My choice of topics might sound odd together, but I've actually woken up this morning with something that's either mild food poisoning or a stomach bug, with diarrhea and stomach cramps. I've considered whether going away is still a good idea, but with surgery so close now, I refuse to give up my last trip away before hospital. Still, I thought these two topics were pretty relevant, so here they are!
11 days to go: Holidays with a stoma
A big concern for a lot of new ostomates is problems they might encounter when going on holiday, particularly if that holiday is abroad. For a few months after surgery, for obvious reasons, travelling far from home is probably not the best of ideas. Travel insurance can be hard to come by after major surgery, plus the added worry of experiencing complications while abroad can lead to more stress than it's worth. It's hard enough explaining stoma problems to some UK medics, let alone trying to battle the language barrier in a hospital abroad.
For this reason, I took it easy on my first trip away post-surgery and at around 3 months out I travelled down to Bournemouth to stay with a friend from university for a family party. I was there for perhaps a couple of days at most. It was far enough away to push me out of my comfort zone, but not impossible to get home had any complications come about. At this stage, I was still getting used to caring for my ileostomy, but had gained enough confidence going out and about at home that I felt ready to go a little further afield. That all went smoothly, and I had a great time - for the first time in a while, it meant I could focus on something completely different, without my illness being at the back of my mind.
Going wig crazy on my first UK holiday post-op
Feeling boosted by this positive trip away, at 6 months post-surgery I took the plunge and booked flights to Spain with a group of university friends, where we stayed in someone's parents' holiday villa. I was understandably nervous about the trip, but as all my friends were going, I didn't want to miss out. It was also a chance to get some well-deserved sun after all that had happened to me since January!
Here's some key tips for travelling abroad with an ileostomy:
- Take medical documents with you to the airport. Online, you'll probably find a lot of horror stories about ostomy patients getting stopped at the airport security checks. This worry, combined with the stories of a couple of travellers who've been particularly unfortunate, is enough to put a lot of people off going abroad with their stoma.
In reality however, the vast majority of people will not get stopped by the airport metal detectors at all, let alone quizzed in depth about their stoma. I did not get stopped going into or out of Spain, nor did I get stopped going into or out of Italy 3 months later. By carrying documents with you (certain organisations such as the Ileostomy Association provide members with stoma information cards written in several different languages), it gives you peace of mind that you'll be able to explain yourself should the very unlikely searching scenario arise.
If you did get stopped in any case, I can only imagine that it would help to be candid, open, and honest. Shelve your embarrassment and explain your condition in as honest, layman's terms as possible - "I have a stoma bag due to a bowel disease - this means that I don't poo in the normal way, but out of a hole in my stomach into a bag. That is why I'm wearing it." This might sound mortifying to admit to, but I would imagine this sort of approach is much more likely to allow you on your way more quickly and easily. You're never going to see that airport officer again, and they're probably going to be just as embarrassed and apologetic as you are.
But scrap that, it WON'T happen. You're gonna be just fine!
- Dress for the plane. Back to what I've just covered - you can get through airport metal detectors easily if you remove all possible avenues of potential alarm-raising suspicion. Avoiding any piece of clothing that might cause an alarm brings a lot of peace of mind. When flying, to be certain that I will not set off an alarm (and so not be searched in the first place), I remove jewellery, belts, shoes, and wear a bra without underwiring. These items are often what cause metal detectors to go off.
Your ostomy bag will inflate slightly on board an aircraft due to cabin pressure. Don't worry about this - it won't become a huge balloon! - but be aware and wear slightly looser clothes that will allow for more comfort and room on board.
- Carry your ostomy supplies in your hand luggage. You will not be allowed your scissors on the flight, so the best option is to cut all your bags beforehand. You will also have to put adhesive remover spray in hand luggage, as it's classed as an aerosol. Some healthcare companies offer sample sachets of adhesive remover gel which could be taken on-flight instead, but remember you'll still have to declare it at security in a clear bag for liquids. As long as your bags and main items are with you at all times, this may avert a disaster if by some chance your hold luggage got lost.
- Take double the amount of supplies you need. Obtaining ostomy supplies abroad is possible, but not easy, and causes a lot of stress that you don't need. It's always better to take more than necessarily than too few.
- If you are going to a hot country, consider packing rehydration salts. Rehydration salts e.g. Dioralyte or Boots own brand are cheap and can be bought from most chemists or supermarkets. One sachet of salts is mixed with 200ml of water to make a salty drink that helps restore the body from dehydration. It comes in a variety of equally disgusting flavours, but definitely works, so just hold your nose and go for it. Unfortunately you shouldn't be mixing it with juice or anything other than water, as this can dilute the solution too much for it to work effectively.
