The “dog days” is a term that originated with the ancient Romans, used to describe the hottest days of the year that could also bring illness or catastrophe. Sound familiar? You are now in the “dog days” of your recovery and it’s not fun. You may be battling discouragement and perhaps struggling with some challenges around the mechanics of your pouch. There’s just no way to skip the dog days – you’ve simply got to get through them – one day at a time. There are hundreds of thousands of folks who have survived the ostomy dog days, and you will too. Hang in there – the dog days don’t last forever. You are stronger than you think.
Former NFL Kicker
Former NFL Kicker, Walter Payton Man of the Year, Grateful Ostomy Patient
Surviving the Dog Days
Rolf shares how you are getting a taste of the Dog Days of NFL training camp.
Roadmap to Recovery
Take a few more steps today than you did yesterday.
In post-op week two you are likely focusing on improving your new skill of changing your ostomy pouch independently. Learn how to empty and change your pouch here.
• The skin around your stoma should be healthy although you may still have stitches around the outside of your stoma. These may be dissolvable stitches or need to be removed by your ostomy nurse or physician.
• Your stoma will continue to decrease in size over the next 2-3 months
• You may be dealing with leaks as you find the right ostomy pouch system (appliance) and application. If you are having problems with leakage from your pouching system, don’t give up. It can take a while to figure out why your pouch is leaking. Learn more about managing leaks here.
Tips for troubleshooting leakage from your ostomy pouch:
1. Make sure you are using the right ostomy supplies (your ostomy nurse can assist you with this. If you don’t have access to a WOCN you can find one here or here. There are many pouching options on the market and accessories that may help. Consider barrier rings or an ostomy support belt or wrap for example. Free samples may be available.
2. You should not have any odor coming from the bag except when you are emptying or changing the pouch. If you have an odor, you may have a little leakage under the wafer/skin barrier that is resting on your skin that will likely cause skin irritation and soreness over time. The skin can become raw and weepy if the leakage is not fixed. Another possible cause of odor can be coming from the tail of a drainable pouch that has not been wiped clean well enough after draining the output.
3. The opening in your wafer/skin barrier should fit snugly around your stoma. The opening should be no more than ⅛ inch larger than your stoma. Learn how to measure your stoma here. Shave hair with a safety razor if needed.
4. Try using a convex wafer if your stoma doesn’t protrude above the surrounding skin (flush or recessed stoma), stoma is in a skin fold or crease. A convex wafer curves inward toward the stoma and gently pushes down on the skin around the stoma causing the stoma to stick out and aim the drainage more directly into the pouch. An ostomy belt applied to a convex wafer can help apply additional slight pressure and stability. Click here to learn more about convexity.
5. Empty your pouch when ⅓ to ½ full and always before bedtime. Consider not eating or drinking 2 hours before your bedtime and attaching a night bag. A night bag attachment allows you to sleep without interruption. Keep the ends of the tubing clean and dry. Replace the night bag every 30 days. Rinse daily with soap and water and weekly with one half vinegar and one-half water solution and hang it to dry.
6. Change your ostomy pouching system or 2-3 days (ideally before a leak occurs)
7. Are you anxious about being awakened in the middle of the night by a leak? Cover our mattress with a “chucks” pad that can protect your bedding and help you reduce your anxiety so you can sleep. → Learn more.
Food and Nutrition
Certain foods may cause odor including asparagus, fish, eggs, alcohol, cabbage, broccoli, cauliflower, kale and Brussel sprouts, cheese, baked beans, and onions.
Potential Complications
May be preventable if you recognize the warning signs early and take the appropriate action
1. Skin problems. Peristomal skin is the skin surrounding your stoma and should look and feel just like the skin on the rest of your abdomen (not irritated or red). Learn more about how to care for your peristomal skin and catch any problems early so they can be addressed.
2. Hernia. This happens when an organ or other tissue pushes through your abdominal muscles and creates a bulge. Since having ostomy surgery increases your risk of developing a hernia, you will want to follow these guidelines:
• Limit your lifting to 5-10 lbs. for the first 4-6 weeks post-surgery (or as directed by your surgeon) and always use proper lifting technique.
• Support the area around your stoma if you sneeze, cough, or laugh by squeezing a folded blanket or pillow.
Learn more about hernias and how to protect yourself here.
Hear Nurse Melody talk about hernias and how to prevent them here.
3. Urinary Tract Infection (UTI). About 25% of patients with a urostomy have a urinary tract infection (UTI) each year. The symptoms usually are fever, pain, and strong-selling urine. Diabetes increases the risk of a UTI.
• Drink at least 8 glasses of fluids each day.
• Eat food and drink fluids that inhibit the growth of bacteria. Examples include cranberry juice, blueberries, peppers, cherries, tomatoes, and sweet potatoes.
CALL YOUR HEALTH CARE PROVIDER IMMEDIATELY IF YOU THINK YOU HAVE A UTI
4. Dehydration. Dehydration is a common reason why patients with a urostomy return to the hospital. Dehydration occurs when your body loses more fluid than it takes in.
Signs of dehydration:
• Being thirsty
• A dry mouth
• Decreased urine output
• Dizziness when standing up
• Muscle or abdominal cramps
5. Diarrhea. is common because part of your intestine was removed and re-routed to make the urinary diversion. This can affect the absorption of fluids from your intestine, resulting in watery stools. Vomiting and nausea are also common in the first few weeks following a urostomy. Patients often report having a loss of appetite and experience weight loss.
6. Nausea/Vomiting . following a urostomy, patients sometimes report weight loss, tasting food differently and feeling nausea or full soon after eating. It is not unusual to lose 15-20 pounds after surgery.
Learn more about hydration from our dietitian, Danielle.
A convex skin barrier (the side that goes against your skin) is curved. Adding convexity can gently push on the belly which helps the stoma protrude up and outward. This can help output go directly into the pouch and not under the barrier which can cause a leak.
• Re-entry anxiety is a term that became more popular when returning to normal life activities in the post-Covid-19 pandemic world. Although this process looked very different for everyone, an estimated 84% of adults reported increased, prolonged stress due to this type of re-entry anxiety in 2021 (APA, 2021).
• Currently, you may be facing your own, personal post-ostomy re-entry anxiety, whether you have already braved the external world or are anticipating it. With small steps, you will eventually work your way through those anxious feelings.
• The next few messages will discuss re-entry anxiety and share steps to work through some of its challenges.
How helpful was today’s message for your recovery?
We offer our sincerest thanks to Joan Scott — a kind ostomate and brilliant writer — for allowing us to include excerpts of, her book, “The Ostomy Raft”, in Alive & Kicking. To purchase a copy filled with tons of practical tips for living with an ileostomy or colostomy, click the button below.
Rolf Benirschke is a former NFL Man of the Year and All-Pro placekicker who played 10 seasons in the NFL for the San Diego Chargers. His career was briefly interrupted when he was diagnosed with Crohn’s Disease that required ileostomy surgery in his third season. Remarkably, Rolf returned to play seven more years with the Chargers, becoming the first ever professional athlete to play with an ostomy appliance. He has been an outspoken champion of the ostomy community for the past 40 years and created Embracing Ostomy Life™ to provide the hope, education and encouragement to ensure that no one goes through ostomy surgery alone.
Join Team HOPE
Do you wish you could connect with someone like you who has an ostomy and similar life goals? You can! Our Team HOPE (Helping Ostomates through Peer Encouragement) program can pair you with a volunteer who has an ostomy that will listen, empathize and suggest resources to help you along your journey.
