Elder: Patricia Giles

Visit #2

10-29-18

Today Pat showed me how she changes her colostomy bag. During this process, she said
she usually changes her ostomy bag about every 4 days. I cut her ostomy wafer to help her out,
she had already marked a circle around all of the wafers to fit her ostomy and claimed that it
made the process faster and less tedious. After changing her colostomy bag, we talked more
about her cancer and diabetes. With her cancer, she said she had rectal cancer about 3 years ago.
Pat said they took out her rectum and diverted the large intestines to create the colostomy. When
asking her about colostomy considerations, she claimed that certain foods presented more odor
than others and that different foods caused her stool to be different consistencies. She said it took
her a while to get used to the bag hanging off her stomach and to learn about the different foods
that she preferred to eat with the bag. When talking with her about her diabetes, she said she was
diagnosed with Type 2 about 8 years ago, when she was 78. She said she takes her Metformin
medication with her breakfast and dinner, because it’s her long acting insulin. She takes her
Humalog whenever she eats as her short acting insulin. Discussing her diabetes more, she is not
very strict with her insulin/glucose regimen. She claims to forget to test her blood sugar before
eating a lot and says she usually runs in the 200’s, and in the 300’s when she forgets to give
insulin before her meals. When asking her why she runs so high and talking about the
consequences, she said that she got tired of being so strict with her disease and that she was too
old to worry about long term issues. I asked whether or not she exercises, she said she doesn’t
leave the house very often and doesn’t like walking far distances because of the numbness in her
toes. We talked further about her diseases and how she goes about her daily life while still
managing her colostomy bag and her insulin levels.