Learn more about some important considerations when a patient has a newly created ostomy in this video interview.

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My name is Cathy Milne. I'm an adult nurse practitioner and certified advanced practice wound ostomy continence nurse, and I practice in Connecticut at Connecticut Clinical Nursing Associates. My practice is somewhat unique because I manage patients across the continuum, acute care, outpatient, long-term care, assisted living, and I actually make house calls to those who are truly homebound.

A patient with a newly created ostomy requires certain lifestyle adjustments. Can you briefly elaborate on the impact these have on activities of daily living?

There's so many adjustments that these people need to be faced with. First of all, they have pain from the immediate surgical procedure, but also the connotation of having your bowel coming out on your belly, now looking at stool or urine coming out on your belly is quite a shock to a lot of people who don't have any medical background. And our framework, at least in the US, is that these things are dirty. Urine is dirty and stool is dirty, so it has that negative connotation. So that's number one. Then they have to learn how to manage this, then they have to think about the impact on both immediate relationships and then social relationships. So their life is turned upside down.

How can clinicians approach these patients and assist them in navigating this transition period and beyond?

So, one of the things I like to do is figure out what is the most burning question for these patients. A lot of times it's, "How do I sleep? How do I shower? How do I buy clothes? What happens if I leak? And I always approach, because I think it's something that people have this burning question, but never really discuss, is how to have sex. And sex actually is really-- there's the physical aspect of sex, but there's the intimacy that is really very important and is really the basis before there's a physical relationship that consummates that relationship. So you really need to work on intimacy first before you have any physical contact.

What suggestions might you have for wound care clinicians who may not interact with this population often?

So, there are a lot of resources out there and the United Ostomy Association is probably one of the best. There are very reliable blogs and support groups for people who have ostomies themselves, who actually help others go through this process. And people should access these sites and these organizations because they're tremendously helpful.