An open Letter to STN's from an ileostomy patient Are you having fun? My ostomy pregnancy - IN THIS ISSUE
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Volume 30 Print Post Approved Number 2 PP 100008088 August 2021 ISSN 1329-959X IN THIS ISSUE: An open Letter to STN’s from an ileostomy patient Are you having fun? My ostomy pregnancy
My ostomy pregnancy By Kate Murray uneventful and my stoma reverted to its normal size when I returned to my pre-pregnancy weight just a few weeks he will learn to understand that his mummy is unique and that having a stoma has been life-changing, but not in after Alex’s birth. Like any new mum, any way life-limiting. I still had to navigate through the For any woman contemplating sleepless nights and exhaustion, the pregnancy with a stoma, I would two life-saving surgeries to successfully rollercoaster of postpartum hormones recommend firstly seeking advice from treat an ischemic bowel. and the difficulties of breastfeeding a a medical team including your stomal I left hospital two weeks later with a baby that had trouble latching, but if you therapy nurse. Secondly, the power of re-fashioned stoma and a 20cm wound were to ask me today, I wouldn’t social media is an undeniable force in right down the middle of my abdomen Kate and Alex, and change a thing. today’s society allowing us to connect which needed daily dressing changes. opposite a recent I was incredibly lucky to have a very Alexander will always be incredibly with other ostomates around the world. picture of Alex just special, a gift to this world and a What I found most useful was being before starting skilled medical team who fought so kindergarten hard to keep both me and the baby survivor. Today, he is a highly active, able to connect with ostomy support preschool. alive and to this day, I am unable to healthy and happy three-year-old. He groups through platforms such as explain how I survived such a life- has and continues to meet all of his Facebook where I was able to find other threatening health crisis. milestones despite my fears that there women to engage with for support. may have been some developmental Finally, pregnancy can be a daunting I spent much of my third trimester delays because of the heavy doses of experience, but an incredibly rewarding trying to comprehend what had anaesthetic drugs and narcotic pain one at the same time. Living with a happened to me and it would take killers that were pumped into my body stoma does not mean you can’t enjoy a several more months to regain my during my pregnancy. happy and healthy pregnancy and strength physically, mentally and emotionally. I was monitored and He is already discovering that I am a whilst my journey was a little more scanned weekly by my wonderful little bit different and often looks at his complicated, for me, having a child is obstetrician and given strict orders to stomach wondering why it doesn’t look the ultimate proof and reassurance of stop work and rest as much as I could the same as mine. I never hide my normality and is a reminder that to allow my body to heal itself. I also ileostomy from him and as he grows up, anything is possible. • needed a lot of support mentally and once a week I would sit down with a psychologist who helped me process my feelings. Even though I am naturally petite, it took weeks for me to develop the typical ‘pregnancy belly’ mostly because of the trauma my body had been through. From that perspective, I was lucky because my stoma only Minimise adhesive W hen I made the decision to undergo stoma surgery in 2010, with an ostomy including a sit-down with my gynaecologist who after some expanded by a few millimetres, and as a result, I had no leaks and was able to continue using the same appliances by skin trauma after suffering through years of painful routine testing advised I should be able cutting the openings a little wider. REMOVE wipes helps to reduce risk of irritation surgical procedures, I had no idea to conceive naturally. With that said, Whilst most women with an ostomy and skin stripping. where it would lead me and how my life both my husband and I were a bit can have a normal birth and delivery, would change, but nine years on I am shocked and surprised when we fell I opted for a scheduled caesarean Order code: 403100 (Box/50 wipes). proud of how far I have come and what pregnant within a couple of months of section primarily for my safety and the SAS code: 3542K I have achieved. trying. safety of my child. My obstetrician was Because of my decision I am happy My first trimester was relatively easy ecstatic when I made it beyond 28 and healthy, I am now a qualified RN – I had no morning sickness, I was able weeks, then 32, 34 and finally 36 weeks helping others in the same situation and to continue working normally and my gestation, convinced that at any time more recently have had the opportunity energy levels remained unchanged, so I would go into premature labour given to share my story across several much so that I was able to continue all the complications I had endured. different settings including national training at my local F45 studio gym. Luckily for us, I was able to deliver on conferences, education days and I was also barely showing, so it was my preferred date, two weeks prior to support groups. Perhaps my greatest easy to hide, but there were also no my due date at 37 weeks and five Contains achievement, however, was becoming a days. Against incredible odds, on major changes to my stoma or the need 11 December 2017, we welcomed a Aloe mum to my beautiful little boy, to make any changes to my current to soothe Alexander, something that may never appliances. healthy little boy, Alexander Benjamin skin have been possible without my stoma. Murray born at 9.37am and weighing in Unfortunately, my second trimester at 2.6kg. For more information, visit So, what is it really like being was not as straight forward. At 16 smith-nephew.com/anz or call 13 13 60. pregnant with an ostomy? The most weeks, I suffered a complication – an It was such an incredible relief to be important thing to remember is that intestinal obstruction likely caused by an able to finally hold our little boy, the Smith & Nephew Pty Ltd (Australia) www.smith-nephew.com/australia. Smith & Nephew Ltd (New Zealand) www.smith-nephew.com/new-zealand. ◊Trademark of Smith+Nephew. All having a stoma may not necessarily be expanding uterus and often associated culmination of an epic journey that trademarks acknowledged. 29080-anz V1 02/21. For detailed product information, including a contraindication of pregnancy. I had with increased maternal and foetal almost cost both of us our lives. indications for use, contraindications, precautions and warnings, please consult the product’s applicable Instructions for Use (IFU) prior to use. done a lot of research into pregnancy mortality. I was gravely ill and needed The recovery from the c-section was 2 | Ostomy Australia August 2021 Ostomy Australia August 2021 | 3
