S4E3 Festive Complications Intro –Welcome to Stoma and Continence Conversations from Coloplast Professional. I'm Paul, Ostomy Care Education Manager here at Coloplast. As a specialist nurse, I know that stoma and bowel and bladder issues impact the lives of those that you care for. This podcast is here to support your educational needs and help you in supporting your patients. You'll hear from fellow healthcare professionals and experts by experience and discuss the latest hot topics in the world of stoma, continence care and specialist practice. This time… My first Christmas, I was a bit concerned about what I could eat because generally pre stoma Christmas I would've always been ill because you start eating rich food. You eat whatever you want, just try it in small portions and if it disagrees with you, don't eat it again. I absolutely love Christmas, but for an Ostomate there are just some issues that we face that other people might just take for granted. Paul – Hi, and welcome to this podcast episode. I'm Paul, and as always, I'm joined by my friend and colleague, the lovely. Hannah. Hannah, how are you? Hannah – Hello, Paul. I'm well. How are you? Paul – I'm not too bad. I'm not too bad. The reason Hannah's laughing is because it took me about three or four attempts to actually get this introduction for the podcast. So that is why Hannah has started with a giggle, and I think having a giggle and having a laugh, it kind of segways us in nicely to the topic of this podcast, which is the festive period and unfortunately some potential festive complications, some of the worries that Ostomates may have over the Christmas period, and how we can encourage the people we care for to enjoy Christmas and have a giggle and have a laugh over Christmas. We've been really privileged to talk to some of the Coloplast ambassadors and we've been asking them their thoughts, their feelings about Christmas. What I would like to do is jump straight into the first one, who is a lovely lady called Deirdre, and here's what Deidre had to say about Christmas. Deirdre - Well, I absolutely love Christmas, but for an Ostomate, there are some. There are just some issues that we face that other people might just take for granted. Such as, well say you're going to Christmas parties, you know, there's lots of, um, Christmas outings and different festive do's going on and things. And, you know, everyone's sort of saying, oh, “What are you gonna wear? What are you gonna wear?” and stuff. And I love my fashion and style. So one of the challenges for me has been sort of like, you know, dressing over the festive period and what underwear I could wear and what products are gonna give me that confidence and the security. And on my page I love to share, you know, fashion ideas and that would be one of the issues that I've come across. I have fun with trying different things and seeing what works with my stoma bag and what works with my new body image. Also, I would say everyone loves a Christmas dinner, so, my Mom is very good and she makes me a separate stuffing with no onions in it, because you can face issues like ballooning and things like that with your stoma bag. You want to enjoy the festive season as much as anyone else, but just having small little considerations such as, you know, things with your diet or what you could maybe change up just to give you a more comfortable day and enjoy the festivities, but also, you know, minimising risks of leaks or anything like that. So they’re are a couple of the issues that I would kind of find over the festive period. Hannah - So what I really like there was Deidre talking about some of the different issues that she can face over the festive period. She mentioned a lot about body image, which certainly is something that concerns a lot of Ostomates over the festive period with… you might be wearing some different clothes, as Deidre mentioned, going out to parties and I can certainly say myself I like to put a bit of a sparkly number on over the festive period. I don’t know if you do Paul, maybe? *laughs* Paul - *laughs* Occasionally, but yeah, not too often. Hannah - And then she also spoke about diet and, onions are something that quite frequently pop up as an issue for ostomates and onions and blockages and things like that. And with blockages come other issues as well, such as leakages. Paul - I think that's it. And I think that kind of comes kind of hand in hand when I listen to Deidre’s it was you know, she was talking about and making sure she had products too, that she felt confident with. Because as we both know, the vast majority of ostomates either worry, you know, worry about leakage to a higher or lesser extent and there's this always constant, this burden of leakage and the burden of the worry of leakage. I dunno about you Hannah, but I know that, you know, for me, Christmas, my weight always goes up. Hannah - Oh yes! Paul - And of course obviously as we know, if somebody's weight goes up, their stoma can change size and