Tuesday, July 2, 2019

Melvin & Me, Part 24: Melvin goes to the Gym!

I find that there are a lot of interesting ideas on what a person with an ostomy can and cannot do.  There are a lot of post surgery facets that folks seem to fixate on:  a very specialized diet, activity restrictions, regular checkups, etc.  These are very important while the body is making that transition, particularly the parts like "don't lift over ten pounds of weight for three months" after the surgery because this can put a lot of stress on some of those fresh sutures.  The dietary changes, too, are especially important as your body is adjusting, that the last thing you would want for a fresh ostomy is a blocked-up ostomy.  Hell, no one wants a blocked-up ostomy.  The body is going to be swollen in these different places for quite some time--any kindness we can give ourselves post-surgery is a good thing.  

But these things don't have to be the forever situation.  This is not to say that some accommodations won’t be made, that there won’t be some permanent changes to diet and activity, but in my experience and in the experience of a few others of my acquaintance the severity and the specifics vary. 

For example, the ostomy diet swears off roughage of any sort:  no leafy greens, anything with seeds, fibrous vegetables, etc.  Makes sense, really.  These contain a lot of fiber that can thicken stool up, cause gas, and/or otherwise be difficult for the body to digest.  At this point, though, I totally have salad, not usually twice in a day as a precaution, but my body can handle salad without much issue.  Some sources will recommend ostomates stick with the rules indefinitely; other sources will say stick with it rigorously for the first six months, then slowly test a food a time to see how it sits with you.  For me, Melvin does not like kale.  For some reason, spinach is fine, but kale can be weirdly painful for me to pass.  But if it were an ingredient in a smoothie, I doubt I would much notice it, apart from flavor (which I’m also not a big fan of, truth be told).  However, I still don’t eat much popcorn because of how the seeds can tear their way through my system, sharp bits in the ostomy bag and everything.  Essentially everything that ends up looking pretty much the same way coming out as it goes in (like corn kernels) doesn’t jive well.  Some folks are troubled by strawberry seeds or cannot stomach more than a cup of lettuce at a time; other folks don’t have any problem at all with these.  We don’t know until we carefully stretch those limits.  Sometimes, I choose to accept the consequences, if that means I get some of that delicious caramel corn in the breakroom:  I have met my emotional need and am prepared for the discomfort to come. 

More than one source has recommended keeping a food journal.  Can you remember what you ate for breakfast yesterday, before you felt nauseous and uncomfortable for a bulk of the afternoon?  Maybe, maybe not, but this way you can at least start to spot those patterns.  I have used MyFitnessPal for tracking online and on their app.  At this point, I have a pretty good idea at this point how my body reacts to different things.  Not everything, certainly, but I have an idea of what things I can eat that do and do not bother my ostomy.  I’m very grateful that my list of what I can eat is pretty broad at this point. What additional restrictions I place on myself, therefore, are an active decision to follow a diet plan of my choice.

However, in addition to the overall problem of blockage and/or painful bowel movements, I also have to keep tabs on how thick or thin my stool is.  Too thick and I could have issues with everything moving through; too thin and I could be losing too much water.  Your large intestine does do the bulk of your water absorption, and I am missing two of the five feet of organ that most people have.  Some foods help thicken things up:  marshmallows and applesauce have been my go-tos, sugar free jello now.  Some foods help thin things out:  juice of some kind tends to be a winner for me.  For my body, a keto diet tends to lend itself toward having looser stool, which I don’t mind because I drink a lot of water to replenish it AND it makes cleaning out the bag a lot easier, letting the liquid roll out instead of squeezing the most disgusting piping bag into the toilet. 

But what about activity?  Can one still go to the gym or build muscle or whathaveyou with an ostomy?  Of course!  Are there some modifications to keep in mind?  Also yes.  But this, too, is going to be specific to the individual, what their emotional and physical limitations happen to be.  There are some aspects to bear in mind:  it’s not particularly comfortable to lie on a plastic ring surrounding that sensitive part of you, a few layers of plastic and cloth between your intestines and the world.  More urgently, though, there’s a hole punched into your abdominal wall—that is bound to affect you core strength, in both general weakness as well requiring some other potential modifications in how one holds equipment or what exercises are used.  

For myself, I have done free weights, machine weight lifting, Zumba, yoga, and lap swimming, all with an ostomy.  I can absolutely do these things.  But I do have to be particularly conscientious of what my body is telling me.  It’s a tough balance, really, between being aware and being hypervigilant.  I need to listen but not obsess,  where I might spend so much energy listening that I don’t end up doing much anything out of fear.  So, in lifting weights, for example, I will go about this activity as one might normally.  The only difference is I am internally watching my abdominal muscles for any sign of discomfort.  Pain is an important indicator, for sure, however in the context of working out, some strain is expected.  Shaking muscles, that’s good, but outright pain is a strong indicator that I need to stop whatever it is I am doing and at the very least lighten the load, likely consider how my body is positioned if I need to adjust that, too, if I don’t stop the activity entirely.  With Zumba, there is a lot of different movement involved, and mostly there is not an issue any of the movement, excepting any activity that involves doubling in half very quickly which I do not do with the same enthusiasm as other movements.  Yoga has a couple of different modifications that I need to keep in mind with any action that takes place lying on my stomach.  The bow pose is one in particular that I am decidedly uncomfortable with, where one lies on their stomach and grabs their ankles behind them or otherwise lifting the legs and arms forward in more of a “Superman” style of things.  This puts a lot of pressure directly on Melvin.  What I end up doing for these moves is either choosing to stay in child’s pose or resting gently on my stomach.  I don’t mind being the only person not doing the pose in these cases.

Lap swimming might seem the odd one out of the group.  Yes, I can go swimming with my ostomy.  Yes, I do have a plastic bag full of poop and air strapped to my side as I do so, but otherwise there is no different than it was before.  This activity was safe before and is safe, still, just with that background concern.  Well, that and one more thing:  it’s really odd to have something inside the bag when I’m swimming.  I tend to empty the bag right before swimming to avoid the sensation.  When I’m swimming freestyle, any liquid in the bag will slosh left to right as my body twists along with the stroke, just a bit delayed from my body’s momentum.  This is even worse when there is air in the bag.  Try taping a partially filled balloon to your side and swim a lap—it gently sloshes back and forth with the body, unconcerned with what the rest of your body is doing.  It feels rather weird.  It’s not painful, just weird. 

The thing is, I’m actually able to do more now with the ostomy than I was able to without it, because my health has been so much better with it.  My colostomy has allowed me to do more than it has limited me.  Isn’t that something?  

My colostomy empowers me to do more than I could before I had it, not less.

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