オストミー関連の覚え書き (Ostomy-Related Note)

Ostomy

6/23/2023 Updated

 

オストミー関連の雑誌が何冊かあります。内容的に捨てたくはないのですが、AIでもない限り、キープしたい記事内容はあれもこれも到底覚えられません…。でも、クローゼットに仕舞っちゃえば、もう「out of site, out of mind」になって、ただ積まれてるだけになってしまいます。

そこで、サーっと読んで、自分が思い出したいようなキーワードにハイライター（マーカー）を入れて、ここにアップすることにしました。主に自分用です。もう後は「Ctrl＋F」で活用するのみ、ということで…。でも、コピーライトの関係もあるので、参照文献として下に記載しています。私以外のどなたかのお役に、もしも少しでもお役にたてたら、とても嬉しいです。

キーワードだけなので、文章にはなっていませんが、つながり（関連）でちょっとは調べたい時の時間短縮になるんじゃないかと思います。

あと、これは自分の以前からの「システム」なので本当に自分用になっちゃうのですが、薬関連にはオレンジマーカーをしてた関係で、ここでもオレンジマーカーしたいと思います。

 

「Phoenix」Summer 2023

「Bonding Cement」(p. 12)

現在市場にある「bonding cement」商品は、次にあげる３種類。For stronger adhesive。

Torbot Bonding Cement – Latex base (10-15% rubber) liquid cement。Irritationを押さえるためにzinc-oxideが配合されています。4 oz.缶で約$15 (torbot.com)。

Uro-Bond – Silicone base brush-on adhesive。For ostomy appliances or external male catheter。3 oz. で約$60 (Parthenoninc.com)。

Nu-Hope Adhesive – Natural rubber base。2 oz.で$12 (NuHopeLabs.com)。

 

「Silicone-Based Adhesive Remover」(p. 13) – works better than others.

Convatec’s Esenta (Convatec社） – 例えば、こちらのサイト (Vitality Medical.com)では、50 ml入りで$20前後。

Coloplast’s Brava (Coloplast)

Hollister’s Adapt Universal Remover (Hollister)

 

Always “Push/Pull” approachで剥がす。

 

「Stoma Plug」(p. 13) for intercourse.

Alterna conseal plug (Coloplast) – Ostomy plugは、コロストミー用しかも直腸・肛門に一番近い「S字結腸部分のオストミー (sigmoid colostomy)」が一番適しています。それ以外 (ileostomyやurostomy)に使用すると、健康を害するリスクがあります。

ガス用のFilter付き。

Sigmoid colon (colostomy)以外の人のオプション：stoma cap, mini-pouch, or pouch wrap.

 

「Products for Urostomy Leaks」(p. 14)

(1) Wafer (barrier) → Extended wear barrier.

  • Drahesive (Convatec)
  • Flextend, Ceraplus (Holister)
  • Xpro, Mio (Coloplast)

(2) Consider new contour (skin contour changes over the time)

  • If belly is firm, then use shallow and soft convexity.
  • If belly is soft, then use deeper, more firm convexity.
  • For a firm protruding hernia, Coloplast Mio Flip pouch may work.

(3) Use accessories for longer wear time.

 

「Itchy skin around the flange」(p. 16)

Aluminum acetate solution – soak skin for 15-20 minutes. (e.g. Domeboro) – sulfa allergyがある方はちょっと注意です。(RxList.com, 2021; Domeboro.com, 2023)

Kenalog spray (PDR.net) (steroid) – may be one-time dose

Other products (e.g. clobetasol ointment/cream/etc. )

 

「Urostomy bags bulge and spill」(p. 16)

この問題に特化した ”Multiple built-in chambers” のデザインのapplianceを選ぶ。(e.g. Coloplast Sensura / Sensura Mio)

Bag の口 (outlet) のデザインもチェックする。大きさや形など。口の直系も商品によって違う。

 

「Funiculitis Prevention」(p. 18)

For hair around the stoma, use mustache/beard clippers with the lowest setting available. Do not use shaving cream or gel to avoid residue on the skin.

Another option is permanent laser hair removing or electrolysis.

