Ostomy Surgery: Things To Expect

Ostomy surgery is a life-saving procedure that alters the excretory pathway. Some diseases can result in the intestinal tract or bladder to stop functioning. Such a condition can lead a person requiring a surgical treatment aimed at bypassing the normal excretory pathway. The newly formed artificial pathway for waste excretion is known as an ostomy.

No matter what type of ostomy you are going to get, there are a few things that can expect before and after surgery.

Preparing for ostomy surgery

First of all, you are going to get an appointment with an ostomy care nurse before the procedure. The nurse will review the surgical procedure and will explain likely changes in the GI tract after surgery. They will also demonstrate how an ostomy pouching system works. You will be given a quick overview of skills that you are going to need to change or empty your ostomy pouch.

Based on where the diseased part of the colon or small intestine starts from, your nurse will mark the location of the stoma on your abdomen. They will make sure that the stoma location is easily accessible to you. Marking the stoma location provides your surgeon with necessary information about the type and location of the stoma.

In the next step, your surgical team will schedule a pre-operative visit. During this visit, the team will examine your condition and will explain the surgical procedure. You can discuss all of your concerns related to ostomy surgery you are going to have.

After surgery, you will need to stay at the hospital for about five days to have an initial recovery. You will be discharged from the hospital as soon as your bowel activity resumes. This resumption is marked by the output of gas and watery stool from your stoma.

Ostomy care after surgery

After surgery, your nurse will teach you the right way to use ostomy supplies to manage your stoma. By the time you will leave the hospital, you will know how to empty or change your pouch. The hospital will provide you several ostomy care supplies to let you adapt to the ostomy care regimen in the best possible way.

After leaving the hospital, you are going to have to make sure that you are not missing any of the follow-up visits, which you are going to need to pay every two weeks for the first few months. These visits will let you steer clear of, or deal with, any complications related to your GI tract, stoma, or peristomal skin.

During the first few weeks after surgery, your stoma will change shape quite frequently. Nurses suggest measuring the stoma every two weeks after surgery. After six weeks, the stoma will retain shape and size.

Many people wonder if there is any diet-related change that they have to bring in their lives after ostomy surgery. It is worth mentioning here that an ostomy doesn’t stop you from eating whatever you want to eat. There are indeed some diet changes that you are going to have to stick with during the first few weeks after surgery, but those changes are meant to keep a more vulnerable GI tract from harm’s way.

As far as the exercise is concerned, you would have to be a bit cautious about heavy lifting. You will need to start low and slow to adapt to the fitness regimen that you intend to continue after surgery. You can talk to your doctor for guidance in this regard.

Tips To Use An Ostomy Bag And Pouching System

You must learn how and when you will need to empty your pouching system to successfully manage your ostomy. This process also includes assessing and taking care of your stoma and the skin around it. You should also know what to do in case the peristomal skin looks less than healthy.

Emptying the pouch

Emptying your pouch is one of the most basic skills that you are going to have to learn after surgery. In the hospital, the nurse will teach you how to measure the amount of stool in the ostomy bag, and also how to empty the bag into a container. You can also empty the pouch into the toilet.

You may wonder when to change the pouch. You will need to empty it once it is one-third to half full. The aim should be to prevent the bag from becoming too heavy as it can undermine adhesion between the skin barrier and the peristomal skin. The frequency at which you need to empty the ostomy bag depends on the type of ostomy you have. If you have an ileostomy, you may have to empty your pouch five to six times in 24 hours. If you have a colostomy, you may need to empty your ostomy bag two to three times in 24 hours.

Changing the Ostomy Pouch

If your ostomy requires you to use closed-end ostomy bags instead of drainable bags, you are going to have to learn about how to change your ostomy pouching system. There may be several steps involved in removing and replacing an ostomy pouch. You may not be skilled enough to change the bag during the first few weeks after surgery, and it is understandable.

Again, you are going to have to learn the process of changing an ostomy bag from an ostomy care nurse. The nurse will tell you what is normal for your stoma and peristomal skin. They will also tell you about the troubleshooting process if things do not seem normal. The lessons you will get from your nurse will help you examine your stoma every time you change the pouch.

It is crucial to keep your ostomy care nurse and doctor on quick dial. You may think that you are fully aware of the process of changing the pouch because you are doing it daily, but you might never know about the occurrence of a complication that’s beyond your understanding. During that situation, an instant call to your ostomy care nurse can help you get rid of that complication.

Urostomy Types And Pouching Systems

There are two types of urostomy: the incontinent (conventional) urostomy and the continent urostomy. Your doctor will determine what type of urostomy is suitable in your case. There will be several factors involved in this scenario.

