>> Ms. Lynn: Hi Ms. Reese, I see you're getting ready to be discharged. >> Ms. Reese: Oh yes Ms. Lynn, I'm a little nervous. >> Ms. Lynn: Okay, well, we're going to talk about your ostomy before you leave, because this is your new ostomy. And we're going to talk about cleaning and how to take care of it. >> Ms. Reese: Oh good. Good, I need to know these things, because I'm going to have to do this myself. >> Ms. Lynn: You are, you are. So let me just wash my hands, okay, alright. And I'm going to put some gloves on. >> Ms. Reese: Will I need to wear gloves at home? >> Ms. Lynn: Not necessarily. >> Ms. Reese: Okay. >> Ms. Lynn: If you're more comfortable with gloves, you can wear them. If not, you don't need to wear them yourself. You just want to remember to wash your hands before and after. >> Ms. Reese: Okay. It just depends on how messy it's been. >> Ms. Lynn: Yeah, right. And then you will make that decision as you do this more. Now what I'm going to -- First, I'm going to talk about cleaning. So when you're going to clean this, this is just like any other body part. You're going to use soap and water, and you just want to clean the stoma and the surrounding tissue, and you just keep on cleaning until it looks nice and clean. You don't want to rub too hard. You don't want to irritate it, but you just want to make sure it's clean just like any other body part would be. And then, we're going to let it -- we're going to pat it dry with a nice dry towel. And then we're going to move on to putting the bag on. You might -- You're going to have a colostomy bag, but we have to make sure we have the right size colostomy bag. >> Ms. Reese: Okay. >> Ms. Lynn: If it's too big, which I'm going to show you, we're going to have breakdown of the skin around it and we want to try and avoid that. >> Ms. Reese: What's breakdown? >> Ms. Lynn: Well if a lot of the surrounding nice tissue is inside the bag, some of the stool is sitting against it, it will cause it to start to become red and almost like -- It might start to look like a blister that's popped -- >> Ms. Reese: Okay. >> Ms. Lynn: -- and the skin would peel a bit. And you don't want to do that. >> Ms. Reese: So what would I do then? >> Ms. Lynn: Well, we do have some products if that happens. >> Ms. Reese: Okay. >> Ms. Lynn: We have powders and creams and we'll tell you all about those and send you with some. >> Ms. Reese: Okay. >> Ms. Lynn: And you can put that on. >> Ms. Reese: Okay that will help it -- >> Ms. Lynn: If that happens, yeah. >> Ms. Reese: -- that's from getting sore. >> Ms. Lynn: Right, right. >> Ms. Reese: Okay. >> Ms. Lynn: And so first we're going to measure if we have the right size. Now we look at this, and obviously that's way too big. >> Ms. Reese: Oh, okay. >> Ms. Lynn: Right? And then, we might try something like this, but then that would be way too small. This -- It has to surround the whole stoma. >> Ms. Reese: Okay. >> Ms. Lynn: So we -- you can just keep moving about until you find the one, and there we go. >> Ms. Reese: Oh. >> Ms. Lynn: So you can see how that one surrounds the stoma. >> Ms. Reese: Okay. >> Ms. Lynn: It's not pinching it off. We don't want to pinch it off. But there's very little tissue inside. >> Ms. Reese: And that will keep the bag on nice? >> Ms. Lynn: That'll keep the big on nice. >> Ms. Reese: Okay. >> Ms. Lynn: So then you would take this hole, this measurement here that you decided was correct. And you would put it up against the inside of the bag. And then that would tell you where you would cut -- >> Ms. Reese: Oh, okay. >> Ms. Lynn: -- because this bag will stick against you -- >> Ms. Reese: Alright. >> Ms. Lynn: -- and it will tell you where to cut. So we have one here. And we cut. And you can either have the bag that sticks on here as wafer. This is called a wafer. >> Ms. Reese: Okay. >> Ms. Lynn: And we've cut it to the correct size and you can see if it's right over the stoma and it's sticky. >> Ms. Reese: Oh. >> Ms. Lynn: And you skin is all clean. You've already cleaned it. So we're going to take off the backing, and we're going to stick it right to your -- >> Ms. Reese: How often do I have to change this? >> Ms. Lynn: Every couple of days -- >> Ms. Reese: Okay. >> Ms. Lynn: -- unless it's a looking extremely messy or -- >> Ms. Reese: Do you think I can do this myself? >> Ms. Lynn: I think you can do this. It takes a little bit of practice. >> Ms. Reese: Okay. >> Ms. Lynn: And so you can see how it would stick to the skin. >> Ms. Reese: Oh, that's good. >> Ms. Lynn: And then it's sort of like -- Do you have any Tupperware at home? >> Ms. Reese: Oh sure. >> Ms. Lynn: Right. So it sort of fits like Tupperware. >> Ms. Reese: Oh. >> Ms. Lynn: So this just pops right on it -- >> Ms. Reese: Oh, that's nice. >> Ms. Lynn: -- just like Tupperware. And then it would stay right on the skin. >> Ms. Reese: Oh that's nice. >> Ms. Lynn: Here you go. And then it has a clamp on the end. >> Ms. Reese: Okay. >> Ms. Lynn: And so when it becomes full, I would say about halfway -- you don't want it to burst or if it fills with gas, which is you can do the same thing. Pull in the seams. You want to just take this end clamp off and you want to have something to