October 2006 Archives

Your help is needed! Do you know the name and designer of this doily? I've seen it before and don't know where to find it. If you know help me out of my misery! Thank you!

O.k. I'll ask about the sex. Is there any position you have to avoid? Have you found any creative way to get around any position limitation that has turned out to be even more fun? :) ~ Joy

There are a few things about sex that are minor details. Such as, I empty my bag just before sex because a full bag is not very sexy. Plus a full bag could snap off or get in the way, and I don't want to think about having a full bag empty its contents during an intimate moment.

Positions have actually become unlimited since my pucker has been shut down. OK, that has been poorly worded, but prior to it becoming a dead end, I was having a lot of internal pain and external abscesses, so only a few positions felt comfortable. With all of that being cleared up, I'm more free ;-)

I can't speak on this from experience, but apparently men can experience some sexual dysfunction as a result of the surgeries, most involving erectile issues.

The bag does make noise during sex, an annoying rustling sound. I'm sure I could reduce or eliminate the noise by wearing a bag cover which comes in satin lace designs for intimate moments. I'm too lazy or cheap or both to acquire a bag cover. Pooky and I don't stare at my bag when I'm naked so it hasn't been an issue between us. :-)

I solicited your questions about what you'd like to know in regarding to what it is like to have an ileostomy, or something like that. I'm still interested in receiving your questions, so post in the comments or send them to me via e-mail.

The following questions come from Noricum, Sock Maven and Shrone Extraordinaire.

1. Do you still have an, um, butthole?
The simple answer is not so simple. I still have what I call "my pucker". My anus is still there, only it doesn't go anywhere. I still have enough muscle left to flex the sphinter. Now, why the surgeon left my pucker behind is a mystery to me. When I talked to other ostomates I was told by one person that she was left "smooth like a Barbie doll" and referred to herself as having a "Barbie butt".

2. How much of your intestines did they remove? Does that affect the shape of your stomach?
All of my colon has been removed. A portion of my ileum (which is the last of the three segments of the small intestine) has also been removed. I do not know how much of my ileum has been removed; however, I do know that the doctor had to remove 8-10 inches during my second surgery of last year.

The shape of my stomach hasn't changed due to less guts inside, but it has changed in shape because I have gained about 15 pounds since my surgery.

3. How does your bag attach? Is there something at the opening for it to attach to? What's the interface between "you" and the bag related bits?
My bag is a two piece system. A flange or wafer is glued to my body with a special ostomy paste. The bag then snaps and locks onto the wafer. The bag has a "tail" which is opened up to allow the bag to drain. I use a bag that has a Velcro closure to make sure it stays closed. The old-fashioned kind of bag used a clip that didn't feel very secure.

The flange/wafer has its own sticky adhesive, but this isn't a very reliable method of attachment. I prep my skin with a protective barrier which is a mild adhesive and kind of like a liquid bandage. The stoma paste helps to protect my skin around the stoma while also sealing the wafer to my body.

4. What are the psychological issues with having your body rearranged like that? How do you feel?
For awhile I was concerned that I wouldn't be able to wear the style of clothing that I prefer, but much of that was solved when I made sure my stoma was placed lower than my previous ones from 1990 and 1995. This made all the difference. I do get a little self-conscious if my bag gets too full in public as I think all eyes are on me, and I have a concern about my bag popping off if I let it get too full (which has happened at home).

Most of the time, about 99%, I don't feel different, and in fact I feel better since having the bag as I'm no longer in constant rectal pain, having to run to the bathroom, or having those issues I dealt with while I still had a functional "pucker". If I eat too much I do feel more bloated than usual and still am not used to the sudden output.

5. Do you think people who haven't been told can tell you have an ileostomy? How do you feel about that?
My assumption is that people don't know. I haven't told anyone at my internship site, just because it hasn't been relevant. I've shared my story at graduate school, just because the environment is right, and sharing it was appropriate and had meaning for me and my classmates.

If people found out about it, I would be open to explaining and answering their questions. I consider myself an ambassador of the bag, as I think it is important to let people know that life isn't all that unusual to wear a bag.

