Since this is a topic we can all relate to, I thought I’d start with something simple. If you still have some of your colon, you probably won’t have as many issues staying hydrated. But with an ileostomy, where your colon has been removed, you’ve lost most of your ability to absorb fluid efficiently. So you need electrolytes and sodium to help. There are a number of really good products to chose from. Many doctors will just automatically send you to a GatorAid product, but I personally get tired of them quickly. My choices are Propel, DripDrop, and LiquidIV. All are easy to find and purchase. At our support group we had a session on hydration and distributed the following graphic. It’s summer now, so staying hydrated is more important than ever!
Since my surgery, it seems much harder to have blood drawn for lab work. Before, my veins were easy. In fact, I have one vein in the crook of my right elbow that was my “emergency” vein. If they couldn’t make a stick anywhere else, I’d offer it up, and it was always good to go. But now I don’t seem to have any available veins anywhere. Even my emergency vein is hard to access. I’ve thought this was due to aging, but after some discussions I’m now thinking it’s more due to hydration.
Last week on vacation I had the opportunity to talk with a friend who is a pre-op nurse at a large medical center in Kansas City. From her perspective, age has nothing to do with drawing blood. However, how much weight you have can make a difference in accessibility and pain. If you have more fat on your arms, that can make finding a vein more difficult (that makes sense), and if you’re very thin the veins are easier to find, but drawing blood may be much more painful. Her best suggestion for all was HYDRATE. Even when they tell you not to eat before lab work, that doesn’t mean you can’t drink water. And for us ostomates with hydration issues, we need to be even more aware of this. Maybe even drink throughout the night when you get up to empty your pouch. She also suggested heating your veins before the blood draw – try taking a hand warmer with you to the lab. This helps to raise your veins, making them easier to find and less painful if you’re thinner. If you’re having blood drawn in a hospital setting, ask if they have a vein finder. All hospitals have them just for this purpose. And don’t be shy about asking for someone more experienced to draw your blood. If you suspect a recent graduate with a shaking needle coming at you, be assertive. Remember, you’re the one that will be bruised.
Although I’d worked in hospitals, and studied anatomy for years, I never appreciated the value-add of a colon in hydration. In fact, when you have a colon, almost all of your body’s fluid intake comes through that. So….without a colon, we have to be extra careful to make sure we get the fluids we need. It took me a couple of months to realize that. After surgery I was feeling so great, but one week I was suddenly tired again and had trouble concentrating. I wasn’t getting enough fluids! Water is great, if you can drink it plain or mixed with something like Crystal Light, but there’s an argument to be made for getting extra electrolytes. I read somewhere that it’s good to supplement 50% of our water intake with an electrolyte-infused drink. Gatorade is often used as an example, but it’s not my favorite. You can drink something like Propel (which they even use for colonoscopy preps now) or SmartWater (which I prefer). I also really like iced tea, which is full of potassium, but no sodium. That being said, one member of my CCFA support group has an eight-year-old daughter that had her colon removed at age six. To have her get the sodium she needed they over-salted all of her dishes, and then encouraged her to drink almost anything she wanted. I’m never without my water bottle now. There’s many ways to get the nutrition we need, but getting enough fluids is the most important of all.