Beauty and the Ostomy: Total Skin Health

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Skin Hydration Beauty Tips for Living with an Ileostomy

BY ELLYN MANTELL

As a self-avowed makeup and skin care junkie, I strongly believe that looking good is greatly related to feeling good. In fact, makeup and attention to my skin has helped me to get through the years of misery that led to my eventual ileostomy four years ago. As I reflect back, I remember asking my husband to search my handbag for lip gloss when visiting me in the hospital with peritonitis, as soon as I was brought into my room post-surgeries and the like. As soon as I felt well enough to walk around my house, I was applying my skin care regimen and blush, so everyone knew I was fighting my way back. My suitcase, always at the ready for another surgery, contained my stash of the perfect lip color to brighten my pale face for visitors, including my physicians making early morning rounds. Somewhere along the way, I recognized that my ability to heal had a great deal to do with the colorful smile I could put on my face!

It is my belief that although we ostomates can live a very full and fulfilling life, some things will just take a little extra attention, and looking our best may be one of those areas. With that in mind, I am planning on contributing information about beauty and fashion, and have named my blog/post/column Beauty and the Ostomy! Look for it in the next Phoenix Ostomy Magazine. In our case, the ostomy is not “the beast” but the beautiful incarnation of our body to heal itself and our spirit, and our appreciation of our stomas is parallel to Belle’s appreciation for her Beast!

What does an ostomy do to our system that impacts our facial appearance, you may be wondering? I believe that our loss of fluids, particularly for ileostomates, is major, so we need to talk about moisture and hydration. Although I am always looking for new products to rejuvenate and enhance the aging skin, I am very aware that all ostomates need to be mindful of how to get well-needed moisture and hydration into the skin, regardless of our age.

From childhood, my skin has always been on the dry side, and I accepted that reality into adulthood. But a very lovely aesthetician informed me that with proper treatment, I could have much healthier skin, since skin that holds moisture, has more of a chance of fighting illness. The glow of healthy skin reveals a canvas ready to be painted or just admired by itself. Whether valid or not, I became determined to make some important changes, and I truly believe good skin care yields results, and that is wonderful!

How Do We Absorb this Very Valuable and Sometimes Unattainable Moisture?

Like anything worth doing, there are steps to absorbing moisture. First, we must drink lots of fluids, primarily water. Many beverages do not add hydration, and may even leach hydration from our bodies. Some believe coffee, tea and soft drinks are culprits. I believe, however, that in moderation, they are fine, as long as lots of water is added to the daily diet. I love hot water, with or without lemon, and drink it all day, along with cold water, with or without lemon. UOAA’s Diet & Nutrition Guide even has recipes for hydration drinks and more ostomate specific information. You may be interested to know that fatigue is lessened, especially midday, by binging on water, rather than a fattening treat.

In caring for our skin, ostomates should use a gentle cleanser most nights, but 2-3 times a week, an exfoliant is a great addition to the routine. The exfoliant can be chemical (vitamin c or acids) or natural, such as grainy or mealy. The skin will glow and the new soft skin will let you know your skin is ready to receive moisture!

Serums are a vehicle of introducing treatment to the skin, and can add vitamins, minerals, usable acids, etc. Every day I read more and more about the addition of serums to beauty regimens, and since they are light and easy to apply, I use them morning and night.

Next, we need to use moisturizing products, and there is a myriad from which to choose. Lotions are lightweight, and wonderful for younger skin, which requires less hydration and may be producing much-needed oils, whereas creams are recommended for the aging skin.

Lastly, sunscreen every day, and oh, by the way, sunscreen, even when it is cloudy! The debates go on about what is the appropriate designated number of SPF (Sun Protection Factor) but my sources tell me 30-70 is best, taking into consideration that any less than 30 isn’t worth the product, and any higher number than 70 is just loading on more chemicals. And if we are in the sun for a long period of time, we should reapply as the day goes on. Be sure to wash off sunscreen and all makeup before bed, apply a night cream for optimal hydration…and let your skin breathe and rebuild during sleep!

(editor’s note: Peristomal skin issues are a whole different issue beyond beauty regiments and critical to medical wellbeing the link above has more information on that topic.)