6. How does it affect absorption of nutrients, and whatever else it is that your gut does?
I was concerned at first that I wouldn't get enough nutrition, but appaently I am since I have maintained my weight of over 140 since earlier this year, and I've crept up to 145 and above over the last couple of months. I can dehydrate more easily, so I make sure I drink fluids. My electrolytes can unbalance easily, so I salt just about everything and sometimes take a potassium supplement. I take vitamins just to make sure I get the important stuff as my diet is pretty limited to processed foods, meat, and easily digested stuff.

Vegetables and fruits in the raw are impossible for me to digest. Dried fruits are lethal as they can cause a blockage. I can eat salad in a small amount, along with corn, but I really need to make sure I limit these as they can stop up my bowels. Cooked veggies in a soup pass through without problems--the more cooked the better I am at processing them. Nuts can be rough, so I limit how much I eat of those, and shredded coconut can bunch up.

This might be sharing too much information, but what comes out of me is all liquid. There are times where the liquid is thicker, like if I eat a lot of potato, cheese, or bread. The thickness is like a tomato puree. The only time I have solid particles is when I eat something like corn, carrot, or nuts—all items that haven't been broken down through digestion.

7. What are the most annoying things about having a bag?
There is an itch that can develop around the stoma that can't be scratched. I can rub it gently, but it isn't something that should be dug into as it would losen the wafer.

The odor is annoying, especially if my bag is getting old, just before I need to change it. I'm the only one who can smell it and it isn't pretty.

Having leaks are annoying, especially when I wake up to them. Having to change my bag in public is the most annoying and I make sure my bag is fully functional so I don't need to do the emergency change in a bathroom stall somewhere.

8. Do people ask annoying/stupid questions? (Are any of these annoying/stupid?)
I haven't been asked any stupid/annoying questions yet. Most people who have asked pose very intelligent, yet extremely curious questions. Sex and body image are commonly asked questions.

9. Do people make annoying/stupid assumptions?
Not that I've encountered—exactly. I had to prove to my school that I was healthy enough and capable of handling my internship, school, and life in general as they had concerns my health wasn't stable. I'm not sure if that was because of my surgical complications or because they assumed having an ileostomy meant I should become a recluse. They weren't too happy with my dietary restrictions and wanted to make it out to be that I wasn't totally healthy as my doctor claimed me to be.

I do have certain health risks that I can manage, such as avoiding those foods that cause bowel obstructions. I make sure I keep my skin clean and attend to irritations immediately so they don't become infected or worsen. I make sure I keep myself hydrated and balance my electrolytes, and so on.

10. What effect has having an ileostomy had on your life? (Health, school, etc.)
I don't spend as much time on the toilet. Draining my pouch is like going pee. My bag typically fills up after meals, so I empty it no less than 3 times per day, but I don't know what my maximum is.

I change my bag every 3-4 days. What this means is I take off wafer and bag, remove all adhesives and clean my skin around the stoma. I then do my routine inspection to make sure everything looks as it should look. I then apply a fresh bag. Changing my bag takes about 15 minutes or less, depending on if my stoma is in a leaky mood.

My biggest physical limitation now is overcoming the 3 months of being bed ridden due to the surgical complications of last year and how that took a toll on my muscles and endurance. Little by little I am coming back to being active, regaining my lost strength. It's been a slow but steady process of doing a little more each day, or at least trying to.

There are a few things that I have to be aware of if I am going out for awhile or away from home. I have to make sure I take enough supplies with me. I've gotten a good routine established with that and have felt comfortable with changing my bag while staying in a hotel room. It's not the same set-up I have at home, but it works well for me.

I was annoyed when I recently flew back to Pennsylvania, how the Seattle airport was super friendly and accommodating of my ostomy supplies, and then Philadelphia was totally by the rules and wasn't going to allow any liquids. I've since learned I need to have my doctor write that I medically require my stuff—which to me is such a violation of my civil rights and freedoms that I have to share and prove my medical condition with total strangers—and this could easily turn into a rant about all of that, so I'll just leave it at that.

Anyone else have questions? What do you want to know about sex and ostomies?

