Discuss any concerns you may have with your surgeon ahead of time. The surgeon you choose should be experienced in a number of ostomy surgeries performed. Ideally the stoma he or she will create should protrude outward from the abdomen at least one half inch for ileostomies. Patients that have stomas that are created flush with the skin tend to experience more skin excoriations with ileostomies and some colostomies. During peristalsis, the skin surrounding the stoma will pull inward with the result being that discharge containing enzymes will get between the barrier and the skin causing the pouch to fail, excoriating the skin.
Ask the hospital where you will be having surgery to help you arrange for an ostomy visitor. You have a right to ask for and receive a trained ostomy visitor through the local chapter of United Ostomy Association Canada. They can match you up with a visitor that has undergone the same type of surgery you will be having and who can answer many of your questions and calm your fears and anxiety. Ask the visitor if you can call them later with any further questions you might have.
Ask the hospital where surgery will be performed if they have an Enterostomal Therapy (ET Nurse) on staff that you can visit to have your stoma site marked prior to surgery being performed. This allows the surgeon to place the stoma on the abdomen in the area that is least likely to be obtrusive or cause pouching problems after surgery. Your stoma will be easier to care for if it is not created in a beltline, fold, or scar tissue crevice in your skin and will result in better adhesion of the wafer, with fewer leakages and skin problems.
The ET nurse can also show you samples of the pouch you will wear during your stay in the hospital. During this visit, make sure that the ET will show you how to change your wafer and pouch and teach you the basics of stoma care before you leave the hospital.
Adopt a positive mental attitude and realistic expectations about your surgery and life afterward. Face the realization that you are not the only person this has happened to in life. There are about a million people out there in the U.S. alone whose ostomy surgeries have allowed them to conquer disease and lead normal healthy lifestyles filled with work, activities, play and relationships. Realize that you must give yourself time to heal following surgery, but do expect to become one of them.
