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Rethinking Recovery

a person holding a baby ;

Despite early mobilisation being part of enhanced surgical recovery pathways (ERAS)6 and abdominal rehabilitation being included in stoma clinical guidelines7, patients are frequently told to be cautious, rest and not lift after surgery. They become less active and live in fear of parastomal hernia or causing themselves harm. Convatec is here to help. In partnership with professionals like yourself, we have carefully crafted Rethinking Recovery resources to help you directly impact stoma patient rehabilitation and outcomes.

A video about discussing the importance of rehabilitation after stoma surgery by Sina Dorudi. ;

The importance of rehabilitation

The lack of structured rehabilitation after stoma surgery is a silent crisis with far-reaching consequences for patients. We discuss how Rethinking Recovery & the me+™ recovery series can help patients recover and why the involvement of the full multidisciplinary team is necessary.

As a runner of marathons and ultra-marathons, Sarah Russell was used to facing challenges. But in 2010, she found herself in a hospital bed with no clear path ahead. Russell, a Clinical Exercise Specialist, had just had emergency stoma surgery and was eager to start planning her recovery.

“I distinctly remember asking the nurses what exercises I should do and having blank faces staring back at me”, she says. Her professional background had been in cardiac rehabilitation where recovery programmes are well established. “I immediately began asking friends, physios, surgeons, and nobody could give me an answer, so I had to figure it out myself.”

She joined forces with Convatec and helped conduct new research. In 2017, she published the findings from a survey of more than 2500 people with a stoma in the UK.1 The results were stark. Half of people were doing less exercise after surgery than before, often because of a fear of hurting themselves. Almost all people surveyed (90%) did not meet UK guidelines for physical activity. Many had been instructed not to do any exercise. 

“This just poured fuel on my fire”, says Russell. “I’m passionate about people living as healthy a life as possible. When people start becoming inactive just because they have a stoma, we’ve got a huge problem on our hands.”

A video about techniques to minimize parastomal hernia risk by managing intra-abdominal pressure. ;

Minimizing the risk of parastomal hernia

Managing intra-abdominal pressure is key to minimising risk of parastomal hernia. Learning how to breathe correctly, to connect and activate the diaphragm, pelvic floor and transverse abdominal muscles as early as possible in the surgical pathway is paramount to safe and empowering rehabilitation.

A video about 'What is Rethinking Recovery?' HCP Training Program for Stoma Care. ;

What is Rethinking Recovery?

An accredited specialist HCP training and implementation programme focused on establishing core abdominal rehabilitation and stoma protective movement as the standard of care for people living with a stoma.

Focused on helping you empower patient rehabilitation, including the me+™ recovery programme, and delivered via in-person training (face to face or virtual).

Supplemented by clinical best practice insights pre-work to be completed in advance of the in-person training implementation support and resources.

For all HCPs working with/caring for people living with a stoma.

People with ostomy bags exercising together, showing that ostomy surgery does not have to limit your physical activity. ;

What is me+™ Recovery?

A 3-stage stoma protective rehabilitation programme directly accessible by people facing stoma surgery or living with a stoma.

Combines practical guidance on stoma protective movements and progressive exercises to support patient prehabilitation and rehabilitation to help people living with a stoma live their best life.

For people of all ages, surgery types and stages of their stoma journey, including those with parastomal hernias.

Testimonials

Ellil Mathiyan Lakshmanan, President of Ostomy Association of Singapore

“The basic me+™ recovery program is something that a patient can easily manage before or few days after surgery. Having done the exercises during the workshop,  I found the exercises easy to understand and perform, without undue strain on the abdomen. What particularly stood out for me during the workshop was the very specific breathing pattern for each exercise, and the clear explanation as to why it was important to prevent build-up of abdominal pressure.”

me+™ Recovery Program for pateints can easily manage before or after surgery ;

Professor Sina Dorudi, Consultant Colorectal Surgeon at The Princess Grace Hospital, London

"As a colorectal surgeon, I’m only too aware of how challenging stoma surgery is for my patients. But I also know how important it is for them to make a full physical recovery and to return to their normal lives."

Following a successful stoma surgery, a smiling elderly woman stands by a lake as she returns to her normal life. ;

Mary Quigley, Clinical Nurse Specialist Colorectal/Stoma Care. University College Hospital Galway

"These “Umbrella breathing exercises” are so easy for patients to understand, they can be done sitting, standing or lying-in bed. I find introducing these simple steps at this early stage gives the patients something to focus on in preparation for surgery and reminding them (when I visit post op) encourages them to continue what at that stage is a familiar process to them and another small but very important step on their road to recovery. I feel that we are laying down the foundations for a healthy core and it may encourages many of them to progress to the me+™ recovery program."

A doctor guiding an elderly couple in the hospital through the Umbrella breathing exercises. ;

Rethinking Recovery - Resources to support you

Rethinking Recovery provides helpful resources to equip you to improve patient care by changing practice. Resources include the latest research findings, evidence, programme implementation support and patient information.

HCP Resources

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For building new skills

Learn more

HCP Resources

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For sharing with colleagues

Learn more

HCP Resources

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For patient conversations

Learn more

References

1. Russell, S. Br J Nurs. 2017 Mar 9;26(5):S20–S26.

2. Global action plan on physical activity 2018–2030: more active people for a healthier world. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO.

3. Husain SG, Cataldo TE. Clin Colon Rectal Surg. 2008 Feb;21(1):31–40.

4. North J. Br J Nurs. 2014 Mar;23(5):S14-8.

5. Schutte G, et al. Int J Colorectal Dis. 2023; 38(1): 29.

6. Tazreean, R. Nelson, G. Twomey, R. Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements. J Comp Eff Res. 2022 Feb;11(2):121-12

7. The Association of Stoma Care Nurses UK [ASCN] Stoma Care National Clincal Guidelines 2016 https://ascnuk.com/_userfiles/pages/files/national_guidelines.pdf

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