Thirteen Curious Thoughts This week I just have a bunch of curious thoughts that don't fit one particular topic, so I'd like to think of this list as cleaning out my mental lint trap. I recently realized that Bugs Bunny is no longer part of the cartoon programming kids grow up with. I believe the argument was that Bugs was criticized for being too violent—due in part to Elmer Fudd always wanting to shoot Bugs—and people were concerned kids would want to go on shooting rampages. I guess that explains why school shootings have increased since Bugs no longer is part of a child's cartoon watching experience. Recently Dove released a video showing that a typical looking woman can be transformed into a supermodel. I have two thoughts on this. One, I'd like to undergo that kind of beauty treatment just to see how I'd look. Second, I hope that no one on TV wants to go au naturel. Imagine what our favorite celebrities would look like without all of that perfecting make-up. As I progress in my internship and hear what parents say about what's going on in schools, it sounds like the schools are setting up an environment for children to be diagnosed and considered ADD or ADHD. I wonder just how many kids are being given this diagnosis/label unnecessarily? I've discovered the joy of casserole and crockpot cooking. Canned soup, meat, cheese,frozen hash browns, canned mixed vegetables, and French fried onions can create endless tasty combinations. There's just 59 days until Christmas. I saw the countdown posted at Wal-Mart on Monday. I prefer to celebrate Yule. I bought Pooky this nifty versatile combination panini/indoor grill/griddle for his birthday. OK, this seems more like gift for me. Well, the story goes is that for my birthday I bought him a wide-slot toaster that fits bagels. He said he likes panini sandwiches, so now I can cook two at once, make pancakes, and even grill hamburgers! It's official: we now own both of our cars! What would you most like to know what it is like to have an ileostomy? Please feel free to ask your question in the comments, or send me an e-mail. The reason I am asking this is I am planning on giving a presentation at Module in January and want to get an idea of what people would like to know. I'm thinking it's going to be time very soon for me to get to a Fuddrucker's and enjoy a delicious meaty burger. I ordered the yarn today to make two different Aran sweaters from the two Crocheted Aran Sweater pattern books I got for my birthday. The colors I got are Amethyst Heatherand and Sapphire Heather. I've just finished reading my 42nd book out of my 50 Book Challenge! The locals are bitching that Seattle's new tourism slogan, Metronatural is stupid. It reminds me of Volkswagen's Fahrvergnügen. What did that mean? The most trick-or-treaters I've gotten is about 80. I still haven't bought all of the candy I need. Last year it rained and we had a ton left to eat. I'd better check the forecast before I buy any candy.

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I was looking in an old notebook, the small kind I keep at my desk and fill full of little bits of information, perhaps a recipe, phone messages, odds and ends. In the midst of the grocery lists and things to-do, I found this poem I wrote based upon a dream I had:

We have traveled
this journey
outside the fence
around the house.
The gate is swung open
inviting the weary
traveller in.
Pass through,
walk up the steps
and knock on
the door.
Welcome.
At last you've come home.

I've been so delayed in posting this, that I am thankful that Trish has been patient with me! My original swap partner for the C'Ville Doily Swap had some technical difficulties so Trish was re-assigned to me at the very end. She then made for me this very special Halloween themed doily!

I'm going to proudly display it each Halloween along with my other decorations as it is very spider-y looking!

Thank you Trish for making me a very special doily!

Earlier this week I received a reveal box from my Secret Pal, KnicKnac! She totally blew me away with gifts not only for me, but some golfer's accessories for Pooky, and crocheted cat toys stuffed with catnip for the beasties! Before I could open the box the beasties were sniffing the box and as soon as I opened it, Mr. Doo planted himself inside of the box and started digging to get at the cat toys!

Then once the toys were released from the box each kitty took to the toys with great wreckless abandon!

The sweater KnicKnac crocheted for me is adorned with adorable cat buttons, and the colors are a grape purple with black—total Shrone colors! It's a little on the large size but will make for a great around the house jacket to keep me warm and snug and comfortable during those soon-to-arrive winter days in which I can't feel my toes.

Not pictured is a bag filled with candy! The reason it isn't pictured is that Pooky broke into the chocolate. There is also a box of gummies which will be all for me since Pooky isn't a gummie candy person.

KnicKnac has been such a marvelous pal, even though I knew who she was. She pretended to be secret just the same, and she solicited information from Smee about a variety of things to make sure that what she sent would make everyone at the Shrone Home happy.