shape, their body profile can change. So it really is important to, when you are talking about the Christmas period with your patients, is to actually just highlight that potentially, you know, if they do put on some weight over Christmas, if they do experience any base plate soiling, so leakage, it's really important for them to keep monitoring the size of the stoma and potentially if they do put on some weight, they may need their base plate altering according to their body profile assessment. So it's not all about diet, even though that does play a major part. It's that other thing as well of just encouraging and empowering your patient to monitor their stoma, to monitor the size of their stoma, to make sure that they're cutting remains correct throughout the entire festive period. Hannah - Another thing that Deirdre did mention, obviously she mentioned the parties, which kind of leads us on to the next gentleman I want to bring in. Cause along with parties, we all know comes alcohol. And Kev here actually talks to us a little bit about alcohol Kev - First Christmas was probably about three months after I got out I think. It actually was better than most Christmases had been previous few years in terms of the food and all that sort of thing. It was a, it was a tough year cuz we lost my Dad when I was in hospital as well. So it was the first year without him. So we all got family together. But in terms of the food side of it, I'd not been able to eat turkey for about 10 years previously. That was one of the things, for whatever reason, set my colitis off. So I actually had a turkey Christmas dinner. I kind of ate everything that I would've eaten before, and more! Usual sort of thing, made sure I chewed it properly, made sure that I was a little bit sensible. We were at home. I actually cooked the dinner so it was in a comfortable environment where I knew I was gonna be okay whatever happened. You obviously met my brother as well, and you'll know his sense of humor that he felt that because I got the stoma, I couldn't get drunk because it would go through me quickly and he tried to put it to the test like Christmas. So I really just sort of worked on the basis that I was going to pretty much do whatever I could in terms of a normal Christmas and touchwood, I was fantastic. It worked really well. We ate, we had a few drinks, we did whatever we would normally have done and touchwood to this day, I've never had an issue over Christmas in terms of food blockages, anything like that. Paul - I think that's a really, really positive discussion from Kev there. And obviously we do have to say being drinkware and, you know, binge drinking is never good. It's not good for your health, etc. But as Kev said there, you know, he still was able to have that drink over Christmas and participate in Christmases like he always has done. Obviously, depending on where somebody is in their treatment journey with a stoma as well obviously we do have to take into account medication, so again, that is down to the individual and their care process as well. But obviously it's that thing of explaining to your patients and explaining to ostomates that, you know, if they do have a little bit too much alcohol, they still have to be able to manage their own stoma as well so it's bearing that in mind. It sounds, it sounds quite normal and you're thinking, well that’s pretty obvious. But, as I say, I'm sure Hannah's had experiences of, well, especially with the more younger ostomates, that it's reminding them that, you know, you do have to still be able to manage your own stoma afterwards. Hannah - I used to set reminders on my phone. Paul - And you see it's those little hints and tips that I think it's vitally important that we remember. It's that thing of, cause I never thought of doing that, setting a reminder every hour on your phone, going “empty your bag”, you know, before you go out. Setting those reminders on your phone and potentially setting the alarm in the morning to make sure you get up and so you can get up and empty the bag if needed as well. So that's really, really important there as well. What was your kind of thoughts on Kev. Hannah - I absolutely loved the fact he said he was able to have his first turkey dinner in years. As a great lover of the turkey dinner at Christmas, that filled my heart with joy! The thought of not being able to have a Christmas turkey dinner, and I can just imagine that every mouthful of that dinner was the best one ever! Even if he had to cook it, which I think is a bit mean actually! *laughs* poor Kev being put in the kitchen, first turkey dinner in years and being put in the kitchen to cook it! But, I see that that was such a positive message for me that a lot of Ostomates, that first Christmas is actually a really positive experience for them. It's not necessarily a negative experience, and that actually those first Christmases can often be better than the ones before it. Paul - Yeah, no, and I completely agree. And as we know, everybody's