The second time around

And how I plan to better manage my pregnancy with an ostomy

Here we go again! We are excited to announce that we are expecting our second child this July! My husband and Waylon and I are so excited to grow our little family. (You can see W showing you where the baby is!)

new baby pregnancy stolen colon ostomy ileostomy colostomy urostomy ibd inflammatory bowel disease crohn's ulcerative colitis

It’s amazing the difference already between the first pregnancy and the second in as much attention you devote to it. With my first, it was pretty much all I thought about, all of the time. This time around, between chasing after a toddler, finishing up my master’s degree and just everything else I have to accomplish in a day, I feel that I’ve had very little time to really just think about it and what all it means. I, myself, am a second child and I suddenly have a whole new appreciation for what that means and my place in my family…

For those of you who followed along with my first pregnancy, you know that I had complications in the end—specifically an intestinal blockage—that led to a series of hospitalizations, a dreaded NG tube, and ultimately to my induction just before 36 weeks when I gave birth to my son. So obviously, we had some things to consider when we discussed the idea of having another child.

So how do I plan to make this pregnancy different from the first? Well, in all honesty, I’m not sure that I can, but I sure as hell am going to try. While I was being cautious with the foods I ate later in my first pregnancy, I realize now that I was not being cautious enough. There were a couple of times that I ate things that were probably a little too risky. Knowing now what the consequences of that can be, I will be sure to be more vigilant in making sure that I avoid problem foods and make smarter decisions. I have already noticed a time or two that I have felt a little blocked up, although nothing that some extra hydration and careful eating couldn’t fix, but it does make me wary about how the next few months are going to go.

I have bandied the idea of going on a mostly liquid diet during the final weeks, but the reality of living for 10+ weeks on a liquid diet when you’re pregnant would not be an easy task. At the minimum, I will be employing a some sort of low residue diet during that time, in hopes that I do not run into the same issues I experienced last time.

But other than some extra caution and some food avoidance, I can’t say that I have done anything differently this time than I did the first time. I have been trying my best to stay hydrated, but that’s a constant struggle, pregnancy or no pregnancy. I am prepared with some larger sized wafers for once my stoma grows, which I expect it will again, and potentially prolapses.

Even with the complications last time, I am still not considered high risk by my obstetrician. I do know they’ll be keeping a slightly closer eye on me, especially as I progress further along in the pregnancy, but the ostomy really doesn’t change any of my treatment, unless there is another complication.

For now, I am focused on trying to eat healthy, but smart from an ostomy stand-point, drink lots and lots of water, and hopefully enjoy a complication-free pregnancy.

(You can read some about my previous pregnancy, as well: All about pregnancy with an ostomy.)

Why is it so $@*% hard to get an IV in?

I have never been an easy stick when getting an IV. It most often takes about 3 sticks to get one to work, and that’s usually after 5 minutes of one of the needles being moved back and forth trying to figure out where the vein went. I think my record is 6 sticks before finding a vein, but I know that’s probably low compared to some of you.

img_4310Even the most confident IV … inputters (?) are surprised by how difficult my veins can be to find. I once ended one nurse’s streak of nearly 100 sticks on the first try. I always try to tell the person before hand that my veins are tricky and they like to play hide-and-seek, looking alright beforehand, but disappearing as soon as the needle goes in. They usually somewhat brush me off at first, but by the end they agree with me.

During my recent hospital stay, which started as a blockage, by the real reason I went in was due to severe dehydration. I’m sure you all know how much more difficult it becomes to get an IV when you’re dehydrated. The nurses could tell immediately that my veins were not going to make it easy, so I had 2 charge nurses each give it a try and both miss the vein. Then they called the IV team. And it was the same old story: Came in confident, but then not 1, but 2 blown veins later, we finally got a blood return on his third try, but fifth overall.

But what’s interesting about this, is what he asked me next.
He said, “What brought you in?”
“Dehydration,” I told him.
He replied, “Is that all?”
“I had an intestinal blockage.”
“Due to…?”
“I have an ileostomy.”
“Due to…?”
“Crohn’s disease.”
And he said, “There it is!”

ibd crohn's disease IV insertion veins ostomy stolen colonHe went on to tell me something that I am surprised nobody has ever told me before. He said that people with Crohn’s disease and ulcerative colitis have notoriously difficult veins to insert an IV into. (Please don’t quote me on some of the more technical aspects here, but this is what he told me.) He said it could be due to a number of things such as some of the medications taken for IBD, getting ongoing IV meds and veins being used frequently for blood draws and other IVs, among other things. He showed me how his veins are mostly straight, but when you look at mine, they are kind of curvy and they have extra little bumps in them, what he called valves. From what I understand, when valves are not working properly, they cause blood to pool is small sections of your veins. Basically, the point of all of this is showing that having IBD can make getting an IV inserted more difficult, since the veins aren’t as straight or smooth as they usually are.

He recommended that I let anyone trying to insert an IV know ahead of time that I have Crohn’s disease, because he said it would change his approach. He said he would likely have spent a little more time picking out a vein and would also start with a smaller needle. The needle he ended up using to get my IV in he said he rarely uses on anybody because it’s so small, but he often has to use it with IBD patients

I found all of this very interesting and wondered why nobody had ever told me this before. But now I’ll be sure to always give someone trying to insert an IV a heads up of what they’re dealing with. We’ll see if they take it more seriously than my warning of tricky veins!

