Living with Colostomy.

Today afternoon, my reading of the day's newspaper was interrupted by a hurried phone call from one of the Nursing Staff at Bangalore Institute of Oncology (BIO), pleading for my help to another patient who needed a temporary colostomy. The patient was diagnosed, like me, with colo-rectal cancer (CRC) and need a colostomy, but he was not convinced about the treatment option and was negating it word-by-word! So, the concerned Doctor suggested him talking to me so the patient could know, in first-hand, the experiences of the colostomy. I am more glad to help him in his case.

Ever since I was diagnosed with CRC in October, 2008, I was left with unbearable pain in the rectal/anal area while and after passing the stools. This pain aggravated since I had my first chemotherapy dose in Apollo Hospitals, Bangalore in February 2009. I was almost restricted to my bed for nearly five months because of the pain, until June 2009, when I had my temporary colostomy surgery to spare me from the pain. The team of doctors at BIO, who were attending me, suggested me undergo the surgery so I could be relieved of the pain which until then prevented me from even sitting straight on my base!

Basically, temporary colostomy or diversion colostomy is a simple surgical procedure wherein a portion of the transverse colon is brought to the surface of the skin as stoma and the waste (i.e., the feaces or stools) is collected in something called the colostomy pouch. This technique will prevent the normal passage of the stools to pass through the rectum/anus and the passage of stools is diverted midway by making an incision on the colon. The upside of this technique is that it relieves the pain, if any, in the rectum/anal passage since now stools will not pass through that route. The downside, though, is that there might be an element of inconvenience because of the additional maintenance of the colostomy pouch, wherein one needs to empty it regularly or as and when the stools get collected in that. (For more details on the technique, please see Colostomy Surgery. To understand more on the anatomy of the colon, please see Colon (Anatomy) and to know several treatment options for CRC, please see Treatment Options for Colorectal Cancer).

It took almost three complete months for my body to get adjusted to the new waste-disposal system. Nonetheless, the maintenance of the colostomy pouch is a bit cumbersome since replacing the pouch and dressing the stoma needs specialized skills and cannot be done personally. Usually, I would replace the pouch every week, though, there were times when it needed replacement once in three days. It dawned on me over a period of time that the frequency of the replacement depends on several such factors as (a) the quantity of the stools collected in the pouch (b) the frequency of the stools getting collected in the day (c) personal hygiene of the stoma area (d) personal dietary habits such as avoiding gassy and non-vegetarian items. As an aside, each replacement session at the hospital costs me around Rs. 500 (Rs.430 towards the pouch + flange and Rs. 70 for dressing charges)!

Of course, life has been never the same again for me ever since I started living with the colostomy. For example, it is

• completely uncomfortable to wear normal trousers since the pouch will be in the abdomen area and hinders the waist band of my trousers from settling in neatly
• very difficult to turn completely sideways, while sleeping, either on left or right side! If I turn left, the contents of the pouch can be felt very sensibly which is irritating; and if I turn right, the pouch is an obstruction, since the pouch itself lies in the right side!
• absolutely inconvenient to visit friends' or relatives' homes or to attend any gatherings because I cannot dress properly! (Of course, the pouch will be beneath my clothing and is invisible to others)
• binding on me to frequently check for any leakages in the pouch or the flange on which the pouch fits in. This not only makes me self-conscious but also feel low sometimes!

Despite all these, my colostomy relieved me from the unbearable and excruciating pain in the rectum/anal area which is a big relief, and definitely having the colostomy surgery is a decisive moment in my treatment. I am not sure, whether in the final stage of the treatment the colostomy is removed to reconnect the colon back to the rectum/anus or a permanent colostomy is resorted to! Fingers crossed and mind numbed, I wait for the time to unfold the answers for me.

(The picture shows the position and nature of the colostomy pouch on the right side of my abdomen. The red circular shape visible at the top of the pouch is the stoma through which the feces are collected in the pouch. To empty the pouch, it needs to be disengaged with the flange fastened with the white straps, and the fastening clip needs to be opened, and the pouch washed and rinsed thoroughly with some kind of disinfectant-mixed water).