I wasn’t originally supposed to have an ostomy bag. When I had my first surgery, the initial plan had been to cut out the cancerous portion of my colon and reattach everything. However, I had a devil of a time with the bowel prep meant to clean out my colon prior to surgery. With that, my chances of waking up from surgery with a colostomy increased significantly. What no one knew until surgery began was that my tumor had grown in the three weeks since diagnosis and reattachment was no longer a wise idea. By that point, my tumor was blocking my colon in two different places and my surgeon was concerned about the possibility of what he called drop metastases. Drop metastases are little bits of cancer that break off from the main tumor and are too small to see. My surgeon wanted to wait until after chemotherapy to be sure any potential drop metastases had been killed before reattaching my colon.

A colostomy is where the surgeon takes part of the colon, or large intestine, and surgically brings it out through a hole in the abdomen. The portion of intestine brought to the surface is called a stoma. With a colostomy, stool is thick, or sometimes even formed. The colon itself is about 5 feet long, and the more colon the surgeon is able to leave intact, the thicker and more formed the stool will be. This is because one of the jobs of the colon is to remove liquid from the waste our intestines produce. An ileostomy is where the end of the small intestine, or the ileum, is surgically brought out through a hole in the abdomen. Stool that exits the body via an ileostomy is much more liquid than in a colostomy because there’s no colon to remove the excess water and return it back into the body. Dehydration is a much bigger problem with an ileostomy than a colostomy because instead of returning liquid to the body, it exits via the ileostomy.

The first weeks with an ostomy of any kind can be difficult. The stoma is constantly changing shape as it heals. The topography around the stoma is changing too as swelling goes down. There is also a lot of trial and error in finding the right pouching system and other products. An ostomy nurse is an excellent resource in finding the right products to try. Colostomy/ileostomy bags come as either one piece or two piece and as closed or drainable. You can do nearly everything with a colostomy or ileostomy that you did before. You can hike, shower, go swimming, and so many other things. There are some dietary changes most people make, as the small intestine isn’t quite up to the task of digesting some foods. The most common problem foods are seeds, nuts, and raw fruits and vegetables. Without those changes, intestinal blockages are much more likely.

Part 2 to come tomorrow