ostomates. This structure has a huge lead to the reduction of services and President’s advantage for ostomates as the support to ostomates and a loss of the message distribution and related support is wholly focused on supporting good working relationship between associations and ostomates. ostomates and not in maximising The future is uncertain while the Create a secure seal profits. Having contact with all potential for a tender process ostomates makes the ability to provide proceeding hangs over us. However, we information and support possible. Our need to soldier on and keep providing to help prevent leakage stoma associations also use donated funds and hundreds of volunteers to the best support we can. Because many of the stoma extend the support they can offer to associations are moving toward online ostomates and most importantly, they with an Adapt CeraRing™ deal with ostomates with care and ordering and membership renewal etc, ostomates will be accessing the compassion. associations websites more and this Our system of distribution of gives a great opportunity to provide products and support is one of the best support and education through those in the world currently. As other websites. countries, who predominately separate There is also room in the future for the stoma support associations from possible further cooperation between the distribution of products, are associations in the development of Adapt CeraRings are infused with experiencing great difficulty in contacting all ostomates to provide educational material for the association’s websites to maximise the support and information they need. ceramides to help protect the skin This difficulty in communication means support and information available to ostomates. As we all know, many of the many ostomates miss out on vital ostomate community are frail and information necessary to manage vulnerable and cannot access the Code Product Description By Allen Nash their stomas. internet so we will always need to have The Australian stoma associations a multimedia approach to information Adapt CeraRing Flat Rings T he most significant matter that have a track record of providing support provision and support. 8805 Standard thickness – 4.5mm Choosing the occurred in the last quarter that and information to their member As the new President of ACSA, I look 8815 Slim thickness – 2.3mm right Adapt affects all ostomates and Stoma ostomates. The quality of the support forward to working through the changes Associations is the Federal Health provided has been evidenced by that we face with the other members of Adapt CeraRing – Round Convex Rings CeraRing will Department Expression of Interest that feedback surveys undertaken by many the ACSA committee and to keep 89520 20 mm – can be stretched to 25 mm depend on was put out to canvas proposals for associations. working with Government to ensure the 89530 30 mm – can be stretched to 35 mm your stoma running the Stoma Appliance Scheme. There is a real danger now if the Stoma Appliance Scheme works well 89540 40 mm – can be stretched to 45 mm size and the Currently the Scheme is run by Health Department proceeds to tender for all ostomates. • Adapt CeraRing – Oval Convex Rings surrounding skin. voluntary organisations across the for the Stoma Appliance Scheme that it country that are managed by may be privatised. This will invariably 89601 22 x 38 mm 89602 30 x 48 mm 89603 38 x 56 mm Monthly Issue: Call Customer Care to determine which size is 3 Boxes best for you and order a sample. (10 per box) 1800 880 851 www.hollister.com.au Prior to use, be sure to read the instructions for use for information regarding Intended Use, Contraindications, Warnings, Precautions, and Instructions for Use. The Hollister logo, Adapt, CeraPlus and “Healthy skin. Positive outcomes.” are trademarks of Hollister Incorporated. Not all products are CE marked. © 2021 Hollister Incorporated. AUH277. May 2021 Ostomy Care Healthy skin. Positive outcomes. 4 | Ostomy Australia August 2021 Ostomy Australia August 2021 | 5
Editor: Rebecca Herbener IN THIS ISSUE My ostomy pregnancy, By Kate Murray 2 Foundation Editor: Barbara Callcott Correspondence/Contributions to: President’s message, By Allen Nash 5 Make the discussion about your stoma easier Email: journal@australianstoma.com.au Your say, Letters to the editor 9 With our free stoma bunny Post to: The editor, Ostomy Australia To my fellow ostomates, By The Gutless Wonder 12 PO Box 267 Gosnells WA 6990 These contact details apply only to matters Celebrating Volunteer Week at OAM, By Lindy McDonald 13 directly associated with Ostomy Australia. An open letter to STN’s from an ileostomy patient, By Viv Parry 14 Email or Word documents are preferred, please include pictures if possible. Nutrition for Ostomates - Are you having fun? By Margaret Allan 16 Published by: Tips and tricks for colostomy, ileostomy and urostomy, By Tyrrell, STN 20 Australian Council of Stoma Associations Inc. Website: www.australianstoma.com.au Stomal Therapy Nurse - Diversion Proctitis, By Monica Stankiewicz 22 Email: feedback@australianstoma.com.au What’s on? Discover new services and events at your local association 22 Patron: His Excellency General the Honourable Zac’s fight for his best life, By Ginny Deane 24 David Hurley AC DSC (Retd) Governor-General Recruitment for ACTA Administration Officer 26 of the Commonwealth of Australia Executive Members: YOU Inc continues to support members wellbeing, By Bonnie Crowe 28 Allen Nash – President National Directory of Ostomy Associations 30 5/7-29 Bridge Rd, Stanmore NSW 2048 Email: acsapres@australianstoma.com.au Living with two stomas, By Maureen O’Donnell 32 David Munro – Vice-president National Directory of Ostomy Support Groups 34 Limited PO Box 370, Chermside South, QLD 4032 Email: acsavp@australianstoma.com.au Directory of Stoma Appliance Scheme Product Suppliers 35 offer (T & C’s apply) Ian Samuel OAM – Treasurer Unit 8, 50 Grant Street Malvern East Victoria, 3145 Email: acsatreas@australianstoma.com.au Index to Advertisers: David Swift — Secretary Ainscorp 23, 25, 31 PO Box 182, Chermside South, QLD 4032 Email: acsasec@australianstoma.com.au Coloplast 7, 21, 26 Printing and Graphic design by: ConvaTec 10-11 Talking about your stoma can be difficult for Graphic Print Group Graphic House, 10–14 Kingston Avenue, Dansac 8, 27 loved ones to understand Richmond, SA 5033 When young children find out one of their closest family Hollister 4, 29 Phone: (08) 8443 8011 members has a stoma or they experience a family member Omnigon 18-19, 28, 33 Cover photo by: Kseniya Resphoto getting a stoma, it can be a difficult thing to understand. Source: Shutterstock Perhaps they have witnessed their sibling, mother, father, Smith+Nephew 3 Advertising enquiries to: The Editor grandfather or grandmother having been ill for a long period Sutherland Medical 5, 17 Advertising & copy deadlines: of time, or perhaps the stoma surgery has been performed in Issue Deadline 3M 12 an emergency. In all cases, with the sweet rabbit, which has April 1st February itself a stoma, makes the difficult discussion about your The ACSA Journal Ostomy Australia was established in 1992 through the inaugural August 1st June sponsorship of ConvaTec Australia. The journal is published three times per year and is stoma that bit easier. December 1st October available free to every member of an Australian Ostomy Association. Offer available to the first 50 Ostomates Editorial: Contributions are welcome but authors must include their names and addresses. Full names may be published unless you request otherwise. Contributions should be sent as Word or PDF Publication of an advertisement in Ostomy Australia does not constitute an endorsement of any products mentioned therein by the journal, ACSA, any stoma association, or any government department to register online* documents. Contributions may be edited in accordance