irrigation

[paula]

hello, this is my first time on this forum. I've had a colostomy for 13 years and always heard about irrigation, and wanted to try but never did. Just afraid, I guess, that something will go wrong. Is it too late? How do we start? thank you for your time.

paula

[steiconi]

It's never too late...If your doctor says you're a good candidate.

First step is to confirm you have enough colon left--ask your doc.

Next, check out youtube for videos of the process. I learned a lot from just a single video (sorry, I don't have a link). Also read through this forum, there's a ton of info.

Now get an irrigation kit. If you use a 2-piece system, get a kit from the same manufacturer, in the same size as your wafer. The irrigation sleeve snaps onto the wafer. The kit includes a clear hanging bag that holds water, with a long tube that ends in a cone. You may have to order sleeves and surgical lube separately.

Fill the bag with warm water and hang (from shower head or something similar). Start with 1000 ml; you can use more or less as you learn what your system needs. Close the water controller. Remove your pouch and snap on the sleeve. (you can also irrigate without a wafer. It can be a little messier.) Put a clip on the bottom of the sleeve. Attach a belt for extra security.

Use a little surgical lube on the tip of the cone.
Open the top of the sleeve and insert the cone in your stoma. Hold in place.
open the water controller slowly; if water leaks out around the cone, you may need to press it in more firmly. Some kits include a device that shows water is running; that's very helpful. You may need to press more or less firmly on the cone to get the water to flow. (Or maybe I'm the only one with that problem--I've got a flush stoma that takes extra care.)

If it hurts, reduce the water flow. When you feel full (or run out of water), remove the cone and seal the top of the bag.
Wait for returns. As sleeve fills, CAREFULLY remove clip and put end of sleeve in toilet. Some people don't use a clip, just put the end of the sleeve in the toilet from the start.

I keep track of time, and wrap things up 10-15 minutes after my last return. Your system may vary, so take notes.

Rinse your equipment and hang to dry. Periodically (some say daily) soak in water with bleach added.

Repeat as needed; some people irrigate every 24 hours, others can go up to 3 days.

Good luck!

[paula]

Thank you so much, Lee for your reply and for taking the time to go over everything step by step. I truly appreciate it. I will check with my doctor first and take it from there. Again, thank you and wishing lots of luck for you as well in this endeavor of ours.

Paula

[BillB]

My suggestions:

Read the two articles at the top of this forum. Really good information in both.

As Lee suggested, check your supplier's catalog for the supplies you'll need. Give them a call. Many will sent samples for initial use.

If you're still serious about trying irrigation, schedule an appt. with your doctor and get his/her advice. You'll need the doc to write the order so your supplies will be covered by your insurance.

Find a WOC nurse who will give you personal instruction. I found the nurses at the hospital where I had my surgery actually discouraged it, for several incorrect reasons. I did find a nurse on staff at one of the local ostomy supply stores. I made an appt. and went to her store where she guided me through the process in their restroom. The $25 I paid was money well spent.

Be patient. It's different for us all. And, post your questions here. You'll get lots of good advice and support.

For me, it made my life normal again. Good Luck!

[Don60]

I challenge the premise that permission and instruction are required.

This forum and the materials it references provide extensive instruction, and the requisite supplies are readily available. While special circumstances such as a transverse colostomy or recent surgical revision may apply, your 13 years of experience with colostomy management provides an excellent background for irrigation.

Just my thoughts on the standard recommendation to see your doctor and WOCN first.

Anyone else?

[steiconi]

I suggested talking to the doc because I have heard that not all colostomates can irrigate.

Aside from that, you can do this all yourself.
The youtube videos are great if you're a visual learner, otherwise it's just doing an enema through your stoma.

[ot dave]

I don't have anything substantial to add to this conversation other than to say go for it. Irrigation for me, gives more than it takes from my daily life. Once you get started and have specific questions, come back and ask, we will be happy to help.

David

[Mikem]

Hi Paula,

Best of luck on your journey. We hope you find success with irrigation.

To footnote some of the recommendations already provided I would like to add:

Doctors prescriptions are generally required to obtain irrigations supplies just like your regular appliances if you get them though insurance or Medicare. However I have found that based on the extreme low numbers supplies I use, I do not bother. Insurance markups are very high and for many programs it costs more to get them through insurance rather than direct from online resellers.

Also be aware that irrigation is not for everyone. Some will be unable due to physical limitations. Some will have low success due to the amount of colon they have left. Others may not be prepared for actual process which some might consider "icky". You become very familiar with your output, much more so than a non-irrigating colosomates. I suspect that puts off a lot of potential gators.

While learning on your own is a viable option it is not recommended. You have to very adventuresome to take the risk and there is not insignificant possibility that something will happen which will cause a mess you might not be prepared for. Having someone available to take you though the process step by step is a great idea.

So in my opinion the simplest process is to:
1. Study the resources.
2. See your doctor assuming you still have a colorectal surgeon to see, otherwise you might have to educate your Primary Care Physician about the prescriptions you will need. Get back with us if that is the case.
3. Get the prescriptions for supplies from you insurance. Get back to us with other recommendations if you do not have insurance.
4. Order your supplies and when you get them make an appointment with a WOCN who is knowledgeable about irrigation. If that is not available or possible get back with us for other recommendations. You do not want to be alone when you first try this. There are stories of people feinting during the process.
5. Survive your first gator experience. After that it is a never ending learning process as is continually changes as we age and adjust.

Again, best of luck with your journey. We are here to help you if you have questions or challenges.

MikeM

[Jimbob]

Let me add that irrigation is a great hobby........Also when you talk to a Dr. if he says there is no Medical reason to irrigate tell him it is a quality of life thing.

[jamesremler]

Good afternoon, first time on the discussion board. I have a perm colostomy since March and just started irrigating about 3 1/2 weeks ago. It seems to be going very well. I irrigate every other night. My questions are how do you know if you are using the correct amount of water and how quickly to infuse it. My first week or two I used about 1200 ml of water and let it go in a fast as it would go and I had no problems. I went to a support group and spoke to a WOCN and she said 1200 is too much (750ml-1000ml should the"right " amount) and I should have it go in slowly. I tried it her way. It is no better. Any guidance?

[Mikem]

James,

My recommendation is to use the least volume possible. I have found continually increasing volume (and time) to get the desired results is required for me. There is no need to rush it.

Experiment to get your best result.

MikeM

[steiconi]

It would be difficult to make a case that any one amount or speed or interval is the "right" one.

From what I've read, people use anywhere from 1000 to 2000 mg for the first infusion. Some stop there, others do multiple infusions.
Some irrigate daily, others routinely go 2 or 3 days.
I would guess that some people have larger colons, or more reluctant pooh, so more water is needed.
I'm impatient, so I go as fast as possible. When I feel full, I stop. Sometimes that's 1500mg, sometimes it's 1000 (after a big meal, for instance).

welcome to UOAA!

[paula]

have not been feeling very well, and have just had a bout with cramps and nausea that landed me in the hospital, that's why I haven't been here. Just wanted to thank everyone who took the time to go through the process of irrigation step by step. I truly appreciate it and will think seriously about it, after getting over this episode. thank you again.

paula

[Majorkahuna]

I have been irrigating for 16 years. I have severe radiation damage in my colon and sometimes it does not last as long as I would like. Mostly can go 24 hours but sometimes it only works for a few hours. I take a few immodium to slow things down a bit. It certainly makes life more enjoyable and mostly predictable.