empty it into. >> Ms. Reese: Okay. >> Ms. Lynn: And you -- This is open on the end and you would sort of just put out the contents. >> Ms. Reese: Is it going to be liquidy or soft? >> Ms. Lynn: It will be more formed. >> Ms. Reese: Okay. >> Ms. Lynn: Because you have the descending ostomy which is the formed stool. The higher up -- >> Ms. Reese: Oh, that means I have to push out, won't it? >> Ms. Lynn: Well, we're going to work on your diet. >> Ms. Reese: Okay. >> Ms. Lynn: And we're going to make sure that we do our best -- >> Ms. Reese: Okay. >> Ms. Lynn: -- to make it easier on you. The higher up the ostomy would be, the more liquidy. >> Ms. Reese: Okay. >> Ms. Lynn: So this is the lower. So this is going to be more formed. And then you could just sort of wipe it off and it's reusable. And then you would just put it -- put the clamp back on. And then, let it go. >> Ms. Reese: Okay. >> Ms. Lynn: And then -- and then there we go. >> Ms. Reese: Do you have any kind of bags you can like don't have to do that? >> Ms. Lynn: Yes there are. Now this is reusable -- >> Ms. Reese: Okay. >> Ms. Lynn: -- but then we have something like this where you can see the ending is closed. >> Ms. Reese: Oh, I think I'd like that. >> Ms. Lynn: Yeah, you could have these. >> Ms. Reese: Okay. >> Ms. Lynn: And then when they get about halfway full, they just -- they're just removed and put in the trash. >> Ms. Reese: Do you think I'll always have to wear this bag? >> Ms. Lynn: Well actually because of where your ostomy is, you may not always have to wear this bag. We can teach you what's called irrigation. And I'm going to show you that. Let's take the bag off. I'm going to take this off just so I can show you. This is an irrigation bag. We'll give you the whole irrigation kit. >> Ms. Reese: Okay. >> Ms. Lynn: And you're going to fill this with about a thousand to fifteen hundred cc of warm water, warm. Cold might cause cramping. We don't want to do that. And then the ending here looks like a funnel actually will go into the stoma. And you can very slowly -- You would be sitting on the toilet, regulate this so that the fluid runs in -- >> Ms. Reese: Is like giving myself and enema? >> Ms. Lynn: It's just like an enema. >> Ms. Reese: Okay. >> Ms. Lynn: And you would just let it run in. And then there's a bag that would be attached to you instead of the wafer. It would be a bag that runs and sits into the toilet. >> Ms. Reese: Okay. >> Ms. Lynn: And then once you're done irrigating, you would take this out and then all the stool that's in your intestines would come -- and your colon would come out and run into the toilet -- >> Ms. Reese: Okay. >> Ms. Lynn: -- and then that should be good for about 24 hours. Now this might take about an hour. >> Ms. Reese: Okay. >> Ms. Lynn: But you just have to do it the same time every day so -- >> Ms. Reese: So then I wouldn't have to wear my bag? >> Ms. Lynn: And then wouldn't have to wear your bag. And if you're concerned, you can wear -- There's very small bags that you can wear that are -- would be completely flat. >> Ms. Reese: I think I've seen those mini-bags. >> Ms. Lynn: Yeah, under your clothing or you can just even put a piece of gauze with some tape. >> Ms. Reese: Oh that would be good. >> Ms. Lynn: Yeah, sort of like the same thing that's on your incision here. >> Ms. Reese: That would be good. >> Ms. Lynn: Yeah, so that would be nice. And it would take about an hour, the same time every day. >> Ms. Reese: Okay. >> Ms. Lynn: And you just -- you do it the same time every day and then you should be okay for the rest of the day. >> Ms. Reese: But I can't do that yet? >> Ms. Lynn: No. We don't want to do that yet, because we want to let -- This is new and we want to let it heal. So when you come back for your next appointment, we'll go through this again. We'll give you the whole kit and you'll have the chance to work with it. >> Ms. Reese: Well that's something to look forward to that I maybe won't have to wear my bag all the time. >> Ms. Lynn: Right. So, right -- If you're at the beach and you're doing this irrigation procedure, then you -- it won't be seen under your bathing suit. You can have it under your bathing suit. It wont even be seen. So you can live a normal life. No one will know it's there and you'll be comfortable. Are you feeling -- >> Ms. Reese: I can hide my colostomy. >> Ms. Lynn: You can. Does that make you feel a little bit better? >> Ms. Reese: It does, that does. I know that I need to do this, but I was worried about having to wear this bag and that's a good option that I may not have to do it. >> Ms. Lynn: Yes, that's correct. So, it's good that you now have the procedure down. We'll review it again. >> Ms. Reese: Okay. >> Ms. Lynn: And this time, we'll let you measure it and do the cutting -- >> Ms. Reese: Oh, okay. >> Ms. Lynn: -- the wafer, so before you leave, we'll have that you know how to do it. >> Ms. Reese: I think I know how to do that. >> Ms. Lynn: Yeah, and we'll do it again. >> Ms. Reese: Oh, well thank you so much. >> Ms. Lynn: Well you're welcome. >> Ms. Reese: That really helped. That really helped. >> Ms. Lynn: I'm glad. >> Ms. Reese: Think I'm a little less worried. >> Ms. Lynn: Good.