a guide through convalescence for ostomates

THE FIRST THREE MONTHS
It is important for you to re-commence your lifestyle as soon as possible after surgery. Convalescence after major surgery generally takes three months, though this can vary depending on your condition prior to having your operation and the type and severity of the surgery performed.

NUTRITION
Calorie demand for repair work following surgery is high and even gentle exercise like walking increases the body's demand for calories. High Calorie sports drinks are a useful and convenient way of obtaining calories quickly. In these early days you will need higher calorie foods to aid your

 

 


Drink plenty of fluid! This will help the healing process by keeping your skin well hydrated. Don't drink large amounts for at least one hour before meals as this will curb your appetite.
recovery.
Poor appetite is often a problem at first. You will no doubt have discussed any dietary restrictions while in hospital and know what foods, if any, to omit or take care with. Take small meals more often at first as your digestive system is sure to be feeling a little delicate. Gradually you will find that your appetite and capacity for normal sized meals is returning to normal.
ACTIVITY LEVELS
Take plenty of rest when you first go home - have an afternoon nap. You will get through the evening much better. Listen to your body - if you feel tired sit down for a little while. Many household tasks can be done sitting down anyway! Don't be tempted to try to overdo things at first! If you push yourself too hard your body will let you know in no uncertain terms.
Whilst you should always accept help from friends and relatives in the early weeks, try not to become too dependant.
EXERCISE
Take short walks to begin with but don't tire yourself out! Remember you have to walk back home. Taking along a friend or just varying your route will make walking more interesting. If your are walking alone let your nearest and dearest know your route.
Abdominal exercises should strengthen your muscles but do not attempt any abdominal exercises for at least six weeks after your surgery or until after your first post-operative check up. Always take advice from your surgeon, stoma care nurse or family doctor if you are contemplating specific exercises at this early stage.
DRIVING
Newer anaesthetic drugs may make it possible for you to drive soon after having a general anaesthetic. It is important for you to check with your anaethetist, surgeon, family doctor or Stoma Care Nurse and your own insurance policy as conditions may vary depending on the drugs used and your insurer.
Your reactions to an emergency situation could be slower than usual which may cause injury to yourself or other people. You could invalidate your motor insurance.
Making an emergency stop could cause pain and damage abdominal muscles not yet healed.
HOLIDAYS
You can be quite confident of being able to enjoy a holiday in the sun but do not be tempted to travel too far too soon. Give your body time to fully recover. It is best to get to know the effects of different foods on your shortened digestive system before venturing around the globe. Be patient and save the long aeroplane journey abroad for next year.
Comfort and a bit of luxury not far from home for a few days, with a partner or friend, will boost your confidence and probably be well deserved

THREE MONTHS AND BEYOND
Following the convalescent period you should feel well and confident enough to resume your chosen lifestyle. Depending on your age this could mean returning to work, running a busy home or living an active retirement.
Whichever lifestyle applies, your appearance will matter to you a great deal. Check the latest fashions in magazines and on television. The only restriction to what you wear is yourself. The more effort you put into your appearance now, the better you will feel and the more appealing you will be to others.

NUTRITION
At this stage you should be in control of your diet and understand different foods and how they affect you. Remember that exercise increases the body's demand for calories and therefore you should increase you food and fluid intake both before and after your exercise period. Eat at least 1.5 hours prior to exercise and 1 hour after exercise.

WALKING
Walking is an excellent exercise. Aim to walk every day if possible, gradually increasing the distance as you feel able. Check with your doctor before taking up more strenuous exercises such as sporting activities, gardening etc...

SWIMMING
Swimming is a very good way of improving your overall fitness. Ask your stoma care nurse if you have any anxieties about swimwear or concerns about the care of your appliance whilst swimming. If you can't swim you may like to take this opportunity to learn.

POSTURE
Try not to stand for prolonged periods but remember to maintain an upright posture when standing - do not 'slump' or 'slouch'.

LIFTING
Gradually increase the amount of activities you do. Should you need to lift remember to place your feet apart (one foot in front of the other), keep your back straight and bend your knees always keeping the object you are lifting close to you.
Try to avoid carrying heavy loads, as when shopping and wherever possible try to balance loads - instead of carrying 1 heavy bag divide your shopping between 2 bags, and carry 1 bag in each hand.


