Questions about Irrigation: Seeking Advice from Specialists

Hi again,
As I said in my previous post, I wanted to chat about irrigation with anyone whose experiences might clear up some things I am still a bit foggy on.
I have been looking into irrigation for quite a while now - I was cleared by my surgeon to try irrigation, I have read stuff here and a bit elsewhere on the web, watched the YouTube videos, etc. - so what's holding me back?
Good question. I think from seeing that lots of you have had good success with this and have seen some significant lifestyle improvements in many cases, I am a bit afraid of trying it out and it not working for me. (Dumb attitude, I know, especially considering I'm generally extremely optimistic about most things).
Anyways, some questions...
1) When you start irrigating, how long does it normally take before things settle into a pattern, i.e. little to no output between irrigation sessions? (I think I've seen everything from 2 days to 6-8 weeks).
2) Is it really necessary to see an ostomy nurse to show how to do irrigation? (It's not like I have somebody assigned to me and if you do enough research, watch all the videos, etc. then aren't you actually quite prepared)?
3) In that doing irrigation is like giving yourself enemas every day or two for an indefinite period of time, is there any reason for concern that you are putting in all that water and like flushing out your intestines on such a regular and constant basis?
4) Are stoma caps the way to go, if possible, once your body has adjusted to the new pattern?
5) Are stoma plugs available for purchase in North America? (I don't see anything when I have searched for them).
6) Is the need to insert a finger into your stoma to determine what angle the cone goes in at just when you first start irrigating? (I saw reference to this in some video I watched).
7) Gas? (I did already get into this with some on this site on another post, and got some great suggestions). But, in short, just wondering how irrigation might improve things once I started with irrigation.
8) If you do irrigation for years and years, is there any issue going back to using a pouch, if you were needing to?

Thx in advance for any thoughts...

Rob

Hi Ron,
I will jump in there to start to answer some of your questions.
I did not do my first irrigation with a stoma nurse. If you feel comfortable, do it without. They say you could become weak but I don't know anyone that ever did. Maybe just don't try the first time when no one else is home. At least you can yell for help if you need to.

First, order your supplies. You will need the water (irrigation) bag that comes with tubing but not all come with the cone on the end that you will need to insert into your stoma. You will need irrigation sleeves. Your pouch system will determine what you need there. If you use a two-piece, you can order the sleeve that will connect to your barrier, same as your pouch. If you use a one-piece, you will need an irrigation belt that will attach to the sleeve and go around your body to attach to the other side, holding the sleeve on.
To begin with, you will only use about 500 cc on your first irrigation. On your second or third, you increase to 1000 cc and your final target is 1500 cc. There is some seepage from around the cone so I always add a little more.
You can choose to stand or sit or lay down while you do this. I never understood how someone can lay down but some do. I started by standing. You attach the sleeve and irrigate in front of your sink. You have a clip on the end of the sleeve that will catch all the output. I had so many mishaps with that clip so I started sitting on the toilet. I have a toilet room so I use an over the door clothes rack with several hooks and use one to hang the bag from. The tubing is very long. You will want to cut the sleeve so that it is just above the water line in the toilet when it is between your legs into the toilet. Not too short because of possible splash or coming out of the toilet and not too long. That creates another mess. I fill my irrigation bag with about 2500 cc of warm water. I only use maybe 1700 cc and I use the remainder for a rinse of the inside of the bag when I am done. I also clean it in the sink when done and use a hairdryer to dry the sleeve before I store it in a zip lock and put it in my little bag I keep my supplies in. It only takes about 5 minutes for the water to go in and it will take anywhere from 20 minutes to an hour for all the poo to come out. Note: be sure the top of the sleeve is closed after you finish putting in the water. When poo starts to come out, it can easily splash up. Not a fun mess to clean up! It should take several weeks to be comfortable and have no output. Everyone is different! You are training your colon to empty at the same time every day. It is important to irrigate at roughly the same time of day. Morning or night, whatever is most convenient to your schedule.

I would recommend continuing to use your same pouch system until you feel confident of no output in between irrigations. Some people irrigate daily and some every other day. It depends on your system.

Caps are definitely the way to go once you feel comfortable of no output. There is a little bit of room in case you do have some residual output. There are also some caps that are more of a bandage. I have never used them so someone else can advise you on those.

Plugs are not approved in the USA. I wish! I do not know if you can get them in Canada or not. I don't think so. Whoever you order your supplies from can tell you.

