Stoma construction

I've been reading the HW ostomy posts every day for about 6 years. I rarely comment because of my offbeat personality. One of the members called me an "old geezer". That's fair.

But, I've developed a nagging concern...and that's the number of people who have trouble with their stomas. Some stomas are recessed, some are flush with the skin, some point in the wrong direction, etc.

I don't accept the notion of "that's the way it is". It seems to me that the surgeon who is held up as a god, who is paid quite well, who has our life in his hands and is supposed to be a "pro" at this is solely responsible for the outcome.

If a plumber repairs your house plumbing and a joint leaks, do we accept "that's the way it is", or "no problem, I'll just do it again and you PAY again". We'd put this plumber in his place.

How dare I compare a surgeon to a plumber!! Hey, they're both mechanics is all.

It's funny but my surgeon said to me, "anyone can take out a colon," but the real skill is in constructing a good stoma. She seemed a bit frustrated that some other surgeons focus too much on how nice their stitches are and such not on quality of life after surgery, which is very related to quality of stoma. She seemed to think that female surgeons paid more attention to the big picture that way than male surgeons (although surely that's way too big a generalization).

But I do think there are some things they can't control.... stomas just sometimes get bigger or smaller, for a variety of reasons (some unknown).

I wouldn't think an "offbeat" personality is a reason to not post here.... nor being a particular age....

Oh, and contrary to what my surgeon says, there are tons of people, including myself, I wouldn't want taking out anyone's colon.... don't think it's quite so easy.

When I had a stoma, or rather the first and second stomas, I never gave it a thought. In both cases, the visiting stoma nurses remarked on what a well-done stoma I had, and while I always thought my surgeon was great, I didn't connect having well formed and situated stomas with his skill. I chose him because he had done most of the collectomies and stomas in the best hospital in town, my GI connected us, and because I liked and trusted him personally.
It seems the question of choosing your surgeon has to take into account their stoma-making skill, and I am not sure how patients can do that. It is not like surgeons keep a portfolio of photos of the stomas they've made. Also, patients don't know very much about stomas and the importance of their shape and size until after they are already dealing with their own new one. So there needs to be more stoma-quality awareness among patients before surgery, so that they can discuss that with surgeons while they consider who will operate. I guess I am suggesting that we here mention this when posting answers to people who write while they are still informing themseves about surgery.

summerstorm said...
Stoma qualtiy awareness, we need a week. Everything else has a week!
We do need to try to mention that to people. Someone usually mentions placement being so important but we don't always remember to tell them that they want a longer stoma, not a flush one.

Lol, this is so true! A good stoma and its placement is a HUGE thing whether it's temporary or permanent. My ileo experience would have been totally different had I gotten a good stoma.

Doesn't a flush stoma go with the territory for loop ileos? Mine is an end and it is a decent length- 3/4" to an inch mostly (before it bends downwards a bit once my pouch ison and under clothing) but occasionally it shrinks to half an inch- I was sure to make sure to ask my surgeon to ensure mine wouldnt ever end up flush.

Probiotic said...
Doesn't a flush stoma go with the territory for loop ileos? Mine is an end and it is a decent length- 3/4" to an inch mostly (before it bends downwards a bit once my pouch ison and under clothing) but occasionally it shrinks to half an inch- I was sure to make sure to ask my surgeon to ensure mine wouldnt ever end up flush.

I think the loop may be trickier to construct (so it sticks out) but there is no reason that it couldn't be done. That's where the skill comes in. There are people who have loops as their permanent ileo.

I want a surgeon to pull out their "stoma book" -images of stomas they've made in the past. I would be so amused, hahaha. It's like you're going in for plastic surgery!

Right now I have a loop and an end. My loop sticks out more.

Active UC'er, I am imagining big, artsy photos of stomas blown up on the walls all over the office.....

Of course, pre surgery, I think any stoma photo looks pretty frightening to many people.... the fact of it obscures the details of a good one vs a bad one...

Exactly. I was imagining how surgeons should keep a portfolio of photos of their work. Likegettig a haircut, you look through their specialty hairstyles/stomas and pick the one you love!

I still get flashes of strangeness iwhen I remember all the thoughts going through me when I had a stoma. It is absolute truth that intestines belong inside the body. Inside. It's just as simple and absolute a fact as if you eat food it will come out your other end later. But then there it was, my insides were on the outside. Doctors deal with the insides of people all the time, but for us or at least for me, it was a very serious confrontation that people aren't meant to go through. Taking care of it sensibly was easy, but getting my head around it was another matter.

     I'm an old geezer too..lol.  You brought up a very important topic.  Before my operation, to be honest, I never even knew what a stoma was!  I was totally ignorant of the entire process of removing the colon, etc..  You know why?  Because I had an a**hole for a GI doctor.  He never once would even discuss my having an operation because he was making too much money pushing the biologics on me.  For twelve LONG years I suffered with ulcerative proctitis and ran the gamut of meds.  I found my surgeon online because I had such poor quality of life and realized at the age of 63, if I didn't do something FAST, I wouldn't reach 65.

     Only by the grace of GOD was I lucky enough to find a GREAT surgeon who did a fantastic job of creating my stoma.  I was not a candidate for j-pouch but I didn't care.  I had the operation June 28th of 2010.  I eat everything...perhaps a bit too much...lol...but never once have I had a problem with my stoma.  As a matter of fact, my wound care nurse told me the day I was discharged from the hospital, that if he had to have the same operation as I, he would most definitely choose Dr. Fry. This nurse has worked in wound care for 30 yrs, so I thought that was a high compliment. 

     Now....if only I could find a competent dentist .