with standard editorial practice. By submitting an connected with the Stoma Appliance Scheme. article, including photographs or writing a letter to us, you are taken to have consented to its publication coloplast.to/AU-Bunny Readers are strongly advised to obtain appropriate professional advice before using any products advertised. in both online and physical forms unless otherwise requested. We preserve past records of all previous journals, including any reader-submitted copy (which may include the use of digital or cloud-based Privacy: The Australian Council of Stoma Associations Inc. has no control over the use of personal storage securely hosted in Australia or overseas) in accordance with our Privacy Policy which may be particulars that ostomates provide to companies in response to advertisements contained in Ostomy viewed at http://www.australianstoma.com.au Australia. Unless the advertiser states otherwise, a company may use your name and address to contact While due care is taken to ensure the accuracy of published material, the Australian Council of Stoma you about its products or services. Associations (ACSA) accepts no responsibility for any information contained in contributions and specifically If readers do not wish to be contacted further, they are advised to tell the company this. Most * Terms and Conditions Conditions of entry: Open to all Australian residents aged 18+ only who sign up to the Coloplast Care program. Entrants must be an ostomate at the time of contact, not currently using SenSura Mio, and sample one or more of the disclaims liability for contributors’ claims or opinions. Readers are strongly advised to seek appropriate companies have said they will comply with such requests. This advice should be taken into account Coloplast SenSura Mio range. If you are not currently using SenSura Mio, register to receive your FREE stoma bunny when you sample SenSura Mio and sign-up to Coloplast Care. Entries Permitted: Maximum of one prize permitted. advice before acting on any medical, pharmaceutical or health-related information in this publication. when responding to company promotions. An electronic copy of this journal is available at www.australianstoma.com.au Complaints: Consumers who are concerned about the way in which stoma appliances are advertised Advertising: Advertisements are published in the form submitted by advertisers. The publisher does are entitled to lodge a complaint with the Therapeutic Goods Administration. Such complaints should be not check the veracity of claims made in advertisements and accepts no responsibility for their content. addressed to the TGA Complaints Resolution Panel, PO Box 764, North Sydney, NSW 2059. Coloplast Pty Ltd, PO Box 240, Mount Waverley, VIC 3149 Australia www.coloplast.com.au The Coloplast logo is a registered trademark of Coloplast A/S. ©2021-06 OST756. All rights reserved Coloplast A/S 6 | Ostomy Australia August 2021 Ostomy Australia August 2021 | 7
Your say Hospital staff suggested I contact the customer service team of the company supplying my usual stoma items. Following some careful discussion, I was sent some high output bags to trial. Letters to the editor Marvellous. Stoma They must have been at least double the normal capacity; a little bit awkward to wear but saved the overflow problem Skin until a return to normalcy. Soul Dear Editor, It seems worthwhile to contact the company direct for There is a lot of talk about leakages, and I certainly had a few suggestions and advice. when my bag was new (September 2019). It was obvious the Isobel Davie wafer wasn’t sticking as well as it could and I came up with the idea of using a grain bag to heat it up. After 40 seconds in the microwave, the grain bag sits on the colostomy bag while the old bag is removed and other Dear Editor, preparations are made. In response to Elizabeth Kay (April 2021 journal) I can honestly say I have had no leaks since using this Hello Elizabeth, system. I love Vanilla Blush products. They have several swimsuits. Rosemary Vanderlaan, NSW They are a Glasgow company so keep in mind the delivery times are slightly longer than local companies. Their website – vblush.com – opens a world of underwear, Helping you Dear Editor, swimsuit and hernia support options that are all beautiful and In reply to David Paterson, QLD comfortable. feel comfortable Hello David, your question was how to contain the enormous Kirsty Evans rush to get to the toilet safely while prepping for a in your own skin colonoscopy. I had that problem too and solved it easily. At the time I was Dear Editor, Nils, Crohn’s Rebel irrigating. To irrigate you wear a long cone shaped plastic My name is Meagan Davey, sleeve, which reaches easily from where I sit, and dangles into I was diagnosed with Crohn’s the toilet. This sleeve is clipped onto the wafer you are disease in 2007 and have been wearing that would normally have your bag attached to it. living with an ileostomy since If I wanted to make beds or put out a load of washing, 2011. I had complications after it was just a matter of folding up the end and clipping it closed a proctocolectomy in 2013. I live (I’m sure the clips come with it). with a chronic pelvic abscess It was an obvious move for me, when doing a preparation, and just a few weeks ago had to wear a sleeve. fistula surgery. This year I must I am sure your supplier could make one available for you, have another major surgery to and if not, they will give you the phone number of the supplier drain my pelvic abscess. When it comes to your skin, there’s and you could ask them for a sample. It has been and continues It works well. no such thing as too much protection to be a messy journey. In reply to Carl Bouwens, SA I wanted to give back Dansac TRE seals are designed to: I hope Thor has settled in and is happy doing his job. to the Crohn’s and stoma • Provide a secure and flexible seal to help protect the I have written in previously about ‘what did I name my new communities in some way friend?’. Long-time readers may remember. and as a result, I have recently skin from stoma output and to be easy to remove published my first book called I call mine the Baby. Why? To me it is obvious. I fed her, • Help absorb excess moisture without losing internal or burped her, changed her, walked the floor with her, at times The Crohn’s Diaries: A Book of Available in 3 sizes: 18mm, 30mm & 40mm external strength to help maintain skin‘s natural balance could have spanked her, and at other time, loved her. Resilience which I consider to I do hope my little bit of experience does help someone. be a trouble-shooting manual • Help maintain the pH balance of naturally healthy skin on living with Crohn’s and its Marion Chisholm, NSW associated issues. It is my For more information about Dansac TRE seal and to order a free sample hope that my story can help please call Customer Care on 1800 880 851 or visit www.dansac.com.au others facing the challenge of Dear Editor, living with Crohn’s disease. For useful educational resources visit www.dansac.com.au/livingwithastoma In response to the letter from David Paterson (volume 29 This book has all the number 3) tips and tricks that I’ve learned about stoma and skin Although not the same situation, I, too, found myself management as well as sharing my story and other advice needing help after significant surgery. My output from related to having a chronic illness. Prior to use, be sure to read the Instructions for Use for information regarding Intended Use, Contraindications, Warnings, Precautions, and Instructions. pre-existing ileostomy had increased and consistency varied The Dansac logo and TRE are trademarks of Dansac A/S. All other trademarks and copyrights considerably hour by hour. Continued page 12 are the property of their respective owners. ©2021 Dansac A/S. DAN050. May 2021. 8 | Ostomy Australia August 2021 Ostomy Australia August 2021 | 9
