November/December 2004
Page 6

Incidentally

By Marjorie Kaufman

No one can tell at a glance that I have an ostomy. Only those close to me know it for sure. Perhaps that is why it is difficult for me to recognize a curious fact: some people do not realize it is a BLESSING, not a DOOM! One wonders whether this knowledge might have some value to the human race - at least that part of the human race that tends to look upon an ostomy as a disaster.

Acceptance is part of being happy. People need happiness as much as then need food; without it they're devoured by restlessness and discontent. How many people who think they resent and ostomy would, if they were truthful, recognize it as a thing they most needed to enjoy life again? How many could, with a simple change in mental outlook, admit it's a BLESSING?

Many people never learn, they never achieve the peace of mind and contentment this knowledge brings. They spend their lives in a prison where an ostomy is the eternal punishment. An ostomy is not DOOM - that's a mental attitude. Nothing is a joy or a burden; only thinking makes it so.

How can we avoid that feeling of compulsion that makes an ostomy a burden? We don't disclaim it. There's no use kidding ourselves about that. Nevertheless, there are things we can do to take the edge off the feeling of compulsion and make things more pleasant. We need to expend or mental and physical energies. If these energies are not expended in constructive fashion, they turn inward and poison our minds an bodies with resentment and dissatisfaction. We need that warm sense of accomplishment, to be needed, wanted and useful. We need it to give balance to our lives. Contentment depends not so much on the BLESSINGS as on the attitude of the person who has it.

SOURCE: Los Ileos News Via The Reroute, Evansville, IN. Sept. 2004, via Inside Out On-line Nov/Dec 2004.

Medications and an Ostomy

• Chewable means it should be completely chewed. Any fragments left may be found in the effluent - stomal output. If you routinely chew all of your tablets or separate capsules, you may be looking for trouble. Many medications are not meant to be chewed.
• Enteric Coated tablets have dissolution delayed. These tablets have diminished or minimal effectiveness for someone with an ileostomy.
• Gelatine Coated are less effective than liquids if the person with an ostomy has short bowel syndrome.
• Liquids are more rapidly absorbed. If you have difficulty swallowing pills, ask for the medication in a liquid form.
• Sustained Release medications take 8 to 12 hours to absorb. These capsules should not be chewed or opened - unless approved by your pharmacist. These capsules are designed to release slowly after they pass through the stomach, not before. Side effects may be exacerbated if directions are not followed.
• Sugar Coated tablets do not dissolve completely until the tablet reaches the ileum. Watch for traces of the tablet in the effluent.
• Uncoated tablets begin to dissolve in the stomach. But, the complete time taken to dissolve may vary among different products ... always ask your pharmacist to be on the safe side.

• Antacids use basic compounds - alkaline - which are used to reduce acidity of the gastric contents. Sodium bicarbonate based antacids are high in salt. Magnesium based antacids have a laxative effect - which means do not take them if you have an ileostomy, irrigate, or have renal failure. Aluminum based antacids delay the emptying time of the stomach; inhibit the absorption of iron; are constipating; and increase the excretion of products in urine like aspirin.
• Antibiotics may often result in diarhhea. If so, then increase your fluid intake. Antibiotics alter the normal bacteria found in the large intestine and may result in a fungal - yeast, candida - infection. The large intestine has either bacteria or fungus, it is never "clean". Make sure you use a micro-granulated anti-fungal powder under your barrier whenever you are taking antibiotics in order to fight off fungal invaders.
• Anti-flatulent medications help in the dispersing and prevent the formation of gas - Mylicon or Gas-X. If the flatus is the result of the types of foods; i.e., beans, broccoli, try Beano.
• Chemotherapy may cause gastrointestinal tract disturbances. If you are currently irrigating and diarhhea begins, stop until the stool regains consistency. Make sure you inform your doctor about all side effects as well as any vitamins, supplements or medications you are taking. Many react to chemotherapy.
• Diuretics may result in fluid and electrolyte imbalances. Ileostomates should not take these - unless seriously researched by your doctor. If you irrigate, you may find you get poor results due to the dehydration of the colon.
• Laxatives should never be taken by a person with an ileostomy. Mineral oil should not be taken with a meal ... it delays the emptying time of the stomach. Bulk-forming products - Metamucil - must be taken with sufficient water or it will be constipating. The best way to control output is through diet. Natural laxatives like warm prune juice as well as adding fruits, vegetables and fluids are best.
• Odour Control can be obtained by medications that have a bismuth subgallate base - Devrom Tablets. Chlorophyll is in parsley but may be purchased in capsule form. They will turn the stool green.
• Pain Medications are constipating so be sure to drink plenty of fluids.
• Salt Substitutes reduce sodium and should be avoided by people with ileostomies.
• Vitamins are often taken without consulting your physician. Always inform your doctor if you are taking vitamins. There are instances when prescribed medications can interact with vitamins resulting in ineffective absorption or cause adverse reactions.

SOURCE: Corpus Christie Ostomy News, Via, The New Outlook Online, Chicago North Suburban Chapter, June 2004, via Inside Out On-line Nov/Dec 2004.