Incontinent (conventional) urostomy

The primary requirement of this type of urostomy is the making of an ileal conduit, which can also be referred to as an internal pouch. The ileal conduit is a piece of small intestine used to transport urine coming from the ureters to the stoma. This conduit is cut from the small intestine, and it is 5-6 inches in length. The remaining part of the small intestine is then connected to the large intestine.

After the stoma has been created with an ileal conduit, the surgeon detaches ureters from the bladder and connects them with the conduit. At one of the conduit is the ureters connected, and the other end serves as the stoma, which is an opening sticking to the abdominal wall.

A patient with urostomy doesn’t have any control over the urine output, so he needs to wear an ostomy pouch at all times to collect the urine evacuated by the urostomy.

Continent urostomy

A continent urostomy also involves the creation of a small pouch, but this pouch has valves to keep the urine from flowing back into the kidneys. Another valve allows the patient to keep the urine in the pouch until it needs to be removed. The patient must drain the pouch four to five times a day with the help of a thin tube called a catheter. You will learn how to drain the pouch by your doctor.

There are different types of continent urostomy.

• A Kock pouch is the most common type of diversion used in the continent urostomies. The pouch, valves, and the outlet in this diversion are made from the end of the small intestine.
• Another type of continent urine diversion is the Indiana pouch. The pouch in this diversion consists of the large intestine, while its outlet consists of a part of the small intestine.
• The ileal neobladder is another type of continent urine diversion. It consists of the small intestine.

Types of ostomy pouching systems

Urostomy Pouches are available in different sizes and types. You can choose the most appropriate ostomy bag with guidance from your ostomy care nurse. Generally, there are two types of urostomy pouches to choose from: one-piece ostomy pouches and two-piece ostomy pouches. A one-piece ostomy pouch has a bag and the skin barrier attached in the same unit. When you will need to change the pouch, you are going to have to take the barrier off too.

A two-piece ostomy pouch, on the other hand, uses the bag and the barrier as two different entities. You can take the bag off, while the barrier will stay in place.

You can pick an ostomy pouch based on your requirements. Make sure to consult with your doctor before engaging in any decision making process regarding your ostomy care regimen.

What Am I Supposed To Eat After An Ostomy

The main fear that I had with getting an ostomy was that I wasn’t sure what I would be able to eat or not. I mean, after all, an ostomy changes pretty much the core nature our bodies are made to do into something that is hardly natural. I’m not trying to slam anybody with a stoma or anything like that, because I myself have a stoma and have had one for years. This is not my intention at all. Rather, I’m trying to voice the fear of many soon-to-be ostomates that are unsure of what their diet will consist of after getting an ostomy. Well, I have a lot of experience with my own stoma and can tell you a thing or two about what you can and can’t eat. 

If you’re fresh out of the hospital, you are likely to have lost a lot of weight. In addition to this, you’re probably going to be feeling pretty awful for a bit. Your body is still adjusting to the new hole that the doctors put in you, and it makes sense that you will not be feeling at your all time best for a minute. The best thing to do after recently having an ostomy is to get plenty of rest at home. I spent the first few weeks after surgery lying on the couch in my sweatpants not doing much of anything other than watching netflix and scrolling through my phone. During this time you will definitely want to start eating some food because, like I said, you probably will lose some weight while you’re at the hospital. It’s best to start eating super bland foods at first that are easily digestible and will not cause any complications with your stoma. It may be true that your appetite is reduced and you won’t feel like eating, but you will want to start eating little and often during this time to keep up your health and recovery process.

Once you start eating more regular foods, it is important to start introducing new foods to your body slowly. While the end goal is to get you back to eating most of the foods you normally eat, it is truly important to take things slow in the early stages after surgery. Certain foods will cause the consistency of your output to change and these things are good to identify early on so you don’t have to pay for it later. Certain foods will also cause more backup in your digestive system and will delay output. Knowing this information means you can play what you are going to be eating for different days and social interactions depending on what you are going to be doing. For example, if you are out all day with friends, it is probably best to avoid eating a lot of fruits and other things that might make your output more runny.

There are also certain things that you should not be eating if you want to avoid gas. Certain foods are notorious for producing gas, like beans and spicy foods; however, there are others that are less known but will also cause a lot of gas if you’re not careful. Carbonated beverages, cabbage, cauliflower, and sprouts can also cause a lot of gas meaning you have to change out your ostomy pouch more than you would like to.