journey is different and you know, that kind of, you know, Kev, and yourself talking about turkey, that kind of leads us on to another one of our ambassadors, Chris. And this is what Chris had to say. Chris - I don't restrict my diet. The colorectal nurse, when I first had my consultation, when she came to visit me one day, I had received a sheet from a, a dietician to say “you can't eat this, you can't eat that. You can't, you know, you can't eat peanuts anymore. You can't eat coconut anymore”. And I said to her, look, what's the crack here? And she looked the leaflet and she tore it up and she put it in the bin and she says, you eat whatever you want. She says, try it in small portions. And if it disagrees with you, don't eat it again. And so, and that's the way I do things. You know, Paul, if, if there's new foods, try them, try them in small portions. And then if it causes you a problem, don't eat it again. If it doesn't, then you know, love life and, and enjoy it. And, you know, that's the advice I would give to people trying new foods at Christmas. Hannah - Another real bit of positivity, I thought from Chris there talking about being able to try foods, and again, not necessarily having to restrict yourself. Also, really interesting thing. I thought there was actually, you can get quite a lot of conflicting information. And you're very new with a stoma it's that one person tells you one thing, one person tells you another thing. So along with the positivity, it can actually become quite confusing actually as well when you hear all this conflicting information. I dunno if you found that as well, Paul? Paul - Yeah. One, of the biggest things, you know, when I used to, you know, have my clinics and that sort of thing, obviously, during the post-op period we'd be, you know, and the pre-op period as well if you were able to counsel someone before surgery. You know, you talk diet. You talk about diet and function and if you go, you know, and lots of people do use Dr. Google and I am an advocate of Ostomates going on and looking online and looking at forums and that sort of thing. But if you go onto all of these different, however you're looking at, you know, getting your information from, there's so many things. They're saying, you can't eat this, you can't eat that, you can't drink this, you can't drink the other. By the time you go through all of those different food stuffs, you know, really the only thing your patient can eat is dust and drink water. You know, it's, you know, that's almost how it appears to a lot of people. I think Chris put it there and Chris's nurse put it there absolutely brilliantly. Everybody is individual and… try it, try it once. Try it in a small amount, slowly introduce things. Introduce things one at a time. Don't introduce multiple things all at the same time because, if you do have a problem, obviously they don't, people don't know what, what it was that actually caused that problem. So introduce things slowly, one at a time. And as Chris said, you know, it's that, try it if anything happens. Potentially you can say, well, do you know what, no, that, that just doesn't suit me. Some people will try it again three months later and don't have a problem with it. Some people try it three months later and they might have a high output or they might become constipated, etc, and they might say, do you know what it's not worth it, but you know, I can eat everything else. I just can't eat that one thing. They can actually, you know, enjoy the Christmas and the Christmas periods completely. And one of the things that always reminds me of is two patients that had, one of them is actually Kev, cause I know that Kev does have a very, very broad and varied diet and he eats a lot of things. Is I think we've all got those patients where they can eat almost whatever they like, all the no-nos they do eat. I remember I had this one lovely, lovely lady, who, if she even looked at an apple peel, she'd be admitted with an obstruction, you know, bless her, her diet was so restricted, but there's everybody in between as well. And I think it's, you know, it's encouraging that positive attitude towards food and, and not being negative about it. Hannah - I absolutely agree. I think a lot of people are put on almost on that negative thought of food before they've even tried anything. And actually that leads us onto our final ambassador, Kathleen, who has also got a really good bit of advice when trying new foods and introducing them into your diet. So here's Kathleen. Kathleen - I would say straight away, it was a better Christmas because my whole life is better since my stoma. But my first Christmas, I was a bit concerned about what I could eat because generally pre stoma, at Christmas, I would've always been ill because you start eating rich food and more food. So you know, but so post stoma at my first Christmas, I was a bit scared about what I could eat and, you know, I might not have had raisons, i've also been told, oh, you mustn't eat