Stoma prolapse, so far, has been the most frightening complication I've had. It can also get extremely painful. Just the opposite of when Bob retracts, or reverts back into the abdomen, the prolapse is when the intestine comes outside the abdomen more than what is normal for a stoma. It can increase in diameter and length, feel very heavy and painful. For me, this went on for three days, but then the after effects lasted a few more days with abdominal soreness around and behind the stoma, decreased appetite and nausea. I believe the stomal area gets traumatized and takes some time to fully recover. According to my stoma nurse, this can happen spontaneously in some people, but also heavy lifting or being overweight may be causes. Basically, the same risk factors for a hernia can also cause a prolapse. Though I have had pelvic organ prolapses in the past, I had no idea my stoma could prolapse! I was so worried about my hernia risk and luckily have so far been able to avoid getting one, but I wish I was also told about prolapse because then maybe, at least, I may not have been so freaked out about it.
I was worried that I had pushed myself too far in the gym because the prolapse began the day after hitting the weights hard as I had worked myself up to 100+ pounds with the cable weight pulls and shoulder presses, but still only up to 45 pounds with actual weights. But because I had worked up to lifting this amount of weight throughout the past six months I think this is probably just a spontaneous prolapse that would've happened regardless. Since it could have been related to the lifting, I had reduced my weights after taking about a week off from working out. I also ordered a prolapse/hernia support belt from my supply company, which I received today.
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| These first two photos are how Bob looked the first time I noticed the prolapse, after I put on a two piece Hollister appliance so that I could keep an eye on it. It came out like this in the morning and stayed this way for the majority of the day. I was a bit freaked out and didn't know what to do about it, so I got in touch with my stoma nurse. She told me to lay down and the stoma should go back in on its own. Though laying down didn't work, it did finally reduce in size late in the afternoon. So I went about my normal routine and hit the gym for an upper body workout, a run and a swim. I did reduce the weight I lifted, though. I got a cramp on the side of my stoma while running but now I wonder if this had to do with my stoma or if it was just a side stitch, as it has happened quite often since I first started running again (only while running). Anyway, Bob was okay that night, and the next morning it was pretty much normal so I thought it was just a one time freaky thing that happened... |
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| Until the next day, which was a Thursday when I work a half day (6 hour day). Well, Bob came back out while I was at work that morning so I was glad it was just a half day. What happens is the stoma gets much thicker as well as longer, and so the wafer that is on [cut to the size the stoma is normally] gets way too tight and can actually strangulate the stoma. I made it through my shift and a long walk with Spot (I decided to skip all workouts because of this prolapse situation), and by the time I got home that evening I was in quite a lot of pain and had to take the bag off. I was so frightened by how big Bob had gotten, even larger than the day prior, it looked to me that Bob had a bad case of elephantiasis! |
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| So my stoma nurse told me that sprinkling granulated sugar on the stoma makes it "crawl" back in. This works by osmosis somehow, not sure exactly the science behind it. Anyway, I had to lay naked in my bathtub without water, and sprinkle the table sugar on. It was a long process and took a lot of sugar, and it was quite a painful experience. It didn't completely work; Bob did shrink down in length, but was still way bigger than normal, especially in girth. |
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| Bob was still large and heavy, but being that it wasn't getting any smaller and was by this time so late into the night, I finally just had to shower, cut the new wafer much larger and hope it would be back to normal in the morning. |
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| This is what Bob looked like,was already starting to get longer again by the time I showered and got the wafer on. I had to cut the wafer to 44mm and it only has measurements up to 38mm because my stoma normally is only 25mm around. So I had to way over cut the wafer and I worried it would have leaked overnight because cutting past the template affects the adhesive quality. Also, I had cut even larger than the part of the stoma near my skin to get it over the more swollen part of the stoma (when the stoma prolapses it is different thicknesses throughout the length)...close to my skin the stoma was not as thick so this put a gap between the wafer and stoma which could cause output to irritate my skin around the stoma. Luckily by the morning Bob was shrunk down quite a bit but I had to cut the wafer to 38mm in diameter, still way bigger than normal. So there was potential for the stoma to either shrink back down to normal and cause a leak or to prolapse again and get strangulated by the wafer. So I called the lead tech before I went into work that morning and explained the situation. I hardly slept because I was up so late trying to shrink Bob then was in pain and also worried about an overnight leak and did not sleep well for the few hours I was in bed. I was still freaked out by what happened plus worried about the potential for Bob to change size again and also I was still in quite a lot of pain. On top of this, I was super worried because I was going back to my x ray job in only one week....I'll have to write another post on my work situation, but the short version is that I had a lifting restriction due to hernia risk when I was ready to go back to work after FMLA, so had to switch to a telemetry monitor tech job which is sedentary and therefore safe. Anyway, thankfully the lead monitor tech was very understanding and able to allow me to work just a half shift. Luckily sleeping and resting completely for a few days allowed Bob to go back to normal, and thank goodness it's been fine ever since. |
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| For reference, this is what Bob normally looks like at 25mm in diameter and maybe an inch or two sticking out....except when it decides to retract which still occurs and is why I'm using a convex wafer and convex ring. |
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This is Bob today with the wafer cut to it's regular 25mm size. Bob is actually kinda cute at this size, and I hope never prolapses again.
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| This is how the prolapse belt goes on. You first bring the pouch through the hole and it should lay flat over the front of the belt. Then, you wrap the belt around your waist and Velcro it together. The belt should be comfortably fitting, not too tight but also not loose. Should be able to fit two fingers between the abdomen and the belt. |
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| This belt has an extra panel that goes across the stoma and Velcro onto the belt, which is supposed to give additional support and keep the stoma from prolapsing. This belt is the cool comfort elastic, which I specifically got since we have hot humid summers, and because it's primarily for work which is very physical and I tend to sweat quite a bit. I must say, it is pretty comfortable for a support belt; it is not itchy and does feel more airy than the regular hernia support belt I have that is not the cool comfort elastic. |
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| These two pics are just to show what it looks like in the back and that it is stretchy and moves with me, which is important for range of motion. |
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| I ordered the NuHope prolapse/hernia belt that is 4inches wide and with a hole that is 2 3/8 inches around to fit the size of my pouches personally. They also have belts that are 2 inches and 6 inches wide, but I feel the 4 inch size gives me more support [than the 2 inch] but with a good range of motion without feeling too restricted. They also have different size rings to fit different size pouches, and they can even make you a custom size. Another thing I love about this company is that their appliances are made in the USA
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I have had one 12 hour shift back at my x ray job so far and Bob is still okay. I'm happy to have this prolapse/hernia belt to give Bob more support and therefore give me more confidence at work which requires lifting, pushing and pulling of heavy equipment as well as patients, stretchers and wheelchairs.
I must also point out that my prolapse situation was much less serious than it could have been. There are others whose prolapses never go back and require surgery. There are others whose stoma prolapses get much larger than mine which makes wearing a regular pouch much more difficult if at all possible. I'm lucky that my prolapse was not serious as it could have been and I hope it never gets to that point.
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