It was very helpful in the very beginning to insert a finger into your stoma to find out which direction it goes. It will help to know that when you insert the cone into your stoma. I used one glove and cut the five fingers off and used one finger each time I felt I needed to insert. I did this a lot in the beginning. Just use generic KY gel instead of buying the expensive stuff. Once you get comfortable, you will find you don't need most of the things that are recommended. It is a bit of overkill!

Mine goes a little to the left, then down a bit and then up., so I know how to direct the cone for the best irrigation. I don't feel you have to do it every time you irrigate to open it up. If you just breathe deeply and exhale, that does the job!

I hope this has helped! Everyone does things differently so once other irrigators chime in, you take the parts you like or think will work well for you and go for it!

Puppyluv

Forgot one question. There should be no concern of doing this. It is only water you insert so it does not hurt your colon. Some ostomates have been doing this for years with no problems. You can stop anytime you want as well.

Pup

Hey pup, just read this now, thanks so much for your kind and very detailed reply. Late here so got to go before I turn into a pumpkin! Lol - thanks again!

Rob

Once you get a chance to sort through the answers to your questions, I will gladly help answer any others you may have! 
Hopefully others will pipe up soon too! 
They usually do! Lol

Pup

Hey pup,

Thanks again for all the great comments.

One other question...

I think I read somewhere on this site, someone saying it's probably best to irrigate like maybe an hour or two after eating. I can imagine that the timing of irrigating relative to your last meal might have some bearing for sure - just not sure how that might be, and imagine it'd be quite variable from one person to another. Any thoughts?...

(Oh, and I have ordered the supplies for giving irrigation a "go" --

Should have them by the end of the week)!

Rob

Yay, glad to hear you are on the way to irrigation!
I think everyone's thoughts on timing are different. I don't irrigate by when I ate last! Sometimes, I get a cup of coffee and go irrigate, sometimes, it might be after breakfast. It has not seemed to matter much in being output free. Not as much as "what" you eat! You could keep a log once you get situated with the irrigating. Try it for a week or two each way and see if you find a difference. It is true that we are all different and what works for one, is not good for another. It would seem, with the way your digestive system works that either first thing in the morning with lots of time since your last meal would give you the best success. Most that irrigate say to do it about the same time every day. I think that is important, especially in the beginning while you are training your colon. Chances are, you can go much longer than the 24 hours in between irrigating so to wait an extra hour or two won't matter.

I only irrigate every other day! If you find your system can go that long, you can get by with that too! You will have to ask MMSh if he started out that way or irrigated every day and found that he could go every other day. I started out every day but wanted more freedom. But the chance of output for me is more likely, not for most that do. They usually control it by diet which I prefer to eat what I want. It comes at a cost! Lol

Pup

Wow, great thoughts again!

The more I read the comments from all of you helpful ostomates and think about this irrigation thing, the more I see that this is a trial and error thing. I will have to come back to many of these posts that you folks have so nicely provided and reread and distill everything down to a set of tactics and methods that work best for me. Should be VERY interesting...

Thanks again,

Rob

If you will think back to your pre-ostomy days..... most people get up and have a cup of coffee, after that coffee a lot of folks have to go to the bathroom. nbsp
I always thought of it like your bowels are inactive when you're sleeping, that cup of coffee just wakes them up. Since this was my normal before surgery, I irrigate mornings before I eat. Take your coffee with you, it may help. I have irrigated at different times depending on what I might be planning for the next few days, but for me mornings work the best. Good luck, if you have more questions someone here will help you out. Regards, mmsh

Hey mmsh, that's great - thanks so much for your feedback! I am looking forward to "giving this a go" - pun intended!

