Physicians of the Zane Cohen Centre
Travelling
Travelling should not be an issue but these helpful tips will make travelling less stressful:
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Always carry identification. Your ostomy chapter, ostomy retailer or company will often provide ostomy identification cards.
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Before departing for a trip, research the name and address of a local ostomy vendor and Enterostomal Therapy (ET) Nurse in the area you are visiting. Your ET nurse can provide you with that information.
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Always take at least one-third to twice as much ostomy supplies than your normal requirement and always carry supplies in your hand luggage. Do not check them with luggage as it could get lost.
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With new airline regulations, you will want to avoid carrying scissors in your luggage. Pre-cut your flanges or appliances in advance.
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To avoid unnecessary questioning by customs officials in the event of a luggage check, carry a letter outlining the medical reasons for the ostomy supplies. Your Enterostomal Therapy Nurse or physician can provide you with a letter.
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Always carry a supply of prescription drugs that you are using. Have a written prescription with the name, address and telephone number of your physician. Obtain the generic name or chemical composition of the drug from your doctor or pharmacist. Brand names vary in different countries.
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Keep prescriptions in their original bottles instead of other plastic containers. This way, you will not have to explain your medication to a customs official.
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Make sure you have travel insurance.
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Do not put supplies in the trunk of a car in the summer. Heat can interfere with the barrier and adhesive.
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If using an appliance with a closure clip, always carry an extra one in your emergency kit. However, a rubber band or child's barrette may be used in an emergency.
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Place your closure clamp underneath your watchband when emptying your pouch to keep it from falling or being misplaced.
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Take advantage of available bathroom facilities to empty your pouch more frequently than you normally would to avoid unexpected bathroom delays.
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Carry extra toilet tissues or pre-moistened wipes in the event the restroom is not well-stocked.
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Always be prepared for potential problems by carrying an “emergency kit”. A make-up bag, tobacco pouch, glass case or man’s handbag (fanny pack) can be used. The kit should contain a zip lock baggie, extra closure clip (if needed), pre-cut flange, pouch, paste (optional), individually packaged pre-moistened towelettes or J-cloths to serve as a washcloth/towel, and a mirror. It is important to periodically check your kit. Heat can interfere with the adhesiveness of the appliance.
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In an emergency, your pouching can be emptied into a ziplock bag or baggie with a twist tie until it can be disposed of later.
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Learn to say "toilet" in more than one language.
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Apple sauce, oatmeal, bananas, cheese, creamy peanut butter, boiled rice, tapioca, boiled milk will help to thicken loose stool.
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Drink at least 6-8 glasses of non-caffeinated liquids each day.
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Caffeine may cause diarrhea. Beverages such as coffee, tea, chocolate and cola drinks contain caffeine.
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Eat lightly and sensible, especially on airplanes. Gases expand as the plane ascends.
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Yogurt helps to control gas formation and buttermilk helps to soothe an irritated bowel.
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If carbonated drinks result in gas problems, a shake of salt or sugar will cause fizzing which helps to dissipate the carbonation.
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Plan your visits to the washroom on airplanes to avoid peak times, such as after meals, after the movie, and before landing.
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Travel with understanding, patient people.
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Following ostomy surgery, it is advisable to carry some form of identification in your wallet or purse. Of benefit to any health care professional would be a list a list of: the type of ostomy, products being used, name and contact information for your Enterostomal Nurse and surgeon. This can be simply written on a card.
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Medical "ID bracelets" can be ordered through www.diabeticdrugstore.com and click on "ID bracelets". Bracelets can also be purchased through drug stores.
Adapted from the United Ostomy Association's "Tips for Travelling with an Ostomy".
Relationships and Sexuality
Many people with new ostomies are concerned with returning to work or school activities. "Will I smell? Will there be noises? Will they see it? What if someone asks?", are commonly expressed concerns. You need to be reassured that there should be no odour as the appliances are designed for stool, however, deodorant drops or room aerosols for the bathroom can be used to add confidence and comfort.