Dealing with intestinal obstructions

I am never not surprised by how debilitating an obstruction is. It’s so much more than an obstructed feeling in your stomach. For me, it makes my entire body ache. It makes me feel run down. More often than not, my first sign of an obstruction is simply feeling bleh. (Yes, I believe that’s the technical term.) Even before noticing a lack of output or stomach pains.

This morning, I woke up not feeling great. Sort of nauseated and tired. It wasn’t until after breakfast (which I didn’t eat) that I noticed my bag filling up with liquid. That’s when I realized why I had been feeling run down, even last night. Now it’s the afternoon and I haven’t eaten anything all day, but I have emptied several bags of liquid output, and everything hurts and I really wish I could curl up in a ball and stay there, praying that it passes. However, I have a 15-month-old, so that’s probably not going to happen.

I have written about blockages a couple of times in the past (See: My first major blockage – which still makes me laugh that I considered it a “major” blockage. After having a major blockage later on, trust me, it wasn’t. And see: Intestinal blockages during pregnancy), but since they are an ongoing concern, I wanted to address them again.

So how do you deal with an intestinal blockage or obstruction?

blockage obstruction intestinalThe first step is doing what you can to avoid them. You do this by hydrating (which I have not been doing well) and by watching what you eat (which also could have used some work this week).

But once you have a blockage of some sort, the next step is to get back to hydrating. Whether you’ve been staying hydrated or not prior to the obstruction, do it after a blockage starts. A blockage can be caused by dehydration and it also causes dehydration by pushing out only liquid output. Hydration can be helpful in getting the blockage to start moving again, as well as simply helping you stay healthy outside of that.

Next, be cautious what you eat. If you’re anything like me, you likely don’t want to eat anything anyways, but if you are hungry, I suggest sticking with non-solids, such as smoothies, yogurt, applesauce, etc. This way you can continue to take in nutrients, but these foods shouldn’t add to the blockage that has formed.

From here, there are a few things you can try… Massage your stomach. This can help get things moving, possibly even break up a smaller obstruction. Use a heating pad. Of course be careful of putting heat on your skin, but the warmth does help your muscles to relax which can get food moving again. Take a warm bath. Another way of trying to relax your muscles. You can also simply wait for it to pass, which it will sometimes.

A lot of blockages can be taken care of at home in these ways, but do be willing to go to the doctor or hospital if things get worse. Severe blockages can lead to more complications, so if you feel that the blockage is not going to pass easily, the hospital is your next option. Only you know your body, so pay attention to the signs it gives you. If you start vomiting or are dealing with extreme pain, it’s time to get medical help. The hospital will make sure you are staying hydrated and getting the nutrients you need, even if you are unable to eat anything. They may opt for using an NG tube, which is not pleasant at all, but it really does work. If a blockage gets too severe, they may consider surgery, but that’s a last option.

Once a blockage passes, you may still deal with some lingering issues. I like to call it an “obstruction hangover,” because the next day I usually still don’t feel quite right, even if I am feeling a lot better than before. I try to take it easy, drink lots of water and stick with either liquids or easily digestible foods. And usually after that, I feel back to normal.

I hope you never have to deal with an intestinal blockage, but if you do, these are some of the things I have found along the way that have helped me get through them. For those who have been through an obstruction, what has your experience been? Do you have other tips that might help somebody get through a blockage?

Will run for ostomy awareness

In just a few short weeks, World Ostomy Day 2016 will be here. And yes, it’s a day for raising awareness, but I think I have found a better way to celebrate the day… And that’s by doing things that I wouldn’t have been able to do prior to getting an ostomy. For me, that has been running.

will run for ostomy awareness 5k resilience

For the past 2 years, I have taken part in the WannaWearOne Ostomy 5K. The first year I did it from out of town as a part of the virtual race and last year I was able to compete in a local race in Durham, NC. (But that isn’t the only local race! Keep reading for more info!) ostomy run race resilience wannawearone This year, the race is taking on a different name: Run for Resilience Ostomy 5K. And I think that’s a very fitting title, because it’s about showing that having an ostomy does not have to stop you from doing whatever you want to do.

Last year’s race was not an easy one for me. I was about 3 months postpartum and I hadn’t been running in a very long time. But it was important to me to take part in this race and to do what I could to show myself and others that having an ostomy was not going to hold me back. I figured I was probably the last person in the race, but amazingly I was not, and I actually ended up winning 3rd place among ostomates in the race! (Check out my LIVE IN ACTION video below!)

So I encourage you this World Ostomy Day to get involved. The Run for Resilience is a great opportunity to do so. (And here’s a Where’s Waldo? opportunity for you: Can you spot me on the Registration page??) The run features races in 5 physical locations–in both the US & the UK–and a virtual race available for everybody to take part. Basically, the virtual race allows you to run wherever you are, while still being a part of the event and the awareness raised. Just be sure to post pictures using #IAmResilient! The races take place on different days during October, so check out the website for what’s happening near you.

Even if running isn’t your thing, find a way to do something. Think about things you couldn’t have done before your surgery. Maybe it is eating a certain food or sitting through a whole movie or going hiking. Find whatever it is and do it! Show yourself and the world that you are resilient and an ostomy is not going to hold you back!

ostomy run race resilience wannawearone