By Kunal Arya
Last year, I underwent a colectomy, a surgery that removed my entire colon. Afterwards, I had to wear a temporary waste-collecting pouch attached to my abdomen known as an ostomy. Until my next surgery, I was now an “ostomate.” One of the early side-effects of the surgery was that I was prone to bouts of severe dehydration that left me hospitalized for a few days. During one of my dehydration-related hospitalizations, the nursing staff wheeled in my new roommate, Randy, an elderly man who had emergency surgery to remove his colon. Without knowing it, Randy had joined the club that I was in: he was now an ostomate.
The next morning, Randy tried to learn how to change his ostomy appliance yet had no success. I wish I could say that the nurse who was to teach him was patient, but with so many patients to take care of, she quickly just put it on for him and left the room. So, when his pouch leaked later that afternoon, Randy was embarrassed that he could not do anything about it. After the nurse replaced the appliance again, I heard him start crying. I knew those tears all too well. I had cried them myself after my surgery.
Although I was weak, I decided to wheel my IV pole to Randy’s side of the room and asked if I could sit down. Randy nodded. I did most of the talking, but when I told him that I was an ostomate, Randy opened up a bit. He admitted that he had yet to accept living the rest of his life without a colon and that he struggled with changing his pouch. At that point, I could have changed the subject, but instead, I asked Randy if I could teach him how to properly replace his appliance. He agreed. By then, I was an expert, so I showed him the tips and tricks that the manual does not teach you.
We practiced a few times, and I helped him see that even though our lives were changed forever, this appliance would let us live normal lives, whether it be temporarily (in my case) or permanently (in Randy’s case). He seemed to appreciate that, and then his face lit up when he successfully changed his pouch for the first time. I knew that feeling too: when you begin to see hope after surgery and finally think that there is a light at the end of the tunnel. As I was walking back over to my side of the room, Randy asked me a question that I did not see coming: how much does the ostomy pouch cost?
It was a great question. I let him know that while the appliance is a godsend, it comes at a hefty price. There are so many supplies that you need, including the pouch itself, the wafer (or adhesive), the tail closure, the adhesive remover, the skin prep wipes, the protective paste, the belt, and the odor eliminator drops. Unfortunately, a pouch is not like a healthy colon – you do not get to keep one for the rest of your life. You have to change the appliance every three to four days and even more frequently if there are leaks or other malfunctions. When my ostomy nurse handed me the product brochure after the colectomy, I was shocked to see how much a month’s worth of supplies would cost me. I balked at the prices even though I was going to need the pouch only for a few months. Randy, on the other hand, had to incur these costs for the rest of his life, so I understood his concern. Most insurance policies do not cover ostomy supplies at 100%.
Facing a surgery that required a major lifestyle change afterwards, I did not focus on the costs to keep me healthy post-surgery. I just wanted to get through the procedure itself without any complications. I told Randy that during my numerous visits to my surgeon prior to the colectomy, he never mentioned that ostomy care would cost several hundred dollars each month. Randy was very keen to even ponder expenses after such a painful operation.
I was discharged from the hospital the next day, and I would like to think that my conversation with Randy helped him tactically with the pouch and the costs associated with it and emotionally by not resigning himself to a second-rate life.
Kunal Arya was a contestant in the 2012 Costs of Care Essay Contest.