One of our ambassadors, Renee, wrote the following about fitness after stoma surgery:
I count myself lucky when it comes to my first stoma surgery. Now I understand that the word ‘lucky’ in this phrase might seem like a strange choice, but when we look at the bigger picture and consider all the reasons why people live or have lived with a stoma, I do count myself lucky. I do this because, unlike my second surgery, it was my choice to undergo the subtotal colectomy and end-ileostomy procedure after failing to respond to countless medications for ulcerative colitis. By having this choice, I was able to prepare myself as much as I could physically and mentally, a choice that many don’t have.
So, as any good millennial would do, I Googled. I searched high and low for as much information I could find about the surgery itself, life after stomal surgery and any and all complications that I may face living with a stoma. Mentally, I was as prepared as I one could be, thanks to blogs and Instagram (where I have since chronicled my own journey). I knew how to massage my stomach to help blockages pass and bought comfortable loose clothing to hide my bag and swollen belly during recovery. However, the physical aspect of having a stoma is a constant challenge.
Following my first surgery, one of the first questions I had for my doctor is when I would be able to “do things again”. I distinctly remember my surgeon’s furrowed brow as he responded, “let’s say about Australia Day you’ll feel back to normal”. As a newly married, eager to recover ostomate, to my ears that meant “full steam ahead on Australia Day” which was approximately 12 weeks post-op. Following surgery, I slowly rebuilt my strength taking care to not over-extend or over-use my abdominals and, on that Australia Day, I sent my surgeon a photo of me skydiving with the inscription “You said I’d be back to normal on Australia Day”.
Unfortunately, the following April I had a life-threatening small bowel obstruction. I had multiple emergency surgeries, complications and a temporary jejunostomy. Months in hospital compared to a few days for my initial surgery meant that my recovery was completely different. The mentally and physically strong woman who walked into the operating theatre in November was an atrophied skeleton following months of complications and pain, but eventually the same steps were taken. From sitting upright, sitting on the edge of the bed and moving my legs, and eventually moving around the ward. Each step felt like a milestone.
Today, over three years since my initial surgery, I am preparing for my first Spartan race. I can still feel sharp sutures under some of my wounds which bring me to tears sometimes, but they also remind me how strong I am. They remind me that every step that resulted in a surgery, has also brought me to today, in the strongest body that I’ve had, lifting more than I ever could and smiling more than ever.
I think that everyone, especially those suffering from a chronic illness, is a doctor of their own body, we tend to have a gut feeling when something is right or wrong – so please, listen to your body and don’t overdo any type of exercise whether you had your surgery 1 day ago or 1 year ago, take everything easy. Secondly, while I like to call myself Dr. Google, please consult with your real doctor or health professional before jumping into anything!
Finally, to answer the big question, what do I do to keep my body and mind strong?
Yoga has been incredibly important in both my mental and physical recovery. The different yoga styles and pose variations allowed me to learn how to listen to my body and accept what it can and cannot do (yet).
When I first started yoga, I protected my abdomen a lot as I was afraid of herniation, however discussing my needs and initial limitations with my yoga teacher I was able to slowly strengthen my core without immediately over-activating the muscles. Styles such as Yin-yoga which focus on deeper longer stretches have been perfect for helping to relax my muscles, specifically the tight muscles in my back and core from hunching over protecting and comforting my stomach for so long.
Lifting weights is also very important for building overall strength. Starting with light weights and building up over months or years has been extremely rewarding for me as I have been able to monitor my progress and see how much my body has changed. I found having someone set a routine for me and actually do the routine with me helped to encourage me through workouts, especially at the beginning when I was using no or light one and two kilo dumbbells.
Set yourself goals and be realistic! I am the champion of setting unrealistic goals so please learn from my mistakes. You won’t be able to lift or squat or press the same amount that you did pre-surgery on your first day back at the gym and that’s fine! Accepting your short-term limitations (no matter how long-term they may seem) has been extremely important for ensuring I stick to exercising!
Once I was comfortable in the gym and could complete whole workouts and gym classes I moved to pilates. The pilates classes at my local gym have been fantastic for targeting my abdominal muscles. I may eat too many tacos for you to see the abs underneath, but I thank pilates for my inbuilt hernia support belt.
The large bowel regulates electrolytes and water management from the stool, and particularly due to its slow transit, it allows our bodily waste to become more solid by reabsorbing water and electrolytes. Therefore, without a large bowel, our bodies are not reabsorbing a large bulk of water and electrolytes, increasing the risk of dehydration.
Formal blood tests aside, I can tell when my body is dehydrated based on the thickness of my output and when I exercise, I know that dehydration may cause a blockage or at the very least uncomfortable output!
Hydration supplements can be found everywhere, I recommend finding samples if possible and trialling as many brands and flavours you can to find one that you enjoy drinking and actually works for you.
I constantly get asked if I wear support bands and the answer is very simple, no. In Australia we are extremely lucky to have the government support our stoma supplies and certain accessories such as hernia support bands. However, despite the horror of my stoma therapy nurse, I personally feel extremely uncomfortable exercising and wearing a support band. That being said, some incredibly fit ostomates around the world swear by support bands for both exercise and everyday life, so again, listen to your body and discuss the different options available to you with your stomal nurse.