Sunday, September 11, 2011

First 100 years of the ostomy! Part One!

The History of the Ostomy Part One!

Let’s go back in time to a period about fifty years ago. My grandmother had to have an ileostomy at the young age of about 22years old due to crohn's colitis disease. She was the youngest lady at the time  in the hospital to have this surgery in our town at the time.  I could never understand when my grandmother would always be changing her ostomy almost 3 to 4 times a day, and what was this belt that she always talked about?  I had my ostomy at the same age of my grandmother was when she had hers ostomy done.  After my surgery my mother seen what the new ostomy products and asked my grandmother to start wearing them! She resisted until they no longer made her ostomy pproducts anymore ....so she gave it a try ....then she began to yell at us because we didn't make her try this sooner! (that was my grandmothers way of saying thank you.) She could finally were the ostomy flange and bag for a  week at a time! I was so happy to see she was no longer chained to the house and to the bathroom!  I remember sneaking a peek when was over at her house. I found some things very usual and a bit scary to me ! There was a whole box of every ostomy product known to man!  The thing I was surprised about the most was the cement that I found. She used  this on her skin to keep the ostomy attached on her! (ouch) I couldn't imagine how uncomfortable these products were to wear! So I thought it might be fun to have a little history lesson about how the ostomy came to be today !!!..........  So you can  Imagine a laboratory filled with  scientist wearing  white lab coats. There’s a distinctive sound of something boiling somewhere in the back ground. There eyes open wide and a  broad grin begins to move across there face. At last! They have found  what they been looking for. After years of searching, Its here it is at last. But do they shout “Eureka!”? No. They shout “Karaya!  A new adhesive. Well, so much for this fantasy. But, how Karaya came to be, is immaterial here. This was the special glue that you may remember as your lifesaver.
Karaya was perhaps the first skin-friendly adhesive to be used in ostomy appliances to keep pouches firmly attached to the abdomen. It was the glue that gave us the freedom to wear a pouch without a belt. Sure, the pouches didn’t always behave the way we would like for them to work. Especially during very hot spells or during strenuous activity, the Karaya seal on the pouch would let go. “Accidents” were to be expected. Those who didn’t like these accidents, always wore a belt!
Until the 1700's intestinal blockages were almost always fatal to a patient. Doctors didn't have the knowleadge of antibiotics or sterile techniques, bowel surgery carried with it a high risk of infection to the patients. Doctors avoided any surgery that entered the abdomen, the membrane that surounds the abdomen organs, where infections were particularly dangerous. Instead, they prescribed treatments such as consumption of the heavy metal mercury, laxatives, enemas, and horseback riding to help move stool through the digestive system. These did little to help the patient’s suffering as you could imagine.
  It was a french doctor that M. Pilore that first attempted ostomy surgery in 1776, after all there treatment failed to work for the patient the doctor attempted surgery to remove the patients blockage as a last resort, with out surgical intervention it would of been fatal to the patients! The doctor made an opening through the patient’s abdominal wall.  He pulled the free end of the bowel through the patient’s abdomen and stitched the bowel to the patient’s skin, creating a stoma where partially digested food could leave the patient’s body. The first colostomy surgery was complete. After the surgery there was the first attempt of the first ostomy appliance: it was a sponge held to the opening with  an elastic bandage to absorb any leakages. Without access to todays appliance, the patient attempted regular enemas to keep the bowels clean. Unfourtually the patient died two weeks later of infection  in the small bowel complicated by mercury poisoning.
Preparing supplies in the 1700
Nurse Eloise Fisher is shown here preparing a bandage with a supply cart visible behind her. Frequent dressing changes were part of the nursing care of Doctors colostomy patients, since there were no colostomy bags at the time for in-hospital colostomy care. When  the Doctors made rounds to examine there patients, They required that all dressings be opened.
 
Over the years the risk of infection continued in the patients abdomen making this surgery extreamly dangerous and was only preformed when there was no other options. Between the years 1716 and 1839 only 27 ostomy surgeries were recorded, But unfourtunally only six of those patients survived the surgery.Ostomy surgery remained a procedure of last resort untill better medical techniques made such surgeries safer. Let’s go back even further in time - when rubber was still the best material available - a time when plastics like nylon and vinyl were considered ‘new discoveries’ and still in their early stages.The first pouch similar to today’s plastic bags only appeared after World War II had ended. And, there was no guarantee that these ‘new’ plastic pouches would be odour-proof anyway, so, because these plastic bags looked so flimsy, it took a while before ostomates considered them as alternatives to rubber pouching systems. Plastic would soon be here to stay and become an absolute necessity for ostomates.
The pictures below are a graphical indication of what being a ostomate in the past decades would have been like. Maybe things are bad at the moment for yourself,  but looking back at these pictures you can't help but feel that things are not as bad now as they were then, and could have been today.



Today’s modern appliances have excellent adhesives, and only a few of us need a belt for added security. These appliances are waterproof, leak-proof, odour-proof and almost fool-proof. And they stick! No belt required. Technology has certainly come a long way!
Continued PART TWO

3 comments:

Linda Kelly Lee said...

As an RN I appreciate this article. This is often a subject that a lot of people will avoid. Glad to see you "bringing it out of the closet".

Anonymous said...

Link to website!http://www.clevelandclinicmeded.com/live/courses/2008/etwoc08/history.htm

Traci Ribble said...

I also got the photos form different websites! Traci