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Meeting your stoma care nurse
Once your colorectal surgeon confirms your suitability for planned stoma surgery, the next step is likely to be meeting your local Stoma Care Nurse. During this appointment, your Stoma Care Nurse will discuss all aspects of the surgery with you, such as what to expect in the postoperative period (whilst you are recovering), when you will be discharged home and how to live with and care for your stoma. This is a good opportunity to ask your Stoma Care Nurse lots of questions. It can be helpful to take a list with you to your first Stoma Care Nurse meeting, just in case your mind goes blank!
Siting your stoma
The Stoma Care Nurse will 'site your stoma' before your surgery. This means they'll place a mark on your abdomen with a permanent pen, showing the surgeon where best to place your stoma. Your Stoma Care Nurse will start by asking you to lie flat so that they can look at your abdomen and assess any potential problem areas, such as old scars or creases. The Stoma Care Nurse will then ask you to sit and stand, looking at your abdomen to see movement and any changes to its shape. This helps to reduce the likelihood of problems down the line such as leakage, skin irritation or difficulties with finding pouches that fit well. You will then be asked about the clothing styles you usually like to wear. There are some restrictions based on anatomy - a colostomy is usually placed on the left of the abdomen, an ileostomy or urostomy is usually on the right hand side of the abdomen.
Remember - stoma siting is a joint decision between you & your Stoma Care Nurse. Don't be shy to say where you would prefer your stoma to be placed!
Trying out a stoma pouch
The Stoma Care Nurse will show you a stoma pouch and point out its features, such as the charcoal filter to release any gas or wind, the hydrocolloid baseplate or flange which sticks onto the skin around your stoma and the opening to empty the pouch (if you are having an ileostomy or urostomy). A colostomy usually requires a closed pouch, although everyone having a new stoma will have a clear drainable bag at first to allow medical staff to see the stoma and make observations. The Stoma Care Nurse may ask you if you would like to practice a pouch change.
Advice and support
Your Stoma Care Nurse can talk to you about any other questions you might have, such as what you should eat and drink with your stoma, any travel or exercise concerns you might have and much more. It is a good idea to take this time before your surgery to gather as much information as possible.
Your stoma care nurse can also point you in the direction of any support groups locally and nationally.