Tips for taking better care of peristomal skin NEW Do Don’t • Change your pouch routinely. • Use soap or other solutions to wash skin. • Gently remove the base plate from top • Over complicate your pouch changing to bottom – people find an adhesive routine. remover helps. • Wait for your pouch to leak before • Clean the skin around the stoma with a changing it. wipe soaked in warm water. • Pull your pouch off too quickly. • Dry your skin thoroughly before applying • Ignore any changes in the skin around your next pouch. your stoma. • Inspect your skin every time you change your base plate. Are you experiencing peristomal skin • Apply a skin barrier spray/wipe if required. problems now? Soft convexity... • Check the hole cut in your base plate is the right size for your stoma. Don’t try to manage skin problems on your own. Seek help from your Stomal confidence to do • Apply the base plate securely around your Therapy Nurse or contact ConvaTec Customer Care on 1800 335 276 or stoma ensuring there are no gaps or folds the things you love in the base plate. email connection.au@convatec.com Introducing THE RIGHT ACCESSORIES CAN MAKE ALL THE DIFFERENCE ALL BODIES ARE DIFFERENT. Esteem®+ Soft Convex combines Whether you are looking flexibility with a shallow convexity, and is designed to conform for better skin protection well to the body and be comfortable to wear. or added security to your ostomy system, you can Flexible Convexity: conforms to the body and helps improve the pouch seal by minimising leaks feel more comfortable with the right combination Easy-View Window: for accurate positioning and observation of accessories. Filter: designed to help minimise odours and ballooning Safe Seal Clipless Closure: designed to make emptying and cleaning easy* For Customer Care and to order your FREE samples For Customer Care and to order your FREE samples Freecall 1800 335 276 or email connection.au@convatec.com Freecall 1800 335 276 or email connection.au@convatec.com Always read the instructions for use and follow the directions for use. *Drainable options only. Always read the instructions for use and follow the directions for use. www.yourconvatec.com.au ® /TM indicates trademarks of ConvaTec Inc. © 2021 ConvaTec Inc. AP-031428-MRL-AU May 2021 O604 www.yourconvatec.com.au ® /TM indicates trademarks of ConvaTec Inc. © 2021 ConvaTec Inc. AP-031428-MRL-AU May 2021 O604 10 | Ostomy Australia August 2021 Ostomy Australia August 2021 | 11
To my fellow Celebrating Volunteer Week at OAM Continued from page 9 In 2018, I walked the El Camino de Santiago with fellow ostomate and Crohn’s advocate Melissa Lord and ostomates By Lindy McDonald I’ve interviewed her in a section of my book where we talk about the importance of goal setting and looking By The Gutless Wonder after yourself to live your best life. How very important it is for me My book is available at most online major book To enjoy this great camaraderie retailers including Amazon, Fishpond, Barnes & Noble With Ostomates both young and old. and Dymocks. To face the challenges, we must be brave and bold. Meagan Davey Humour is our most powerful weapon To live our lives without depression. Hearing so many stories that made me laugh Disclaimer: Ostomy AUSTRALIA does not endorse Reduced my misery and confusion by half. the contents of readers’ letters nor do we vouch for Col, Uri ad Ili are some stoma names we use the accuracy of any claims made in those letters. But often more imaginative ones we choose. Readers should not rely on any such claims in the Many are clever, often an amusing one, absence of medical advice and should consult their And some of us just refer to it as a tummy bum! treating doctors prior to embarking on any course of So continue to look on the bright side of life, treatment. We can all achieve great things in spite of the strife. O Write to us: send your letters to Forget all those problems that always abound, ur volunteers are more than the Editor PO BOX 267, Gosnells WA 6990 Remember – a smile a day makes the world go round! volunteers. or email: journal@australianstoma.com.au They come ’to work’ with a smile, a willingness to help and a desire to get the job done. They want to give something back. They want to make a difference to people around them. WHY THEY VOLUNTEER According to our volunteers, the To build on existing friendships or make rewards of volunteering at OAM are new friends. Maybe with someone that Not all barrier many and they encourage others to put Get more confidence and more peace of mind so you can get on with life. Caring has just started volunteering with us, it’s their hand up to volunteer in their for an ostomy can be a challenge – but it to give them confidence or to join in and films are created communities. doesn’t mean you have to miss out on life. be part of our great team. Often, it’s to 3M™ Cavilon™ No Sting Barrier Film helps help other ostomates, to ’pay forward’ WHY WE CELEBRATE equal. protect the tender skin around your stoma, the benefit they received from our VOLUNTEER WEEK for improved comfort and pouch adhesion. association, the Ostomy Association of We love having an opportunity to give Available on the Australian Stoma Appliance Melbourne (OAM). back to our volunteers and to Scheme in a convenient pump spray bottle. acknowledge their achievements as Choose Cavilon No Sting Barrier Film. they are an integral part of our success. Their dedication and hard work are 3M Code: 3346 reflected in the excellent feedback we receive about them and our association. SAS Code: 3544M One word simply sums up our Volume: 28 mL volunteers – Amazing Allowance: 1/month From all at OAM - we sincerely thank you and look forward to seeing you every week and especially during Volunteer Week when we can share our appreciation of you all. Trustworthy Try it for yourself and As we say at OAM: Energetic experience the difference, visit Enthusiastic 3M.com.au/ostomy * Please note that samples will be the 1 mL size. Very good cooks Always read the instructions for use. Reliable to request a free sample. Do not use on infected areas of skin. Offer their time Simply sensational If symptoms persist, talk to your health professional. Love a laugh 3M Australia Pty Limited 3M and Cavilon are trademarks Volunteers are not paid — not Understanding 3M.com.au/ostomy ABN 90 000 100 096 Phone 1300 363 878 of 3M Company. © 3M 2019 All rights reserved because they are worthless, but Necessary because they are priceless. • 12 | Ostomy Australia August 2021 Ostomy Australia August 2021 | 13
