Newsletter Serving Members and Friends
of the Triangle Ostomy Community
How to Treat a Blockage
Calendar - Meeting Information
Tips from Our Members
Minutes from last Meeting
December 6: Ostomy meeting 7:30pm Rex Hospital
December 19: Crohns & Colitis Support Group 7:30pm Duke Health, Raleigh
December 25: Chanukah begins
December 25: Christmas
January 1: New Years Day
Next Meeting: December
Program: Holiday Social! - As the holiday season builds, wouldnt
it be nice to spend some quality time enjoying each others company?
Thats exactly what we are planning. Bring yourself, your loved one/s,
and something tasty for all to enjoy.
Meetings are held the
first Tuesday of each month at 7:30 PM in the Rex Surgical Waiting Room, 4420
Lake Boone Trail, Raleigh, NC. Enter through the Rex Hospital Main Entrance,
which is near the Parking Garage.
Reminder: In the event of inclement weather on the day of a scheduled
meeting, please contact Rex Healthcare at 919-784-3100.
Dont forget that J-Pouchers are always welcome at our monthly meetings.
Contact Lora Edgars at 919-596-5410 for all the details.
Attention WOC Nurses:
As a result of the dissolution of UOA, our WOC Nurses will no longer receive
statements for annual membership dues. Our chapter is extending courtesy membership
status to these fine professionals in appreciation for their guidance, support,
and loyal service.
More good stuff in
the printed edition!
...like recipes and puzzles. If you do not currently receive the printed edition
of The Bypass, be sure to email us with your address!
Holiday Blockage Connection
With the holidays approaching,
I thought this would be a good time to include information about blockages.
I was told by my WOC Nurse, that ostomates tend to get blockages more often
around the holidays. Personally, I have had 3 blockages, one on New Years
Day (from mushrooms), one on Thanksgiving (from broccoli and green beans),
and one after a party (too much popcorn!). You might ask, "why?
Around the holidays or at other events, we tend to eat more food and different
foods than we are used to. Also, we might eat without realizing how well we
are chewing. While you are talking to your Aunt at Christmas dinner, you just
gulp down your green bean casserole without even thinking about it. Before
you know it, you realize you hardly chewed your food! You may just have a
rude awakening in about 8 hours.So, remember to think about what you are eating
and always chew your food really well. And then, if you still find yourself
with a blockage, the articles in this newsletter will be very helpful. Happy
- Jennifer Higdon
How to Treat a Blockage
Thin, clear liquid output with foul odor; cramping abdominal pain near the
decrease in amount of or dark-colored urine, abdominal and stomal swelling.
Step One: At Home
- Cut the opening of
your pouch a little larger than normal because the stoma may swell.
- If there is stomal
output and you are not nauseated or vomiting, only consume liquids such
as Coke, sports drinks, or tea.
- Take a warm bath to
relax the abdominal muscles.
- Try several different
body positions, such as a knee-chest position, as it might help move the
- Massage the abdomen
and the area around the stoma as this might increase the pressure behind
the blockage and help it to "pop out." Most food blockages occur
just below the stoma.
If you are still blocked, vomiting, or have no stomal output for several hours:
- Call your doctor or
WOC/ET Nurse and report what is happening and what you tried at home to
alleviate the problem. Your doctor or WOC/ET Nurse will give you instructions
(ex., meet at the emergency room, come to the office). If you are told to
go to the emergency room, the doctor or WOC/ET Nurse can call in orders
for your care there.
- If you cannot reach
your WOC/ET Nurse or surgeon and there is no output from the stoma, go to
the emergency room immediately.
- IMPORTANT: CLIP AND
SAVE THE INFORMATION FOR HEALTH CARE PROFESSIONALS AND TAKE IT WITH YOU
TO THE EMERGENCY ROOM AND GIVE IT TO THE PHYSICIAN.
- IMPORTANT: TAKE ALL
OF YOUR POUCH SUPPLIES (eg., pouch, wafer, tail closure, skin barrier spray,
irrigation sleeve, etc.)
Food that can Cause
The following is a list
of some of the foods that can cause blockages. Every person is different,
and certain foods may affect some people more than others. Add the following
foods to your diet one at a time and in small amounts, so you can identify
which foods may bother you.
