Preparing you for stoma surgery - Omnigon
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Preparing you for stoma surgery Everye’s journey to a sta is differe
Transcript of Preparing you for stoma surgery - Omnigon
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Preparing you for stoma surgery
Everyone’s journey to a stoma is different
This booklet will provide some information as you prepare for your surgery. No doubt, you have had a lot to take in and think about after talking with your surgeon and finding out you need to have a stoma. It can be daunting to say the least, but your surgeon has connected you with a Stomal Therapy Nurse to support you in the lead up to surgery.
To make it easy for you to understand the information in this booklet, we have included the meanings of commonly used words and terminology.
Disclaimer: All information shared in this booklet is general in nature and should complement discussions with your surgeon and Stomal Therapy Nurse.
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STOMAL THERAPY NURSE A Stomal Therapy Nurse, also known as an STN, is a specialist nurse with knowledge and experience in caring for people with a stoma. They will be there to help as you prepare for surgery, while you are in hospital and then after you go home.
STOMA An opening or hole in the body, also known as an ostomy. Derived from a Greek word meaning “mouth” there are different types of stoma, depending on what part of the body the stoma comes from. Your surgeon will have discussed with you what type of stoma is planned for you, so we will discuss the specific types throughout this booklet. It is important to know that not all stomas will look exactly the same.
OSTOMATE Any person with a stoma.
OUTPUT What comes out of your stoma. For a urostomy that is urine and for a colostomy or ileostomy that is stool (faeces).
POUCH The waste collection bag that covers your stoma. It is designed specifically to hold the output and protect the
skin, adhering to the abdomen. It is also known as a bag, stoma bag or appliance. All pouches are lined with plastic, so they are waterproof and leak proof as long as it is sticking well to your skin. Each pouch is designed for specific stoma types, so each may have slightly different features and your STN will help guide your understanding of how they work.
ILEOSTOMY A stoma made in the last section of the small intestine, the ileum, and this stoma produces a loose stool output. For more on ileostomy see pages 6-7.
COLOSTOMY A stoma made somewhere in the large intestine, also known as the colon, and this stoma generally produces a more semi-solid/solid stool output. For more on colostomy see pages 4-5.
UROSTOMY A stoma that drains urine from the urinary tract. The most common type of urostomy is called an ileal conduit. For more on urostomy see pages 8-9.
ILEAL CONDUIT A type of urostomy which drains urine from the urinary tract through a stoma formed from bowel tissue (ileum). For more on ileal conduit see pages 8-9.
Commonly used words
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ColostomyA colostomy involves a surgical procedure to create a stoma in the digestive system.
The stoma is formed in the large intestine, also known as the colon… col (colon)-ostomy (stoma).
While the colostomy can be formed anywhere along the colon, the most common place for a colostomy is in the sigmoid on the left hand side of the abdomen.
There are many reasons that someone may need to have a colostomy formed. The stoma may be a temporary measure to manage a particular disease or medical situation, but in other cases may be required permanently for life.
Some of the most common reasons for a colostomy include:
• Managing bowel or rectal cancer • Diverticular disease• Crohn’s disease• Obstruction of the bowel• Trauma and injury to the bowel• Bowel incontinence• Healing complex wounds in the anal area• Congenital abnormalities of the newborn baby
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For further information on living with a colostomy ask your Stomal Therapy Nurse OR contact Omnigon Customer Service for a copy of the ‘Your Guide to Colostomy’ booklet.
Your STN will show you some pouches and will perhaps give you one to take home, so you can become more familiar.
A 1 piece is where the baseplate and the pouch are made together as one.
A 2 piece is where the baseplate and the pouch are separate pieces. The pouch connects to the baseplate using a “click on” or “stick on” type connection.
The waste that would normally pass through your rectum and anus, will now pass through the colostomy stoma and into a secure pouch attached to your abdomen. There is no voluntary control in the passing of waste or gas from the stoma.
There are two main types of stoma pouches that could be used for a colostomy; a 1 piece or a 2 piece, and generally the pouch used is known as a “closed pouch”.
EXAMPLE OF A COLOSTOMY
1 PIECE 2 PIECE
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IleostomyAn ileostomy involves a surgical procedure to create a stoma in the digestive system.
The stoma is formed at the end of the ileum, the last section of the small intestine… ile (ileum)-ostomy (stoma).
The ileostomy is usually located on the right side of the abdomen, and the waste product will pass from the stoma into a secure pouch on your abdomen. There is no voluntary control in the passing of waste or gas from the stoma.
