I had seen pictures of stomas before my colostomy operation but I wasn’t prepared for the first sightings of the shockingly pink colour of my bowel as it jutted blasphemously beyond the surface of my white abdomen — a terrifying glimpse into the inner workings of my body. Utterly disconcerting. The stoma, as it is called, the small mouth-like opening to the left of my navel, is approximately twenty-three millimetres in diameter and protrudes from the surrounding skin by a millimetre or so. It’s insanely wrinkled but the folds of flesh are smooth and rounded, just as you’d imagine a cross-section of intestine would look.
The stoma seems to have a life force of its own: a slow, rhythmic peristaltic movement that gently pushes its contents along. When the bowel is full, it opens up like a flower and, with a squelching fizzle, expels its offending load — a six to eight centimetre long stool as thick as a man’s finger. This can happen several times in succession, and since there are no sphincter muscles to physically hold anything back, the movement is uncontainable: an involuntary reflex action that one has no control over. When the fetid load has been discharged, the stoma becomes motionless (pun unintentional). The creases and folds come together and the little pink hole closes up.
A disconcerting feature of this little pink crater, this fairy ring of offal, is the way it spontaneously ejects gases. It’s unimaginably badly behaved, always blowing its trumpet exactly when you don’t want it to. It’s an errant, mischief-maker, and its loud to boot. A deep tuber-like rumble guaranteed to hit a flatulent note exactly when you don’t want it to: in the middle of an important meeting, or perhaps when you are out with friends and enjoying a meal in a restaurant. I have learned to make fun of it.
The pouch into which the stool collects, has a self sticking flange which adheres firmly to the skin. It also has a clear plastic window. This handy feature serves two purposes: it helps when positioning the pouch (the hole that fits around the stoma is machine-cut exactly to size), and it gives one an insight into how the stoma is working (through this little aperture one can observe the stools oozing out). It also has a rather ingenious charcoal filter which allows gases to escape unnoticed. One disadvantage, of course, is that the filter can become clogged. Then pouch will blow up like a balloon, the excess gases having no means of escape (unless you wear a two-piece bag or one that is openable). My bag is openable. One merely unravels the end and smooths the air out of the opening. It’s called: “burping the bag”. The charcoal filters are usually very efficient at sterilising unpleasant odours.
To remove the pouch, one lifts the edge of the flange and squirts glue remover beneath it. Repeat this process until the flange comes away from the skin. The used pouch is then placed in a small polythene bag which is tied and disposed of. Having exposed the stoma, the area is scrupulously cleaned with soap and water. A thin film of barrier cream is applied to the skin. This takes less than a minute to dry. Only then can the new pouch be pressed into position, the self adhesive flange smoothed down and around so that it is firmly stuck. Hey presto! Job done.
Occasionally, and quite unexpectedly, the stoma erupts as it is being cleaned. A small parabolic hollow forms in the surrounding flesh, which then suddenly flowers out and up as it discourages its putrid load. As the stool makes its squidgy exit, a quick calculation of its trajectory is necessary to avert a disaster. With a deft movement a cleansing wipe is strategically positioned to gather the squidgy eel, the grotesque remnants of previous meals rising like a Phoenix and threatening to defile its surroundings as it collapses under its own weight.
A fun way to determine how fast one’s peristalsis works, is to swallow sweetcorn whole. If you make a mental note of the day it was ingested, you can compare it to the moment it appears in your stools. Its rather amusing to see the yellow corn emerging from your body, the smooth kernels glistening within the stool as it is rudely ejected. For the record, mine takes approximately two or three days depending on how much fruit I’ve had. For example if I eat a kiwi in the morning, and three or four prunes in the afternoon, I can shunt the whole load through in forty-eight hours. Not bad for somebody with a spinal injury and a rather flaccid bowel.
How I love my stoma. If I could, I would give it a tender kiss — after a thorough clean, of course. Hey, maybe there’s an opening on you tube? I could become a millionaire, with many viewers fascinated by my little pink mound. I guess somebody, somewhere would find it sexually attractive. Perhaps if I licentiously slipped a sausage in and out? Yes, there’s potential there. I can see the money ticking up.