The OZtomy Nurse Project

People can experience many different kinds of pain and discomfort throughout their stoma life. From post-surgical recovery pain, to intestinal blockages, to long term chronic conditions; Learning to understand the cause and establish relevant treatments for this pain can be somewhat troublesome, and is one of the most common reasons for contacting a medical professional or stoma nurse. This episode of TOZNP discusses different kinds of pain that an individual might experience if they have a stoma, describing the symptoms, the possible causes, and relevant treatment options for appropriate pain relief.

Welcome to 2020! The year of coronavirus. Living with a stoma is difficult enough. Learning to live with a stoma amidst a global pandemic presents its own set of challenges. This episode talks about the current covid situation and its impact on those who live with a stoma. It discusses the changes to stoma nursing services, patient education and the management of individuals who have either a new or existing stoma. We also discuss current concerns with obtaining ostomy supplies while in isolation, the availability of ostomy products globally and the availability of community assistance. Finally, we answer some common questions relating to coronavirus, the gastrointestinal impact of those who test positive, and how this virus will affect us all in the short and long term.

Living with a stoma at Christmas time can be slightly different than the typical person's experience. Diet concerns, travel arrangements and obtaining supplies can make the holiday season an anxious time for some of us. In this final TOZNP episode for the year we cover what to consider if travelling to see loved ones for christmas, what to eat, what to try and what to avoid, and even lists a couple of recipe ideas for cooking at christmas. Finally, a humble thank you goes out to all the listeners of 2019 who have helped make The OZtomy Nurse Project so successful.

Learning to live with a new stoma is overwhelming and scary. What's more, learning how to manage a new stoma as well as practicing self care can be a tricky path to tread. During the post-operative recovery however, your stoma nurse is not only educating you on the physical aspects of stoma care, but also gently guiding you through the minefield of thoughts and feelings related to these confronting new changes. This episode explains the concept of Psychological first aid, a technique designed to reduce the occurrence of abnormal emotional responses and symptoms of post traumatic stress disorder.

In the first of an upcoming series of ostomy product company interviews, I interview Jeremy Eakin and Mark Gilpin from Eakin Healthcare about the history of the Eakin brand, exploring how they came to be a thriving ostomy product supplier in today's market. For those who currently use Eakin products or for those curious few, this episode is a fun way to get to know the men behind the scenes of this highly successful company, which currently exports to over 30 countries through a network of 40 distributors, with other offices in Japan and the Netherlands. 

Unsure what you can, can't and should, shouldn't eat with a stoma? Sometimes our appetite can take a while to return after surgery. Also, concerns around low fibre foods that still have high nutrition can leave a person overwhelmed when it comes to meal prep. This episode shares three of my personal favourite meals to cook, as they are quick to prepare, easy to digest and can feed not only the individual, but the entire family too, including the kids! 

Did you know that not all stomas require a pouching system? The term "continent" stoma is a type of bladder or bowel diversion that utilizes surgically created internal reservoirs that can be emptied several times a day. These stoma's still require proper ostomy nurse care and education, but are an innovative way for individuals to retain their independence, and continence, instead of having an incontinent stoma, like a colostomy, ileostomy, or urostomy. This episode highlights the main types of continent stomas- the ACE, MACE, K-pouch, Mitrofanoff, Monti, and Indiana pouch.

How we die is sometimes as important as how we have lived. It is a very personal journey that affects us all differently. But what should we be thinking about and what happens when we head towards the end of our life whilst living with a stoma? This episode aims to help you understand what may happen to a person with a stoma as death approaches, the practical things you may need to think about when caring for a person who is dying with a stoma, and what options are available for managing these changes, any unused stoma supplies, and what supports are available before and after death.

In reality, for most people, a stoma has little or no effect on the ability to enjoy sex, regardless of sexual preferences or lifestyle before surgery. Sex and intimacy when living with a stoma are complex subjects to talk about, and have many aspects to consider. This episode talks about the physical, emotional, and psychological pressures that influence ones' life after stoma surgery. Also, we discuss the physical considerations like sexual function, sexual positions, timing, discretion, with tips and techniques, as well as where to find information about sex and how to live a happy and healthy intimate life with an alternate exit.

Stoma products: we certainly cant live without them, so how do we learn about them? This episode showcases the companies that supply products and accessories to Australians living in the stoma world. We feature each brand, the distributors that provide these products, and the highlights of each website that assist patients, families and nurses to learn everything they need to know about life with a stoma. From finding educational videos, to patient stories, to product sample requests, jump online today and get to know the home pages of each company, to find the info you need. 

Crohn's disease is a type of chronic inflammatory bowel disease that causes areas of the digestive tract to become inflamed, causing pain, swelling, ulceration and bleeding. The inflammation most commonly affects the end of the small bowel (the terminal ileum), the large bowel and the area around the anus, but it can happen anywhere along the digestive tract. For people who suffer from Crohn's, surgery sometimes results in the formation of a stoma. This episode explains how Crohn's was distinguished as an autoimmune disease and how exactly it affect's those diagnosed. Additionally, when a stoma has been formed, there may be additional peristomal skin care requirements, to manage this debilitating disease.