 

 

 

 

過去号

Umbilicus (belly button) leaks (drainage) – laparoscopic surgery – chemically cauterize with silver nitrate (Phoenix Fall 2022, p. 8)

Ileostomy output – food you eat. enzymes, secretions such as acid, bacterial action on the food in the gut. Also transit time. Transit time affects more to colostomy than ileostomy (Phoenix Fall 2022, p. 8)

Abdominal pain/cramps – rapid transit – liquid Imodium (slow down and decrease transit time), hyoscyamine (Nulev) may help cramps (Phoenix Fall 2022, p. 8)

s/p ileostomy surgery s/s – dizziness, fatigue, HA, nausea, tachycardia – anemia and dehydration. Need iron and fluid intake. Liquid Imodium (decrease output). Prenatal vitamins has more iron than women’s/men’s (Phoenix Fall 2022, p. 8)

Hernia prevention – “core exercise” – pelvic muscle exercise, presurgery marking (Phoenix Fall 2022, p. 10)

Distended abdomen – gas or food – eating slower and smaller – simethicone (Gas-X) to reduce gas (Phoenix Fall 2022, p. 10)

Pouchitis r/t J-Pouch r/t UC – incidence rate 10% over several years. Initial BM is 6-10 times a day but decreases gradually – Antibiotics or probiotics (Phoenix Fall 2022, p. 10)

Stoma noise prevention – (1) outfit, (2) food type, (3) how you eat – (1) compression or snug-fit garments (ex. Stoma Stifler or Stealthbelt’s), (2) reduce gas-produce foods, (3) eat slowly – enzyme supplements (ex. Beano or lactaid contains enzyme for lactose intolerant people) – quick & fast walk after meals (Phoenix Fall 2022, p. 12)

Ostomy pouch system selection – web tools – Coloplast’s BodyCheck tool (17 different languages)- ConvaTec’s Ostomy Product Selector (Phoenix Fall 2022, p. 13)

Mild soap for cleansing skin around stoma – no oil, no fragrance, no lotion -> Ivory or Dial (bar soap and liquid are both available, ) – Safe n Simple Peri-Stoma Cleanser & Adhesive Remover – Coloplast Brava Skin Cleanser wipes – Remember, no alcohol (skin gets dry), or no dimethicone or lanolin (protect skin but pouch system doesn’t stick) (Phoenix Fall 2022, p. 14)

High output pouch system for more watery output during the night – longer pouch size (9″ (standard) vs 11-14″-long) and hold more (2 3/4 cup vs 4 1/2 cup) – wider outlet (standard) vs narrower outlet with plug or cap (like tube) – wash and reusable – insurance may cover certain pooches per month (Phoenix Fall 2022, p. 16)

Stoma protection (遊園地に行く時も忘れずに) – stoma cup, StomaDome, Ostomy Armor (Titanium Max is good for fierfighters or police officers), Stoma-Protech (around $50, Ostomate のお孫さんが開発した新商品。one size fits all), Stoma Guard (2-piece system, 2 cup sizes) (Phoenix Fall 2022, p. 18, p. 20)

Extreme fatigue after colostomy surgery – common causes are anemia and deconditioning during the hospital stay. Deconditioning refers physiological change due to inactivity or prolonged bedrest – take iron & vitamins – takes weeks to months to go back to the same energy level (Phoenix Winter 2022, p. 8)

Ileostomy cause high blood sugar level? – No, it does not affect directly; however, medications (e.g. steroid), weight gain, stress level may alter the blood glucose level. Check A1C (Phoenix Winter 2022, p. 8)

Numbness in arm, leg, hand, etc. after total colectomy – Altered Na+ level is common after surgery – often temporally – After colectomy, small intestine and kidney start working on sodium absorption for compensatory mechanism (Phoenix Winter 2022, p. 10)

No output from ileostomy – s/s: swollen and bloated abdomen – causes: narrowing intestine or kink – tx: frequent catheterization from stoma and release pressure or surgical correction (Phoenix Winter 2022, p. 10)

Purpose of ileostomy scope by gastroenterologist – one of the reasons is to check if there is any residual bowel mucosa (lining) – beneficial to prevent recurrent Crohn’s disease or other complications (Phoenix Winter 2022, p. 10)

Pouch filter – typically filters are carbon/charcoal filter – works for 1-2 days depending on stoma type and also contents – last longer with colostomy with formed stool but shorter for ileostomy with pasty or liquid content. New type of filters: Sensura Mio by Coloplast – compare with Assura or Sensura by Coloplast. Con is suctions gas too well and can interfere with flowing of stoma output. Other product is Osto-EZ-Vent. Otherwise, just simply go to bathroom and vent the pouch (Phoenix Winter 2022, p. 10)

 

 

 

参考文献

The Phoenix, the official publication of UOAA, Summer 2023, 18 (3).

The Phoenix, the official publication of UOAA, Fall 2022, 17 (4).

The Phoenix the official publication of UOAA, Winter 2022, 18 (1).