Writer with an ostomy bag

I can’t tell you the exact moment that reading became an obsession for me, but it was early on.  I can remember my mom always saying to us, “reading is the magic key to take you where you want to be.”  Oh, how very true that was.  As the years went on and as the pages continued to turn, I found that I specifically liked to read Christian Fiction novels.  I decided to write my first novel at 25.  That began a career and life that I never imagined.  Dr. Suess says, “oh the places we will go.”  I went a lot of places that was for sure.  

Interestingly enough I chose that genre to write about and not about my own experiences.  I had learned over the years that a lot of writers like to write about things that are a little closer to home, but I found this avenue to be an actual escape from my present reality.  I love creating stories about spies, FBI agents, CIA agents, Marshalls, a billionaire, and the list could go on forever. These heroes were always caught up in some kind of trouble, but in the end, they always found a way through the struggle.  The also always learned something about themselves and others through their experience.

I could write an 800 page novel about other people’s lives, but I often struggle to come to grips with the outcome that has been written for me.  I was fitted with an ostomy bag when I was 30.  Life was moving fast, and pages were being generated astonishingly fast. It was during that time period that I started to experience quite a bit of pain in my abdomen.  It was gradual, so it didn’t concern me at first, but over the next few months, it got to the point where I was often doubling over in pain on multiple occasions.  So, I did what most people my age would do.  I waited another week before going to the doctor.  What a bad idea that was.  I was rushed to surgery to try and fix a tare in my urinary system.  I woke from that surgery to find that I had an extra appendage, if you will, attached to me.  Wow I wasn’t expecting that.  The stoma and ostomy bag was put into place to make sure that the urine output had somewhere to go.  I had slowly begun to become blocked and that is what was causing the pain and discomfort.  As the healing began, I started to evaluate what I was doing with my life, if it needed to change at all, and I couldn’t help but have that little question floating around as to why this had to happen.

I would have to say that the why is still a question that I don’t have a really concrete answer to, but It doesn’t bother me so much anymore.  I’m ok to just ride the wave and see where it takes me.  Through all the doctor’s appointments, the weening off any medicine, and just and overall healing of my body, I continued to write.  As I indicated in the beginning, my books were a fantastic outlet for me to get lost in another world, and after my surgery, I would say they continued to fill that same void of escape that I so desperately needed.

My medical experience didn’t change my life drastically, but what it did do for me was remind me how important it is to listen to your body.  When It is trying to tell you something, don’t ignore or put it off.  I’m so thankful for the medical professionals that were put in my path from beginning till end.  I will continue to educate myself on my procedure and how I can make everyday living that much better.

Stay fit with your stoma

The more we have been locked down in 2021 the more my wife and I watch crazy love shows with people looking like supermodels.  It has moved us to actually work out a ton and to try and be just as fit.  It is because staying active and doing what you love is an important part of being healthy.  There is no reason not to be just as fit as you want. The mind and body are both important and nothing should stop you from doing what you love if it can be helped.  Don't let COVID-19 and all the lies involved stop you from going out and being active or heading to the gym.  And having a stoma shouldn't stop you from doing the things you love and unless your medical professional tells you differently don't let it! It is dumb and literally naive to give in to a fear of something that is not real.  So there are many things that I like to do and some of them are refreshing for the soul.  I mean that if you are not getting out and seeing the world or enjoying life sometimes your body begins to shut down and your mind suffers.  For me, I know that I need to go on vacation and enjoy the open outdoors and even try to do it on a regular non-vacation basis.  If it's working out or even hunting that you want to do, then go and do it.

So part of being active is also being in shape enough to hunt.  I mean it, dragging a 200 lb deer through the woods, or carrying it for miles is work.  Now I don't let my ostomy get in the way and in fact, it can be useful for hunting.  I generally like to use the quality gear and shop mostly at Hollister Ostomy Supplies. If you don't know what type of gear you may need go online and find a good large corporation.  It is pretty cool that they offered samples to help me find what would work best while hunting as well. So keep them in mind when you are working and looking for good gear for your outdoor trips or hunting excursions and for being safe.

I am going out with my brother in law this year and going to teach him how to hunt.  He does not have a stoma, and that is just fine.  We are not jumping into anything crazy so we are starting with the easiest version of hunting in my book and that is squirrel hunting.  To me this is easy because you don't need to start off with the skills of tracking, being quiet or smell work.  I mean that you can be a terrible hunter and still get squirrels for dinner. 

This makes it so you can be successful and not disheartened by failing at any one of the many things that can go wrong when deer hunting.  This is also a great way to go over the basics of firearm safety outdoors and not just at a range.  My brother in law is a great shooter at a range, but being outdoors and muzzle control is very important. It is going to be a fun time and I am going to do it all with an ostomy bag on my hip and a nice ostomy guard over my stoma.