Noises are often muffled by clothing and can be further muffled by placing an arm across the stoma site. The appliance itself should not be visible — the key point to remember is that as a person, you have not changed, but rather, have undergone a surface change giving you back your health.
The decision to share with others that you have an ostomy is very personal. Disclosure will occur only if you want it to.
Sexuality and Intimacy
Life with an ostomy should not limit or curtail your sexual activity. Often, the return to health and well-being, and the associated improvement in energy and strength, will encourage a return to sexual relations. Hesitancy or worry at the beginning is normal. Most individuals are concerned with perceived changes in their desirability and attractiveness to their partner, and are worried about how to manage the appliance during intercourse. Communication is key. Be open with your partner and share concerns and worries. Comfort and confidence will come with time.
There are some things that you can do that may make your experience easier. If you are using a two-piece system, a mini-pouch or stoma cap is available to make the appliance more discreet. You can switch to it prior to engaging in sexual activity. Remember that smaller pouches and caps have a limited capacity and should not be worn for extended periods of time.
When wearing your regular pouch, try to empty it before beginning relations. Some people like to secure the pouch against their skin to minimize its movement and lessen any "rustling" noises. This can be done simply with tape, or more creatively with things like cummerbunds, crotchless underwear, a half-slip, or a tube top stretched over the appliance. Try different positions, as some may be more comfortable than others. Sexual activity will not hurt your stoma. While being sensitive to your personal needs and that of your partner's, maintaining a sense of humor throughout will help with the transition.
If you are entering into a new relationship and it is progressing towards intimacy, then disclosure well in advance of sexual activity is helpful. While the amount of information you may want to share about your illness is a personal choice, you may want to start the conversation with: "I had an illness that required surgery on my bowel. I needed to have my bowel diverted to the outside and now I have an ostomy. That surgery allowed me to feel healthy again."
Living with an Ostomy
An ostomy should not affect your ability to resume your normal lifestyle. Many people find they can continue with all of the activities that they enjoyed prior to illness and surgery. There are many individuals with ostomies who are distance runners, swimmers, skiers, skydivers, scuba divers, hockey players, and football players - the list is endless.
Bathing
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Bathing or showering is not restricted by an ostomy. You should bathe or shower with the entire appliance on, or the entire appliance off on your appliance change days. The water or soap will not hurt or damage your stoma although make sure to thoroughly rinse the soap off your skin if bathing without the appliance, so that the new appliance can attach properly. Clothing
There are no real "do's or don'ts" with clothing, as most choices are more a matter of comfort. Unless you chose to tell people, your ostomy appliance will likely not be obvious under your clothing. Concealment of an appliance is somewhat dependent upon the type of appliance worn (a one-piece versus a two-piece) and the location on the abdomen. In general, patterned fabrics tend to conceal the appliance more easily than solid colors. The choice of underwear is again a matter of personal preference. Some people prefer loose underwear while others want more support and may chose a lycra pant/brief; some may want the pouch covered with underwear, while others prefer to wear a low cut pant/brief. It is often a matter of experimenting to determine what works for you. Check with your ET (Enterostomal Therapy) nurse or local chapter of the United Ostomy Association to see if there are specialty shops or resources in your area for specialty clothes and underwear.
Odour
No one should ever detect an odour of stool when the appliance is secure and in place. Presence or absence of odour in the stool is somewhat determined by each individual's body chemistry. There are, however, measures, which can aid in reducing the odour of stool when the appliance is emptied. Measures would include adding commercial deodorizing tablets or liquids to aid in de-odouring the inside of the appliance or using aerosols or wicks to freshen the bathroom. It is also important to clean the lower end of the pouch after emptying with tissue or a wipe.
Gas
There are several suggestions that will help with gas production. It is important to eat regular balanced meals. Skipping meals is more likely to increase gas production. Initially after surgery, there will be more gas as well as noise as the bowel has been handled and is empty. Gas and noise lessens once diet and activity is resumed. Food should be eaten slowly and in a relaxed manner. Activities such as gum chewing, smoking, mouth breathing, drinking carbonated beverages or sucking on ice chips can all encourage swallowing large amounts of air contributing to an increase in gas production.