Preparing for Unrelated Major Surgery with a Stoma

I recently had to have a total knee replacement. I have needed this surgery for over 2 years, but due to having bladder cancer and needing a radical cystectomy, it was put on the back burner.

So, now it was finally time to go and get my arthritic knee replaced. I hadn’t undergone any major surgery since my cystectomy. I had been to the hospital as a "day case", but no overnight stays.

Arriving for my pre-op assessment

I turned up a little early for my pre-op assessment to ensure we got a car parking space, and also, I wasn’t quite sure how far away the orthopedic department was. Upon arrival, I was given a form to complete. It asked the usual: name, address, date of birth, etc.

Then, the form had a checkbox giving the following two options to mark:

• Do you have a colostomy?
• Do you have an ileostomy?

I have a urostomy!

NO! But I have a urostomy. I scribbled lines through “colostomy” and “ileostomy” options and tried to legibly write in “urostomy” myself. I quickly completed the rest of the form and waited to be called in to see the nurse.

Meeting the nurse

I entered the medical room, and the nurse and I proceeded to go through the form I had just completed upon my arrival. Lists of medications that I regularly take were discussed. Next was my scribbling out bit, where I had crossed out “colostomy and ileostomy”. She looked a little confused by this, and if I’m honest, she seemed a little annoyed. "Why has this been scribbled out?” the nurse curtly asked.

Explaining the different types of stomas

I went on to explain the different types of stomas and that mine was a “urinary diversion” due to having had my bladder removed. I explained that it was on the right-hand side of my body. I explained that a “colostomy” was to collect feces and was usually on the left-hand side of the body. I explained that each type of stoma has its own specific function and individual needs. I then asked if I should connect to a night bag for surgery. The nurse really didn’t have a clue. She had never come across a urostomy before.

Educating the professionals

We sat for a little while, and I explained all about my urostomy. I went on to show her my emergency pack which contained all that was necessary for a bag change. I explained what each item in the pack was for and how often I needed to change it. Once I explained that having a urostomy meant I had no control whatsoever over my urine output, it was jointly decided that it would be best to hook me up with a night bag once in the operating room.

Be prepared to explain your needs

Don’t presume medical staff has experience with urostomies! This, I was to find out, would be the first of many encounters I would have with medical staff who knew nothing about urostomies. When I went onto the ward before surgery, I was asked, “Can you not remove your bag and catheterize?" Be prepared and willing to explain your needs and other information about your stoma. Hopefully, this will help to raise awareness among hospital staff.

Have all your stoma supplies

Ensure that you take ALL required stoma supplies into the hospital with you. Don’t forget night bags, connectors if you use them, and your own night bag stand because it’s highly unlikely that your hospital will have these on hand. Also, take more stoma supplies than you would normally require and make sure you have tested at least one bag out of the batch before taking them into the hospital with you. I once had a batch of bags that had an adhesion fault. They wouldn’t stick properly. It’s really important, especially if opening a new box of bags with a different serial number, that you have checked they are OK. Hopefully, these tips will help make surgery easier for those of us living with urostomies.