Please write to me at ellynmantell@aol.com with any beauty and fashion questions you have. I am very interested in what interests YOU!

No Stress Air Travel with an Ostomy

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Traveling through airports can make anybody nervous as security lines get longer and wait times increase. For some people living with an ostomy, air travel can cause further anxiety.

Universal pat-downs performed by Transportation Security Administration (TSA) agents and uncertainty surrounding procedures at the screening checkpoint can add to an already stressful experience.

Luckily, United Ostomy Associations of America (UOAA) is working on your behalf to help make your next airport security screening run as smoothly as possible. But you need to be prepared beyond just packing the right supplies and emptying your pouch before a flight. With our tips and latest guidance from the TSA, you’ll be empowered with the knowledge to help make your next travel experience a positive one.

“We have been working with the TSA for over three years now and have established an excellent working relationship,” says George Salamy UOAA’s TSA Liaison and representative on the Coalition. In fact, at a past TSA Disability and Multicultural Conference, OAA was the recipient of a Community Participation Award.  “Recognition by the TSA with this award illustrates how we are helping our constituents, the ostomates, who want to travel with little inconvenience,” George says.

One way we do this is by participating in conference calls where we provide input from the UOAA traveler perspective. The system is a work-in-progress and complaints about invasive searches outside of protocol, though rare, still occur.

Communication is critical in navigating the security process. Inform the TSA officer that you have an ostomy pouch before the screening process begins. For discretion, you may provide the officer with the TSA notification card or a medical document describing an ostomy. Expect to be screened without having to empty or expose the ostomy through the advanced imaging technology, metal detector, or a pat-down. If your ostomy pouch is subject to the additional screening you’ll be asked to conduct a self pat-down of the ostomy pouch outside of your clothing, followed by a test of your hands for any trace of explosives.

You may also undergo a standard pat-down of areas that will not include the ostomy pouch. Remember it is normal protocol for agents to request a pat-down of any travelers. Be aware however that at any point during the process you can ask for a Supervisory TSA Officer, and a private area for the screening as well as be accompanied by your travel companion.

As an ostomy traveler, if an incident occurs that differentiates from the protocol (such as being asked to undress the area around your ostomy) know that this is not allowed. It is important to report this to the TSA and follow-up with UOAA to ensure appropriate and immediate action is taken. Upon review of security footage corrective action may be taken in the form of additional training and/or discussions with appropriate personnel at the airport to help prevent similar incidents from happening again.

Before your next trip view our tips for ostomy travelers. We will continue to educate and communicate with the TSA with the goal of making travel easier for all those traveling with an ostomy. No people living with an ostomy should ever be discouraged from travel whether for work, to see family and friends, a vacation or a journey around the world.

Fashionable Living with an Ostomy

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Our Ostomy Gives Us Power!

Ostomy Visitor talks clothing and embracing life

By Ellyn Mantell

As president of our Ostomy Support Group in Summit, New Jersey, I have met many future ostomates over the years since I have had mine, and we have met in various places, depending upon their health, etc. The one that stands out in my mind is a meeting at a shopping mall a few weeks prior to her ostomy, with Carol, a woman who wanted not only to see the stoma for herself but to understand how it would fit into her life. She loves clothes, as do I, and was frightened she would need not only to purchase a new wardrobe but to change her style of dress.

The best way to show my stoma to her was to go into a fitting room in a store. We brought in some clothes that were of interest to her, and I proceeded to try them on, demonstrating how my stoma (Lily, as I have named her) would fit neatly and snugly under the clothing. I was reminded that as soon as I had my ostomy four years ago, I gave away all of my belts and fitted pants. I was certain I would never wear them again, despite being told that wasn’t true. To the contrary, I saw pictures of great looking women with ostomies online in tight jeans with belted waists. It was just too hard to imagine myself wearing belts and jeans with a pouch, and since these women were not in front of me, I couldn’t ask them “how do they manipulate their appliance to be comfortable and secure?”

