ANNE ARUNDEL COUNTY MARYLAND

OSTOMY ASSOCIATION, INC. P.O. BOX 847

GAMBRILLS, MD 21054

OFFICERS President: Stan Baker 410-672-5219

958 Fall Ridge Way Gambrills, MD 21054

Vice President Paul Rossi Secretary Mary Keller Treasurer Lyn Rowell 410-672-6983 Webmaster: Janice Winters

BOARD OF DIRECTORS Allyn Mellits Joan Gardner Sandi Burnett Bob Keller

OSTOMY ADVISERS: Joyce Onken BSN, RN, CWOCNLead Inpatient Wound Ostomy Nurse AAMC

We’re on the Web! www.annearundelostomy.com Volume 45 Number 5 February 2018

Thank you Anne Arundel Medical Center for printing our newsletter.

Note:Meetingsareheldat7:30pm,thefirstThursdayofeachmonthattheBelcherPavilionatAnneArundelMedicalCenterinAnnapolis.Fromthe2ndflooroftheparkinggaragetaketheentranceintotheBelcherPavilionandonceinsidetaketheelevatortothe7thfloorandcheckwiththedeskfortheroomnumber.

If AA County Schools are closed due to inclement weather, there will be NO MEETING.

UPCOMINGMEETINGS

February1st–Dr.Kahan,PainManagementMarch1st–Dr.CarolTweed,Hematologist&

OncologistApril5th–ToBeAnnounced

The Anne Arundel County, Maryland, Ostomy Association, Inc. (AACOA) is a non-profit, volunteer-basedorganizationdedicatedtoprovidingreassuranceandemotionalsupportforpeoplewhohavehadorwillhavesomekindofostomysurgery,suchasacolostomy,ileostomy,urostomy(urinarydiversion)oracontinentprocedure.ThegoaloftheAACOAistoprovidemoralsupport,information,andeducationtopeoplewithostomiesandtheirfamiliesandfriends.MembersreceiveTheRamblingRosebudnewslettermonthly.DUESare$15pleasemakecheckouttoAACOAandmailtoAACOA,POBox847,GambrillsMD21054-1454

MembershipApplicationPleasePrint

FullName_______________________________________________________________________________________________________________________________

Last FirstM.I.Address:_____________________________________________________________________________________________________________________StreetAddress Apartment/Unit#_____________________________________________________________________________________________________________________

City State ZipCodePhone:()DateofBirth:Gender:

EmailAddress_____________________________________________________________________________________________________________

Reasonforsurgery:____Crohn’s____UlcerativeColitis_____Cancer_____Other__________________________

Emergencycontactifweareunabletoreachyou:______________________________________________________________________Whattypeofsurgeryhaveyouhad?

☐Colostomy ☐Urostomy ☐Spouse/FamilyMember☐Ileostomy ☐Parentofchildwith ☐Other(pleasespecify) Howdidyouhearaboutus?

☐InternetSearch ☐ET/WOCNNurse ☐Other ☐Hospital ☐Physician

2017-2018

As the winter months descend upon us, snow and ice are likely to occur in our area. If you have an ostomy,

you might find these tips helpful in feeling prepared when unexpected weather events occur: • Always have a 7-10 day supply of medications and ostomy supplies available in your home.

• Do not keep ostomy care products outside or stored in your car, they can freeze!

• Stay hydrated! Make sure you have enough clean drinking water on hand for at least five days.

• For dietary needs, keep non-perishable, ostomy-friendly foods on hand with your emergency supplies.

• Disposable lanolin-free cleansing wipes are acceptable alternatives if you don’t have access to running

water. Keep them with your emergency supplies.

• Consider warming your ostomy wafers/pouches under your arm or in warm hands if your in a cold

environment when changing the appliance

• Keep a copy of your prescriptions, name and order numbers of your ostomy products, healthcare

provider contact information , and medical insurance information with your emergency/back up

supplies.

• Review your emergency preparedness plan with your family and friends. Having a support system in the

event of winter weather will give you additional peace of mind.

Have more questions about planning for winter weather? Or for any ostomy-related issues, call us at 410-773-

0300.

Colleen, Joan, and Sue

Adapted from ConvaTec publication 2017

Schedule Your Ostomy Consultation Today!

p. 410-773-0300 (x3) f. 410-773-0302

Austin Pharmacy & Medical Supplies Baltimore

6729 York Rd Towson

901 Dulaney Valley Hunt Valley

10757 York Rd

February2018 TheRamblingRosebud

4

PRESIDENT’SMESSAGE Nowthatwinterisover…Oops!That’snotforanothertwomonths.Withwhatwe,andtherestofthecountry,havebeenthroughforthepasttwoweeks,itseemsasifwintershouldbelonggone.However,wehaven’tevengottentoPunxsutawneyPhilyet.AsIwritethis,that’sstillthreeweeksaway.Ihopeyou’veheldupdespitetheharshcoldandbitterwinds.Formypart,IwasreadyforspringatthebeginningofNovember.

