This topic is about someone who is dealing with multiple health challenges, including complications from a stoma, the need to lose weight, and an upcoming knee surgery. They are seeking advice and reassurance from others who might have faced similar situations. Here are some insights and advice shared by the community:

- In 2006, they had an emergency colostomy due to a bowel perforation from diverticulitis, and were told a reversal was not possible.
- By 2008, they developed a large parastomal hernia. After two failed mesh repairs, a third repair placed the bowel "in a cage."
- The hernia has worsened again, and the surgeon insists on weight loss to 80 kg before considering surgery, unless it becomes life-threatening.
- The stoma is now inverted, causing issues with sealing and odor, leading to feelings of isolation.
- Additional health issues include a total knee replacement in 2012, complicated by bilateral pulmonary emboli, requiring lifelong Warfarin. They need another knee replacement and use a walker for mobility.
- They are experiencing significant depression and fear of dying during future surgery, feeling isolated and ashamed of their emotional struggles.
- They are seeking advice from others who have faced similar stoma or hernia failures and weight-loss requirements.

Additional questions and information include:

- Considering asking their GP for psychological support due to feeling overwhelmed.
- Concerned about taking many pain medications and the risk of stroke or further clots.
- Uses a treadmill, but knee pain limits exercise duration, and they are looking for safer alternatives.
- Curious about how a high-placed stoma functions and what hypothyroidism is.
- Progress updates include starting to remove unhealthy foods with home-delivery groceries, losing 6 kg in two weeks, and scheduling a total knee replacement for January 16, hoping improved mobility will aid further weight loss.

Advice and insights offered by the community:

1. Psychological & Emotional Support
- Seek professional counseling or a psychologist experienced in chronic illness issues. Connecting with other ostomates can reduce isolation.
- Practice positive self-talk, mindfulness, and gratitude. Lean on family, friends, and pets for support.

2. Weight-Loss Strategies
- The surgeon's weight target is important for reducing hernia pressure and surgical risk. Focus on healthy eating and portion control.
- Use a "buddy system" for motivation and visualize post-surgery goals to stay motivated.

3. Safe Exercise With Bad Knees
- Consult with a GP or orthopedic team before heavy treadmill use. Consider alternatives like seated cycling, water aerobics, or short walks with a walker.

4. Managing Stoma, Odor & Leaks
- Weight loss can help with appliance adherence. Consider maternity-panel jeans for comfort and support. Consult a stoma nurse for fitting advice.

5. Medications & Health Precautions
- Continue monitoring Warfarin and inform surgeons about anticoagulation status. Confirm the safety of over-the-counter pain medications with Warfarin.

6. General Encouragement
- Many have reported improved quality of life after knee replacements and weight reduction. Celebrate small successes and keep the community updated on progress.