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Going Home: Part I

Below you will find tips and suggestions on such topics as your emotions and talking with your children. We also will discuss important issues including pain, gas, diet, and fluids and hydration.

Your Emotions
Most people like to feel in control of their emotions. Yet, the physical and emotional stress of surgery can throw even the strongest person for a loop. Why? Because your body is responding to normal physiological change.

When the body is under stress, it produces a hormone to get us through the tough time. After a major stress—such as surgery—is over, the body abruptly turns off this hormone. This often makes us feel depressed and emotional. These feelings usually pass in a short period of time.

If you are feeling down, don't give in to depressive behavior such as sleeping all the time or just doing nothing. Instead, try to get up and move around. Sit in the sun; watch a funny movie, or talk to someone who makes you feel good.

Remember: People who care about you want to help. Let them know that one of the best ways that they can help you is by letting you talk about your feelings. And don't be afraid or too proud to ask for practical help such as shopping for groceries or running the vacuum cleaner. In a very real way, you will be helping your family and friends by giving them a way to offer you support.

Talking Helps
Talking to people with whom you feel comfortable is very important. Share your feelings with your family and friends. Many people tell us that sharing their experience made them closer with their family and friends.

Explaining Your Surgery to Your Children
If you have small children, you may wonder how to explain the surgery to them. Children tend to sense when we are trying to hide something from them. Their imaginations will think up situations much worse than they really are.

For most children, a simple explanation of why you needed surgery and how it will help you get better will satisfy them. Your family lifestyle and your own feelings will help you to decide whether or not to show them your ostomy.

Pain
By the time you are ready to go home, you will still be feeling some pain. To help control the pain, you will receive a prescription for pain medication when you are discharged from the hospital.

The pain should continue to lessen. As it does, you may want to use Extra Strength Tylenol instead of stronger pain pills. Aspirin and drugs like ibuprofen (i.e., Motrin) may cause stomach irritation and shouldn't be taken on an empty stomach.

Remember: Avoid alcoholic beverages when you are on pain medications, since they can cause the medicines to have a much stronger effect.

Gas
Unfortunately, most people suffer gas pain or cramps after surgery. This can last for several weeks. To relieve gas pain or cramps, you may try taking simethicone products such as Gas X or Phazyme, a gel cap that dissolves in the lower intestine. Beano, which is an enzyme, also helps some people. These are all non-prescription and are available in most drug and grocery stores.

Certain foods or liquids can cause gas. You may want to avoid the following:

Foods That Can Cause Gas   Beverages That Can Cause Gas
Dried beans
Broccoli
Corn
Hard cheeses
Mushrooms
Cauliflower
Spinach
Dairy products
Peas<
Cucumbers
Radishes
Onions

  Carbonated beverages
Beer
Milk

Other things that can cause gas formation include: poor fitting dentures, sucking on mints, smoking, straws, talking with your mouth full, lung diseases such as asthma or emphysema, or anything that causes you to swallow more.

Overeating and/or drinking too much liquid during a meal, can cause the stomach to empty early and increase the amount of gas caused by digestion.

Diet
When you first return home, you probably will not have much of an appetite. Though, in general, you will have no restrictions on your diet, you should be careful to introduce bulky fiber in your diet slowly.

In patients with an ileostomy, non-digestible dietary fiber can cause a food blockage in the lumen of the bowel near the abdominal wall or stoma. Foods to avoid include:

Foods That Can Cause A Blockage
Seeds
Nuts
Coconuts
Popcorn
Chinese vegetables
Food skins
Meat with casings (i.e., sausages)

  Raw mushrooms
Celery
Raw Carrots
Oranges
Broccoli
Cauliflower
Corn

Remember: It is usually best to begin eating slowly. Eat what you can, but don't force yourself to eat. And be sure to chew your food thoroughly.

Other Dietary Restrictions
If you had to restrict your diet prior to surgery because of diabetes, heart disease, high blood pressure, or other medical reasons, you will have to continue to do so after surgery.

Fluids and Hydration
You may have a tendency to dehydrate quickly. That's because fluids are absorbed in the colon. Without a colon, you must be careful to drink plenty of fluids such as water and Gatorade. You may find that you need to drink as much as 6 to 8 glasses of fluids a day to keep yourself adequately hydrated.

Additionally, most patients with ileal pouch anal anastomosis&mdash:who have a temporary ileostomy&mdash:need to take Lomotil or Imodium to avoid dehydration.

This is because the temporary ileostomy is about three feet upstream from where the pouch is sewn to the anal muscle. As a result, there is less bowel working to absorb fluids.

Both medications work about the same. (One Lomotil pill works similar to one Imodium capsule.) Most patients will need to take one to two tablets or capsules before meals and at bedtime. Your doctor will advise you on which medication is best for you.

Monitoring Hydration
A good indicator of your hydration status is the amount and color of the urine you pass.

  • You should be urinating 5 to 6 times a day, and the urine should be a light to mid-yellow.
  • If urine is odorous, deep yellow, and only small amounts, you should increase your fluid intake.

Remember: Nausea, vomiting, diarrhea and excessive sweating can also contribute to dehydration.

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