November/December 2004
Page 3
Abdominal Changes
By: Arthur Clarke, RN, ET
Gettysburg, VA
The surgeon allowed only so much moveable bowel in the construction of your stoma. Once that piece of bowel was pulled through your abdominal wall, it was tacked down on the inside of the abdominal wall and on the outside of the skin. That length will remain constant through your life, therefore, if the wall of your abdomen thickens (i.e., with fatty tissue), the length of the bowel used for your stoma is not affected.
One result of the limited length of bowel with increased abdominal wall thickness, is that when you sit or stand, the changed position causes the abdominal wall to shift forward and down, and the stoma segment prevents the peristomal skin from shifting as much as the rest of the
abdomen. The limited movement results in a "skin well" around the stoma when you sit or stand. Skin adjacent to the stoma becomes quite mobile being pulled down, then flattened by your changing positions. I have found that an appliance with a firm, convex surface which "pushes" the skin back and holds it stable, relative to the stoma, works much better than highly flexible pouches.
SOURCE: Metro Maryland; Hemet, San Jancito,CA; The Re-Route, Evansville, IN, VIA: The Regina Ostomy News, November/December 2004 , via Inside Out On-line Nov/Dec 2004.
Hints From All Over
- Wear protection between the pouch and your skin to prevent a rash from perspiration (especially in hot weather.)
- Leave a little bit of air in the pouch after emptying and before clipping it shut. The air provides space for the effluent to flow down into the pouch, rather than sideways or underneath the adhesive wafer.
- Apply your pouch standing, lying or sitting; but, do not allow abdominal wrinkling or this will break the seal when you straighten up.
- Do not suppress a sneeze. If you seal your lips and pinch your nose while sneezing, you create enormous pressure in your nose and throat, which can force infections into your sinuses or ears through the Eustachian tubes.
- Don't put limitations on yourself just because you have a stoma.
Enjoy Yourself!
SOURCE: The Re-Route, Evansville, IN September 2004 , via Inside Out On-line Nov/Dec 2004.
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