When abroad, keep hydrated with plenty of isotonic drinks and juices and eat salty snacks. Water is not necessarily the answer, as it can flush out your system and ironically cause further dehydration.
- Pack imodium. These kind of drugs can be a bit of a lifesaver, in any case. I have them in my pocket whatever country I happen to be in.
Me in Malaga, Spain
When you get abroad though, you'll find that all these worries melt away into the summer sun and you end up having the most fantastic time. The idea of a foreign holiday is scary because it's something new and completely different - and there's no option to bolt home if there's any issues. However, your ostomy was made to give you a better life, and allow you to take part in things like holidays that would never have been possible before, so don't let your stoma hold you back.
Me in Rome, Italy
10 days to go: Stomach bugs and food poisoning with a stoma
Seen as I'm cuddled up on the couch writing this blog with a stomach upset, I feel in a pretty good place to explain sickness bugs and stomas! It's happened to me a few times before, so I'm prepared and know how to handle it this time.
Symptoms of a stomach bug with a stoma are very like regular symptoms:
- Stomach cramps
- Diarrhea
- Vomiting
- Loss of appetite
- Raised temperature
The main problem with a bad tummy and an ileostomy is dehydration. Your poop is fairly liquid at the best of times, and when you have 'diarrhea' with an ileostomy, your stoma output is literally just brown water, as fluid as if it was running from the tap. Your output may smell extremely bad. Your bag will fill with water sometimes several times an hour, and the output will feel hot as it empties into the bag against the skin. I've found that I'll have a wave of stomach cramps, then my bag will suddenly fill.
If your stomach bug is mild, it should last no longer than 24 hours. This sort of bug can potentially be tackled at home. Drink only isotonic drinks - avoid water. Eat salty snacks, like crisps or pretzels, if you can stomach it. Consider drinking rehydration salts even if you don't feel dehydrated. The point is, to keep on top of your bug before it becomes an issue - making sure you stay hydrated is the biggest plus here.
Be aware and watch out for the symptoms of severe dehydration. If you have any of these, call NHS 111 or visit A&E. These include:
- Feeling very thirsty
- Dry mouth, tongue and dry eyes that do not produce tears
- Dry, papery feel to skin
- Weakness
- Dizziness/fainting
- Palpitations
- Confusion
Being admitted to hospital for dehydration can be alarming, but it's actually a very quick and easy problem to sort. I was once admitted to hospital with my ileostomy for dehydration in October 2014. The story went a bit like this.
I'd just been to Italy, and on our last day we visited the ruins at Pompeii and ate at a local restaurant. Unfortunately, the meat my dad and I ate at the restaurant appeared to be the problem, as we both developed food poisoning the next day when we were due to fly home. My mum, who's veggie, was fine. As we were so busy getting to the airport and boarding the plane, I didn't have time to buy/make rehydration salts and thought I'd be fine. I emptied my bag several times at the airport and on the plane, and each time it was just water, getting clearer each time. Our flight touched down at around 7pm, and my parents drove me back to my university accomodation before leaving for home.
In the uni flat on my own, I began to realise just how ill I felt. I was shaking, and felt dizzy and dazed. All I wanted to do was curl up and sleep, but I realised something wasn't right. My tongue was dry to the touch, and the skin on my face, arms and hands had begun to feel leathery. My bag was still filling with clear water, despite not eating anything in the past 24 hours, and I was emptying it every half an hour. I remembered that I hadn't urinated since before our flight.
I rang NHS 111, who advised me to go to an out of hours GP. It took an unusual amount of effort to get the bus to the GP practice - and in the time from leaving the house, to getting the ten minute bus, my bag had filled to the brim with more water. The GP noticed my racing pulse and commented that my eyes looked sunken. I remember rubbing my eyes at one point and they were bone dry. By this stage, I also felt pretty confused. I mixed up times and dates, forgot my address, and was generally pretty out of it. The GP called me a taxi to A&E - it was now around 1am in the morning!
My cannula in, ready for rehydration to begin
Once there, they confirmed I had severe dehydration and set me up on a trolley in a side room. There I received intravenous saline fluid through a drip in my arm. I fell asleep for most of this. At 4am, a nurse came in and woke me up telling me the saline was finished, and I was fine to go home. I got a taxi home, not quite believing how quickly everything had developed!
If you're ever unsure, consult an emergency doctor for advice on dehydration, because sometimes a bug can be so severe that you just can't manage it yourself.
Greta information about ostomy management
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