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| Dan 1980s |
The appointment with the ostomy nurse, Denise, was surprisingly straight forward. We went again to the surgery department and didn’t wait long to be ushered in by someone to a room before the nurse appeared. This was show-and-tell.
An ostomy nurse deals specifically with people who have colostomies. She is on intimate terms with the stoma and bag. The ostomy supply companies keep her flush with materials.
Denise was an Asian American woman with a full hair cut short and a no nonsense way of talking. She procured a sample bag from one of the cupboards, where they were stashed, holding it up.
“Ten pouches can last a month, and you pay at most 20% depending on your plan, like a medication prescription,” she instructed, pointing at the bag. “They deliver them to your home in three days, depending on how quickly the order is placed.”
It was important to keep the stoma clean, and the skin around it, which was covered by a flange with adhesive.
“What about the irrigation option?” Dan asked.
Denise explained that it took one to two hours, and doing it at the same time every day was important. It was essentially giving yourself an enema. She said it was best to do it from the start if one was interested. The body, then, would be used to it.
Dan hung on her every word.
This new information didn’t make sense to me. I wondered why couldn’t one just start doing it later if the bag didn’t work out, but let Dan and Denise go through the show-and-tell.
She talked about the advantage of the two piece, in that it was easier to see and, therefore, learn, how to change the bag, which you needed to do every three to four days in the beginning. The flange was a circle-shape that went around the stoma, the opening. You first put the flange against the skin—it had built-in adhesive—and pressed for a while, letting the warmth of your touch help it stick to the skin. Then you attached the bag to the flange, snapping it on to the rigid circle. Then you were in business.
The one-piece, she said, was something you could graduate to, after adapting to the two piece. “It’s easier for most people to use the two piece at first.”
The one piece sounded smoother and less bulky, even if it was more difficult.
“It’s important to look at the skin,” she said. “You want healthy skin, since it’s going to be covered up all the time.”
“Uh huh,” Dan said, focused on her.
“You will have the same bowel movements you’ve always had. Your stools will still be firm because of the journey through the colon. Remember, you’re not having the colon removed, so no loss of liquid,” she said.
She talked about how heat affects the skin, and that one may need to change the bag more often. The paste and the powder are for skin problems, meant to keep the skin under the flange dry.
Dan asked, “Where do they put the stoma? How do I wear my pants?”
I had read about some problems around this. Sometimes they surgeon put the stoma too high or too low, and the pant line cut off the flow, or caused the contents of the bag to bunch up at the top, and “pancake.”
“It should be in a comfortable place for you. I would have to wear looser pants if I had one.” She patted her stomach.
Denise answered every one of Dan’s questions. This was different from any of the other appointments, where varying degrees of withholding information was standard, and we didn’t know the end point, let alone what questions to answer aside from what had come up in our research and what the previous appointment or doctor has alluded to. Denise seemed to see her job as making things as clear as she could. The appointment felt like we actually accomplished something.
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