Rob

G'day from Australia, mate. I have been irrigating for 6 years now and like to think I have cleared all the hurdles, so here goes...
I did the first one in the presence of my stoma nurse, but in hindsight, it was not needed, but it was part of the service.
I still use my finger prior to inserting the water cone. There is a reason for this for me, as sometimes I need a couple of goes to find the colon as your body may change. To me, it feels like there is a big "room" just under the skin, and right at the back, there is a small "door". If I don't get my little finger in that door, the water all squirts back out! But... everyone is different.
I used to do it in the morning just after breakfast, but as I used to drink 3 or 4 cups of tea, I would have a "repeat" a half hour or so after irrigation was complete. I finally figured this was because the bowel was emptied via irrigation, so the tea shot straight through, which was annoying as I never knew when I was finished. I changed to the afternoon, and end of problem.
Keep a diary for a while of what you eat and how the process goes, e.g. I can't eat baked beans, real nutty muesli, and grainy bread. When eating out, gotta be careful of certain salad dressings. All these go through the system in me like an express train!!!
I did it daily for a couple of months, and then it became every second, and if you quickly identify the foods that tend to whizz through, you should have no probs with remaining "clean" for 48 hours. I have on occasions gone 72 hours, but did not make a habit of it. I have never been game to use the plugs as you never know when you might eat something and it reacts!!!!! But that's me.
There will be accidents along the way, I am sure, but they should not be too bad, or you may sail through the whole thing without a hitch. And you will develop your own method of doing certain things, and the process could take as little as 15 minutes or up to an hour, but you will experience a feeling of freedom.
I use about 1.2 litres of water at 37degC and 6 minutes to inject the water, and all is over in 20 to 30 minutes barring any "follow ons" !!
Good luck, mate.

Hi there Ajahn,
I don't know what time it's there 'down under' but I'll post this back now anyways (up here, it's just about my bedtime).
Hey thanks so much for all your great and interesting comments. I hope to give irrigating a first try in the next 2 or 3 days.
I liked your comment about inserting your finger into the stoma prior to starting - sounds sensible. I guess, as you said, we're all made a little bit different so I will have to see what I need to do.
I am expecting the "diet thing" to be huge for me largely because I will want to keep to as many of the items that I deem to be my 'healthy choices' in what I eat - i.e. not have to deviate much from my current choices just to make irrigation work a certain way for me.
It should be an interesting experience (and long adjustment) I expect...
Thx again.

Good day,

I'm from Quebec (Eastern Township). I speak French, and Google will translate for me.... lollll.

I will try to answer your questions. To begin with, I got it into my head that an ostomy is like raising children. "It takes consistency."

The more regular you are in your approach, the more your ostomy will regularize.

I did like you and watched the videos with the ruff and the big bag, which I didn't like at all.

Yes, it's important to enter your index finger at the start to familiarize yourself with which side the stoma is located inside so that the cone stays in place without any more water coming out. Then it will no longer be needed, and you will be able to enter the cone (with pharmaceutical gel) without stress.

Remember that it is quite normal at the beginning (1-2 months) not to succeed in having water flow all over the place and not in the intestine,

but I will give you my tip that I do every morning at 5:30 am before I go to work.

-First, I no longer wear a collar and bag, so it is easier to irrigate.

-Second, I don't use the long bag (like in the video). What I do is fill the bag with 6 cups (1.5 liters) of water at the right temperature. I hang my bag very high, I enter the cone in my intestine, I kneel (with a good foam to protect my knees...... after all, I am 62 years old soon... lollllll) in front of the toilet, I raise the seat up, I put a large strip of toilet paper on the toilet to protect against splashing.

-Third, I open the connection, and the water starts to come in. It takes me 3 minutes, and the water is all inside my stoma.

But as soon as I remove the cone, immediately the water starts to come out, and 20 to 30 minutes later everything is ALMOST finished.

I get up from the toilet, and I put a small round plastic dish (2.5'' high x 10'' circumference) with a Kleenex inside the dish to absorb the stool. The dish covers my stoma very well, which is supported by my panties because there is residue sometimes for another hour.

This way, I can shower and get ready for work. And before leaving, I put a cotton pad and a tegaderm film that I stick on my stoma, and I drill a small hole in the top to let the air pass for the gas (see my photo on the site).

- I saw a stoma person once; she knew a little about irrigation but had never done it. I decided to experiment on my own with trial and error.

- I saw stoma plugs on the internet, but nothing for sale for Canada. But in the UK, it is popular.

- Irrigation has completely changed my life for 4 years. I swear to you that if it is possible until my death, I would not want to carry any more bags. - With the irrigation, I accept my handicap a little more.

If you have any questions, please write to me.
Have a good day! And thanks to Google translation.....looooooooooooolllllllllll
Danielle

Hey Danielle,

Thanks so very much for your feedback! You have a lot of great suggestions and years of experience as well. I liked the idea of using Tegaderm film along with the cotton, nice and slick coverage. I guess you feel that protects your stoma well enough?

And the Google Translate is quite good, right! I think if you had written your comments to me in French I would have 'missed' a lot! My school days French is pretty well lost now - so there would be MUCH more loss in understanding than "lost in the (Google) translation"! LOL

Thx again and have a great day!