Chapter 05: The Stoma Nurse?
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Once you've been told of your up and coming Colostomy it is a good idea to ask your Surgeon or GP to arrange a meeting with the local Stoma Nurse. This is a highly trained Nurse with many years nursing experience who deals specifically with Stomas and the relating conditions. He or she will be well aware of any anxieties you or your family may have towards the operation and it is prudent to have a long chat with them to help ease any fears.
The Stoma Nurse will probably arrange to meet you at your home, this way you feel more comfortable around your own surroundings. The Nurse will then be your guide through the Colostomy for as long as you need their services after the operation and they are always there in case of any problems that might arise after the event.
It is a good idea to have your family with you at all the meetings if at all possible. That way you have their recollection to call upon as you will almost certainly forget some of the things she tells you, and it is nice to have that reassurance.
In the pre-operation visits the Nurse will take the opportunity to test you for skin sensitivity. This is a simple case of sticking small samples of a variety of bag adhesives onto your skin, most probably your back. They will be left in place over a few days then removed and any red rashes or skin sensitivities to certain brands will be noted. These days most bag adhesives are very hypo-allergenic and sensitivity is rare. However even if you are allergic to certain brands (as I am) there are such things as Second Skin Wipes which prevent the adhesive from touching the skin yet don't compromise bag security. They are fairly simple alcohol based wipes that you rub onto your skin before sticking the bag into place which creates a thin layer, like a second skin. The Bag then sticks to the second skin and peels off easily when removed leaving your skin free of allergy.
During these pre-operation visits you will probably see your first few bags and get a rough idea what they look and feel like. You'll be made aware of all the different styles - drainable or closed, one piece or two piece, large bags or small bags - the possibilities are unlimited.
Without a doubt the most important part of these early meetings will be establishing the location of the Stoma. This is quite a task at times as you are needed to think ahead to the future and what you expect you'll need from your stoma. This is difficult as, at that stage, you are still unnerved by the whole idea of a Colostomy. You need to consider the trousers or skirts you wear for example. Where does the waistband generally lie? The last thing you need is your waist band constantly rubbing against the stoma.
Then there comes future doubts over sex, you could do without the stoma getting in the way of that!
The Stoma Nurse will get you to lie down, sit down, crouch, maybe even stand on your head (only joking!) to try and find the best possible position for your Stoma. If you disagree with the positioning express your opinion as that will not be the only place it can go. Areas around old scars, natural creases, skin conditions, the hip bone and your belly button are best avoided. The chances of finding a location that you are perfectly happy with all your life, through all your different clothes is minimal, so in the end it is best to make an agreed compromise.
As a general guide line a Colostomy Stoma is best placed on the left hand side of your abdomen below the belt line avoiding all irregularities. But most importantly it needs to be accessible. You need to be able to see the Stoma clearly for when you come to clean it after the operation and in the future.
If after talking to the Stoma Nurse you are still concerned about life with a Colostomy it could be possible for you to talk to someone from your local support group, or if there isn't one near you try phoning the British Colostomy Association helpline.
These support groups are run by Colostomists on a voluntary basis and are very useful. It is comforting to talk out your fears with someone who has already been down that road.
If you organise a meeting with your local group member then you'll find that just the fact that they are sitting there is a comfort as it shows that there is a life after a stoma, however distant it may seem at the time. And I'll make you one guarantee... if you'd not been told you'd never have guessed they had a stoma, so why should anyone think you have? The only people who'll know you have a Stoma will be the ones you tell! Honest.