This topic is about living with Short Bowel Syndrome (SBS) and exploring alternatives to long-term IV hydration and PICC lines. A 61-year-old woman with a permanent ileostomy and SBS is seeking advice on managing her condition. She has faced numerous challenges, including high ostomy output, dependence on central lines, dietary restrictions, and lifestyle limitations. Here are some helpful insights and advice for her situation:

1. Consider reading "A Patient’s Guide to Managing Short Bowel Syndrome" by Carol Rees Parrish. This book provides easy-to-understand information on osmolarity and hydration strategies. You can access a free PDF by registering at www.shortbowelsyndrome.com.

2. It is important to know the exact length of your remaining small intestine, as this information is crucial for planning your nutrition and hydration. If the hospital that performed your surgery is not releasing your records, you might want to consider seeking legal assistance.

3. Collaborate with your home infusion company and their dietitian to create a structured plan for gradually reducing your dependence on total parenteral nutrition (TPN) when it is medically safe to do so.

4. Explore the use of Oral Rehydration Solutions (ORS). These are balanced electrolyte drinks with a specific sodium-glucose ratio designed to enhance fluid absorption through the gut, which might help reduce your reliance on IV hydration.

5. Investigate the reasons behind your ostomy appliance failing after 25 hours. Possible causes could include high-volume liquid output, skin irritation from current adhesives, or hernias. Improving your pouching system might help increase wear time and protect your skin.

6. Consider reaching out to experienced SBS patients for personalized guidance through private messaging. They may offer valuable insights and support based on their own experiences.