We've hit off so well that I asked KnicKnac if she'd like to become co-coordinator of the Secret Pal swap with me and Anna. She's agreed so for the 2007 season of SP there will be the three of us!

Yesterday was my first pro-sem meeting in which I and my fellow classmates gather to discuss how our internships are going and show video clips from our sessions that reveal our snags, successes, and topics of question and discussion. My first presentation will be on November 30th, so I have until then to find an agreeable family willing to be taped and given the extra attention that comes with being selected as a case study.

What was completely *evil* was that the commute to Seattle was 2½ hours. I suppose it was more evil because I was tired, and haven't endured traffic in many months. I do not regret giving myself 3 hours to arrive. The drive home was unpleasant as I ate something that cause my bag to rapidly fill up. I was so tired I resisted pulling off to find a clean, safe bathroom. I did have to stop for gas on the way home, and reached my point of absolute fah-tee-gue (fatigue) where I didn't care if my bag snapped off. I just wanted to get home and collapse into a deep 20 year sleep.

When Pooky arrived home just 10 minutes after I did, his stomach alarm went off. I wish feeding him was easy like the cats. Open can of tuna, shake out onto a plate. Watch kitties inhale tuna. Repeat in 24 hours. Now dearest Pooky has reasons why he can't be the cook—citing that I am finicky about the preparation of food and that he can't meet my exacting standards. I admit I have standards. I don't like burnt food, and I like food prepared in specified ways to maximize the ease and enjoyment of eating it.

But I think what it boils down to is that Pooky doesn't like making food. He likes eating food. I prefer making food and am only so-so about eating it. We compliment each other, unless I get so tired that I only want to dissolve into endless sleep.

What happened is that Pooky agreed to make us some canned and packaged soup. He did that while I tamed my abused bag. It was just what I needed as my stomach felt froo from the stuff I snacked on during pro-sem. We promptly went to bed after the Mets lost. Pooky was unhappy, but I was too tired to care.

Thirteen Things About Commuting My commute one-way to my internship site is about one hour. Here's 13 things about commuting that have come to mind. I spend at least 6 hours per week driving. That's almost one night's sleep. How did I used to spend those 6 hours? Apparently blogging as my entries have gotten fewer. Instead of giving out speeding tickets and paying a fine, I wonder if it would encourage people to obey traffic laws if they got pulled over and given a reward for going the speed limit and driving safely? Even though Inky gets 35mph, the miles rack up quickly and so does the cost of gas. I need to get more music, or find my stack of music CD's that I know that I have and have misplaced. I can only listen to the radio for only so long. I am so thankful that my time for commuting is not during the height of traffic. Otherwise I'd have exploded by now. For every three asshole drivers there is one kind and courteous driver. During the hour I think about what needs to be done on my never-ending, never-completed to do list. Surprisingly, the hour goes by quickly. Commuting is like waiting in line at the grocery store. It's a very inefficient use of time, yet no one's really thought of a way to eradicate it. On a more esoteric level, driving is a lesson in physics. It's a physical object moving through space over time. Perhaps there is a connection to be made in this regarding the space-time continuum. If it weren't for the Heisenberg Uncertainty Principle being a hinderance, teleportation as seen in Star Trek could be a mode of transportation. Good-bye commuting! I've seen some interesting vanity license plates. One that sticks in my memory is LDYVAMP.

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At my internship there is a dress code that requires to dress business casual—basically no blue jeans, but other colors of denim are OK. Being that I haven't gone clothing shopping this decade, and I've gained an extra 15 pounds since my surgery, I've scoured the latest L.L. Bean catalog for sale items and recently found some good prices at Wal-Mart.

As I was admiring my new wardrobe I saw that I had acquired a lot of corduroy pants, turtleneck shirts, and casual jackets. All styles basic, comfortable, and certain to keep me warm since I am always freezing.

But then the realization hit me: corduroy pants, turtlenecks, and jackets are the quintessential attire of therapists that I have encountered—I had inadvertantly dressed like the stereotype I have long held in mind! I've since come to the conclusion that if this therapist gig doesn't work out, perhaps there is a future for me in opening a chain of clothing stores for therapists. The store would stock neutral and dark shades of corduroy pants, tweed jackets and slacks, and coodinating turtleneck shirts. Sensible and fashionable shoes would also be sold.