Knowing it would have been invaluable to me to actually see an abdomen in clothing, I wanted Carol to have the proper introduction to dealing with her wardrobe. We laughed as I told her of my quest to replace my jeans and belts over the years – since I have learned I can wear almost anything! In truth, my “go-to” outfit is most frequently leggings and tunics, dresses and full-legged pants with a tank, covered by cropped tops. I am what is known as “funky and fashion-forward dressing,” as I learned when I was the fashion trainer for Macy’s years ago, and happily, my style hasn’t had to change due to Lily, who requires a high-output pouch that is so long, and I am so short, that it rests on my thigh!

Wide-eyed, but a little more able to envision her own “Lily,” Carol and I left and grabbed some tea at the nearest Starbucks. We sat and talked about the changes she anticipated and feared, and then she asked me what I really, very truthfully, feel about being an ostomate? Without missing a beat, I very simply said POWERFUL! I told her that as I look around at the many people shopping, I know I have a secret, and that secret is that I am strong, a survivor, and I can help others. Knowing that gives me the most positive feeling, and I am grateful, and want to share it!

I have checked on and even visited Carol as she recovered from her surgeries – since there were a few. Sadly, there is no straight line for any of us, and depending upon the reason for the ostomy, recovery can have many twists and turns. My own led me to need to spend weeks in the hospital and then a rehab facility. But she is improving daily and gaining back her strength and determination. I know she will join our support group or another closer to her home. I also know that before too long, she, too, will be accomplishing her goal of like me, being trained to become an Ostomy Visitor…to meet with and help others learn how to cope with their ostomy, and how POWERFUL they truly are, as well!

Tips for a Successful Recovery after Ostomy Surgery

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By Diana Gallagher, MS, RN, CWOCN, CFCN – Facilitator for the NWA Ostomy Support Group

updated 11/3/2022

For many, ostomy surgery is lifesaving but their initial feelings on living life with an ostomy are negative. For individuals with years of unresolved incontinence or inflammatory bowel disease, however, life after surgery is frequently viewed as a positive improvement. For them, an ostomy is the promise of a return to a normal life.

As you prepare for surgery, or recover from emergency surgery, the following are important tips to help you transition into your new life and embrace living with an ostomy.

Select a surgeon with valuable experience in the type of surgery that you are facing. General surgeons as well as specialty surgeons can perform ostomy surgery. Specialty surgeons are those who have completed additional education, training, and fellowships within the specialty. These surgeons will be identified as Colorectal or Urology Surgeons. You can find a local physician through the website for the American Society of Colorectal Surgeons or by contacting the American Urological Association.

See an Ostomy Nurse. BEFORE surgery, your surgeon may refer you to a specialty nurse, like a Certified Wound Ostomy and Continence Nurse (CWOCN). If not, you will need to find a specialty nurse. This nurse will help ease your transition into living with an ostomy. Although education may be provided during your hospital stay it can be difficult to focus and remember because of anesthesia, surgical pain and stress. Your ostomy specialist will provide comprehensive education including practice pouch changes before surgery. In addition, he/she will identify and mark the best location for your ostomy. This is important because during surgery it is difficult for your surgeon to know where the waistband of your pants sits, where creases or irregularities exist and other special considerations to consider when selecting that optimal site.

Attend a United Ostomy Associations of America (UOAA) affiliated support group (ASG) meeting in your community if possible. You may think that you do not need a support group or feel that you are the type of person who does not feel comfortable in a group setting. Put those feelings aside; listening in the beginning is a good start. Join your local group, even if you don’t initially find someone your age with a similar story, there is a lot to learn. UOAA affiliated support groups are truly one of the BEST places to obtain the necessary education, helpful hints, support, and resources and many groups offer online meetings. Don’t feel that you are alone.

For more details search this website for trusted ostomy information including a New Ostomy Patient Guide, specifics on the major ostomy types, ileostomy, colostomy, urostomy and resources on topics such as diet and nutrition, sexuality emotional concerns, IBD and ostomy and much more.

FAQs

 

Determine which supplies will work best for you. Learn about the different ostomy pouching systems. In the beginning, you will most likely receive sample products from a number of companies. It is helpful to keep the 2 piece products from each manufacturer separated; wafers from one company will not necessarily snap onto a pouch from another company. The sampling program will help you try a variety of products to learn which ones work best for you.