ThespeakerforthismonthisBrianS.Kahan,OD,oftheKahanCenterforPainManagementatAAMC.Inkeepingwiththetenorofthetimes,hewillbediscussingtheuseofmedicalcannabis,ormorecommonlymedicalmarijuana.Ifyouaresomeonewhoexperienceschronicpain,hispresentationshouldbeveryworthwhile.(WhenIspoketohimaboutbeingourspeaker,hesaidhewouldmostlikelyhavesomehandoutsforourmembersandguests,buthewasnotgoingtohavesamples.)

ManyofyourespondedtothecardwhichSandisentsolicitingyourinputonwaystoimproveourAssociation.Ifallgoeswell,we’llbeabletodiscusssomeofthepreliminaryreturnsattheFebruarymeeting.FromtheresultsofthefirstreportshesenttomembersoftheBoard,doctorsandnursesarethevastpreferenceforspeakersatourmeetings.

SeeyouareourmeetingonFebruary1st.Takecare.Staywarm.Besafe.

Stan

Items from this newsletter may be reprinted in other ostomy newsletters, provided proper credit is given as to source of material.

OSTOMY ADVISORS FOR STOMA HELP To consult with one of the ETs below, a physician’s referral is necessary and a fee will be charged. Call for an appointment.

BALTIMORE WASHINGTON HOSPITAL 410-787-4578

ANNE ARUNDEL MEDICAL CENTER Michelle Perkins, RN, BS, CWON

Jenn Davis, RN, BS, CWON Anne Fischer, RN, BS, CWON Joyce Onken, RN, BS, CWON

Sarah McClain, RN, BS, CWON Email ostomyRN@aahs.org

443-481-5508 / 443-481-5177 Private Consultants

Joan M. Sullivan, MAS, RN, CNA, CWOCN 410-932-7312

The Ostomy Nurses at Austin Pharmacy 410-773-0300

No referral necessary ($40 consultative fee)

UPCOMING MEETINGS February: Dr. Kahan, Pain Management March – Dr. Carol Tweed, Hematology & Oncology April - WOCN Presentation – Skin Management Rescheduled from January

THE MID-ATLANTIC’S LARGEST OSTOMY DEALER

We have a dedicated group of Ostomy Supply Service Professionals that are committed to keeping you in your active lifestyle. Northern Pharmacy and Medical Equipment has an attentive staff that cares about your quality of life. Make us your first step in getting back to life as it was meant to be. After all

“We’ve been here for over 75 years, there must be a reason!”

Our Ostomy Department provides a full range of comprehensive services and quality products from trusted brands you can rely on.

WE OFFER: x� Delivery anywhere in the United States x� Free delivery available x� Next day delivery is available x� Large inventory of ostomy & wound care

supplies in stock (we stock an inventory of over 5,000 boxes of supplies)

x� Customized hospital and clinic service plans available

x� In-house Medicare and insurance billing specialists

x� Personalized pharmacy/medical supply specialist available

x� Easy ordering by fax, phone, online, or in-person.

x� Toll Free 24 hour hotline x� Acceptance of all major credit cards

Northern Pharmacy and Medical Equipment 6701 Harford Rd, Baltimore, MD 21234 Harford Rd & Northern Parkway www.NorthernPharmacy.com

SPEAK DIRECTLY TO OUR OSTOMY SUPPLY MANAGER: AARON SACCO Phone: (410) 254 2055 x260 Fax: (443) 740 9297 woc@northernpharmacy.com

February2018 TheRamblingRosebud

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UROLITHIASISbyA.Trudeh,RNET,Lexington;viaWorcester(MA)NewDiversions

Urostomates, ileostomates and transversecolostomates have one thing in common:continuous output with a loss of fluids. If theliquid intakedoesnotexceedtheoutput, theseostomates may be dehydrating their bodies,making themselves prone to a condition called"urolithiasis," which refers to the presence ofstonesintheurinarysystem.

Thesestonesmaybe foundanywhere fromthekidney to the bladder. They vary in size frommeregranulardeposits,calledsandorgravel,tobladder stones the size of an orange. In themajority of stones, 90% are composed ofcalcium, with 5-8% uric acid and 1-3% cystineaccountingfortherest.

Conditions which predispose to stoneformation are: (1) infection, (2) periods ofimmobility, (3) concentrated urine, (4)abnormallyhighconcentrationofcalciumintheblood,(5)heredityand(6)dehydration.

If you were to develop urolithiasis, thesymptoms you may experience are: (1) lowbackpainand/orsevere,sharppaininthelowerback radiating to the groin; (2) chills, fever; (3)difficultyorburningwithurination; (4)blood intheurine;(5)nausea,vomitinganddiarrhea.Seeyourphysicianas soonaspossible if anyof theabovesymptomsappear.

