This topic is about getting back into exercise after having a panproctocolectomy and a permanent colostomy. The person had surgery due to ulcerative colitis, and although cancer was unexpectedly found, they are recovering well and are eager to start exercising again. Here are some friendly tips and advice for easing back into physical activity:

1. Begin slowly and take gradual steps, just like starting exercise for the first time. Increase weights, cardio, distance, or intensity only as you feel more comfortable and stronger.

2. Focus on strengthening your core to reduce the risk of a parastomal hernia:
- Practice simple abdominal contractions by exhaling first and never holding your breath.
- Follow ostomy-specific core routines available online, such as:
- A YouTube video: https://youtu.be/x5SqFVexly0?si=eSVeF3hfed_a3a9Q
- Ostomy.org's video “Core Exercises With an Ostomy” by Susan T: https://www.ostomy.org/vlog-core-exercises-with-an-ostomy/
- Consider working with a physiotherapist who understands core and incontinence issues.

3. Try low-impact or beginner-friendly activities like walking, hiking, gentle stretching, yoga, using a stationary bike, or light resistance/strength training. Gradually increase the duration or intensity, such as returning to full pickleball play after about four months.

4. Use supportive gear to protect your stoma and boost your confidence. This could include belts like the Stealth Belt or other ostomy support garments, especially for activities that make you sweat or involve physical work.

5. Remember to stay hydrated and replenish electrolytes during and after exercise.

6. With a strong core foundation, you can eventually return to almost any activity, including weights, cardio, gym workouts, and even barn chores.

7. Explore YouTube and other online resources for a variety of ostomy-specific exercise tutorials.

8. If your healthcare providers haven't discussed hernia-prevention strategies with you, make sure to ask for guidance. Some people have experienced parastomal hernias that might have been avoided with earlier education.