Posts tagged Ostomy Care
Regardless of a person’s age, diagnosis, or sexual preference, ostomy surgery infringes on the high value society places on beauty, body, sexuality, cleanliness, and self-control. Changes to the body after ostomy surgery are not only visible to the individual who had the surgery, but also to the sexual partner… Even well informed people have difficulty making these adjustments.
The possibility of an ostomy is an oft-cited fear among newly diagnosed colorectal cancer patients, and even keeps some individuals away from getting screened for the disease. It may be difficult to believe, but some are so afraid of the possibility that they would rather subscribe to the deadly idea that “ignorance is bliss.”
Regardless of your age, gender, marital status or sexual orientation, you will continue to be a sexual being even if you join the thousands of men and women currently living with colostomies or ileostomies. That’s not to say that you won’t experience changes in your bedroom habits- and this blog post will attempt to address those changes and point you towards resources that will help you take care of your beautiful (sexy!) self.
Treating sexual dysfunction as a side effect
The sexual wellbeing of cancer patients has received increased interest from medical and psychological professionals in the past decade. Sexual dysfunction is not sexual failure– it simply means that your body is have trouble with the physiological processes that lead to arousal or orgasm. The CCAC therefore encourages you to discuss any sexual concerns in a frank, open discussion with your physician.
Afraid it will be embarrassing? Consider this: would you neglect to tell your healthcare team about physiological changes in your skin or pain in your stomach? Then why neglect to tell them about physiological changes in your genitals or pain during intercourse?
It’s difficult to fit the media’s very narrow definition of what is sexy, and many ostomates fear being altogether “banned” from feeling desirable because of their new apparatus. The taught, smooth abdomens of celebrity models don’t exactly hint at the digestive processes happening inside, do they?
Added to feelings of inadequacy are the anxieties a new ostomate experiences about the possibility of odour or leakage- neither of which are likely if the proper precautions are followed. To reduce anxiety and increase confidence during sexual encounters, the UOAA suggests:
- Emptying the pouch before engaging in sexual activity and securing with tape
- Changing to a smaller, closed-end, disposable pouch before romantic encounters
- A cummerbund or sexy lingerie-inspired cover-up if insecure about pouch visibility or if movement of the pouch is a concern
- Experimenting with personal lubricants for dryness
- Trying a variety of positions- “man on top” and “side by side” positions may be most comfortable at first.
Still not convinced that an ostomate can feel sexy? Jessica Grossman is a gorgeous model- whose ileostomy pouch is often the star of her photoshoots. She speaks about her experiences at Uncover Ostomy.
Of course, the changes aren’t just in your brain- your pelvic/abdominal region has undergone significant changes, too. During surgery, blood vessels and nerves involved in having and maintaining erections or creating natural lubrication could be damaged, and the removal of the rectum and closing of the anus may impede your ability to maintain the sexual practices you have already established.
Full communication with your partner and your doctor is the best way to manage physical sexual side effects.
A word about protection
Women with colostomies and illeostomies can get pregnant- and can produce beautiful, healthy babies with regular prenatal care. A male ostomate’s ability to reproduce may not be affected either- so adequate protection is still absolutely necessary if you are not intent on conceiving. Similarly, Sexually Transmitted Diseases don’t care if you have had an ostomy!
The United Ostomy Association of Canada can help you find more information about support groups in your area, or point you towards online groups. Find out more at www.ostomycanada.ca or contact the CCAC at 1-877-50-COLON (26566).
Intimacy After Ostomy Surgery by Gewn B. Turnbull. The full guide can be found on the United Ostomy Associations of America website here.
The Canadian Cancer Society publication Sexuality and cancer: A guide for people with cancer. It can be downloaded here.
It’s estimated that, on average, North Americans consume less than 50% of the daily recommended levels of fibre- which could be a problem, since fibre consumption has been shown to significantly reduce blood cholesterol levels, lower variance in blood sugar levels and facilitate regularity.
But not everyone should be eating a diet rich in fibre. We recently received an inquiry from a patient looking for low-fibre recipes that would be suitable for a post-ileostomy diet. This individual was also instructed by a physician to put on weight. Tricky!
PUTTING ON WEIGHT
Let’s discuss each problem independently of the other. Putting on weight safely and healthfully can be just as difficult as losing weight can be. The key is to keep your diet healthy, while introducing more calorie-dense foods. Katherine Zeratsky, Registered Dietitian with the Mayo Clinic, suggests the following, upon clearance from your physician:
- Eat more frequently- five to six small meals through the day
- Eat nutrient-dense foods, like nuts, seeds, lean protein, low-fat dairy products etc
- Drink fluids at least 30 minutes before meals, but not with. This will let you keep your appetite for the nutritious foods you’ll be eating
- Limit diet soda, coffee and tea. These items have little nutritional value and few calories. Instead, consider homemade smoothies with a variety of fresh fruits and lean dairy products
- Add calorie-dense snacks, such as nuts, peanut butter, cheese, dried fruits, or avocado. You may with to have a small bedtime snack as well.
- Add cheese to casseroles, soups and scrambled eggs; nonfat dried milk to stews, and lean chicken to soups
- When selecting sweets, be sure to select items that also provide nutrients. Yogurt, fruit and granola bars are good choices.
- Exercise! It may seem counter-intuitive, but regular exercise will stimulate your appetite. If your doctor condones it, consider starting a moderate weight training routine as well.
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The British Columbia Cancer Agency has created an excellent resource on low-fibre options that you may wish to share with your doctor or Registered Dietitian when creating an ileostomy-friendly diet plan. Among their recommendations:
- Have very small servings of food
- Eat more often throughout the day. Aim for six to seven small snacks per day
- Drink as much as you can. Aim for six to eight cups of fluids per day
- A multivitamin and mineral supplement may be necessary if your diet is very restricted
- Avoid any foods that make your symptoms worse. These might include: vegetables like booked spinach, swiss chard, and peas; Figs/dates, prunes and some berries; High-fibre cereals like All Bran, Shredded Wheat or Raisin Bran; whole-wheat pastas and breads; Snacks such as popcorn; Legumes such as beans, chickpeas and lentils
- You may be more comfortable with low-fibre foods, including: vegetables such as asparagus, cucumber, peppers, skinless potatoes, tomato, lettuce and mushrooms; fruits such as cantaloupe, banana, watermelon and grapes; hot cereals such as Cream of Wheat; Cold cereals such as Rice Krispies or Cornflakes; White, cracked wheat or 60% whole wheat bread, plain bagels or flatbreads; regular noodles and pastas; white ric; any lean meat; any lean dairy
- If your symptoms become more frequent and intense, your doctor may recommend temporarily cutting out fruits and vegetables alltogether, or temporarily avoiding all solid foods
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The American Cancer Society’s new cookbook, What to Eat During Cancer Treatment, helps cancer patients and their caregivers by providing great recipes and useful, comforting advice about cancer nutrition.
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The Cancer Lifeline Cookbook is designed to help patients through difficult nutritional situation. Kimberly Mathai, a registered dietitian, and Ginny Smith, a freelance health journalist worked together to create this resource.
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Over 138,000 French-language copies sold, now available in English! A highly accessible and practical text, with beautiful full-colour illustrations.
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