Ulcerative Colitis is one of 2 major types of inflammatory bowel disease (IBD) — a chronic and debilitating condition which causes the large intestine become inflamed, with ulcerated sores within the lining of the bowel. Although medical and surgical advances have improved treatments for UC, the ultimate cause and cure remains unknown. This episode explores the history of IBD, the symptoms of ulcerative colitis, and the treatment options available, including temporary and permanent stoma formation options for people living with inflammatory bowel disease.

"Focusing on Fistula's". A fistula is an abnormal connection between two organs. Abdominal fistulas, which are treated much the same way as a stoma may result from a wide variety of conditions and circumstances. Stomal therapy management of fistula's can be quite challenging and frustrating, but also, ultimately, rewarding. A solid understanding of related anatomy, physiology, and metabolism is required by specialist caregivers, in order to successfully meet these challenges.

Radiation therapy uses a form of X-rays to destroy or injure cancer cells so they cannot multiply. Commonly, a course of radiation therapy is used to shrink a tumour before surgery for locally advanced cancers. Occasionally, if the cancer is found to be more advanced than originally thought, radiation therapy may be used after surgery to destroy any remaining cancer cells. This episode examines the history of radiation therapy, how it is used today, and the side effects that may occur following treatment, if you live with a stoma. As an added extra, i interview a radiation therapist to understand how radiation treatment works in todays modern cancer treatment world.

Chemotherapy may be used before and after stoma surgery to get rid of cancer cells and reduce the chance of the cancer coming back. If your doctor recommends chemotherapy, you will probably start as soon as your stoma has healed and you've recovered your strength. But living with a stoma and undergoing chemotherapy can often be problematic, with skin, nerve and bowel changes sometimes causing problems with your normal routine. This episode explains how chemo works, what parts of the body can be affected, and  how these important drugs can affect daily life with a stoma.

In this episode i interview a work colleague who had his first nursing experience with managing people with stoma's back in his home country, the Philippines. John's perspective on how our countries differ is an excellent reminder that we in Australia are so very fortunate to have a healthcare system that supports and funds the supplies for people living with a stoma.

A prolapse is a stoma that turns outwards through itself, causing abnormal lengthening.  Although rarely life threatening, the appearance of a prolapsed stoma can be distressing for people, and sometimes requires some changes to your stoma care routine. This episode explains why prolapses occur, who is at risk, and the conservative and surgical options to treat this difficult complication of stoma formation.

A high output stoma refers to an excessive volume of faecal output from either a newly formed stoma, or one that has been established for a long time. It is more common in those who live with an ileostomy and is a precurser to dehydration, renal failure and malnutrition. In severe cases, hospitalisation may be required to correct fluid and electrolyte losses. This episode explains what is high output, the causes, prevention and treatment for this condition, and how to manage high output through nutritional, medical and practical pouching strategies. 

National Stomal Therapy Awareness Week runs from June 10-16, to acknowledge and support people living with stomas as well as their specialist medical professionals. Evidently, Bowel Cancer awareness months falls in June also! This quick change episode pays tribute to those with a stoma, stomal therapy nurses and our ostomy product partners. We also highlight the statistics of bowel cancer, to raise awareness of the prevalence of this disease. Finally, a heartfelt shout out to all who are affected by bowel cancer, including those who have lived or live with a stoma, and are alive today thanks to effective screening and life-saving surgery.

"Beating the Bulge". Parastomal hernias are an unfortunately common complication in those with a stoma. They occur as a result of weakness in the abdominal wall when the stoma is formed, which is associated with multiple patient and surgical factors. This episode today talks about the reasons for hernia's evolving, what we do about them (if at all) and how to try and put preventative measures in place so that hernias can be avoided during your stoma life.

"The Separation Conversation". Muco-cutaneous separation occurs when a newly formed stoma separates from the skin at the junction that has sutured the bowel to the abdominal surface. This creates a wound around the stoma that requires additional care during your pouching regime and can occasionally make the pouching process overwhelming and complex. The causes of MCJ separation vary but are often related to poor healing ability, obesity, medications, radiation and chemotherapy, amid many other factors. Today's episode explains what is muco-cutaneous separation, how and why it occurs and how stomal therapy nurses assess and treat this problem. 

  Dehydration can occur when a person does not drink enough fluids to replace the fluids lost as waste moves through the body. In terms of those with a stoma, dehydration is the MOST common reason for readmission to hospital following stoma formation. It is important to know the signs and symptoms of dehydration as well as preventative measures.  These symptoms can include thirst, dry skin, abdominal cramps, rapid heart rate, confusion and low blood pressure. Dehydration can also upset your electrolyte balance (especially potassium and sodium). Diarrhea, excessive perspiration and vomiting can also increase this risk. Today's episode explores dehydration, how it happens, the signs and symptoms and how to treat and maintain hydration in those who live with a stoma.