There are many conditions that may result in the need to have abdominal surgery and an ileostomy formed. The stoma may be a temporary measure to manage a particular disease or medical situation, but in other cases may be required permanently for life.
Some of the most common reasons for an ileostomy include:
• Management of an inflammatory bowel disease such as Crohn’s or Ulcerative Colitis
• Managing bowel cancer
• Familial Adenomatous Polyposis (FAP)
• To prevent complications following large bowel resection
• Congenital abnormalities of the newborn baby
For further information on living with an ileostomy ask your Stomal Therapy Nurse OR contact Omnigon Customer Service for a copy of the ‘Your Guide to Ileostomy’ booklet.
A 1 piece is where the baseplate and the pouch are made together as one.
A 2 piece is where the baseplate and the pouch are separate pieces. The pouch connects to the baseplate using a “click on” or “stick on” type connection.
Your STN will show you some pouches and will perhaps give you one to take home, so you can become more familiar.
When you have an ileostomy it changes the way your digestive system would normally work, and there will be quite a period of adjustment as your body adapts to this new normal.
There will be a lot of focus on teaching you about digestion, nutrition (how food keeps you healthy) and hydration (keeping your water and electrolytes balanced), especially in the first few weeks and months.
There are two main types of stoma pouches that could be used for an ileostomy; a 1 piece or a 2 piece, and generally the pouch used is known as a “drainable pouch”, having an end that can be opened to allow emptying of the pouch up to a few times/day.
1 PIECE 2 PIECE
EXAMPLE OF AN ILEOSTOMY
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UrostomyA urostomy involves a surgical procedure to create a stoma allowing urine to drain from the body, usually done because some part of the urinary tract is diseased or not functioning normally.
It can involve any part of the urinary tract… kidneys, ureters or urinary bladder.
The most common urostomy performed is called an ileal conduit, whereby a segment of small bowel (ileum) is used to create a channel (conduit) that is blinded on one end, while the other end is brought out onto the abdomen as the stoma.
The ureters, two tiny tubes that normally drain urine from the kidneys into the urinary bladder
are then re-attached into this conduit, allowing urine to drain through the conduit and out of the stoma.
It is usual for there to be two tiny tubes (stents) coming out of the stoma to keep urine flowing freely through ureters and conduit for the first couple of weeks or so. These will only be temporary.
Many people who require an ileal conduit have a bladder cancer, which will also require removal of the bladder at the time of their stoma surgery.
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For further information on living with a urostomy ask your Stomal Therapy Nurse OR contact Omnigon Customer Service for a copy of the ‘Your Guide to Urostomy’ booklet.
A 1 piece is where the baseplate and the pouch are made together as one.
A 2 piece is where the baseplate and the pouch are separate pieces. The pouch connects to the baseplate using a “click on” or “stick on” type connection.
Your STN will show you some pouches and will perhaps give you one to take home, so you can become more familiar.
There are two main types of stoma pouches that could be used for a urostomy; a 1 piece or a 2 piece, and because the pouch is specific for urine it is known as a “urostomy pouch”, with either a tap or a bung at the bottom to allow regular emptying of the pouch.
The urostomy pouch can also be connected to a night drainage bag to collect larger volumes of urine overnight, so there is no need for you to get up and go to the toilet to drain the pouch. For some this will mean a better night sleep than you have been having in the lead up to your surgery.
1 PIECE 2 PIECE
EXAMPLE OF A UROSTOMY WITH TEMPORARY STENTS
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Siting your stoma (pronounced "sighting")
As well as helping you understand more about life with a stoma, your STN will meet with you prior to surgery to help “site” your stoma. This may be done as an outpatient in the few days before your surgery or after you have been admitted to hospital for your surgery.
The decision on where your stoma is best located is an important one, and your STN will spend some time working with you and discussing the reasons for siting. Ideally, the best spot for your stoma is where you can easily see it, so that it is as easy as possible for you to learn to look after it.
If possible your STN will look at your abdomen in a lying, sitting and standing position, to gain an understanding of your abdomen shape and where the natural creases, navel and skin folds are.
They will talk to you about where you normally wear your clothing waistbands, feel for where the
edges of your abdominal muscle are, while all the time looking for the area with the smoothest contour for the best adherence of your stoma pouch.
Once you and your STN have identified the best spot, a permanent ink dot will be drawn on your abdomen to mark the spot and a light dressing will be applied to prevent the mark from being removed. The surgeon will use this mark as a guide to form the stoma at the end of your surgery.
While STNs and surgeons work together on the placement of your stoma, it is important to know that there are circumstances when the surgeon may not be able to place the stoma exactly in the pre-chosen spot.