Order your regular supplies. Once you know what you like best, an order can be placed through a distributor. There are countless distributors to choose from and depending on insurance, your supplies can be delivered monthly or every three months. The first time that you order, it is logical to order a month’s worth of supplies. As your expertise develops, you may fine-tune your list. Insurance normally pays 80% of supplies that are medically appropriate. If you have a secondary plan, the remaining 20% may be covered. Check for a list of the established limits for each product. Reorder supplies so that you are never without the supplies that you need.

Select a place to keep your ostomy supplies organized. Many people keep their basic supplies in a bathroom drawer, others buy a plastic organizer with several drawers that can be moved about. Excess supplies can be stored in a closet but regardless of where you choose to keep supplies, it is best to avoid temperature extremes and high levels of humidity.

Be prepared. In addition to the extra supplies that you keep on hand at home, always keep a small pouch with all the supplies necessary for a complete change with you. Like your other supplies, these should be kept away from temperature extremes and humidity. Hopefully, you will rarely need to make an unplanned change, but being prepared, makes most ostomates feel secure and confident. If you anticipate an occasional return to the hospital, keep a bag packed with your preferred supplies. The hospital may not have the brands that work best for you.

Promptly consult your ostomy specialist for any problems. This might be a decrease in normal wear time, a change in your stoma, or a problem with your peristomal skin. A good practice for all is to hydrate properly to avoid complications.

Recover from surgery and LIVE life to the fullest. Having an ostomy does not change who you are or what you are able to do. After recovery, work to strengthen your abdominal muscles to help prevent hernia risk and enjoy all your old activities including swimming. Every October UOAA holds the Run for Resilience Ostomy 5k where people of all ages prove living with an ostomy does not need to be limiting.

Advocate for yourself. You will find that not everyone is knowledgeable about ostomies. Educate others when possible but always be willing to advocate for yourself and others. You can also help to advocate on the national level by supporting UOAA’s advocacy program and taking part in events like Ostomy Awareness Day held on the first Saturday in October. UOAA works toward a society where people with ostomies and intestinal or urinary diversions are universally accepted and supported socially, economically, medically, and psychologically.

Share your experience and tell your story. Your story has the power to help others as they begin their journey. Connect with others in person or online and offer to help the next person who has this life-saving surgery.

 

For updates on the latest ostomy resources,blogs, events and advocacy sign-up for UOAA’s monthly E-Newsletter or become a part of the official UOAA community with a national membership. For more information contact United Ostomy Associations of America at  info@ostomy.org or 1-800-826-0826.

Back to Work with an Ostomy

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From the board room to construction, to long shifts in a hospital, people with living with an ostomy (colostomy, ileostomy, urostomy, ect.) work every job imaginable.  Embracing a “new normal” in life after ostomy surgery is key to living an active life, and that daily norm means going back to work.

According to the American Society of Colon and Rectal Surgeons once a person has recovered from surgery your ostomy should not limit your return to work. When you return depends on your individual recovery, ease of pouch management and how physical your job is (due to the increased risk of hernia).

Whether to tell your employer or co-workers is a personal choice depending on your unique work situation, but some feel it comes in handy if you require frequent breaks or other accommodations. Remember your co-workers will likely not realize you have an ostomy unless you tell them. With some preparation you’ll soon be confident in the workplace, and for many, feeling in better health than before surgery.

Here are a few tips from the UOAA Facebook community and Advocacy Network.

