is the same as when you take off your watch or a pair of stockings and is normal. Inspect your skin in a sitting position to see if creases or low areas form around the stoma. This will tell you where to take special steps to even out the area when you put on your skin barrier. Stretching the skin to make it smooth may be all you need to do, or you may need a dab of ostomy paste to help seal the area. COLON AND RECTAL CLINIC OF ORLANDO Phone: 407-422-3790 Fax: 407-425-4358 www.CRCOrlando.com DOWNTOWN NORTH SANDLAKE HEALTH CENTRAL EAST ALTAMONTE If your stoma is not perfectly round, do not trace and cut a round circle. Instead, make the skin barrier fit exactly. Your ostomy nurse can show you how. It should just miss the stoma, sealing down on the skin right next to it. Your skin barrier should not go over any red, wet mucosal tissue, the kind that forms the stoma. If you wear a pouch with a Karaya ring on it, the ring should gently touch the stoma all around. INSPIRATIONAL WORDS Omaha Ostomy Digest 01/15: UOAA Update March 2015 110 W. Underwood Street, Suite A, Orlando 308 Groveland Street, Orlando 9430 Turkey Lake Road, Suite 118, Orlando 10000 W. Colonial Drive, Suite 483, Ocoee 7975 Lake Underhill Road, Suite 310, Orlando 616 E. Altamonte Drive, Suite 202, Altamonte Spgs TRAVEL COMMUNICATION CARD INFORMATION UOAA has prepared a card that travelers with medical conditions or devices can present to TSA personnel. They also have an additional card that may be helpful if you need immediate restroom access (for example, on board the airplane). Visit www.ostomy.org. News From the TSA: TSA has launched TSA Cares, a toll-free helpline to provide information and assistance to passengers with disabilities and medical conditions before they fly. Call TSA Cares toll free at 1-855-787-2227. Visit TSA’s website at: www.tsa.gov/travelers/airtravel/disabilityandmedicalneeds. Na`Scent Remember: a new stoma can change size for up to a year. Remeasure your stoma every time you change the skin barrier for the first six months after surgery and every month thereafter. Always re-measure if you are having a leak. Measure the stoma at the base from side to side and from top to bottom. Many stomas are oval. If you are cutting a skin barrier of a one-piece pouching system, no skin should show when it is in place. However, making sure the skin barrier doesn't touch the stoma unless it is an extended-wear skin barrier manufactured to be able to touch the stoma (these skin barriers are designed to "turtleneck" where they touch the stoma). Since it can be tricky to cut the opening to the correct shape without leaving gaps around the stoma, manufacturers have developed skin barrier seals and ostomy paste that can be used to fill the gaps. Paul R. Williamson, M.D., FASCRS, FACS Andrea Ferrara, M.D., FASCRS, FACS Joseph T. Gallagher, M.D., FASCRS, FACS Samuel De Jesus, M.D., FASCRS, FACS Renee J. Mueller, M.D., FASCRS, FACS Mark K Soliman, M.D. Ostomy Odor Eliminator - More than freedom. - More than security. - Gives ostomates an odor-free life. Contact: Shelley Dittmer, Member 407-929-3668 [email protected] www.nascent4u.com WHEN TO CALL THE DOCTOR OR OSTOMY NURSE The Right Connection, Ostomy Assn. of San Diego UOAA Update May 2015 • • • • • • • • • If cramps last more than two or three hours. If you get a deep cut in the stoma. Excessive bleeding from the stoma opening or a moderate amount in the pouch after emptying several times. Bleeding at the juncture of the skin and stoma. Severe skin irritation or deep ulcers. Unusual change in size or appearance of stoma. Severe watery discharge lasting more than five or six hours. Strong odor lasting more than a week. Any other usual occurrence regarding the stoma. If you are depressed, You are living in the past. Note: See Page 6 for local and state outpatient ostomy clinics. If you are anxious, You are living in the future. “When my wife and I travel together, she does all the driving. All I have to do is turn the wheel and push the pedals.” If you are at peace, You are living in the present. Lao Tzu From “Downtime” by Ron Dentinger, Comedian and Banquet Speaker www.banquetspeaker.com “We could certainly slow the aging process down if it had to work its way through Congress.” Will Rogers 5 OUT PATIENT OSTOMY CLINICS IN CENTRAL FLORIDA The Ostomy Association of Greater Orlando frequently receives calls from individuals who are dealing with skin and product issues. Below is information on outpatient ostomy clinics. Orlando Health Wound Healing Center Services Provided: Comprehensive ostomy and fistula care are offered, as well as pre-operative stoma site marking and teaching. Donations of ostomy supplies are welcomed as we see many indigent and homeless individuals. Location: Orlando Health Wound Healing Center Lucerne Annex 818 Main Lane Orlando FL 32801 DAYTONA Florida Hospital