Thursday, March 30, 2017

Types of ostomies...

For several years now, I have wanted to write about the various types of ostomies. There seems to be a lot of confusion and misconceptions out there regarding ostomies. Generally speaking, there are three types of ostomies.

Colostomy: A colostomy is where the colon is surgically diverted through the wall of the abdomen to create a stoma.

Ileostomy: An ileostomy is where the ileum, which is the lowest part of the small intestines, is surgically diverted through the wall of the abdomen to create a stoma.

Urostomy: A urostomy is where a stoma is created to help divert the drainage of the bladder and urethra.

There are different "subcategories" within the realm of ostomies such as J-pouches but today we are just talking about generalized ostomies. The reasons as to why a patient may need an ostomy vary. A patient may have a blockage or obstruction, cancer, GI conditions such as Crohn's, Diverticulitis and Irritable Bowel Disease (IBD), infection, an injury that resulted in the need for an ostomy or motility issues. The reasons are vast. Some ostomies are temporary while others are permanent. It just depends on the patient and the medical situation.

Monday, March 20, 2017

Looking back...

As human beings, when we mature and grow older, our outlook and perspectives change. Next month is my thirtieth birthday. As I look back over my twenties, I can see how I have grown and changed as a person. If someone would have told me what my twenties would entail, I would have never believed them and possibly questioned their sanity. This time of year always make me reflect on what I have been through with my gastroparesis. I am so thankful to be where I am today in life.

Years ago when I was in the process of preparing to have my colon removed, it took about six months for everything to fall into place. I had to have further GI testing, additional GI consults and opinions and a procedure done to rule out the diagnosis of Hirschsprung's Disease. During one of my GI appointments at Temple University Hospital in Philadelphia, I was seeing one of the nation's best GI doctors who specialized in motility disorders just like my local GI doctor. I remember conveying my wishes to him to have my colon removed and asking his opinion on the surgery. I explained to him that my local GI doctor recommended the surgery. Without the surgery, he didn't expect me to live to see my thirtieth birthday. Shockingly this GI doctor disagreed. He thought that the surgery was too big of a risk. The outcome would not justify the risk. I remember thinking that yes, medically he is qualified to tell me his opinion. He had devoted his life to medicine and studying how this disease "works" but he didn't know on a personal level what it was like to live with my disease every day. I wanted to live a long and full life.

Fast forward a couple of years and I was in the same situation again, needing an additional surgery to save my life, an ileostomy surgery. The day I met with my surgeon is a day that will I remember for the rest of my life. Originally I had went to my surgeon that day to see if he would remove the remaining eight inches of my colon that was a left as a hookup for my small intestines. He explained that by removing the remaining colon, he would be putting me at risk for obstructions and the possibility of my intestines "falling" which would cause a whole list of complications that could not be fixed. An ileostomy was my only surgical option at this point. My GI tract was delayed from the gastroparesis. There was no guarantee that an ileostomy would work. If this surgery failed then my GI tract would be considered to be "in failure" and a transplant would be my last option. The cleaning out regimes eventually would stop working. Transplants are not a fix all, end all solution. They come with their own set of complications.

After leaving that appointment, I realized how short life could really be. Things that I had wanted for years to have and be in life may not actually be possible or happen. The following few weeks were really hard for me. People my age were out pursuing their careers, getting married and having babies. I was at home cleaning out and picking out ostomy supplies. I honestly didn't think I'd ever get to be a parent.

As with all things, time does wonders to one's perspective. Over next few years, I grew as a person. I accepted my new "normal" and way of life. I grew to like and even appreciate my ileostomy. It had saved my life. The night before my ileostomy surgery, my body began shutting down. It was horrible. I have never been or felt so sick in my life nor wish to do so again. My parents explained to me later that their prayer was that I survived the night. Now as a parent myself, I can't imagine how hard that must have been on my parents to see their child in such a state. I can't imagine how hard it was for Jacob, my husband. I never would have imagined that four years post ileostomy, I would be married and have a nineteen month old daughter. My gastroparesis is still "there" and it still affects my daily life, nothing has changed. I still have to do my clean out regimes and watch what I eat. I am so thankful and appreciative to be here living the life that I do.