Thursday, March 22, 2007

Colostomy

After the surgery to remove the primary tumor in my sigmoid colon, I was left with a colostomy. Normally the digestive system goes: mouth, esophagus, stomach, small intestine, colon, rectum and out. My metastatic tumors threatened to grow back into my colon if it was reattached to my rectum, so instead the end of the colon was brought through the abdominal wall to exit near my belly button.

That meant that I could no longer go to the bathroom in the usual way. There was no sphincter to control bowel movements, so stool spontaneously exited through the stoma as it reached that stage of digestion. I had to wear a plastic pouch to collect the stool; it clipped onto a flange that adhered to my belly like a big bandage and had a clip at the bottom so that I could empty it a couple times a day.

On the upside, one doesn't have to worry about finding clean public restrooms around town when one has a colostomy. That can be liberating for someone who's had trouble with frequent or sudden bowel movements. On the downside, the colostomy needs care, the adhesive can be irritating to the skin, and its presence is socially awkward. It made a visible bulge under my shirt, the lack of a sphincter meant that I couldn't control the sound of passing gas, and it required explaining to anyone who was going to see me shirtless.

I developed a few tactics to minimize the disruption of my lifestyle:

Basic colostomy bags are clear, smooth plastic, but I found that Hollister makes opaque, beige bags with a cloth-like cover. That helped greatly in reducing the visual impact of having a bag of shit hanging from my stomach. The cloth-like cover kept the plastic from getting sweaty and sticking to my skin.

I started wearing white undershirts to help hold the bag close to my body and make my outer shirts lie more normally. A big contributor to the bulge is gas collecting in the sealed bag. I switched to bags with small carbon-filtered vents that let the gas exit odorlessly during the day.

I eventually learned to wear a belt attached to the bag at night to hold it tighter against my skin in bed. That kept the adhesive from peeling off and let me go about five days between changing flanges. Since peeling off the adhesive was a big contributor to skin irritation, that reduced both leakage and discomfort.

After learning to care for the ostomy, my activities were nearly unrestricted. I had to avoid bending too much at the waist and stopped swimming, but everything else I could do normally.

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