Our skin plays one of the most important roles in stoma care, as it is the surface on which the pouching system is constantly adhered. Having healthy skin and a well-fitted pouching system help to maintain security and confidence in your appliance. When skin becomes damaged however, the potential for leakage and further complications arise. Being able to recognise the source of the skin damage can be difficult, whilst understanding the relevant treatment can be even harder. This episode explains some of the unfortunate but common skin complications that can occur as a result of stoma formation and pouching, and what suggestions a stoma nurse may make to treat the problem.

In this 'quick change' episode we explain the basic process for setting up and changing your ostomy pouch. We also highlight some hints and tips for making the process easier and encourage you to relax and keep trying. It really is, after all... just arts and crafts.

"The Irrigation Conversation". Colostomy irrigation is a method of bowel management for people who have an end colostomy in the descending or sigmoid colon. It is a process that those with a stoma perform by passing a water enema into the large bowel via the stoma, to evacuate the contents in a controlled way. This episode explains the eligibility criteria for irrigation, the process and the pro's and con's of performing this regular ritual.

This week we carry on from part one, by discussing the educational and technological advancements in surgery that prompted the improvement of surgical operations as a whole. From the first discovery of ether as a form of anaesthetic and sedation, to the discovery of antibiotics by Alexander Flemming, we look at how these progressions started to widen the scope of stoma formation by developing new types of stoma's, including the ileostomy and the urostomy. Finally, we look at the very first possible colostomy ever created on Australian soil, right here in Victoria.

What was a person to do in ancient times if they needed a stoma? In a time absent of anaesthesia, antibiotics, or even electricity, many people who suffered horrendous intestinal obstructions, hernia's or battle wounds were sure to die a painful and miserable death. Todays episode explores the ancient principles of intestinal surgery, looking back at the first surgical techniques used to repair the bowel, and the influence of several surgeons throughout the last 300 years that paved the way for modern techniques to be practiced, in order to create the types of stoma's we see and live with today.

There are many types of surgeries performed that may result in a temporary or permanent stoma. With all the medical terminology and consultation with a surgeon, some information may get lost in translation. The type of surgery performed largely depends on the area within the bladder or bowel that is diseased or affected. This weeks episode explains the different types of 'resection' that is performed for many individuals who have surgery that eventuates to living with a stoma.

Many have heard on the grape vine that you can dab a small amount of Mylanta on any areas of skin irritation around the stoma to help heal the skin and assist with pouch adherence. Whilst this might work for some people, the science behind this practice is somewhat elusive. This episode explains what components of Mylanta may appear to resolve skin problems and why people might choose to follow this age old suggestion, when other more effective products are available.  

In a perfect world, we would all be able to get by with a simple ostomy pouch that suited and fit every single one of us. However, our bodies... and stoma's are unique and often additional products are needed to get the adhesion, security and protection we need to live independently with an alternate exit. This episode discusses the range of accessory items that are available under the stoma appliance scheme, their functionality, plus what issues may lead to the suggestion of implementing an accessory product to your stoma regime.

The science of the appliance- Choosing an ostomy appliance is rarely straight forward. For the new patient, a lack of knowledge of means relying on the Stoma Nurse to make an informed choice and educate appropriately. For the Stoma Nurse, many factors make up this choice in order to recommend the most appropriate and functional pouch for the individual. This episode talks about the range of modern ostomy appliances, their general and unique features and the underlying elements that determine how we choose the right pouch for you.

I Heart Guts is a company that sells plush toys in the shape of bodily organs. As a stoma nurse, i see hundreds of patients affected by diseases of the bladder and bowel. So as a light-hearted gesture i want to tell you about how to grab an intestine or bladder plush toy, that in my opinion (and odd sense of nurse-humour) would be a fun, but cute gift.  

A urostomy, also called an Ileal Conduit or Urinary diversion, makes a new path for urine to flow through your body. This type of operation results in a tube of small bowel that is removed from the remaining bowel so that it can be used to facilitate the exit of urine from the kidneys and ureters. This episode explores the surgical technique of creating urinary diversions, the historical versions of how this technique was developed, and the features of the pouching systems used to collect urine for emptying.

An Ileostomy is a stoma constructed from either the end or a loop of small intestine out onto the surface of the skin to form an exit for intestinal waste. This weeks episode explores how this type of stoma differs from the colostomy, how it is constructed and its appearance on the body. We also cover what to expect when considering this surgery, and the recommendations for adjusting to life with a small bowel stoma, including diet and pouching options.

In this first of a three part series on stoma types, we explore the 'Colostomy'. A colostomy is formed by bringing part of your colon (your large bowel) out on to the surface of your abdomen. We discuss what to anticipate if you are having this surgery and provide some general helpful hints on diet and pouching options for the colostomy.    

Welcome to the launch episode of the OZtomy nurse project, the podcast that explains everything you ever wanted to know about life with a stoma. From the ancient origins of intestinal failure, to the newest techniques of the Mitroffanof, the OZtomy nurse takes you through a journey of discovery into all things ostomy.