  1. Be Prepared:  In the case of a possible leak have a complete change of your ostomy supplies as well as a change of clothes you can bring to the bathroom. “Pack in a backpack, zippered tote, or small duffle bag that you can store in your desk drawer or locker” –Jane Ashley-publishing/author
  2. Know Your Rights: You have legal rights under the American Disabilities Act prohibiting employment-based discrimination. Workplace complaints to UOAA are rare but it can still occur. “My coworkers all knew, especially of the trials and tribulations pre-op. But still, there was hostility and harassment at times.” Jacque- Retired Government.
  3. Dispose/Empty Your Pouch Properly: Investigate the best restroom/changing facilities to empty or change your pouch. Consider the use of pouch or ostomy type deodorants. “My purse contains a 1-ounce bottle of Poo-Pourri, a Tide pen, a lubricating deodorant sachet, and baby wipes.” Margie, Academia.
  4. Find the Best Clothing for Your Job: Consider loose clothing if sitting for long hours or a stoma belt if you have an active job with lots of bending. A skin barrier may be helpful if you perspire on the job. “I wear a hernia belt”- Megan-Nursing
  5. Don’t Stress Stoma Noise: If your stoma decides to speak up at the next meeting relax, you may be the only one who notices “All bodies make sounds” Penny- Construction
  6. Hydrate: “Stay on top of your fluid intake. Don’t get distracted and have it result in an ER visit.” Heather Brigstock-Nursing
  7. Find Support: Know that you are not alone. UOAA has about 300 affiliated support groups around the United States that offeradvice, information and support.

Wish some preparation and patience you’ll soon be confident in the workplace, and for many, feeling in better health than before surgery.

How to Change Your Ostomy Pouch

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Basic Tips for Changing your Ostomy Appliance

 

By Wendy Lueder

 

If you feel overwhelmed by changing your appliance, please know that your feelings of anxiety will diminish over time. I know it can be difficult at first but it will become more routine with practice. Knowing just what you’re going to do can be helpful so here are some basic guidelines that you may wish to use.

  1. To start, wash your hands!
  2. Set out your equipment within easy reach on your bathroom countertop. You will need: an old bath towel on the floor and Kleenex tissues (without any lotion!) to catch any unwanted output while changing; plastic bags for clean-up; a washcloth if you don’t shower; clean bath towel; pencil and stoma measuring guide; scissors or x-acto knife if you don’t use the new “moldable” skin barrier wafers; a skin barrier wafer; Stomahesive or HolliHesive paste or product such as Eakin Cohesive Seals (preferred by this writer) a new pouch; a tail closure if you use a drainable pouch that doesn’t have the built-in Velcro closure ; hair dryer and finally, a swivel make-up mirror.
  3. Empty your pouch as normal. DO NOT rinse your pouch out when emptying. This only reduces adhesion. If you get this advice, ignore it. Rinsing out pouches is an obsolete suggestion that is totally bothersome and no longer valid for modern ostomy equipment. Empty your pouch while sitting comfortably and normally on the toilet. Put some toilet paper in the bowl first to avoid any splashing. If you use a tail clip, carry an extra one with you in case you accidentally flush yours down the toilet
  4. While holding a corner of the tape that holds your appliance to your body, gently push your skin in toward your body to remove the appliance. Pushing your skin inward is far less harsh on it than if you pull the appliance off and away. Try it and feel the difference. You only need to use an adhesive remover if: A) you have worn the skin barrier wafer a very short time and the adhesion is still very strong and/or B) your skin is irritated or tender and can be easily damaged. I personally prefer the spray adhesive removers as they leave less residue. However, I only use them if I have worn the barrier for less than two days between changes.
  5. Put the old pouch, wafer and other waste (not the tail clip!) into a plastic bag for disposal. Sealable sandwich bags work great.
  6. Clean the skin around the stoma with a washcloth and warm water or by getting into the shower and using your hands. Be gentle. Do not use scented or cream soaps as they will diminish adhesion of your skin barrier. Any waste coming out of the stoma will merely wash down the drain.
  7. Pat your skin dry with Kleenex and for best results use a hair-dryer on low setting to complete the job. The cleaner and dryer your skin is the better your skin barrier will adhere.

Measure your stoma with a measuring guide (usually supplied in the box with your skin barrier wafers) using the make-up mirror placed on the countertop to get a better look. This is especially important if your surgery is recent as your stoma will become smaller over a period of months.

For all Skin Barriers except StomaHesive Wafers measure right up next to the stoma. For StomaHesive Wafers add an eighth of an inch space between the stoma and the wafer hole. Only this brand of wafer is “stiff” and could damage your stoma if it is too close. All other types of skin barrier wafers are more flexible and won’t damage the stoma if placed right up next to it. If your stoma is oval take two measurements, one each of the larger and smaller diameters.

  1. Trace the correct size and shape onto the back of the wafer with the starter hole in the middle. Cut out the hole either with your scissors or more easily by using an x-acto knife.

