This topic is about a 54-year-old individual who has been living with C7 quadriplegia for 27 years and is considering a colostomy due to ongoing bowel issues. Despite these challenges, they lead an active lifestyle, enjoying activities like swimming and hand-cycling. They are curious about how a colostomy might affect their ability to continue these activities and are seeking advice on the next steps.

Here are some helpful insights and advice:

1. Having a colostomy should not prevent you from swimming, cycling, or engaging in other physical activities. Many people with colostomies report being able to continue all their previous activities without any limitations.

2. If bowel problems are significantly affecting your quality of life, surgery might be the best option to regain independence and improve daily living.

3. Personal experiences from others with colostomies show that they continue to work full-time and enjoy activities like biking, fishing, skiing, camping, and four-wheeling.

4. Hand function is important. As long as you have enough dexterity in your fingers and hands to manage changing the colostomy appliance, it is considered a reasonable option.

5. The placement of the stoma is crucial:
- Before surgery, a nurse or surgeon will help determine the best spot for the stoma while you are sitting, standing, and bending. They will consider your waistline and skin folds to avoid any dips or creases.
- The goal is to find a flat area that is easy to see and reach, and that stays clear of belt lines.

6. For the procedure, the Cleveland Clinic Foundation's Colorectal Surgery Department in Cleveland, Ohio, is recommended as an excellent center.