OFFICERS President: Stan Baker 410-672-5219 958 Fall Ridge Way Gambrills, MD 21054

Vice President Paul Rossi Secretary Mary Keller Treasurer Lyn Rowell 410-672-6983

Webmaster: Janice Winters BOARD OF DIRECTORS Sandi Burnett Bob Keller OSTOMY ADVISERS: Joyce Onken BSN, RN, CWOCN Lead Inpatient Wound Ostomy Nurse AAMC

Website: www.annearundelostomy.com Volume 46 Number 6 March 2019

UPCOMING MEETING March 7th, 2019

Charlie Black, Aqua Fit

PART II April 4th – Nurse Presentation

The Anne Arundel County, Maryland, Ostomy Association, Inc. (AACOA) is a non-profit, volunteer-basedorganizationdedicatedtoprovidingreassuranceandemotionalsupportforpeoplewhohavehadorwillhavesomekindofostomysurgery,suchasacolostomy,ileostomy,urostomy(urinarydiversion)oracontinentprocedure.ThegoaloftheAACOAistoprovidemoralsupport,information,andeducationtopeoplewithostomiesandtheirfamiliesandfriends.MembersreceiveTheRamblingRosebudnewslettermonthly.DUESare$15pleasemakecheckouttoAACOAandmailtoAACOA,POBox847,GambrillsMD21054-1454

MembershipApplicationPleasePrint

FullName_______________________________________________________________________________________________________________________________Last FirstM.I.Address:_____________________________________________________________________________________________________________________StreetAddress Apartment/Unit#_____________________________________________________________________________________________________________________

City State ZipCodePhone:()DateofBirth:Gender:

EmailAddress_____________________________________________________________________________________________________________

Reasonforsurgery:____Crohn’s____UlcerativeColitis_____Cancer_____Other__________________________

Emergencycontactifweareunabletoreachyou:______________________________________________________________________Whattypeofsurgeryhaveyouhad?

☐Colostomy ☐Urostomy ☐Spouse/FamilyMember☐Ileostomy ☐Parentofchildwith ☐Other(pleasespecify) Howdidyouhearaboutus?

☐InternetSearch ☐ET/WOCNNurse ☐Other ☐Hospital ☐Physician

“The best and most beautiful things in the world cannot be seen or even touched - they must be felt with the heart. – Helen Keller

2019-2020

HAPPY SPRING !!! Happy end to Winter and beginning of Spring! If you haven’t updated your ostomy accessories lately, perhaps consider adjusting if your products do not seem up to par. Consider Safe n Simple’s line of No Sting Skin Barrier Wipes and Adhesive Removers. Safe n Simple also has a great ostomy pouch deodorant, Assure C, that is unscented and colorless. Only a few drops are needed at a time, so the product is both effective and economical.

Hollister’s Adapt Cera Ring protects and heals as the products is made with a component that preserves skin’s natural moisture integrity. It is designed to promote healthy skin, provide a custom fit, and prevent leakage. Additionally, Coloplast’s Mio Soft Convex product line works wonders for uneven contours that don’t do well with firm convexity.

For more product specification, give us a call, or stop by! Consultations are available by appointment.

Schedule Your Ostomy Consultation Today!

(P) 410-773-0300 (x3) (F) 410-773-0302

Austin Pharmacy and Medical Supplies Baltimore

6729 York Rd Towson

901 Dulaney Valley Rd Hunt Valley

10757 York Rd

March 2019 The Rambling Rosebud

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PRESIDENT’S MESSAGE At our meeting in February, Charlie Black of Aquafit Physical Therapy in Odenton was our speaker. He gave a presentation and demonstration of how to develop and maintain your body’s core. His presentation was so good that we asked if he would come back. Much to our good fortune he agreed to return for our March meeting. (We had planned to have an open discussion meeting.) Prior to our regular chapter meeting, we had a Board of Directors meeting in which we are planning the future direction and function of our chapter. Although we accomplished much, we decided that we would continue our efforts prior to our March meeting. If you would like to attend, we would appreciate your joining in. We will begin at 6:30pm before our regular meeting which starts at 7pm. See you in March. Stan

Items from this newsletter may be reprinted in other ostomy newsletters, provided proper credit is given as to source of material.

UPCOMING MEETINGS March – Charlie Black, AquaFit Physical Therapy returning by request! April – CWO Nurse Ann Fischer

OSTOMY ADVISORS FOR STOMA HELP To consult with one of the ETs below, a physician’s referral is necessary and a fee will be charged. Call for an appointment.