critical but to point out the patient’s An open letter to STN’s perspective in a constructive way; the products explained, however for many post-op ostomates the ostomy Understanding ostomates have no lived experience prior to their surgery I from an ileostomy patient potentially creating opportunities for situation seems quite surreal and the wonder at what stage in the hospital STN’s to rethink ways of assisting their medication made it hard to concentrate stay/ post op situation new ostomates By Vivian Parry ostomy patients. especially after a major operation. could receive purposeful, encouraging I came to understand how hard Ward advice to assist their transition out of MEDICATION FOR PAIN RELIEF the hospital space back to the reality of nurses as well as STN’s work, literally My surgeon advised me on the morning running from room to room to keep up being home. (I was not advised of a major flare up and subsequently found and don’t want to bother my friends after my procedure, I must maintain my possible community STN home visit to myself receiving Infusions. The first with washing. with the demands of their nursing roles. pain medication schedule without fail. check on my progress). infusion was deemed after three Other than on the internet I have I wondered how the hospital system He explained if this routine was not My hope in writing this letter to you is sessions to be unsuitable. The second never seen a stoma or the appliances; could reorganise and prioritise duties strictly adhered to my pain would that you have gained fresh insight into type of infusion created serious side will I be able to change my own pouch more efficiently for both the staff and increase with little chance to return to some of the important issues this effects ... where to from here, I before I leave hospital? patient’s benefit. my current relatively pain free situation. ileostomy patient needed you to know. wondered. It was not long before I was How long will it take for my stoma to At the post-op meeting I appreciated ordered to have another scope. The I became distressed when my pain A bit of a reminder how incredibly decrease to its normal size? the STN asking me, from my patient’s result was life altering for me. It seemed medication arrived significantly late or difficult it is for your patients to be brave perspective, if there was anything within What if I need to revise the occasionally forgotten. I started setting through the ostomy process. I had an area of ’grave concern’ and I her area of responsibility I felt could appliances, who will I contact? the alarm on my phone to make sure needed to see a gastroenterologist have been done differently or improved I strongly believe you and your Blockages. I am 90% vegetarian the medication arrived within a surgeon to discuss my options. This upon? I replied ‘You could show more nursing colleagues can work through who will give me guidance on diet, and reasonable timeframe; a responsibility I outcome was my worst nightmare empathy and understanding’. She told this information to bring about positive will that be during my hospital stay? never thought a patient would have to realised. me she thought she was doing exactly awareness and change. Will I be given advice about skin care, deal with. Being used to medical appointments that. I offered ‘if you could have taken Ostomy patients do understand their I could not believe how fearful I became how to deal with gas and odour? Will I FIRST APPLIANCE CHANGE five minutes, just once, to sit beside me STN, and the Ward nurses have many on the day of my consultation with the receive advice on how to lie in bed, and ask if there was anything I needed patients to care for. We in turn have dress, have a shower or bath? When it came to attempting my first surgeon. I lost my favourite scarf on the appliance change (48 hours after the to know or was concerned about, I only one STN to guide us through this D way into the building and didn’t even Will there be home visits, or do I call would have felt that connection’. Her physically and emotionally challenging ear Stomal Therapy Nurses, operation) I was not in great shape notice until I reached for it hours later a community nursing service? reply, ’I don’t have time’. time in our lives. My name is Viv, and I would like physically or mentally. The STN seemed and it was gone. What I didn’t write down but did to think a bit of bullying was a form of I left the hospital and arrived home to Given support, empathy and to share my ostomy lived experience The surgeon confirmed my reveal to the STN was my fear and ’tough love‘ and she was short of time. discover I couldn’t remember the understanding of our situation we would with you. I am hopeful my personal specialist’s opinion; my luck had run dread of the procedure and my serious I would have appreciated her information I received at my initial do our best to work with you to gain the experience will inspire, inform and out, a pancolectomy resulting in an concerns about how my life would be understanding my medical and consult weeks ago; essential advice on most favourable outcome, for both our challenge you to address the issues I ileostomy was my fate. into the future. I concluded with ’I don’t emotional condition. Seeing my stoma how I should sleep appropriately, keep sakes. have raised. want an ileostomy. I have tried every for the first time, swollen and angry my pouch dry in the shower and In February 2019 I arrived at my I held off as long as I could to make Thank you for taking the time to read possible treatment over the years to looking with the accompanying drains, manage to avoid leaks. stomal therapy appointment, the first my pre-operative Stomal Therapy Nurse my letter it has been a privilege to share avoid this outcome!’ catheter, and drip on board, still shaky step on my ileostomy journey; one that (STN) appointment, I needed to go I felt lost and alone with my swollen my thoughts and ileostomy lived had taken twenty-five years to arrive at ’No one wants this operation‘, was on my feet, a kind-hearted approach body complete with add on appliance; I experience with you. A huge Thank You through all the emotions that came this day. An ulcerative colitis (UC) the STN’s only comment. Reflecting on would have been invaluable. felt socially unacceptable and from all your ostomy patients, we are rushing to the surface: grief, anger, fear sufferer from the age of 35 my that statement two years on, I believe I did appreciate being signed up to ever grateful you have chosen caring for and self-pity. I had lost the UC battle embarrassed to draw attention to my patients deserve a more considered gastroenterologist warned ’You are and the price to be paid was, in my response. Her words were all I had to the Colostomy Association and having situation. Not the best homecoming. us as your career. • walking down a well-worn path of UC mind, a devastating loss of quality of life. sufferers before you; an ostomy is support me through the procedure. The internet confirmed my worst fears waiting for you, it’s just a matter of time!’ and added new ones, appliances, ’No one wants this operation‘… How Not being one to step away from a leaks, restricted diet, blockages, was I supposed to process that? Helpful tips for ostomates battle I pledged to myself there and dressing to camouflage the appliance, I believe this was a lost opportunity then I would never have the operation. antisocial noises... on and on it went. to provide positive support. Public If it meant a restricted diet, annual hospitals provide counsellors. Private I would also like to share eight for about $5 and each cap last excessive rubbing would cause a skin It all seemed so bad I decided to some valuable tips with my for weeks). I cover the rolled-up pouch irritation. By accident one appliance scopes and serious medication then ‘so patients can gain referrals to trained make the recommended pre- admission fellow ostomates bringing the elastic up to the top, twist order replaced my wipes with a spray be it!’ I was not going to have the counsellors. The question is ’How does appointment with the STN to find out Diary: I have found keeping a diary and re-cover the area about three adhesive remover… Best mistake operation. the STN detect which patients need the true facts of the situation for myself. noting the days I need to change times until it fits securely. If any water ever! One spray around the appliance My bowel and I survived my first counselling?’ To make the most of my appointment my appliance, very helpful. It is not does seep under the cap, it stays edges and the pouch lifts off cleanly in specialist who eventually retired. I chose Never having sought any kind of the ’early’ changeover that causes below the rolled-up area. After my one go with no residue left to remove. time I decided to write down my major my next specialist with care stating at therapeutic counselling in the past I problems; it’s the ’late‘ changeover shower I carefully remove the cap and I then use the adhesive remover wipe concerns. I wanted to make sure I put our first meeting that losing my large regret not being offered counselling on that can lead to day or night-time dry the surrounding skin. Happily, the to clean around the whole area. After bowel was literally ‘off the operating forward all my queries because I knew this occasion. I feel my recovery would leaks because the adhesive no longer pouch stays dry. a wash down with warm water I allow table!’ He assured me medical in my case, having relevant information have been easier if, right at the start, I adheres to your skin. In each month I Product: From my first solo home my skin to air dry. The other products attitudes had changed together with would help me through the ileostomy could have expressed my fears to write K for keep and CH for change on appliance change I had problems I like are the Aloe seals used to create advanced treatments; he felt sure we procedure. Looking back over my someone trained to respond in a more each day of the month as a reminder. with left over adhesive residue on an added buffer against leakage and had a good chance of keeping my UC notes as I write this letter, I am a bit valuable, effective and beneficial way. Shower: Before I shower, I empty the my skin. I knew it was important to the flange extenders. The extenders in remission. surprised how relevant for a ‘stoma pouch, roll it up towards my naval and have a clean and dry area to attach assist the shower process by creating novice’ my questions were: REFLECTIONS ON MY a larger adhesive area and they are a My annual scopes continued and secure each end with an elastic hair the new appliance to. The adhesive over the ensuing years low level After my op: will I be in acute care or IN-HOSPITAL STAY removal wipes didn’t always do the great line of defence and a visible early tie. Using a soft disposable shower dysplasia floated in and out of pathology back in my room? Will I have a catheter? The following points are reflections on cap (discount chemists sell packs of job effectively and I was concerned warning signal against leaks. results. About three years ago I had a What shall I pack? I live on my own my in-hospital stay. My aim is not to be 14 | Ostomy Australia August 2021 Ostomy Australia August 2021 | 15
Are you having fun? Nutrition for Ostomates By Margaret Allan Margaret Allan advises both FUN IS INDIVIDUAL WORK, ostomates and the public on diet The type of fun you have after stomal and health-related matters. She surgery may be different to what you did is the director of the consultancy for enjoyment before you had surgery, Nutrition For Ostomates. To contact but the concept is still the same – doing her or read more nutrition articles REST, something that makes you laugh, feel supporting the health of ostomates, lighter, lifts your heart and brings joy into go to www.nutritionforostomates. your life. It is often said that laughter is com.au the best medicine, and you can A Worldwide WORK certainly cope better when you can brand now in T PLAY hat might seem like a silly question. laugh. Fun helps you focus on the You might be thinking “I’m an ostomate – how can I have fun?” present and enjoy the moment rather than dwelling on the past or fearing the , Australia REST, However, the two don’t necessarily have future. Fun can provide some mental to be mutually exclusive. As an rest and a brief reprieve from the daily ostomate it is important to still find joy in concerns or challenges. Fun helps you • Going for a stroll in a pleasant A Worldwide life, even if it is just in the little things. forget what is going on in your life and environment, such as a park, the brand sizing now inpurchase PLAY Stomal surgery can be a very big allows you to just indulge in a pleasant bush or the beach Contact your stomal nurse or refer to our size guides to ensure correct prior to deal. It can momentarily take the light activity. Australia • Visiting your favourite place out of life. And there may be major What one person experiences as fun • Going on a picnic (at a venue with adjustments to make afterwards. It can may not be the same for others, and so seem as if you are being thrown a the concept of fun is very individual. toilet facilities of course) or sharing a lovely meal with friends WE’RE HERE TO You are eligible to claim up to 6 Breathable pants or 3 Shield belts, or mix and match with a combination of both. SUPPORT YOU (1 Shield belt = 2 Breathable pants) massive curve ball and are being You may need to adjust or moderate Contact your stomal nurse or refer to our size guides to ensure correct sizing prior to purchase challenged in a very profound way. your fun-filled endeavours for a little • Floating away in a bed of delicious You can feel overwhelmed and insecure daydreams… while after stomal surgery in order not about so many things, such as how to to stress or strain your body whilst it is YourWE’RE HERE canTO THERE ARE MANY AND VARIED You are eligible to claim up to 6 Breathable pants or 3 cope with the new circumstances, what still recovering, but even then, you can WAYS TO HAVE FUN. THE GOAL Stomal Nurse help find Shieldthe most belts, suitable or mix garment and match for you. of both. with a combination your life is going to be like from now on and what the future holds. There can be still indulge in enjoyable pursuits. And whilst your body is healing you could FOR YOU IS TO WORK OUT WHAT SUPPORT YOU (1 Shield belt = 2 Breathable pants) REPRESENTS FUN FOR YOU NOW, a lot of uncertainty. also spend the time daydreaming of AS THE PERSON YOU ARE TODAY, 6 6 33 33 But these feelings don’t have to be what you WILL do when your body Your Stomal Nurse can help find the most suitable garment for you. AND THEN ENGAGE IN THAT permanent. You can learn to cope, you is ready. ACTIVITY AS OFTEN AND FOR AS can make the adjustments, and you can LONG AS POSSIBLE. find your way through the maze of SO, ASK YOURSELF: WHAT Aim to lighten your mood as much as uncertainty towards a new way of life REPRESENTS FUN FOR YOU? you can. When you’ve had some fun, that is still full of meaning and purpose. FUN CAN BE SIMPLE check in with yourself – how does it And this process can be made easier Fun does not need to be taxing or feel? Do you feel happier, lighter, more by having some fun! expensive. It doesn’t need to be a liberated? Do you feel that you can large-scale endeavour that requires a lot cope with your challenges a little more of time, energy or money. Fun can be easily? If so, make fun a priority in your free, and even if it only lasts five minutes life and schedule some more light- can have a beneficial impact on your hearted, joyful activities into your diary wellbeing. It can involve really simple to keep up the momentum. After all, Breathable Range Shield Belt Support Girdles activities such as: practice makes perfect! Breathable Range Moderate Support Shield Belt Firm Support Support Girdles Firm Support • Sitting in a sunny spot reading a Moderate Support Firm Support Firm Support I recently heard a blessing that book or a magazine contained the phrases: Contact your association Contact today today your association for your allowance for your allowance • Having a coffee and a good chat with ‘May you be at peace, may you be a loved one well, may you find loving kindness.’ • Chilling out watching a funny movie I would add ‘May you also have fun!’ 1300 6641300 027 664 027 Mon - Fri 9am to 5pm, For more information visit For more information visit sutherlandmedical.com.au • Singing along to your favourite music Wishing you good health and 5pm, Public Holiday sutherlandmedical.com.au Mon - Fri 9am toexcluding • Sharing a joke with a like-minded happy days, excluding Public Holiday friend Margaret • Sutherland Medical, Unit 2, 195 Chesterville Road, Moorabbin VIC 3189 Sutherland Medical, Unit 2, 195 Chesterville Road, Moorabbin VIC 3189 16 | Ostomy Australia August 2021
Prevention is better than cure! 6 6 Your allowance is Don’t worry if 33 6 support pants or you’ve used up your OR 3 belts or a combination allowance, you can per calendar year buy more directly (1 support belt = 2 support pants) from Omnigon. SUPPORT PANTS BELTS Up to 50% of RATING 3. w? Did you kno ostomates may develop A hole in Su pport not MODERATE Garments is After surgery 1 a parastomal hernia Men’s Support Pants Diamond Plus Boxers ed by recommend 2,3 Wear during light exercise clinicians Prevent or support But with the right a small bulge 2x colours 2x colours prevention strategies in place, you could stay Diamond Plus Briefs Diamond Plus in the better 50% Support Waistband Reduce your risk of developing RATING 4. a hernia by wearing a support INTERMEDIATE garment and following the Wear during daily activities practical advice provided (housework, shopping, golfing) in the Omnigon Support Support a more developed hernia Garments Guide. Support Briefs IsoFlex for Her Support Belt Contact us today to RATING 5. receive a FREE copy! FIRM 2x colours Wear during active work or sports 1: Colorectal Disease ª 2018 The Association of Coloproctology of Great Britain and Ireland. 20 (Suppl. 2), 5–19. 2: Thompson JM. A summary on parastomal Support a more developed hernia Total Control KoolKnit hernias, February 2009. 3: Thompson MJ. Parastomal hernia: incidence, prevention and treatment strategies, British Journal of Nursing, 2008 (STOMA Support Belt Support Belt CARE SUPPLEMENT); 17 (2), 16-20 18 | Ostomy Australia August 2021
Tips and tricks for colostomy, ileostomy and urostomy By Tyrrell, STN – NSW FREE H aving a stoma is a life changing process. Yes, it is challenging, yes, it is hard to deal with, but with the help of a • Measure your stoma regularly. After surgery do it weekly for six weeks, then monthly for three months, then every better digestion and reduces risks of blockages. samples • Do not eat hard vegetables e.g., Stomal Therapy Nurse (STN) as an three to six months to check for carrots, celery, corn, or tough meat, ostomate you will, over time, become change. pineapple, mango and coconut. These confident in self caring for your stoma and • Eat a well-balanced diet, some fibre, foods can cause a blockage. be able to resume your previous lifestyle. vegetables, fruit, protein and the odd Reintroduce foods slowly and maintain Everyone deserves the opportunity to drink. Drink pear juice if constipated. a balanced diet of carbohydrates, embrace life to the fullest. In my 40 years • Put small rolled up toilet tissue (size of vegetables, fruit and protein. of nursing, I have witnessed people who a marble) into pouch to allow stools to • Seek help from your STN if you are have had a stoma turn their life into drop more easily down to bottom. experiencing leakage, skin problems, whatever they wanted it to be. They have • Warm up your base plate or pouch pouch fitting issues, pain or bleeding been able to resume their work life and before fitting especially in the colder from your stoma. exercise including swimming, golf, cricket, winter months e.g., put it inside your rugby, surf, ski (snow and water) and shirt against your warm body or use UROSTOMY skydive. Many have continued with a hairdryer on a warm setting for • Check your stoma size regularly gardening and household chores. 30 seconds. - monthly for the first three months Women have still been able to give birth. • If stools are dry or pancaking put olive then six monthly to check for changes. What I am about to share with you is oil/lubricant deodorant on the inside of • Cut base plate or one piece pouch as the knowledge I have gained over 30 the pouch. This will help stools slide close as possible to your stoma size years of working as a STN. I have to thank down. (1 mm). my patients and my fellow STNs who have • Drink 6-8 large glasses of water daily, • Using a seal can help wear time and shared their ’tips and tricks’ to better plus tea and coffee if you desire. reduce urine leakage problems. manage stomas, peristomal skin problems • Use warm water only to clean skin • Wash your peristomal skin with warm and appliance management. around the stoma (we call that the water only. Maintaining and protecting healthy skin is as easy as 1, 2, 3 with the When I first started working as a STN peristomal skin). • Dry the peristomal skin well with a soft we did not have the wonderful pouches, accessories and skin technology that • If the pouch filter gets wet, change the pouch. lint cloth, Chux or hair dryer on a cool-warm setting. Brava® Healthy Skin Set we are blessed to have at our fingertips • Change the pouch when its 1/3 or • Use rolled up gauze on top of the today. We certainly have come a 1/2 full. stoma to collect urine while drying your long way. skin. • Do not lift heavy objects – a hernia may I have learnt many general tips and develop. • Warm up your base plate or pouch tricks over this time as well as specific tips before application. • Contact a STN if you have leakage, for colostomy, ileostomy and urostomy. skin problems, pouch fitting issues, • Change your pouch early in the • Overall keep everything simple when morning before you start drinking pain or bleeding from your stoma. caring for your stoma. fluids. • After selecting the appliance that you ILEOSTOMY • If you use a night bag, connect the like, stay with it. tubing to the bottom bed sheet, PJs • Measure your stoma every week for the or person. • Order your products in a timely first six to eight weeks so you can cut manner. Do not over order but also do • Drink 6-8 large glasses of water per Remove Cleanse Protect your base plate or one-piece pouch to not leave it to the last minute. day (unless your doctor says the right size (a hole 1-2 mm bigger otherwise). • Have adequate number of stoma than your stoma is ideal). supplies on hand – one month backup • Change