Measurestopreventstoneformationare:drink2to3liters(quarts)offluiddaily--preferablywaterandjuices.Includeacidicjuicessuchascranberrytomaintainacidurinewhichhelpspreventinfection.Urinateduringthenightifnecessary.Exercisedaily.Usecautionwithfoodscontainingcalcium.Sinceacertainlevelofcalciumisrequiredforgoodhealth,restrictyourdietonlywiththeadviceofaphysician.

WhyDoesn’tMyTapeStayStuck?FromNorthCentralOklahomaOstomyOutlook&JacksonvilleFLMailbag:

Thisquestionisoftenaskedbecausenonstickingtapecanleadtosomeratherembarrassingsituations.Usuallyitisnotthefaultofthetapeitself.Manufacturersgenerallyproduceaprettyreliableproductthatdoesitsjob...providingthe“workingconditions”areproper.Andthereisthe“rub”–theworkingconditions!Herearesomenonos.

Moistureontheskin:Tapewillnotstickproperlyifthereismoistureontheskin.Afterwashing,drytheskinwithahairdryer—towelsmayleaveyourskindamp.

Insufficientapplicationpressure:Inordertostick,pressuremustbeapplied,particularlyattheedges.Water-solubleforeignmatterontheskin:Suchasresidualsoap,skinprep,driedperspirationormucus.Perspirationandmucusshouldbewashedoffwithwater.Ifwipedoff,athincoatingofdriedmatterisleftontheskin.Stomaloutputorperspirationwilldissolvethisfilmandunderminetheadhesive.

Touchingtheadhesivebeforeapplication:Moisture,skincellsandothermaterialtransferfromyourfingersandreduceadhesion.

Loosesolidparticlesontheskin:Suchaspowder,flakyskinoranoverabundanceofdeadskincells.Thebestremedyistostickdownandpeelofftapebeforeapplyingadressing,thusremovingtheloosematerial.

Subjectingtheadhesivebondtostressimmediatelyafteradressingisapplied:Ittakestimefortheadhesivetoflowintothemicroscopicirregularitiesoftheskinand

Happy Valentines Day

February2018 TheRamblingRosebud

7

develop100percentcontactandmaximumadhesion.

Stretchingoftheskinundertheadhesivearea:Adhesiveswillreleasewhenthesurfacetowhichtheyareattachedisstretched.Ifyourdressingalwayscomeslooseinthesameplace,chancesarethatyournormalbodymovementsarestretchingtheskinatthatpoint.Youmighttrytostabilizetheskinbyapplyingaone-inch(ormore)widetapebeyondtheedgeofthedressing.

Lowsurfaceenergyleveloftheskin:Adhesiveswillonlysticktosurfacesthathaveahighersurfaceenergylevelthantheadhesive.Averyhighlevelresultsinapermanentbond;nearlyequallevelsproduceaveryweakornobond.Oilsandwaxymaterials,includinglotions,mineraloilandmoisturizingsoaps,suchasDove,areabsorbedbytheskin,makingitniceandsoft,butalsoreducingthesurfaceenergyoftheskintoapointwherelittleornoadhesionresults.

Sometimesamoreaggressiveadhesiveisrequired:Thebandageorfoamtapesshouldbeusedinsuchcases.

Amajorityofallegedtapeadhesionproblemsarereallyduetophysicalskininjury:Theskinconsistsoftwolayers,theepidermis(outerlayer)andthedermis(innerlayer).Ifthetapeisplacedontheouterlayerwithtension,theconstantpullontheouterlayercancauseastraininthebondwiththelowerlayer,inducingirritationorcausinganactualseparation,formingblisters.Thesameeffectwillalsotakeplaceifswellingoccursafteranadhesivebackedpouchisinplace.Topreventthistypeofinjury,gentlyplacethetapewithouttensionandthenpressdownwithfirmrubbingmotion.

Skindamagemayalsobecausedbyrapidremovalofadhesivetapes.Ifyoupickupacornerofthetapeandpushtheskinawayfromtheadhesive,skintraumaisreduced

substantially.

Rednessoftheskinmayalsobecausedbychemicalirritantsthataretrappedbetweentheadhesiveandtheskin.Usuallytheirritantisresidualsoap(Ivoryisaknownoffender),skinprepsthatarenotcompletelydry,deodorants,antisepticsandotherouterskincoatingssuchaslotionsandsunscreens.

Chemicalsubstancesfromwithinthebodymayalsocauseirritation.Whenthesebyproductsaretrappedundernonporoustape,theincreasedconcentrationattheskinsurfacemaycauseaproblem.Anothercauseofskinirritationmaybesmallquantitiesofpouchcontentsontheskinthatarenotremoved.Theenzymespresentwithanileostomydonotknowthedifferencebetweenyouandapieceofsteak.Withaurostomy,alkaline(highpH)urinedoesthemostdamage.Certainfoods,suchascranberryjuice,maylowerthepHandminimizetheproblem.Ifskinprepisusedforprotection,besureitisnon-watersoluble.

Remember the person in the mirror has come through so much so be kind to yourself.

A.A.C.O.A. P.O. BOX 847 GAMBRILLS, MD 21054