BALTIMORE WASHINGTON HOSPITAL 410-787-4578

ANNE ARUNDEL MEDICAL CENTER Michelle Perkins, RN, BS, CWON

Jenn Davis, RN, BS, CWON Anne Fischer, RN, BS, CWON Joyce Onken, RN, BS, CWON

Sarah McClain, RN, BS, CWON Email ostomyRN@aahs.org

443-481-5508 / 443-481-5177 Private Consultants

Joan M. Sullivan, MAS, RN, CNA, CWOCN 410-932-7312

The Ostomy Nurses at Austin Pharmacy 410-773-0300

No referral necessary ($40 consultative fee)

“It was one of those March days when the sun shines hot and the wind blows cold: when it is summer in the light, and winter in the shade.” Charles Dickens

– Richard Warren .” ― Edith Lovejoy Pierce

As Stan mentioned, Charlie Black taught us how to strengthen our core and is coming back to follow up. Your “core” refers to the muscles in the abdomen and back. Strengthening the abdominal muscles is particularly important for ostomates as surgery weakens them.

THE MID-ATLANTIC’S LARGEST OSTOMY DEALER

We have a dedicated group of Ostomy Supply Service Professionals that are committed to keeping you in your active lifestyle. Northern Pharmacy and Medical Equipment has an attentive staff that cares about your quality of life. Make us your first step in getting back to life as it was meant to be. After all

“We’ve been here for over 75 years, there must be a reason!”

Our Ostomy Department provides a full range of comprehensive services and quality products from trusted brands you can rely on.

WE OFFER: x� Delivery anywhere in the United States x� Free delivery available x� Next day delivery is available x� Large inventory of ostomy & wound care

supplies in stock (we stock an inventory of over 5,000 boxes of supplies)

x� Customized hospital and clinic service plans available

x� In-house Medicare and insurance billing specialists

x� Personalized pharmacy/medical supply specialist available

x� Easy ordering by fax, phone, online, or in-person.

x� Toll Free 24 hour hotline x� Acceptance of all major credit cards

Northern Pharmacy and Medical Equipment 6701 Harford Rd, Baltimore, MD 21234 Harford Rd & Northern Parkway www.NorthernPharmacy.com

SPEAK DIRECTLY TO OUR OSTOMY SUPPLY MANAGER: AARON SACCO Phone: (410) 254 2055 x260 Fax: (443) 740 9297 woc@northernpharmacy.com

March 2019 The Rambling Rosebud

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Last month I mentioned my husband’s keto diet. I found this article we printed several years ago which goes a bit further to explain how a digestive tract, altered by ostomy surgery, is impacted by some specific diets. Even if you have no intention of trying to lose weight, it contains useful information about how the digestive tract works which can aid your ostomy management.

Diets And Ostomies - What's Safe? by Terry Gallagher; via Vancouver (BC) Ostomy

HighLife and Metro Halifax (NS) News

Dieting holds special risks for some ostomates. Before I go into this further, let me stress that I am talking here to those with urostomies and ileostomies as well as, to a lesser extent, those with transverse and ascending colostomies. If you have a sigmoid colostomy, then you can basically do what you like with regard to diets, within reason and common sense, as your digestive system behaves as 'normal.'

Before starting any diet, it is well worth seeing one's own doctor to discuss the suitability of the prefered diet with him or her because of the problems which dieting can cause as well as any underlying other medical conditions which may make dieting or a particular diet hazardous.

Let's look at the problems in more detail. The urostomate has special requirements to avoid dehydration so, provided that the urostomate doesn't cut back on fluid intake, then they, too, can generally diet as they wish. The guide for the urostomate, remember, is at least 3 litres (about 12 glasses) of fluids per day. However, any urostomate who has short bowel syndrome because of the surgery to make the ileal conduit needs to take the same precautions as an ilestomate as set out below.

The ileostomate has lost the ileocecal valve at the end of the ileum where it joins the cecum and the colon. This valve slows down the transfer of food from the terminal ileum (the last part of the small intestine) into the cecum to allow for greater

absorption of food through the ileum. With the loss of the valve, food passes through the system faster so the food is less well absorbed. In addition, the colon absorbs mineral salts such as sodium and potassium as well as water from the stool. While the ileum takes over some of this role, ileostomates still lose ten times as much sodium and potassium as a person with all or most of a colon. These factors together provide the key to the problems which some diets may cause.

