This topic is about someone who has been living with a permanent ileostomy for over five years. Initially, the ileostomy was supposed to be temporary, but due to complications, including a severe respiratory issue, it became permanent. The person is now trying to adjust to this new reality, facing challenges like weight gain, limited mobility due to spinal fractures, and emotional distress. Here are some pieces of advice and insights shared by others:

1. Diet
- Some have found success with weight loss by following a strict carnivore diet, which includes only animal products. It might be helpful to research this diet further.
- Consulting a registered dietitian can ensure you get the necessary nutrients while managing calorie intake, which is crucial given the osteoporosis and chronic pain.

2. Exercise & Mobility
- Before starting any exercise program, especially with back issues, it's important to get a referral to a physical therapist.
- Chair-based exercises can be a good option, allowing you to stay active while seated, protecting your joints and spine.
- Start with very small goals, like walking for just one minute inside your home each day, and gradually increase as you feel comfortable.
- Even short walks around the house or using stairs can be beneficial; consistency is key.
- Consider using aids like a hiking pole or cane to help with balance and to take breaks when needed.
- Simple seated stretches can help improve flexibility and overall well-being.

3. Mind-set & Emotional Support
- Connecting with others who have permanent ostomies can make acceptance easier, as many find it helpful to view the appliance as life-saving rather than temporary.
- It's normal to feel disappointed, and joining an online community can provide support and help process these feelings.
- Focus on maintaining mental resilience and celebrate small achievements along the way.

4. Skin & Stoma Care
- If you experience recurrent ulcers near the stoma, consulting with a stoma nurse can be beneficial. They can recommend modern barrier rings, powders, and wafers to help reduce skin issues.

5. General
- Remember that any movement is better than none, and small daily actions can add up over time.
- If a reversal becomes possible in the future, consider it a bonus, but for now, focus on improving your quality of life.