First Session

I am pleased to say that I survived my first session with a client. I saw all members of the family. I didn't feel as nervous as I anticipated, rather at ease for most of the time as somehow I became filled with confidence. I will need to discuss with my supervisor about how the sesion went for me, as well as get some pointers on how to do things a little differently.

I think I am relying too much on paraphrasing and need to be able to reframe key statements, or at least know how to address them, as my clients had some key issues that I indicated that I understood, but wasn't certain about what to say in a therapeutic sense.

Cats as Therapists

I've been thinking how I might be able to incorporate feline traits and interactions into therapy, as I find the beasties in my life to have always been a great healing source through dark times. Cats possess a deep wisdom and profound nature that I have long admired and have been in awe of.

Today I was looking for some resources on relaxation techniques and stress management and found this title: Cool Cats, Calm Kids: Relaxation and Stress Management for Young People. It's about how cats can serve as a role model for finding calmness, etc. I love it!

Thirteen Things About October October has a lot going on for it in my way of thinking. Here's just some of the stuff collected in my head. It kicks off the last quarter of the year. Halloween! I get to wear a wizard costume and no one will think I'm odd. I get to give out candy to strange children and no one will think I'm trying to lure them into my gingerbread house and eat them. October also kicks off the holiday seasons. Once Halloween comes, it's just a matter of cooking a turkey for Thanksgiving and before you know it is Yule and Christmas and then New Year's. I do miss the autumnal colors of the foliage in the northeast. The colors here in the northwest aren't very remarkable. I don't like the arrival of the cold mornings and evenings. I miss summer already! I don't like the shortening days and the return to standard time at the end of the month. I like selecting pumpkins. I used to like carving them, but now since Pooky does such a great job of carving them, I just watch in awe. I develop an unnatural craving to make and eat soups. The weather is still good to play 9 holes of golf. I can work again on my sweater projects (and start new ones!) I start planning my holiday gift lists and I start making the gifts I'll give. The change of seasons puts me into an introspective, reflective mood. This month has some of the most incredible moon rises where she looks supernaturally large.

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Thirteen Things I Learned at Module l The topics covered at Module 1 include: Law & Ethics, Narrative Therapy, Structural Therapy, and Epistemology. This list reflects the information that has stuck to my brain. Narrative Therapy helps the client to externalize their problem by anthropomorphizing and discussing the problem in the third person. Structural Therapy was developed by Salvador Minuchin, and in this modality of therapy, family hierarchy and idiosyncracies are noted. Laws of confidentiality are to be taken very seriously. Also, it's best to have a no-hugging/touching policy. Hand shaking is the only exception. Epistemology can be summed up like this: how do we know what we think we know? By the end of the lecture on epistemology, I came to realize that what I think, what I believe, and what I know and whether or not if I truly know anything is far too much of a mental exercise to contemplate at the end of an intensive 5 day module. The childhood programming I received from my mother regarding the drills she'd have on what to do if a stranger came to the house, etc. and to be suspicious of strangers has been unlearned. I'm no longer anxious and afraid to meet new people, or be in a room full of 50 new strangers. "Sneaky poo" is the euphemistic term for encopresis. Where most therapists run into legal trouble is in creating dual relationships with their clients. A dual relationship is forming a friendship outside of the therapeutic setting, going into a business deal with a client, or the extreme: having sex with a client. I can be disciplined in how much I allow myself to dwell on missing Smee, or talking about Smee to my classmates. Our respective internships will be both our greatest learning opportunities and challenges. I need to ask myself: What kind of therapist do I want to be? What kind of therapist will I be? I can survive without checking my e-mail hourly. Getting my own hotel room is sublime! No roommate!

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The purpose of the meme is to get to know everyone who participates a little bit better every Thursday. Visiting fellow Thirteeners is encouraged! If you participate, leave the link to your Thirteen in others comments. It’s easy, and fun! Be sure to update your Thirteen with links that are left for you, as well! I will link to everyone who participates and leaves a link to their 13 things. Trackbacks, pings, comment links accepted!
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