Thursday, September 24, 2009 at 4:00 AM
As part of ideastream's special coverage this week of colon cancer, assistant producer Katie Baker talks with an Ostomy nurse about the work she does helping people with failed colons make this big adjustment. Be aware: the report does get graphic.
Baker: An ostomy is used when your colon stops functioning normally and your body needs a new route for waste. Through surgery doctors create an opening in the digestive tract to connect part of your small or large intestine to a bag attached to the abdomen. The bag serves as the new bypass to eliminate waste in the absence of a healthy colon.
There are no tubes or needles, just a bag attached directly on the surface of the skin. One million people in North America are living with the reality of an ostomy every day. Coleen Potts, a Cleveland Clinic nurse who specializes in the care of people with ostomies, says, “It’s the new normal.”
Sometimes an ostomy is temporary, sometimes it’s permanenet and sometimes there are complications. Getting the correct bag, sized and fitted to a person’s abdomen, can lead to temporary problems. On occasion a patient may experience skin irritation or bag leakage but once the correct size is determined usually the side effects are minimal. She explains how it works.
Potts: “This is a two piece system where the pouch the actual barrier sticks on someone’s abdomen. We would cut the opening here and then the pouch actually sticks on what we call the flange. It actually snaps on very similar to a Tupperware. And then they would wear that for 3-4 days and empty it from the spout. You would empty it from the spout whenever it gets from 1/3 to ½ full. And then you would take it off and throw it away and put a new one on.”
Baker: Potts says in the early 1960s the Cleveland Clinic established the first nursing program devoted specifically to the care of patients with failed colons.
Since then Wound Ostomy nursing, as it’s called, has become mainstream in major hospitals throughout the country. Potts has worked at the Clinic for 26 years, and she’s been in the Wound Ostomy department for seven and she’s been a patient herself.
Potts: “After my son was born back in 1987 I suffered from ulceritivecolitis and thought at the time that it would probably be the worst thing that could have ever happened but as it turned out it was not only life saving but also gave me back my life because I was one of those people that was running to the bathroom 40 times a day and losing a lot of blood. I totally know where my patients are coming from. I think that’s why I’m good in my position because I was where they are, I’m way past that now but I was there.”
Baker: Potts asseses every patient and what might help them make the adjustment. Depending on the person and whether she thinks it would help, sometimes she shares that she too has an ostomy.
Potts: “This girl said um… she was there with her boyfriend and she was really really upset because she came to the doctors office and she was told she needs to have an ileostomy. And as sick as she is and she’s on a pretty good dose of steroids and she just doesn’t want that bag and so I came in and in and felt really lucky that I got to talk to her and then when I told her she started crying and she blamed it on the steroids and I gave her a Kleenex and I said ‘its ok that’s just part of the process’ and I think I do make people cry when I tell them.”
Baker: One of the most common concerns among new ostomy patients is odor. But Potts says things have come a long way in the last 50 years.
Potts: “Pretty much when you walked into a room and you had something like that years ago you would know it because odor would follow them but nowadays they are all disposable so a patient puts it on and then wears it for about 3-4 days. Empties it multiple times during that 3-4 days and then takes it off and puts a new one on and they are all they stick on with an adhesive.”
Baker: In addition, infection is no longer a serious threat. These days you can even swim with an ostomy.
Potts: “I was in the Atlantic Ocean a few years ago that pouch was not coming off so it’s definitely allowable. The pouches can hold up against water and waves and activities and we tell our patients they can shower as well and go in hottubs—a pretty normal life.”
Baker: And one more thing ostomy nurse Coleen Potts wants people to know. It doens’t put an end to intimacy with a spouse. I’m Katie Baker, 90.3.
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