"I Have to Have an Ostomy?"

Editor’s Note: This is part one of a two-part series on ostomy.

The Washington Center for Wound Healing and Hyperbaric Medicine is part of Washington Hospital Healthcare System here in Fremont. Their services include a comprehensive ostomy care program for patients living with an artificial opening in the body to divert stool or urine.

The United Ostomy Associations of America estimates that about 1 million people in the United States have an ostomy, which is a surgically created opening in the gastrointestinal tract or urinary system for patients with certain conditions.

General or colorectal surgeons create the opening, called a stoma, allowing urine or feces to leave the body and collect in an exterior pouch that the patient must empty and clean daily. Colostomy and ileostomy refer to openings in the colon and small intestine (ileum), while urostomy occurs in the urinary system.

“It’s very important to offer ostomy services,” says Thuy Vo, a nurse practitioner (NP) certified by the Wound, Ostomy, and Continence Nurses Society. “Especially because an ostomy is a complex surgical procedure, and patients may have complications and comorbidities.”

Most patients with ostomies have gastrointestinal or urinary cancer, inflammatory bowel disease, incontinence, birth defects, or other medical conditions that prevent the body’s normal processing of waste.

Comprehensive Care for Inpatients and Outpatients

Vo is one of two NPs working with a team of about five specialty nurses certified in ostomy care. NPs are advanced practice nurses who diagnose, treat, emphasize prevention, and help people better manage their health. The team provides care, education, and support for patients transitioning to home and moving forward, living with an ostomy. The ostomy team works both in the hospital and at the Washington Center for Wound Healing and Hyperbaric Medicine at 39141 Civic Center Drive.

“When a patient is having an upcoming scheduled surgery, the surgeon often sends them to see our team at the outpatient center so we can discuss their concerns, provide education, and tell them what to expect after surgery,” says Vo.

The team can also help determine the best location for a stoma incision. Since everyone is built differently and body types vary, height, weight, muscle, fitness level, and skin condition all play into this determination. The goal is to choose an optimal site that will reduce the risk of complications while considering the patient’s quality of life.

Having this type of surgery can be overwhelming for patients, so the team is supportive and reassuring. “People have a hard time with a stoma. It can be very depressing for people to wake up from surgery and see a hole in their abdomen. We ease patients into it and hold their hand. We’re there for counseling and education,” she adds.

For an inpatient who may have had emergency surgery, Vo and the team can help them understand the procedure. “It can be shocking to see a stoma,” she explains. “Not everyone is ready to look at it. We help them with that.”

Temporary Versus Permanent Surgery

For some patients, an ostomy might be temporary. Those who had an ostomy to allow their colon to heal, for example, can have the ostomy reversed when they’re fully recovered. But others, including people with cancer, severe cases of inflammatory bowel disease, and birth defects, might live their entire lives with an ostomy.

“One of the keys to living successfully with an ostomy is having a good attitude,” Vo continues. “This, along with understanding how to care for and maintain the pouch, is important.” The skin around the stoma, for example, is prone to infection and erosion and must be cared for properly. In addition to advising on care of the ostomy site, the team can help patients with diet, exercise, skin care, new products, psychosocial issues, intimacy, and more. “Patients can live normal, fulfilling lives,” she stresses.

The ostomy team is comprised of certified nurses who have special training in ostomy care. In addition, the NPs and nurses are certified in wound care, which includes treating hard-to-heal ulcers, diabetic and gunshot wounds, and other types of injuries.

The ostomy program is part of the hospital’s Wound Care and Hyperbaric Medicine services, including hyperbaric oxygen therapy, a simple but effective treatment providing patients with pure oxygen inside a pressurized chamber.

The outpatient wound clinic is open to patients Monday through Friday. The outpatient ostomy clinic is open on Fridays. “The service provides continuity of care until patients are independent with their care. We help them avoid complications, readmissions, and improve their quality of life,” says Vo.

For more information, contact the wound and ostomy clinics at 510.248.1520 or visit the website whhs.com/Wound.

Coming Next: A patient shares how her positive attitude—and family support—helped her through an ostomy.