After Ostomy Surgery: The Work Begins

The patient’s real work begins after ostomy surgery ends and the recov­ery process begins. Over the next days, weeks, and months, you will work to heal, to strengthen your body, and to care for your stoma. How­ever, not all of your work will be phys­i­cal. Just as you have to deal with phys­i­cal changes and phys­i­cal heal­ing dur­ing the recov­ery process, you also have to deal with self con­cept changes and emo­tional healing.

In the Hospital

Dur­ing the first few days after surgery, your body will start the heal­ing process. You will prob­a­bly con­tinue to receive pain med­ica­tion through the IV. You will sit up in bed and even take short walks as soon as pos­si­ble, because move­ment helps to get the bow­els mov­ing again. Once the doc­tor hears bowel sounds and the stoma begins to func­tion, you may be able to begin eat­ing clear liq­uids such as broth and juice. After your body accepts clear liq­uids, you will begin to add other liq­uids and solid food.

Bar­ring com­pli­ca­tions, your hos­pi­tal stay should last about a week. While in the hos­pi­tal, you will prob­a­bly also receive instruc­tions about stoma care, how to change the pouch, and how to care for your body as you heal from surgery. This instruc­tion should also include infor­ma­tion about where to pur­chase med­ical supplies.

Recov­ery at Home

Your work con­tin­ues once you’re home—but you get to con­tinue the recov­ery process sur­rounded by your friends, fam­ily, and your own things! Expect this phase of recov­ery to take about six weeks. When you return home, there are a few things you need to remember:

• Con­tinue to fol­low your doctor’s instruc­tions. Walk­ing, exer­cises, med­ica­tions, appro­pri­ate diet, and follow-up vis­its are all cru­cial to full recov­ery, so keep them up!
• Remem­ber that your pri­mary respon­si­bil­ity is recov­ery. Don’t let “real life” dis­tract you from tak­ing care of yourself.
• Your activ­ity will be restricted at first—but at home, it’s easy to “cheat” and try to do more than your body is ready to do. Fol­low your doctor’s instruc­tions and avoid heavy lift­ing, house­work, dri­ving, and other stren­u­ous activ­ity until you receive a med­ical okay. Remem­ber: push­ing too hard before your body is ready can injure your heal­ing wounds and lengthen your recovery.

Dur­ing your first few weeks at home, you will learn more about your stoma and its care. You will need to keep the skin around the stoma clean. You will need to watch for skin irri­ta­tions, which can be caused if diges­tive con­tents leak onto the skin. You will prac­tice chang­ing the pouch, pos­si­bly with the help of your nurse. Con­tact your physi­cian or ET nurse with any ques­tions or con­cerns about stoma care.

Find­ing Support

In the midst of all the phys­i­cal changes you face after ostomy surgery, it’s easy to for­get that you also need to deal with major self con­cept changes. Phys­i­cally, ostomy surgery does not inter­fere with the abil­ity to enjoy sat­is­fy­ing social inter­ac­tions. Phys­i­cally, ostomy surgery does not inter­fere with the abil­ity to have ful­fill­ing sex­ual rela­tion­ships. But a person’s social and sex­ual lives are heav­ily influ­enced by his or her self-concept—so deal­ing self-concept changes is a crit­i­cal part of the heal­ing process.

Your doc­tor will prob­a­bly send you home with check­lists of things to do (walk, do your exer­cises, take your med­ica­tions) and not to do (heavy lift­ing, house­work, dri­ving.) Unfor­tu­nately, no sim­ple check­list exists for “deal­ing with self-concept changes.” So how do you heal emo­tion­ally as well as physically?

1. Find an ostomy sup­port group. This is prob­a­bly the sin­gle best thing you can do to help your­self heal emo­tion­ally. An ostomy sup­port group can pro­vide answers to your prac­ti­cal ques­tions, reas­sur­ance when the going gets tough, and true under­stand­ing of what you are expe­ri­enc­ing. An ostomy sup­port group can help you con­nect with oth­ers who have faced—and conquered—the prob­lems you’re fac­ing. You can find both local and online sup­port groups through the United Ostomy Asso­ci­a­tions of Amer­ica, Inc. (www.uoaa.org.)

2. Rec­og­nize that grief is a nor­mal reac­tion to any loss—including sur­gi­cal losses. Accept and express nor­mal grief emo­tions such as sad­ness, fear, anger, and denial. Allow your­self to cry, to get angry and pound your pil­low, to jour­nal about your fears, because these things help you to work through the emo­tions rather than get­ting stuck in them.

3. Edu­cate your­self about the phases of recov­ery most patients go through after a seri­ous acci­dent or ill­ness: shock, denial, acknowl­edg­ment, and adap­ta­tion. Dif­fer­ent peo­ple go through these phases in dif­fer­ent orders and at dif­fer­ent rates. Under­stand­ing the phases of emo­tional recov­ery will help you to under­stand that your feel­ings are nor­mal and that you can get through them.

If you remem­ber to accept your feel­ings, take care of your­self, and con­nect with oth­ers, you will progress toward emo­tional heal­ing. Most impor­tant, know that you aren’t alone.