- foods with fibrous
peels (like apples)
- dried fruits
- raw crunchy vegetables
- cauliflower, Chinese
Print and Save: Information
for Health Care Staff in the event of a blockage
EMERGENCY ROOM STAFF:
Symptoms: No stomal
output; cramping abdominal pain; nausea and vomiting; abdominal distention,
stomal edema, absent or faint bowel sounds.
- Contact the patient's
surgeon or WOC/ET Nurse to obtain history and request orders.
- Pain medication should
be initiated as indicated.
- Start IV fluids (Lactated
Ringer's Solution/Normal Saline) without delay.
- Obtain flat abdominal
x-ray or CT scan to rule out volvulus and determine the site/cause of the
obstruction. Check for local blockage (peristomal hernia or stomal stenosis)
via digital manipulation of the stoma lumen.
- Evaluate fluid and
electrolyte balance via appropriate laboratory studies.
- If an ileostomy lavage
is ordered, it should be performed by a surgeon or ostomy nurse using the
---- Gently insert a lubricated, gloved finger into the lumen of the stoma.
If a blockage is palpated, attempt to gently break it up with your finger.
---- Attach a colostomy irrigation sleeve to the patient's two-piece pouching
system. Many brands of pouching systems have Tupperware®-like flanges
onto which the same size diameter irrigation sleeve can be attached. If
the patient is not wearing a two-piece system, remove the one-piece system
and attach a colostomy irrigation sleeve to an elastic belt and place it
over the stoma.
---- Working through the top of the colostomy irrigation sleeve, insert
a lubricated catheter (#14-16 FR) into the lumen of the stoma until the
blockage is reached. Do not force the catheter.
Note: If it is possible to insert the catheter up to six
inches, the blockage is likely caused by adhesions rather than a food bolus.
---- Slowly instill 30-50 cc NS into the catheter using a bulb syringe.
Remove the catheter and allow for returns into the irrigation sleeve. Repeat
this procedure instilling 30-50 ccs at a time until the blockage is resolved.
This can take 1-2 hours.
- Once the blockage has
been resolved, a clean, drainable pouch system should be applied
Because the stoma may be edematous, the opening in the pouch should be
slightly larger than the stoma.
from the President
Holidays to all my valued members and friends!
I hope we all will take
a few moments this holiday season and give thanks for all the many wonderful
blessings that have been bestowed upon this past year. We have so much to
be thankful for; such as the medical professionals who worked their magic
to enable us to lead exciting and productive lives; our care givers who stood
by our side through some pretty rough times and helped nurse us back to good
health; and lest we forget our wonderful membership who helped us understand
that we have just begun to realize what a great life we have ahead of us.
Let's also remember those
less fortunate and hope that some day soon they will realize the benefits
that we have been blessed to receive. That their misfortune will be short
lived and they will once again be able to realize the great life they so richly
Our meeting is going to
be a time for socializing and connecting with one another. It's a good time
for us to just relax and enjoy this time of year and share our stories with
each other. Please bring a finger food/snack of your choice for everyone to
enjoy. Also, please bring a loved one or other significant member of your
Thank you so much for
a great year and I look forward to seeing you on Tuesday, December 6th, at
Yours in service...........................................Dan
Hints, Suggestions, and Tips from our
The By-Pass offers us
a wonderful vehicle to share our ostomy tricks with the rest of the community.
If you have an idea youd like to have included, please contact Jennifer
Higdon or Dan Wiley. If you find suggestions posted here helpful, be sure
to tell the person who contributed them.
I was taught by my
ET nurse to take care of a blockage on my own. I always carry my "blockage
supplies" with me on vacations. I haven't had to use them while traveling,
yet, but at least I have them handy.
Ive had a couple
of blockages. Theyre not pleasant to say the least. One of the things
I can do myself is massage my abdomen - I can usually feel if there is a blockage
there. My mother taught me to rub and massage my belly when I had digestive
cramps/difficulties, and it works with an ostomy - at least mine - as well.
want your input!