Memorial Medical Center Location: Center for Wound Healing and Hyperbaric Medicine Florida Hospital Memorial Medical Center Center for Wound Healing 301 Memorial Medical Parkway Daytona Beach, FL 32117 Ostomy Clinic Phone: 386-231-3615 Appointment and doctor's script/order required. Insurance: Most insurances accepted. This facility is a Medicare assigned provider and accepts Medicare Secondary insurances. Location Note: Above address is for the Hospital. The Wound Healing Center is located just west of Main Lane at the intersection of West Gore Street and Kuhl Avenues. The entrance door to clinic is under the drive through canopy. Ostomy Clinic Phone: 321-841-5469 FAX: 321-841-7470 Requirements: Appointment and doctor's script/order required, along with demographic sheet, last progress note. Insurance: Most insurances accepted. Medicare and secondary insurance accepted. Principal Staff: Donna L Sellers, BSN RN CWON, Ostomy Clinic. Karen Durigan, Nursing Operations Manager. Central Florida Wound and Skin Consultants Services Provided: - NP-C/WOCN specialists provides ostomy evaluation and refitting to homebound or ALF patients in their homes. - We are a mobile ostomy, wound and lymphedema medical practice caring for Medicare patients only. - Our medical practice also specializes in customized hernia support options. - Preoperative education and stoma marking. - Postoperative education on stoma management including pouching system selection and education on self-care. - Assistance with appliance fittings, pouching system failures, peristomal skin loss, ulcers, and rashes. - Management of complex, high output fistulas. - Services also offered at Assisted Living Facilities in Orange and Seminole County. Phone and Fax: 407-359-6426 Requirements: No doctor's script/order required. Insurance: We are Medicare providers and do not accept HMO or PPOs. We bill direct to Medicare and secondary insurances. Self pay rates: $175.00 for initial visit, $75.00 for additional visits. We accept payment by cash or check. Principal Staff: Tabassum Merchant MS, WOCN, MSN, NP-C Debbie Moulavi CWON, MSN, NP-C Collaborating Physician: Rita Laracuente, MD PALM BAY Health First Outpatient Wound Center/Ostomy Clinic Appointments on Wednesday’s only. To schedule an appointment: 321-434-6100. Appointment and doctor's script/order required. OAGO GIFT ROOM The Gift Room is stocked with donated unused ostomy supplies that we collect and provide, free of charge, to fellow ostomates who are uninsured or underinsured. This service is run solely by the Ostomy Association of Greater Orlando, Inc. on a volunteer basis under Gift Room Director Evelyn Vihlen. For information call 407-862-6567. OSTO GROUP This not-for-profit organization provides free ostomy supplies to those without insurance. Your only cost is shipping and handling. Call 877-678-6690 or visit their website at www.ostogroup.org. FRIENDS OF OSTOMATES WORLDWIDE - USA UOAA Update November 2014 The modern ostomy supplies we take for granted in the U.S. and other developed countries may be unavailable or too costly in many areas around the world. People resort to plastic bags, rags, and duct tape, resulting in poor skin, odor, no jobs, and no school. Since 1968, the Friends of Ostomates Worldwide-USA (FOW-USA) has collected new supplies from U.S. individuals and groups and sent them overseas where needed. From Afghanistan and Cameroon to Zambia and Zimbabwe, to over 70 countries, our shipments have made a difference. You can too, with supplies and financial donations: FOW-USA, 4018 Bishop Lane, Louisville, KY 40218. Phone: 502-909-6669 Website: www.fowusa.org Medical Supplies & Services Since 1953 Home Health Care Centers www.Binsons.com About Tabassum Merchant and Debbie Moulavi: Board certified nurse practitioners with a speciality in wound and skin disorders. Additional training through WOCN Program at Emory University. We are also known as NP/ET/WOCN specialist. Able to write prescriptions and provide a medical service for the treatment of ostomy related disorders. “Nurses are the heart of healthcare.” Out Patient Ostomy Clinics in Central Florida continued 2069 Aloma Avenue Winter Park, FL 32792 Phone: 407-679-2135 Fax: 407-671-7303 Ostomy Supplies and Medical Equipment 762 E. Altamonte Drive Altamonte Springs, FL 32701 Phone: 407-691-3009 Fax: 407-691-3021 Hours: Monday-Friday 8:30 AM - 5:30 PM, and Saturday 9:00 AM - 2:00 PM To report abuse, neglect, or exploitation call 1-800-962-2873 Donna Will Cardillo 6 We thank our OAGO members and those named or anonymous below who gave additional support to our programs in 2015. Binson’s Home Health Centers Newsletter Ad Colon & Rectal Clinic of Orlando Newsletter Ad Florida Hospital Youth Rally John Yeater Youth Rally, Gift Room Rent Jack & Carol Ann Vreeland Gift Room, Gift Room Rent Elizabeth Kardatzke Programs, Youth