Continence: A Proactive Choice to Have a Colostomy
Following his serious injury, Rhett Brown made the proactive decision to have a colostomy to manage his bowel care. The following extract has been taken from Rhett’s inspiring book, This Way Up.
Eight years ago I broke my neck after a fall at a construction site, causing a 100% dislocation of my spinal cord. Since then my life (I’m now on the wrong side of 60) has been lived on wheels in the fast lane, and I haven’t looked back.
As with most spinal cord injuries, defecation is one of the most complex side effects, as it cannot happen naturally. For me, I was inducted at the Spinal Unit into their routine of two suppositories every second day, then sitting on a commode chair with a bucket underneath me.
My caregiver would then evacuate my bowel with a gloved finger.
This would take up to 10 insertions over a two to three hour timeframe. What a barbarous, humiliating and humbling experience that was! Not to mention time-wasting and limiting to my lifestyle, worrying about being near a commode every second day, and wondering whether I’d be able to empty my bowels easily or need ‘the finger’.
As well as all that, you knew the day’s activities could not begin until this circus was completed.
Now, the trouble was, often your bowel was not completely empty. This could compound and quickly lead to constipation which, over many episodes, would stretch the bowel, forcing the goods to travel even further. Eventually very powerful bowel stimulants would be needed to keep your system regular, with catastrophic results (planned or unplanned). After two and a half years, and one very messy accident off the commode, I decreed that was it for me. No more! I volunteered for and underwent a colostomy operation.
The bowel was cut at the transverse position and an anus, which looks like a beautiful rosebud, was made on the side of my lower abdomen, just below the trouser belt line. Over this we place a specially made waterproof collection bag, which has a carbon filter (so farts rarely smell) and is held in place with a sticky ring. My faeces simply flow into this bag as needed. When the bag is full we change it with a simple but rigorous routine consisting of attention to cleanliness round the rosebud, washing the skin gently with a neutral pH soap like Dove, then thoroughly drying the skin and finally applying cavilon barrier spray to protect it from faeces and to give the bag a better surface to adhere to. Then the new bag (which has a precut hole) is placed over the rosebud and pressed down to complete the seal. This takes five minutes. How easy is that? My day is liberated! All that time sitting waiting is now mine. I am free to move about and do what I want.
I can travel without the need for a toilet or a commode because I am self-contained.
I feel normal.
No one can see the bag.
No one knows it’s there.
On refection, I should have had the procedure done much earlier. For me it has been the most liberating, sensible decision I’ve made about my rehabilitation since the accident. Sure, there is the odd problem about a bowel evacuation overfilling the bag. Yes, I admit that. And occasionally the bag falls off due to not being stuck down properly. But even these incidents are minor compared to the massive positive gains to my physical and emotional wellbeing and lifestyle.
Intimacy + Sex
An area of great concern to those with a spinal cord injury or other debilitating long term condition is that of personal relationships, love, and sex. My wife divorced me straight after my accident. I saw myself as ‘unmarketable’, given my high attendant care needs. Yet I craved companionship. It is said we all need to love and be loved for our general wellbeing.
I soon learned that conventional sex was not an option for me, despite an arsenal of medications available to help with this. They did not work in my case, which limited me further in terms of finding a partner. Or so I thought. A change in mindset was needed!
For walking men, sex is 95% physical and 5% emotional. I turned that thinking around so that sex is 95% emotional and 5% physical. Believe it or not (as I have discovered) many women thrive in a relationship of plain honesty, support, caring, and understanding. Touching, cuddling, and kissing ‘the old fashioned way’ are what many people want, as they may not have had such closeness in previous relationships. Sleeping together is rewarded by the knowledge your loved one is right there. They can be touched, listened to, and smelled, all the primeval senses working for pleasure. A poke in the ribs will generally stop any snoring! For the more adventurous, sex can be enjoyed digitally or orally. In loving relationships, these options can be discussed openly and a level of common understanding about preferences reached.
So for us in the disabled world, a full life is absolutely possible. We are able to appreciate each other and share the joys, the laughter, the excitement, and the contentment which come from having a mate.
Certainly it will take that special person to cope with any needs that go hand in hand with disability.
But do you know what? Having such a connection makes your mate all that more special, someone to cherish on a higher level. And those people are out there.
Rhett’s workplace accident and rehabilitation experience have led to a new career for him as a safety consultant, motivational speaker, and author.