Fistula, fistulie, fistulo, fistula, ha, ha, ha, ha, ha

Today is a holiday and like most other Americans, I am looking through my medical supply catalog trying to decide what type of ostomy supplies I want to buy. Do I want a drainable pouch or a closed end pouch, a one or two piece system, opaque or transparent, cut-to-fit or pre-cut barriers, convex or non-convex, mini or maxi length, and click or non-click closures? I have tried some of these out after getting free samples from the manufacturers and from the ostomy nurses at my doctor's office and at the hospital. 

I am getting used to wearing the colostomy appliances, but I still don't like it. I've heard that some people who had Crohns or diverticulitis and ended up with colostomies have found that they enhanced the quality of their lives. I'm thankful that I had the option to divert the waste from my fistula, while I'm going through the treatments, but I really hope that the colostomy can be reversed, when all is said and done. It takes more time to put on, empty, and remove the gear, and I'm using a lot more toilet paper trying to keep the end of the drainable pouch poop-free. Even though my stoma is low, the top of the pouch is above my waist, which requires that I either wear pants with a waistline right under my boobs, or shirts that cover the top of my waist. I'll take what's behind door number two. 

Not long after I came home after the colostomy surgery, my bags leaked every day for a week, and I could not figure out what I was doing wrong. The leaks started after the home health nurse visited me and proclaimed that I was an expert who did not need a home health nurse. I had to put on a new bag each time I had a leak. Health insurance companies will only pay for 20 drainable bags a month, and I was going through 2 or 3 a day. Plus, some of the leaks happened when I was away from home. Luckily, I took an extra bag with me, except for once when I was in Kroger's parking lot getting ready to shop, and had to go back home. Actually, even if I'd had an extra bag, I probably would have gone home to change the bag rather than change it in a public restroom. (The thought of taking a flight across the ocean and having to empty or change a bag in an airplane restroom is unfathomable.) 

When I went back into the hospital for the chemo treatment, I contacted the hospital's ostomy nurse, and she visited me. She determined that the shape of my belly had changed (less swollen) since the surgery, so that there was a dip in the area at the bottom of the bag where it adhered to my stomach. The dip was causing the seal to break. Her fix was to start me using a two piece system and adding a skin barrier ring, which sticks to my skin and to the bag. This worked, but the two piece systems have plastic rings on the barrier and the bag, which snap together and they add a little extra weight to the setup. I don't need any extra weight to lug around. And I don't like being aware that I am wearing colostomy gear. And when it comes to opaque or transparent bags, I want opaque. I'm pretty sure there's not going to be anything unexpected in the bag, and I'd rather not view the shit every time I go to the bathroom. And now, I sleep in my underwear, because when I move around in bed, the bag flops around. I don't like sleeping in my underwear; that area needs some breathing time and it's not getting much.

My team at work sent me a really nice Visa gift card last week, and I used it to buy a bigger purse - which does not smell like a rotten banana - so I can carry extra ostomy supplies. One of the manufacturers of the ostomy supplies sent me a bag for carrying supplies and it has their name on the outside. Maybe, I could just get a tattoo on my arm that says "I poop in a bag made by 'their name here'."

I was thinking the other day that in spite of the fistula which precipitated the need for the colostomy, I am grateful that it developed. For those of you who don't recall, a fistula "is an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect." In my case, the fistula is between my rectum and vagina and was caused by the tumor "breaking on through to the other side." If the fistula had not developed, the cancer probably would have gone unchecked. A word to the wise: discuss changes in your bowel habits with your doctor and request that your doctor do a DRE (digital rectal exam) at your annual physical. If you're not getting annual physicals, start now. I had noticed changes (frequency, color, and size) in my bowel habits for several months, but thought that that, like a lot of changes in my life, was because I'm getting old. It wasn't until the discharge appeared that I went to see my doctor. As they say, "hind"sight is 20/20.