Surgery can be very difficult at times and bringing a stoma to the surface of the abdomen can be extra challenging in some situations.
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Your surgeon will have discussed your surgery with you and the length of time they would expect for you to be in hospital, generally a 7-10 day stay is not unusual if all goes well.
The STN will visit you regularly throughout your hospital stay to help you learn about your stoma care, and the medical, nursing and allied health team (e.g. physiotherapist, dietitian, social worker) team will all be working together to assist in your recovery and planning for your discharge home.
Each day you will be learning a little more about your stoma; how to remove your pouch, clean your stoma and skin and re-apply your new stoma products. Try not to worry too much, the whole team are there to help you and they will guide your learning each day dependent on how your recovery is going.
You will not be discharged home until the medical and nursing team, especially your STN, are happy that you are ready and managing your stoma care. If you wish, your partner, a family member or a close friend may also be learning and supporting your stoma care while in hospital and as you prepare for home, so you have the extra help once you’re at home.
It is usual for your STN to arrange your first stoma supply order before you leave hospital, and in Australia that includes helping you complete paperwork to join a Stoma Association.
You will be given a toiletry bag that includes stoma supplies to take home with you, this is also known as your "discharge kit". Or the STN may arrange for it to be delivered to your home directly from the ostomy product company. Either way, you will have enough supplies to last you until that first month’s order is delivered.
What to expect in hospital
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AUSTRALIAN STOMA APPLIANCE SCHEME (SAS)The SAS is a scheme set up by the Australian Government which provides support to people with a stoma. The scheme allows access to all Australian residents with a Medicare card to the most suitable and clinically appropriate stoma related products fully funded by the health department.
AUSTRALIAN STOMA ASSOCIATION/SIn Australia, most people with a stoma can access the supplies you need for your stoma care under the SAS funding. There are Stoma Associations all around
Australia to help distribute the stoma products, and once your stoma is formed your STN will help you apply for membership to one of the Associations. There is a small yearly membership fee, and the Association will then help with your regular monthly supply of products.
NEW ZEALAND SUPPLY OF STOMA PRODUCTSIn New Zealand, your Stomal Therapy Nurse is responsible for ordering and supplying your products, and they will help explain the process once you have your new stoma. In most District Health Boards (DHB) your stoma supplies will be delivered to your home address free of charge.
Where do I get my stoma supplies?
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Advice from ostomates“While my STN prepared
me well and I feel good about my stoma cares, she suggested quietly I get a mattress protector for my bed….and while I have not had a leak from my pouch at night (thank goodness) I feel reassured knowing I won’t spoil my mattress if I did.”
“I have a full length mirror behind my bathroom door and it makes things so much easier when I can see my body clearly in the mirror, so I check the skin around my stoma so much better.”
“I cleared out a small section in my linen cupboard to store my stoma supplies in, my bathroom is very small, and often gets quite warm and humid after a shower…my STN told me to make sure they were kept in a cool, dry place.”
“When I first went home I was pretty tired and weak, I found sitting down in the bathroom on a plastic chair in front of the vanity to do my stoma bag so much easier than standing, and I laid out all my stuff on the vanity top within easy reach.”
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As well as your normal personal toiletries, take some extra comfy clothes to hospital ready for your discharge home.
Remember your tummy will still be sore and a little swollen from surgery so loose clothes are best.
You may need some underwear a size larger than usual, for ladies a full brief to come up and over your stoma pouch may be more comfy, and for the gentlemen a comfy boxer style may be a good option.
If you live alone, with limited support close by then consider freezing some meals/soups or stocking some pre-packaged frozen meals from the supermarket ready to go. Cleaning cloths like “chux” will come in handy for cleaning your stoma, so get an extra packet of those too when you are next at the supermarket!
Depending on what type of stoma you are having, ask your Stomal Therapy Nurse OR contact Omnigon Customer Service for a copy of the ‘Your Guide to Colostomy’, ‘Your Guide to Ileostomy’ or ‘Your Guide to Urostomy’ booklets for more information and common questions about living with a stoma.
For extra support and information, check out our website Omnigon Connect, an ostomate support program to help you with all stages of your stoma management. Visit the online hub www.omnigonconnect.com.au and sign up today to access your fellow ostomates’ stories, credible advice from the experts, valuable resources and the ability to connect with Stomal Therapy Nurses directly.
Helpful tips before you go to hospital
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Notes
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Between now and the next time you see your Stomal Therapy Nurse or surgeon you may have thought of other things you want to know. Write them below so you do not forget and take this booklet with you to all your appointments for reference.
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