Rally, Gift Room Sherman G Miller Youth Rally Thomas P & Mary E Martin Gift Room Rent Neal Mengel Gift Room Rent J Robert Deem Gift Room Pamela Richardson Programs Rose Cuozzo Programs, Youth Rally, Gift Room Richard Brenneman Programs, Youth Rally, Gift Room Howard L Kaskel Programs Fran Murawski Gift Room Robert Zuleeg Programs James R Bell Programs Kay Cobb Gift Room Henry Hartmann Programs Jean Nicoletti Programs Shabbir Adam Programs Selena Rucker Gift Room Irene Fortuna Gift Room Ricky Norris Gift Room DEHYDRATION AND THE ILEOSTOMY By Terry Gallagher, UK (Edited & Excerpted): UOAA Update March 2015 In someone with a working colon, the colon is responsible for absorbing most of the water we drink and that is contained in our food. In addition, electrolytes such as sodium and potassium, essential to maintaining good health, are absorbed there. Removal or disconnection of the colon immediately causes the first problem because of the removal of the ileo-valve. This valve is between the ileum (or small intestine) and the colon where the appendix is attached. Its purpose is to hold back the food in the ileum to enable it to be absorbed better. As an ileostomate, when we lost this valve, food and water pass through our digestive system faster, so less is absorbed, often accounting for weight loss when a person first recovers from the surgery. The ileum does absorb more water to compensate, but still absorbs much less than the colon did. Waste from the ileum normally has about 30% of the water remaining, while waste from a colon has about 10% remaining - quite a difference. In addition, the ileostomate loses ten times as much sodium and potassium as someone with a colon. Because of all this, anything which upsets the balance in our bodies has a much faster effect, as well as happening much quicker than in a person with a working colon. A typical example is gastroenteritis. A person with a working colon with the same degree of infection may be sick and have diarrhea for a couple of days, whereas someone with an ileostomy may well end up in the hospital as an emergency. This may apply to other problems with upset the digestive system's balance as well as gastroenteritis. When these occur, a person with a working colon experiences nausea, vomiting, fever, abdominal cramps, sometimes bloody diarrhea and signs of dehydration (including the veins on the back of the hands and elsewhere becoming invisible). Those of you with an ileostomy may fill up very rapidly with fluid. On emptying, the pouch can refill in minutes. You may feel nauseous and develop abdominal discomfort. You may rapidly begin to experience the symptoms of dehydration, which dry mouth, decreased or virtually nonexistent urine output, heart irregularities and dry skin. In many cases, you can see urine out has ceased. This is a medical emergency! If hospitalized for dehydration, the ileostomate may expect iv solutions to be given. The fluid given will be saline, potassium, or potassium and glucose to replace those essential electrolytes lost as mentioned earlier. Expect an EKG (to check for heart problems), bloods to be taken and stool and urine samples (to check for infection), and check and abdominal x-rays. Dehydration treatment can also lead to kidney damage, which may be permanent, requiring lifelong dialysis or a transplant. If you become ill with diarrhea, vomiting and fever that persist and you find yourself with a pouch which is filling and refilling with fluid and start to develop a dry mouth with abdominal pains, seek emergency treatment immediately. Normal people may sneer that we're making a lot of fuss for a simple "tummy ache", but we're not! It can be much more serious for us than for people with working colon. OSTOMATES GUIDE FOR HOSPITALIZATION By Lindsay Bard, MD: UOAA Update March 2015 It is important for a person with an ostomy who needs to be hospitalized, to know that he/she should be handled differently than someone without an ostomy and how. Rule 1 - The Cardinal Rule!: If you feel something is being done or going to be done to you that might be harmful, refuse the procedure. Then explain why to the medical personnel, especially your physician. They will then decide with you, if the procedure will actually be in your best interest. Rule 2 - Supplies: Bring your own supplies to the hospital. Never assume the hospital will have the exact pouching system or irrigation system you use. Most hospitals have some supplies available. These are used for emergency situations. Rule 3 - Instructions: Take to the hospital two copies of instructions for changing and irrigating your pouch. Rule 4 - Communicate!!! Again, let me stress that you communicate with the hospital personnel who take care of you. You will have a better hospitalization and they will have an easier time treating you. “Give her a day, and then in return