MEET SAM: SOON-TO-BE STOMA NURSE WITH A STOMA.
Sam is a Registered Nurse (RN), and has been for over 12 years. She has worked on a surgical ward for the majority of that time, caring for patients with new and pre-existing stomas.
I did have an advantage going into my surgery and plenty of insight as to what having a stoma involved. That being said, I have learned so much more than my training and experience has ever given me.
I am currently studying to become a qualified Stomal Therapy nurse (STN)--this is the term we use in Australia. I’m halfway through my postgraduate degree, which is a year long.
I have Crohn’s Colitis, otherwise known as Granulomatous Colitis. Most people with IBD have Crohn’s disease or Ulcerative Colitis. For years they thought I had Ulcerative Colitis, then after my colon was removed, they found Crohn’s granulomas in the deeper lining of my bowel. I still have my Ileostomy because there is a risk the J pouch surgery would fail and that Crohn’s could flare in the J pouch or my small intestine. As a mum of two young girls it’s a risk I don’t want to take right now, and will most likely never chance.
1. WHAT ARE YOUR MUST-HAVE PRODUCTS?
Eakin! As in the Eakin Cohesive slim seals that sit around your stoma between you and your bag. They give such a great seal! I feel confident that I won’t leak, which is a major thing for us Ostomates. You want to be out and about not having a worry of filling your pants with poo and the embarrassment and mess that comes with that is horrible!
I do keep a spare pair of scrubs in my work locker for added security and a change of clothes in my car in case I’m far from home. But knock on wood these seals with a convex bag have been my insurance against the dreaded leaks!
On that note, my bag of choice is the Coloplast Sensura mio. I was drawn to it at first for it’s modern pretty grey look but it has more to offer. It comes in 3 sizes, I prefer the medium (holds about 350mls), it can be converted into a smaller bag when needed by tucking the bottom soft Velcro up to the top section and it dies quickly when wet in the shower/bath or swimming. Its adhesive is great, always lasts the distance. I prefer the one-piece drainable bag and change it every 2 days but have left it for 5 days when I felt lazy without any issues.
I used a flat bag at first, thinking it would be more easily hidden under clothing compared to the convex base. However I was experiencing the dreaded leaks when wearing fitted clothing so changed back to the convex as a suggestion by my Stoma nurse and I haven’t looked back! My stoma sticks out well, about one inch, but I was leaking due to pancaking--the stool was getting stuck and pushing back out around the base of the stoma. I haven’t had any leaks since using the convex again. I use the soft convex. You cant even tell the difference, it doesn’t sick out more, as I previously thought.
2. HOW LONG DID IT TAKE YOU TO FIND THE RIGHT PRODUCTS? WHAT WAS THE PROCESS LIKE?
It probably took a few months of trial and error, which helps, but more importantly so does a good Stoma nurse! I am lucky to have the best (I reckon) one going! She has many more years experience than I and has troubleshooted countless stoma related problems. She gave me a great starting point, introduced me to the Sensura mio and Eakin which I love so much. She kept it easy by simplifying the process, just disposable cloth and water to clean at first, no unnecessary accessories to confuse me. Once I had the basics mastered I started to experiment, finding out what I liked and didn’t like, then adding products to my routine.
ADHESIVE REMOVER - I use the Dansac remover spray. Removes the bag easily, preventing trauma to my peri-stomal skin.
CLEANSING WIPES - I use the coloplast Brava cleansing wipes to clean my stoma and surrounding skin. They are just so handy.
BARRIER WIPE - These aren’t totally necessary but I just like using them, just one each bag change which helps remove old adhesive, usually the Eakin can leave a bit of itself behind and this removes it easily.
STOMA SEAL/BARRIER RING - Eakin Cohesive slims are the best, as previously mentioned. I just stretch it to fit my stoma, or pull it apart and wrap it around the base of my stoma, which isn’t a perfect circle, so this gives a perfect fit.
STOMA BAG - Coloplast Sensura Mio - One piece drainable midi in soft convex.
TAPE EXTENDERS - I like using one or two of the Coloplast Brava extenders around the outer edges of my bag adhesive for added security when desired.
3. WHAT WAS THE ADJUSTMENT PERIOD LIKE WHEN YOU FIRST GOT YOUR OSTOMY?
It really didn’t take me long to adjust. Having my previous stoma experience I think helped a great deal, but I think, mainly, it was the fact that I felt so well compared to pre-stoma when I was so ill. I hadn’t been eating properly for a long time because the pains it would cause me were horrendous. Also I just didn’t have an appetite. I would survive on nutritional drinks supplied by a dietician at the hospital and the occasional low fibre meal or snack. I always enjoyed my food and drinks and the social events that go with it. I would be miserable missing out on things or just struggle through only to suffer more after them.
Almost immediately after the surgery--ok maybe after the first day of anaesthetic and morphine--I felt FREE! Free of those painful cramps in my gut that haunted me for so long. I really felt like a weight had lifted off my body and it was wonderful. I had never been more excited about hospital food! As soon as I could eat I was demolishing everything they delivered on my tray!
I felt such an improvement that whenever I had a negative thought about my stoma, or even if I do today, I just think of how I felt before it and those negative thoughts go away.
4. HOW DID YOUR CHILDREN RESPOND TO YOUR STOMA?
My daughters were only young when I had my surgery, Josie was 3 and Sydney was 1 year old. They didn’t know much about what was happening at the time. As soon as I was out of hospital they were curious and would watch me change or empty my bag. Now they aren’t fazed at all by it, they don’t really comment much at all. If they do I just say the stoma has made mummy better. I think I was lucky this has happened while they are young, they won’t know me any different.
It was so tough caring for them when I was unwell before the surgery, I would be scared to take them out, especially on my own. Now we go to the park, ballet, parties, travelling... you name it! I think the osto-mum me is a much more enjoyable mum.
5. WHAT ADVICE DO YOU HAVE FOR OTHER OSTOMATES?
I think it’s a process for everyone, because we are all so different and there are so many products available to navigate.
Trust in your Stoma nurse, follow their advice, and if you wish to try products do so a bit later. Too many products can be confusing, keep it simple if you can.
Talk to other ostomates. Most areas have a local support/information groups. I really enjoyed my local one and still attend, it’s every 2 months. I especially love the fact you’re sitting in a room full of people with ostomies but wouldn’t know it to look at us--it's a great feeling.