EXERCISE FOLLOWING ABDOMINAL SURGERY INVOLVING THE FORMATION OF A STOMA

As a result of the operation you have had, it is possible that your abdominal muscles have become weakened, resulting in poor posture, backache and a 'dragging' feeling in the lower part of your abdomen.
While you were in hospital you were probably taught some simple exercises by the ward physiotherapist, which would be beneficial to continue. If you were not taught any exercises, or have forgotten, don't worry its never to late to start!
Remember - always check with your surgeon or GP that he/she is happy for you to exercise. Do not exercise if you are feeling unwell or excessively tired.
Shown below are some very easy exercises you could do, if you wish, which should help to strengthen and tone your muscles. All these exercises should be comfortable to do. Try to repeat each exercise 10 times. Don't worry if you can't manage 10, just do as many as you can increasing the number as you get stronger.

If you should feel any discomfort or pain whilst doing the exercises stop exercising and consult your doctor if you are worried.

PELVIC TILTING
Lie on your back on a firm surface (a bed with a good mattress will be fine) with knees bent and feet flat on the bed. Pull your lower tummy in, tilt your bottom upwards slightly whilst pressing the middle of your back into the bed - try to breathe out as you are doing this and hold the position for two seconds. Let go slowly.


 KNEE ROLLING
Lie on your back on a firm surface (a bed with a good mattress will be fine) with knees bent and feet flat on the bed. Pull your lower tummy in. Keeping your knees together, slowly roll them from side to side. A little way at first, then gradually increasing as far as is comfortable.


HIP HITCHING
Lie flat on your back with your head on a pillow. Bend one knee up and keep the other straight. Pull your tummy in. With the leg that is straight and keeping it straight, draw up at the hip towards your armpit. Then stretch the leg down as far as you can. Do the same with the other leg.


LIFT AND TWIST
Lie on your back on a firm surface (a bed with a good mattress will be fine) with knees bent up and head on a pillow. Place both hands on the front of your right thigh. Lift your left shoulder and head towards the outside of your right knee. Hold for 3 seconds then slowly return to the starting position. Now do the same to the opposite side.


SUPPORT GARMENTS
A support belt or girdle is useful to wear during strenuous work, including gardening or Do-It-Yourself. Always ensure you use correct lifting methods.
Support garments will also ease the abdominal 'dragging' feeling sometimes experienced after surgery. Some people develop a hernia either at the operation site or around the stoma and this may cause discomfort. A support garment will help support any hernia temporarily until corrective surgery is performed or permanently if the surgeon does not advise surgery.
Recent advances in fabric technology means support garments no longer have to be heavy and cumbersome to be effective. Panty girdles, girdles (with or without suspenders) and belts created from beautiful lace, satin and damask are all available for ladies. There is also a wide selection of belts with soft cushioned elastic for men.

For a full range of support garments available on prescription click here

REMEMBER
This advice page is a general guide. You may have many more questions which need to be considered in returning to a healthy happy lifestyle. Your stoma care nurse is the key to the many professionals who are there to help you on the road to recovery. If you have any questions however small - don't hesitate - give her a call! She will be pleased to help you!

For further information...

BRITISH COLOSTOMY ASSOCIATION
15 Station Road
Reading
Berkshire
RG1 1LG
Tel 01189 391 537

UROSTOMY ASSOCIATION
Central Office
18 Foxglove Avenue
Uttoxeter Road
Staffordshire
ST14 8UN
Tel 0870 7707931
Fax 0870 7707932

ILEOSTOMY AND INTERNAL POUCH SUPPORT GROUP
P.O. Box 152
Scunthorpe
DN15 9YW
Tel 01724 720150

OstoMART Ltd would like to thank the following stoma care specialists...

France Pinches - Russels Hall Hospital, Dudley, West Midlands
Di Jones - Leeds General Infirmary, West Yorkshire
The Physiotherapy Department, Queens Medical Centre, Nottingham

...for their help in producing this information.

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