| Doc Talk
Doc Talk features articles on health issues from our own WVMC experts. Doc Talk is an educational resource and does not replace regular medical care.
Pat Lannoye, RN, specializes in working with ostomy patients. An ostomy (as a colostomy, ileostomy, or urostomy) is an operation to create an artificial passage for bodily elimination
What is an ostomy?
Pat: The true word for ostomy is new opening, so you can have a new opening into any part of your body and it will be called an ostomy, as in tracheostomy is a new opening into your trachea, or a gastrostomy, which is a new opening into your stomach. It’s often with the bowel, some sort of opening into the bowel, whether it is for urine or stool.
What conditions warrant an ostomy?
Pat: There are many conditions, from infants to adults. Infants have different kinds of atracias, which means there is no opening from the inside to the outside for their bowel or bladder, all the way to adults who have ulcerative colitis or Crohn’s disease, which are diseases of the bowel that wreck the bowel. Crohn’s disease is throughout the whole system from the mouth to the anus. Ulcerative colitis just involves the colon, so when the colon is taken out the disease is gone. There are cancers, like bladder cancer where your bladder needs to be removed to save your life. Bowel obstructions – some require a very temporary ostomy, lasting just a few minutes, six weeks, eight weeks and they’re gone. That’s nice when you don’t have to have an ostomy forever.
What are some common issues for patients with new ostomies?
Pat: When you get a new ostomy, it’s swollen. When the swelling goes down you need a new size of appliance. Another common problem is the appliance isn’t sticking to your skin correctly – there’s a problem with adhesion. Sometimes the appliances just don’t work for a patient, and we can change to a different size, a different manufacturer, whatever is necessary.
How to patients get trained?
Pat: Ideally, they are trained ahead of time. In our area, urostomy patients don’t go to the hospital until they’ve seen me. I usually spend an hour teaching them about the appliances and what they will need to do. When the nurse at the hospital teaches them they will have had some training already. They’re only in the hospital for seven days or less, and that’s not really long enough to learn how to do it. I usually send them home with Home Health, so Home Health can transition them. We get the appliances from a mail order source usually. There are some places in Wenatchee and Cashmere, but there are so many companies and so many varieties of appliances, it’s hard for them to keep a fresh stock of them. A company in Spokane can get them out in two days. There are a certain number that Medicare and other insurance will allow them to have.
What process do people go through to get to see you?
Pat: Anybody can call me, but I usually work with patients who see doctors in our system. The urology department calls me right away when they have a patient who needs my services. Surgery department calls<
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