This topic is about managing an ileostomy after undergoing rotator-cuff or bicep surgery. The person involved has had an ileostomy since 1988 and is concerned about how to handle their pouch with one arm immobilized. They are also worried about the potential for constipation or blockage from post-operative opiate pain medications. Here are some helpful insights and advice shared by others who have faced similar situations:

- **Emptying and Changing with One Hand**
1. Practice one-handed techniques before surgery to get comfortable with the process. Many find that trial and error helps improve their skills quickly.
2. You can roll up and secure the tail of a one-piece drainable pouch with one hand, although cleaning it might be more challenging.
3. Keep the fingers of your operated arm moving; light finger use can help steady the pouch during changes.
4. While you can manage alone, don't hesitate to accept help from your partner when needed.

- **Choosing Between One-Piece and Two-Piece Systems**
1. If your current one-piece system works well, consider sticking with it to avoid introducing new variables right before surgery.
2. Some have tried adhesive-backed two-piece systems, which can prevent leaks but may require full bag replacement each time.
3. Others found two-piece systems harder to manage one-handed, so practicing with the familiar one-piece might be easier.
4. Keep both systems available so you and your husband can decide what works best in real time.

- **Pain Management Without a Colon**
1. Many with ileostomies have used opiates like Percocet, Vicodin, or Ultram without experiencing constipation when the colon is absent.
2. Some needed little or no opiates, as hospitals often over-prescribe. Try the lowest effective dose and taper off quickly.
3. A step-down regimen that worked for one person was transitioning from Percocet to Vicodin to Ultram, then discontinuing, while watching for mild withdrawal symptoms.
4. Consider additional pain management options like a single-shot nerve block, Toradol, steroid packs, or anti-nausea agents to minimize opiate use.

- **Preventing Post-Op Discomfort and Aiding Recovery**
1. Continuous-flow ice-pack devices or homemade hot/cold packs can help control shoulder pain. Some insurance plans may cover these machines.
2. Stock up on extra ice, such as Chick-fil-A nugget ice bags or frozen peas, as you'll need near-constant cold therapy for the first 4-6 weeks.
3. A good recliner can be invaluable, as many find it comfortable to sleep in for several weeks.
4. Use a scarf or commercial sling now to practice daily tasks one-handed and identify where you might need assistance.

- **General Reassurance**
1. Many who have undergone similar surgeries or managed with a broken arm have successfully emptied and changed their pouches independently or with minimal help.
2. Ensure you take adequate pain relief, as uncontrolled pain can hinder recovery more than careful opiate use. Consult your surgeon and pharmacist, and keep your support community updated.