I know that everyone read my posts about my upcoming possible amputation surgery

and the response was surely touching, both here and over at UC.  It will be one week from today, and it will be a fairly complex surgery for the repair of damage to my legs from Charcot Disease.  The operation will first try a new corrective approach, and my last hope for retention of my legs - I am in a study for surgical correction and this will be my 15th and 16th surgery.  Should the surgery fail, they will take my legs below the knees.  I am as prepared as anyone could possibly be and am lucky to have the greatest wife in the world to care for me - as she and I were recently remarried and re-exchanged our vows.  She wanted to do this as a sign of love and hope, and I am truly blessed to have her.  I doin't think I would be in a position to live, and would not choose to without her incredible ability to cheer me and spur me on.  You might also remember the stories of my mother in law whom she recently to off and told her not to come help - as she is a hindrance rather than a help.  She has been telling her to divorce me since my Ostomy and can be quite mean to me, alwasy spraying fabreeze when she comes to visit.

Oddly, My ostomy is somewhat of a problem while I am down.  The last surgery (about 10 hours) resulted in my whole flange coming off in recovery, and unbelievably the nurses not being able to put another system on.  Evidently not something they stock in the recovery room, so they had pads on me until they called for my wife, who was gowned and had my emergency supplies with her, she was amazing telling the nurses how to clean the area, and she took over from there.

I will be in an orthopedic ward of the medical center, and unfortunately, having gone through this before, are not versed in ostomies and calls to that area take hours for a nurse to appear.  Also, the incredible amount of antibiotics they must give (since I was also a MRSA patient after 1 surgery) gives me incredible bag filling liquid with emptying at least 2-3 times an hour and a whole appliance change daily.  I know this seems like small potatoes considering what I am about to go through, but I will be on so much morphine and for a very long time, both in hospital and whilst home (if I have legs after the surgery - if not I will be transferred to a rehab hospital where they have absolutely no knowledge of ostomy care and protocol.

My wife can't be there 24/7, and I don't want her to be.  But I am also aware that I will be so out of it, almost in a semi-concious state that I don't want to be in my own stuff for up to several hours at a time - and I pity my poor room mate to come.

Has anybody else had any experience with this more left of center ostomy issue?  I know my poor wife will want to stay at all hours.  I am sort of perplexed by this one - and don't want to bother either the incredible nurses in the orthapedic wards or my wife.  I am thinking about enduring the pain so I can handle things myself, but I know what that pain is like, and I am in total panic over that.

Any suggestions would be very helpful, and am sorry to go on so.

Thanks and love to all,

bob  (and I am sure my wife sends her best regards)   

Bob~sending love and hugs to you and your wife!!

Can you have a pouch with gravity drain be used during your high output period? They can divert the output to a larger 'container' to be emptied less often by someone else. You'd still have to have the appliance changed by someone, but you'd get some relief by not having to empty a small pouch more frequently.

---

Crohn’s dx 1989
some terrible years before my
Proctocolectomy in 2008

My hospital is pretty terrible with ostomy care. I did have difficult stomas to bag, but the nurses could never do it. Most of the time they would refuse to even help me because they were busy and mine took an exceptionally long time to bag. The ostomy nurse only works part time, so I usually had no assistance. If I was already leaking, I needed them to at least gather supplies for me so I could do it, but often, they wouldn't come in time and I would have to do it myself anyway

---

27/F Diagnosed with unspecified UC 11/08 (symptoms for over a year before)
Asacol, Prednisone, Remicade with no success--no remission for over 2 years
8/09 colonoscopy shows that the whole colon is affected
12/18/09 Removal of colon, creation of J-Pouch and ostomy; recessed stoma
12/30/09 Takedown too soon; RV fistula
1/9/10 Second Ileostomy Surgery with sparing of the J-Pouch
1/25/10 Stoma Revision Surgery and Attempted Fistula Repair(couldn't find it)
3/30/10 Takedown again
Lomotil 1 Tsp. (4/day), Questran (3/day), Flaygl 250 mg (3/day), TPN 14 hrs/day, IV fluids 4 hrs/day Prednisone 7.5 mg (1/day), Florinef .05mg (1/day), Sandostatin infusion 300 mcg (2/day), Gluten free diet

Good luck Bob...wishing you my best.

Tom

Believe it or not I am going into Geortetown University in Washington DC, one of the "finest" hospitals in the country with a magnet nursing program.  The problem is that now nursing is such a highly specialized field, that osteo nurses are not really trained in ostomy care.  I have heard their GI department is first rate, but there is a shockingly few number of nurses who even know the basics of ostomy care, no less the variants of products that exist out there.  The doctors are aware of the situation and have advised me to bring many more products than I would normally need - but it is an organizational problem, and an education problem.  Bowel movements are not the domain of nurses at these higher end hospitals and they have nursing assitants empty bed pans and the like-  these aids are sadly minimum wage, often immigrants with this being their first job in the country, and also have language barriers, and are also not taught anything other than bedpan cleaning, and urination. 

Elimination is not in the domain of the nursing staff, so anything that is out of the ordinary, is not understood and addressed.

I have been even trying to find nurses aids that you can hire to augment your nursing care at about 20-25 per hour, but I have been told now by several agencies that I would have to teach these assistants in the whole process. 

Not that bag elimmination or replacement is rocket science, but it is beyond some of the skill sets of staff that I have been forced to use in the past.

In Washington DC, the vast majority of nurses are coming in as immigrants from the Asian countries and Africa - Lord know I welcome them to our wonderful country...but the job is more than standard bedpan duty - and Georgetown, as well as Washington Hospital Center only has two WOC nurses full time in terms of staff, and it is their job to teach patients with new or problematic ostomies, not assist in patient daily care of elimination or appliance changes.

I do hope that I have made it clear that this is not an immigration issue - America should welcome all who want to better their lives - but this is a bit more difficult than their current job position and potential language skills. 

I appreciate all the kind suggestions and have consulted the patient advocacy area, and they confirm along with my doctor, that I have to play the major role in ostomy care while in a non GI related department, ward, or ortho center.

Otherwise the nurses at Georgetown are top notch, and I have zero complaints during 14 previous surgeries.  Washington Hospital Center is another story entirely with the surliest nurses I have ever experienced (except in their oncology department where I was given Remicade for UC, they were exceptional and compassionate).  Of course, this is a personal opinion, I am sure others have diffferent views on WHC in DC.  But I do prefer Georgetown, again personally.

So, it is up to me, my wife, and a paid assitant for when my wife is not there - and we will try to teach him or her.

Love to all here

bob