raisons. So that knocks out dumpling! Or Christmas pudding, mince meat pies, Christmas cake - I love all these things. I denied myself that just in case. And then always, again, not eating too much. But now I eat, I love Christmas cake and mince meat pies and dumpling. What I would say to anybody is try it. Don't go for a big plateful first, but try it and chew properly. I think that might be the thing. We have to be aware that maybe our life is slightly different. Our plumbings are a bit different, so take care of it and chew properly, and I think when you're a child, you were told to chew your food, so just chew things. Maybe don't spend too long in a hot tub! But! You can still go in the hot tub! Paul - I have to admit that both Hannah and I probably haven't laughed as much as we did laugh when we were talking to Kathleen. She was an absolute star And, if she's in the hot tub at Christmas, I want to go and spend Christmas with Kathleen! She was an absolute star. She is a lovely, lovely lady, but she kind of echoes what Chris said, didn't she Hannah in relation to just trying stuff, you know, that she kind of denied her first Christmas. But after that she just tried things and I said she's now living life, in a hot tub. I can, I'm just picturing Kathleen in a hot tub eating a mince pie! Hannah – Strangely enough I was actually picturing a hot tub eating Christmas cake, so we were kind of on the same line there a bit! Making sure she chewed it very, very well! Paul - Exactly. I think that's it. And I think the biggest message I had from Kathleen's was it's the chew it. Chew it, chew it, chew it, and chew it again. I always used to say two things, two bits of advice when it came to diet with the people I was looking after, which is chew, chew, chew it again, when you think you've chewed it enough just chew it one more time. And if it's difficult to chew, it's difficult to poo! And a lot of Ostomates quite like that last one because it kind of, it does just make sense, you know, if your teeth can't break it down and you're chewing it for ages, it probably is gonna cause you some problems as well. So, you know, obviously there are those times and we do have to give ethical evidence based, information to Ostomates because we know that pulses can be difficult to digest. Things like your peas, your sweet corn, your nuts, your seeds, your mushrooms. You had some issues with mushrooms, didn't you, Hannah? Hannah - Oh yes! Mushrooms were, were my faux shall say during stoma times, but I had no issues with things like onions. Onions were absolutely fine with me. I was able to eat skins on apples, things like that. It was really only mushrooms that were my, I say they were like my nemesis, my kryptonite. Paul - And that's it. And as we all know, every single individual with a stoma is different. They'll have different problems, different worries, different concerns. And I think from all of the ambassadors that we spoke to and have participated in this podcast, I think the thing that most resonates with me is the positivity that they all put across about Christmas and the openness to say that - Yeah, do you know what complications can happen, but do you know what it's about living life and you know, living life with a stoma and living it to the extremes and living it as much as they want to. Hannah - Absolutely. And that's what it's about with your stoma. You are living your life with the stoma, not the stoma living your life. It's, you can still, as all of our ambassadors have shown, live a normal, happy, and healthy life with a stoma. So thank you to all of them for spending that bit of time with us and talking about their Christmas experiences. Paul - Yeah, just from my point to echo that, thank you to all the ambassadors who did take part. And there is some information as always on the Coloplast Professional website and the link for that is in the podcast description. We do have lots of information on there, so you've actually got a whole diet section on the website, but also you can download the Safe Digital Resources there as well, which I know is incredibly well received by both nurses and Ostomates alike. And that goes onto a little bit about Dr. Google. I know that lots of people are worried about Dr. Google. But in this instance, the Safe Digital Resources directs people and Ostomates to resources that we know are safe and give proper appropriate advice. I mean, there are some Christmas bits in there as well, so please log on to www.coloplastprofessional.co.uk you can register for all of our educational updates. And there's loads information on all of validated tools, I mentioned body profile assessment earlier as well that is on there. So from myself and from Hannah, we'd just like to wish everybody a very happy and safe festive period. And we will speak to you soon. Thank you. Hannah - Merry Christmas everyone. Outro - Stoma and Continence Conversations is brought to you by Coloplast Professional. To learn more, visit www.coloplastprofessional.co.uk