The Atkins Diet is very high in fat. Those ileostomates like me who occasionally (who am I kidding...too often is probably more accurate in my case!) eat a high fat meal know that we will have very runny output which floats because of the high fat content. It's called steatorrhea. The stool also tends to be frothy from trapped gases.

The food passes through the digestive system much faster than normal as it is lacking in fiber which gives the intestine something to 'push' against during peristalsis -- the wave-like movements of the walls of the intestine which move the food through the digestive system -- as well as being well 'lubricated' by the high fat content. The problem with this is that the rapid passage of this fatty food means that not only are essential nutrients in terms of proteins not absorbed, but the vitamins and minerals are not absorbed either, leading to malnourishment. One vitamin which is fat soluble and can cause problems is vitamin K. Vitamin K is necessary for the production of blood clotting factors and proteins necessary for the normal calcification of bone. Because vitamin K is fat soluble, the fat malabsorption caused by its rapid passage through the ileum may result in the person becoming deficient or short on vitamin K. The very fatty liquid stool just rushes through the ileum so that little is absorbed of essential nutrients. This also overloads the pancreas and can cause problems there.

The Atkins Diet, being high fat, can produce

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chronic steatorrhea in the ileostomate so that the person rapidly becomes deficient as well as lacking protein. Dehydration is also a problem as water forms an emulsion with the fatty stool and is less well absorbed. If this diet is continued, the person may suffer protein deficiencies as well as osteoporosis through the vitamin K problem mentioned above.

The recommendation from the medical profession for ileostomates and those with short bowel syndrome from their surgery (perhaps through adhesion removal) is to diet by reducing food intake of both fats and carbohydrates, especially simple carbohydrates such as sugar, while taking care to maintain hydration by drinking plenty of fluids. For example, baked potatoes are complex carbohydrates with virtually no fat. Add low fat cottage cheese and a helping of mixed salad (for me, lettuce, tomatoes, cress, beetroot, sliced peppers, etc.- you get the idea!) and you get a meal which is both low fat and low carbohydrate and also full of fiber along the South Beach Diet lines.

The Atkins Diet isn't suitable for ileostomates as there are too many risks of malnutrition causing unhealthy weight loss produced by loss of needed body tissue and lack of vitamins and minerals, as well as the risk of dehydration. A low fat, low simple carbohydrate with reduction in complex carbohydrates diet together with plenty of fluids is the safe way to lose weight.

Urinary Discharge Can Affect Skin and

Kidneys Via Contra Cost (CA)) & S Brevard Fl

Urostomates have to be especially careful about cleanliness. Bacteria from stale urine can cause white, gritty deposits on the skin and stoma, which can be irritating, abrading the skin like

sand paper. Fresh urine doesn’t usually hurt the skin unless it is trapped in contact with it. If urine collects under the pouch, the bacteria multiply rapidly. This skin should be completely cleansed and dried before applying tapes, barriers, faceplates, etc. Empty the pouch frequently. Keep the urine acid (through diet) to prevent gritty deposits. A quarter cup of half water and half white vinegar solution sloshed in the pouch around the stoma will dissolve any deposits. Solutions for cleaning and disinfecting urostomy equipment can be obtained from your appliance dealer.

Aging and the Ostomate Edited by B. Brewer, UOAA Update 3/12

Skin: As we grow older, subtle changes occur in our bodies. The most insidious is our skin. It loses elasticity and becomes thinner and drier, thus becoming prone to wrinkles and irritation. These changes can become real problems for those who must wear a pouch all the time. To prevent leakage as the skin becomes more wrinkled, one should stand up straight when changing the pouch. With one hand, stretch the skin so that it’s tight, and with the other hand attach the pouch (using a mirror may help you see what you’re doing).

Bruise: The skin over the entire body tends to bruise more easily and heal more slowly as we age. We need to be more careful when removing a pouch. A skin barrier covering the entire area under the pouch, or a very thin application of a skin-care product may help protect the tender skin.

Strength & Agility: Aging may also result in less strength in the hands, arthritis, lessening mobility or pain in the fingers can make it difficult to put together a two-piece pouching system. A one-piece pouch may eliminate the task of stretching a pouch over a faceplate. In short, aging is something we must face. Considering the alternative—it’s not that bad!

A.A.C.O.A. P.O. BOX 847 GAMBRILLS, MD 21054