Next month were looking for suggestions regarding your favorite appliance
manufacturer and model - tell us why you like it and how it benefits
your lifestyle. Send your comments and suggestions to Anke - email firstname.lastname@example.org
or call 968-8461.
Dwight D. Eisenhower
34th President of the United States
Bringing to the Presidency
his prestige as commanding general of the victorious forces in Europe during
World War II, Eisenhower obtained a truce in Korea and worked incessantly
during his two terms to ease the tensions of the Cold War. On June 8, 1956
Eisenhower developed vague, ill-defined discomfort in the lower abdomen at
12:30 am. His physician arrived at the White House 30 minutes later and found
moderate distention and tympany, but no particular point of abdominal tenderness.
The President slept fitfully for the next few hours. Tap water enemas in the
morning gave no relief. The pain became colicky and centered on the umbilicus
and right lower quadrant. Without surgery, Eisenhower's bowel obstruction
could easily have killed him. Even so, the decision to operate was contentious.
Eisenhower had had a serious heart attack just nine months earlier, and this
made surgery risky. As you might expect, it is difficult to decide to operate
on the President of the United States when he might not survive the operation.
At operation, the terminal 30 to 40 cm of the ileum had the typical appearance
of chronic "dry" Crohn's Disease. An ileotransverse colostomy (internal
ostomy) was performed, bypassing the obstruction. The post-operative course
was smooth as well.
He began conducting official business on the fifth post-operative day.
from the November 1, 2005 Meeting of the Triangle Ostomy Community
Dan Wiley, President opened
the meeting by welcoming the visitors who introduced themselves to the group.
Ruth Rhodes, Treasurer reported that the response to the payment of dues has
been wonderful. Ruth Rhodes mother needs our prayers as she is 91 years
old and in the hospital with Pneumonia.
The presenters for this
meeting were Ed Withers (who maintains the Raleigh UOA website) and Stephanie
Yates (the Rex Hospital WOC nurse). Ed used a computer projector to explain
the use of search engines to obtain information on the internet. He then demonstrated
how to maneuver around the Raleigh UOA website which can be reached by using
Internet Explorer and typing in the address www.raleighuoa.org. Ed reviewed
the website links that lead to general medical information, ostomy supply
vendors, ostomy education and ostomy support services. He also reviewed access
to the chapter newsletter via the Raleigh UOA website both in PDF form (printable
version) and in HTML (faster, text version). Stephanie Yates provided the
handout Criteria for Evaluating Health-related Web sites. She
encouraged members to use caution when obtaining information over the internet.
Medical information should be verified by visiting multiple sites and comparing
information from different sources. It is important to recognize that anyone
can post anything they wish on the Internet, so just because it is posted
on a web page does not make it factual. It is also important to clearly distinguish
between fact and someones views/opinions on an issue.
Stephanie Yates then used
the computer projector to show pictures of her recent trip to Moscow and St.
Petersburg. This was an educational trip designed to allow nurses from the
USA the opportunity to share information and compare healthcare systems with
Russian nurses and other medical staff. Stephanie related to the group that
the healthcare system in Russia is much as it was here in the 1960s.
There are signs of poor infection control, poor sanitation and the lack of
antibiotics to treat infections. The life expectancy is much lower in Russia
averaging in the mid 50s. Stephanie found the Russian medical staff
to be very friendly and eager to share information with the USA team. The
Russian doctors and nurses are quite aware of the medical technology as it
is developed, but since they do not have access to all of the technology,
they improvise and make the best out of what they do have to treat patients.
They are proud of their accomplishments and continue to improve their healthcare
system. Stephanie showed pictures of the ostomy nurses that number as only
a few for the millions of people that they serve. She was able to meet the
leaders of an ostomy support group in Russia. The group provides education
and emotional support to the members. The medical system in Russia is supported
by government funds. The exact process of medical reimbursement/payment of
services was complicated and not clear to Stephanie and the other nurses who
visited Russia. However, it was interesting to note that ostomy supplies are
free to those who have ostomies and Stephanie shared pictures of the supplies
and the display boards that the Russian WOC nurses proudly displayed.
Dan closed the meeting
by reminding everyone that the December meeting will be one of fellowship
and visiting as we approach the holiday season. Members are welcome to bring
food if they wish.