I realised recently that it is a long time since I updated this blog. I am doing several posts today, to bring it up to date – each one will be dated as if I had done them at the time, to keep things in chronological order, but I am in fact writing them in early May.
The Ileostomy and Internal Pouch Support Group (IA), formerly known as the Ileostomy Association, of which I am a member, had its local AGM at Kennford in Devon on 5th March. These meetings are always good to attend because you get to meet up with others in the same situation, meet old friends and make new ones. There is always a good exchange of ideas and experiences, both informally, chatting over coffee and lunch, and through discussion in the more formal part of the meeting. They have a table where you can put unwanted supplies, and take whatever you need, and they have the usual raffle and sometimes a quiz. There is usually a visiting speaker.
On this occasion we had a colorectal surgeon from the Royal Devon and Exeter Hospital in Exeter, speaking about hernias. A parastomal hernia is a very common problem indeed with ostomates, particularly people with a colostomy, and especially if they are older, and overweight, and being a smoker puts one at greater risk – the incidence of parastomal hernias is quite high, because the abdominal muscle wall is compromised by cutting a hole through which the intestine is brought out to form the stoma. He spoke about the problems of repairing them and how the risk of recurrence is high, and other measures that can be taken to prevent them developing. Some surgeons are now inserting a mesh around the stoma when the stoma is first created, and while this does strengthen the weak point, if further surgery is required (for instance if the stoma is reversed, or there are further abdominal problems requiring surgery) the presence of the mesh makes it a lot more difficult to operate. He spoke about synthetic meshes and also the use of pigskin!
A hernia can develop even through a simple activity like coughing or sneezing! In order to prevent hernias developing one should avoid heavy lifting, and if one has a severe cough, support one’s abdomen when coughing. There are various support garments that can be worn as well, but he said that these are more useful after one has developed a hernia than in prevention, although my stoma nurse did refer me to a fitter of support garments as a preventative measure.
He spoke about the anatomy of the abdomen and the different muscles involved. He said that in recent years, surgeons have tended to site stomas more towards the midline than before, and this could help in hernia prevention over time; being sited more towards the side of the abdomen, the musculature is weaker and more likely to herniate.
He asked for a show of hands and quite a few people indicated that they had developed hernias.
In the morning we had the business part of the meeting – the AGM, with appointment of new officers, financial report, etc. etc. and details of future meetings, outings, presentations by manufacturers, etc. Lunch was provided, and tea and coffee.