It Happened One Night

It's been 25 years since I had ileostomy surgery and more than 20 since I had a blockage. Not a bad record -- I'll take it! Alas, I slipped up recently and ate my lunch in too big a hurry, and worst of all, I had not been getting enough fluids for a couple of days when it happened. Yes, a blockage.

Throughout the evening, I tried the usual home remedies: warm bath, drinking hot tea, massaging the abdominal muscles, and several others of the suggestions that come from our ET nurses, but to no avail. Finally, I had to decide whether to continue these home remedies or go to the emergency room to get help before things got worse. Yes, of course these things happen at night, not during the day when you could get help from some source other than the ER. So, at 11 p.m., I was describing my symptoms to the ER admitting desk receptionist. Four hours later, with the aid of a shot to completely relax the muscles and small bowel, I went home painless and with a functioning ileostomy. No surgery, no overnight stay. Whew!

The reason I bring up this experience is to point out several things that all persons with any type of ostomy should incorporate into their care. I have read these admonitions for years and have advised new patients in visits and in our monthly support group meetings to do these things. I did them in my early years as an ostomate, but have failed to follow these important guidelines as my ostomy experience has matured. I paid the consequences that night recently, but have set forth to do all of them from now on.

• First, chew all foods thoroughly; avoid rushing through a meal.
   
• Drink plenty of fluids all through the day, every day. Keep an extra change of your pouching system packed and ready to go -- you know, the one you carry around with you "just in case." You will even need this change if you go to a hospital.
   
• Keep a written description of your pouch-changing procedure and the product names and numbers for your favorite pouching system. Include a description and any particulars of your physical condition which may be needed by healthcare professionals. Example: "Total colectomy with end intestinal ileostomy; rectum closed; no rectal temperatures; must wear pouch at all times; no irrigations (except for lavage performed on the advice of a colorectal surgeon or ET nurse)." Should you become separated from this written description, you need to be able to tell the healthcare professionals what you have.
   
• Don't assume the healthcare professionals will know all they need to know just by being told you have an ileostomy.
   
• Establish yourself as a patient with a highly qualified colorectal surgeon, even if you are many years post-surgery. Put the surgeon's name and phone number on your written information.
   
• Establish yourself as a patient of a qualified ET nurse. Just as you still have need for a surgeon to call on, you also have need for an ET nurse to call when you need management advice.