Momma gives you the other 364” Will Rogers 7 Ostomy Association of Greater Orlando Officers President Lori Cohen 407.399.8371 [email protected] Vice President Patrick Gessel 801.558.3074 [email protected] Past President Secretary Marie McDuff 407.297.8053 Treasurer Evelyn Vihlen 407.862.6567 Board of Directors Marketing Director Shelley Dittmer 407.929.3668 [email protected] Past President Director and Web Editor Bob Woodrow 407.297.8053 Gift Room Director Evelyn Vihlen 407.862.6567 Youth Rally Director Stephanie Crane 612.669.9990 Mentor-Visitation Team For assistance pleased call: Lori Cohen 407.399.8371 [email protected] Newsletter Editor Patrick Gessel 801.558.3074 [email protected] Advisors Physicians Thomas B. Blake III, MD Sergio W. Larach, MD, FACS, FASCRS Renee Mueller, MD FASCRS FACS Wound Ostomy and Continence Nurses Florida Hospital Sloan Bartlett, MSN RN CWOCN 407.303.5600 Extension 110-9271 Winter Park Memorial Hospital Terry Barton, BSN RN CWOCN 407.646.7523. Ambassador for the Youth Rally Committee, Inc. Kate Markwith THE PHOENIX, UOAA’s MAGAZINE The Phoenix is a great source of information. The Phoenix is also available as an online version for $19.95. You can subscribe to the hard copy or online version by using the form on this page or by visiting their website at www.phoenixuoaa.org. $29.95 $49.95 ABOUT US: The Ostomy Association of Greater Orlando, Inc. is an IRS 501(c)(3) tax-exempt charitable corporation in the State of Florida with “umbrella” status under our parent company, United Ostomy Associations of America, Inc. We are an all volunteer support group dedicated to assisting people who have or will have intestinal or urinary tract diversions by providing emotional support, family support, educational services, advocacy, and promoting the services of this organization to the public and professional communities. IMPORTANT NOTICE Articles and information printed in this newsletter are not necessarily endorsed by the Ostomy Association of Greater Orlando, Inc. and may not be applicable to everyone. Please consult your doctor or WOC Nurse for medical advice that best suits your specific situation. POPULAR OSTOMY RELATED WEBSITES www.ostomy.org United Ostomy Associations of America (800-826-0826) is an association of Affiliated Support Groups. UOAA serves people with ostomies and other intestinal and urinary diversions through its affiliated support groups. UOAA is a member of the International Ostomy Association. Their website has a large discussion board with over 10,000 topics posted by ostomates. Individuals can join UOAA simply by joining the Ostomy Association of Greater Orlando. www.ostomyassociationofgreaterorlando.com Our website contains information on our support group including meeting calendar, directions to our meetings, new member application, useful links, list of ostomy suppliers, helpful articles, and much more. www.Ostomy.Inspire.com The Inspire Ostomy Support Group is a great way to meet and connect with a community of people who understand what you’re going through. ConvaTec partnered with Inspire to create this social network where people with ostomies can gain emotional and informational support. www.c3life.com A website dedicated to helping people with ostomies live their lives to the fullest. Supported by Hollister Inc., c3life.com is part of Hollister’s mission to help make life more rewarding and dignified for those with ostomies. www.meetanostomate.com Provides a free collection of real-life tips and tricks from ostomates. www.ostomates.org/ The aim of “Shaz’s Ostomy Pages” is to give you as much information as possible regarding ileostomy, j pouch, colostomy, urostomy, or any type of stoma surgery. It’s for ostomates by ostomates. www.ostomyland.com/ Has provided ostomy support since 1998, including interactive support, chat, blogs, lifestyle guidance, lists of ostomy product manufacturers, and ostomy undergarment and accessory manufacturers. www.uncoverostomy.com IDEAS, or the Intestinal Disease Education and Awareness Society, is a registered Canadian charity that works to eliminate the stigma associated with intestinal diseases through education and awareness. www.google.com Type “youtube” in the google search box, then type “ostomy” in the youtube search box. All the audio/visual guidance you could ever want. THE OSTOMATES PRAYER Oh Lord, as we have been reborn, let us multiply our good fortune and share it with those ostomates who do not know how good the life you have given us can be. Let us vow in the years ahead to renew the work of our group, as you have renewed our lives. We thank you for our lives, for the mutual support of each other, and for the chance you have given us to help others. Amen. Via the Clermont County Chapter, the Batavia OH Chapter, and Indianapolis IN Chapter 8
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