your pouch daily or base plate It is essential to protect your skin from the everyday wear and tear associated with bag changes and using ostomy • Wash your skin with warm water only. every 3-4 days, or if leakage occurs. is a good idea. • Dry your skin with a soft low lint towel, products. The right products can help prevent many peristomal skin issues. The Brava range of supporting products • Wash your hands thoroughly before • Cut your base plate or pouch to the Chux or dry with a hair dryer on a deals with the most common of these. stoma care to prevent bacteria entering size of your stoma. warm-cool setting. your stoma and developing an • Wash your skin with warm water and • Warm up your base plate or pouch infection. A urinary tract infection will Developed to meet your skins needs, this 3-step care routine gives your skin and stoma exactly what it needs to be dry your skin well before applying your before fitting especially in the colder see your urine cloudy, smelly and you happy and healthy, while allowing you to have worry free bag changes. The set includes Brava® Adhesive Remover pouch or base plate. winter months e.g., put it inside your will have a reduction in your urine Wipes, Brava® Skin Cleanser Wipes and Brava® Skin Barrier Wipes. • Empty your pouch when its 1/3 or shirt against your warm body. output. Seek a review with the GP 1/2 full. • Change your base plate or pouch in if issues. • If you have a problem or question the morning before eating. This will • Seek help from a STN if you have skin contact your STN before the problem reduce your output volume making for problems, pouch issues or bleeding Request your free samples today becomes a big issue. a better change. from your stoma. • Keep up your fluids. 6-8 glasses of 1800 531 823 • Have a yearly review with a STN. COLOSTOMY water daily plus other fluids e.g., tea, • Cut a one-piece pouch and/or base coffee and juices. Source: https://omnigonconnect.com. plate just a little bigger than the stoma • Chew your food well and eat small au/advice/tips-tricks-colostomy- (1-2 mm). meals to being with. This assists with ileostomy-urostomy/ • Coloplast Pty Ltd, PO Box 240, Mount Waverley, VIC 3149 Australia www.coloplast.com.au The Coloplast logo is a registered trademark of Coloplast A/S. ©2021-05 OST762. All rights reserved Coloplast A/S 20 | Ostomy Australia August 2021 Ostomy Australia August 2021 | 21
Diversion Proctitis THE NATURAL By Monica Stankiewicz, Stomal Therapy Nurse D iversion proctitis is also known as diversion colitis as it can affect a part of the rectum or colon after stoma formation. Symptoms include abdominal or rectal pain, Avoid soaps to cleanse the area as this may increase rectal skin CHOICE FOR bleeding, excessive mucus or ongoing sensation of needing pH and encourage skin to pass a bowel motion or can even loosen motions from breakdown. Warm water the stoma. to wash the area is It is reported that the cause of diversion proctitis is due to a enough. lack of short chain fatty acids (a biproduct of fermented dietary A panty liner or fibre) which are absent when the bowel is starved due to the incontinence pad is often PREVENTING diversion in the faecal pathway. This changes the way certain used to prevent under-pant soiling. cells (enterocytes) absorb and metabolise. This leads to poor Copious amounts of rectal stump mucus is a concern and functioning, smaller, abnormal cells in the bowel /rectum should be assessed by a medical specialist (general mucosa (the cells that line our body cavities, such as mouth, practitioner / colorectal surgeon / gastroenterologist). It may intestines, rectum etc). This is known as ‘mucosal atrophy’. warrant further investigation. The risk of infection is due to increased bacterial load due to LEAKS. changes in the normal cells function and a decrease in normal TREATMENT healthy bowel bacteria. It is very important to engage a gastroenterologist to assist with navigating a diagnosis, investigations and providing WHO IS AFFECTED? information on the best treatment for you, whether its medical Although suspected to be uncommon (as true incidence of the or surgical. disease is unknown), it can occur in any patient with an There is some research conducted about the effectiveness ileostomy or colostomy, occurring in the remaining bowel or of short chain fatty acid enemas to improve diversion proctitis rectal stump. or diversion colitis, however outcomes from the studies are Diversion proctitis is reported mostly in those who have varied. Medication management tends to be mainstay inflammatory bowel conditions such as Crohn’s disease or treatment ranging from oral anti-inflammatory/ ulcerative colitis but does not exclude other disease processes immunomodulating medication to biologic treatment. Referral such as bowel cancer or diverticular disease. to a colorectal surgeon may be necessary if surgical intervention is required. PROTECTION OF SKIN INTEGRITY Incontinent mucus from the rectum is not uncommon. It is very Monica is a Wound Management, Stomal Therapy and important to protect the surrounding rectal skin due to Dermatology Nurse Practitioner* for Community and increased mucus or bloody discharge from the rectum. Oral Health, Metro North, Queensland Health and can see Barrier wipes, barrier creams or barrier sprays can be effective ostomates with any skin or general concerns, through a in preventing skin loss. referral from a GP. • Confidence® Natural has a superior wafer* that adheres more securely for longer. Greater adhesion* and absorption to help what’s on? prevent leakage Unique, five-sided Flexifit® wafer bends Discover new services and events Celebrate World Ostomy Day and flexes with your body at your local association To all members, their families and carers of Ostomy Infused with Aloe extracts for softer skin Associations Australia wide. Mackay (QLD) Ostomy Support Group Saturday 2 October has been internationally declared as AWARENESS DAY World Ostomy Day. CONFIDENCE® NATURAL Following a very successful gathering in 2019, the Mackay The natural choice for preventing problems We wish to raise and promote awareness for people (QLD) Ostomy Support Group will be holding its biennial with stomas and will be holding a free zoom event that will Awareness Day on Friday 1 October 2021. involve information and fun events on the day. We hope Entertainer Luke Escombe will again be in attendance along to enlist support from Stoma Nurses, Ostomy Supply with a Motivational Speaker, Gastroenterologist, Stomal Companies and Guest Speakers. Therapy Nurse, Product Suppliers and other guest speakers. Save the date and keep an eye on your Associations’ For free samples call Toll Free For Queensland Ostomates, further details regarding this websites for more information at it evolves with information, FREE event will be on a flyer with your order. timings, the program and where to RSVP if you wish 1300 784 737 (NZ 0800 100 146) For further information phone Sandy on 0418 150 507. to register. or visit www.ainscorp.com.au ®Registered trade marks of Salts Healthcare Ltd. ©Salts Healthcare Ltd 2021. Products and trade marks of Salts Healthcare Ltd are protected by UK and foreign patents, registered designs and trade marks. For further details, please visit www.salts.co.uk *Compared to our previous Salts hydrocolloid wafer. 22 | Ostomy Australia August 2021 Ostomy Australia August 2021 | 23
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