There are new moldable skin barrier wafers that you do not need to cut but merely manipulate to create the correct size opening. This is especially helpful if your stoma is oval and is highly recommended by this writer. Follow the manufacturer’s directions to create the perfect size opening for your unique stoma.

  1. If you use paste, peel the paper from the wafer and apply the paste only by the width of the tubes opening around the cut circle in the wafer. Allow alcohol to evaporate for approximately thirty seconds. Unfortunately paste is poorly named. Paste is really merely caulking and has no adhesive property.

If greater protection is needed than paste can afford (such as for ileostomates who have a caustic output), try using an Eakin Cohesive Seal or similar product instead of paste. these seals have the consistency of silly putty, and lasts far longer and will not wash away from heavy output.

Small dabs of paste or small pieces of Eakin Seals are great to fill any dimples in your skin that you may have. The flatter the surface of your skin around the stoma, the better the seal. Do fill in those dimples if you have them.

  1. While leaning slightly backwards to smooth out your skin, remove paper backing from the skin barrier and apply it slowly and carefully over the stoma. Use the magnifying side of your mirror to see that you are correctly setting it in place. Remove the paper backing from the surrounding tape and smooth it out on your skin being careful not to create any wrinkles as they may latter dig into your skin.
  2. If you use a two-piece system, snap the new pouch onto the wafer. Never tug down on the appliance to see if it is secure. Instead, feel with your finger all around the “Tupperware” closure to make sure the pouch and wafer are as close to each other as can be. If you detect any space, push the pouch toward your body until you feel it close the gap. You may hear a series of clicks as you apply the pouch.
  3. If you use a tail clip, apply now. Hold your appliance in place with your hand for a full five minutes to ensure a secure seal. All skin adhesives are more effective if held in place after first application as the heat from your hand improves adhesion. If your stoma is flush to your skin, use a skin barrier wafer with built-in convexity. The convexity will gently push the skin toward your body around the stoma giving it some extra length. When the stoma thus protrudes a bit more, its output goes more easily into the pouch. The new adhesives and skin barrier wafers stay put well for days.

Some bleeding is normal when touching your stoma, but report any unusual color, size, shape, or bleeding to your Ostomy nurse. Try different products. Call your Ostomy nurse or ostomy supply companies and ask for free samples. You may have to shop around to find products that leave you feeling comfortable and secure. You should be no more aware of your appliance than you are of your underwear. Always follow any special instructions provided by your health care professional as they know your specific situation better than any general guidelines an article such as this could provide

If your abdomen is very hairy, you may want to gently shave off the hair under your skin barrier wafer. Be careful not to cut or damage your skin.

These suggestions are gleaned from years of helping ostomates cope and are just that, suggestions. They come from over thirty-five years of experience, but are in fact just the input from a layperson. I’m not a nurse, I’m an ostomate. Your healthcare professionals always know best and you need to follow their advice, not mine.
Bottom line: Your appliance should be comfortable, stay on for at least a few days between changes, odor-free (not odor resistant) and leak extremely rarely. If not, go see an ostomy nurse and change your routine until you find the products that work well for you. Best of all, studies done at Duke University verify that the longer you’ve been an ostomate, the better it gets. Problems do diminish with time and experience. You should be able to forget you’re an ostomate and get on with doing the things you really enjoy. There’s no stopping you.

Additional Tips for ileostomates only:

Try changing first thing in the morning when output is at its slowest. Many ileostomates report that eating four to five marshmallows right before changing stops all output from the stoma for several minutes. I personally have found this to be true. As marshmallows are pure sugar, please don’t try this if you’re a diabetic.
As the output for ileostomies is far more caustic than for colostomates and urostomates, don’t put off changing your appliance when needed. There are two indications you need to change, one is “itching” and the other is a “burning” sensation. If you itch, it may be merely dehydration. Drink a glass of water. If the itching continues, you need to change. If you feel a burning sensation on the skin around the stoma, change as soon as possible. The output from your ileostomy is caustic and will damage your skin. Avoid the vicious cycle of damaged skin -> poor adhesion due to damaged skin -> leakage -> damaged skin.