Hiking with an Ostomy? Don’t let it slow you down

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Q&A with Doug Dallmann

Long summer days are a great time to enjoy the outdoors – especially hiking. But before hitting the trails, it’s important to be prepared. Doug Dallman, stage III colorectal cancer survivor, is an avid hiker and nature enthusiast. He’s also an ostomate. Here are his tips for hiking with an ostomy.

Q: Briefly, what is your cancer story?

I was diagnosed with stage III rectal cancer in 2010. I was 40 years old and my tumor was detected during a routine physical (despite having symptoms that went misdiagnosed/undiagnosed for years). I responded well to chemotherapy and radiation, but surgery left me with a permanent colostomy. I’ve been cancer free for over eight years.

Q: How long have you been hiking/backpacking with an ostomy?

I was back on the trail in the summer of 2011. I started with short day hikes once I had my strength back and eventually worked my way up to multi-day backpacking trips.

Q: What types of barriers/challenges have you encountered out on a trail as a result of having an ostomy? How did you overcome?

The biggest challenge of hiking and backpacking with a stoma is, of course, dealing with stoma output when the nearest bathroom is miles away. If I’m just doing a day hike, it’s not that big of a deal. I’ll just irrigate in the morning and then I know I won’t have to deal with any output for the rest of the day. Backpacking is another issue entirely. It can be done, it just takes more planning. First, I make sure I have enough ostomy supplies to swap out bags (I always bring more than I think I’ll need, just to be sure). Second, I had to figure out a way to keep the belt of my pack off of my stoma. Otherwise, I’ll eventually be cleaning up a big mess on the trail. For my Pacific Crest Trail (PCT) hike, I crafted my own pack belt modification out of a stock bar of stock aluminum I picked up at Home Depot. It’s not perfect, but it’s doing the job. Another option is to use one of the many commercial stoma guards on the market. I looked at them before I started this thru-hike, thought they were a bit pricey, and I liked the idea of coming up with my own solution.

Q: What are your top three pieces of advice to people who are new to hiking with an ostomy?

First, take it easy. Ostomates are susceptible to hernias, so it’s good to build up your core strength before getting back out on the trail. Then, go for a few test hikes. Start with short walks around the neighborhood with a light pack and go from there. Second, make sure your ostomy setup works for hiking. You’ll be sweating a lot and you want to make sure your stoma supplies are able to keep a good seal for the length of your trip. I’ve had some issues on this hike with stool leaking under my wafer and am thinking of changing to a wafer that holds a tighter seal against my skin. Third, think through your game plan for dealing with swapping out a bag on the trail. This means having enough extra stoma supplies and having a plan for carrying used bag(s) back to the trailhead. (Leaving a blue bag on the trail is NOT an option!) This means having lots of cleaning supplies in case things get messy. If you’re backpacking, carry a trowel. Dig a cathole, dump the contents of the used bag in the hole and pack out the rest.

Q: If someone has to change their ostomy bag while on a hiking or backpacking trip, where is the best place to do so?

Anywhere you feel you’ll have enough privacy. If it’s a busy trail, you may have to walk off trail a bit. On the PCT, hikers are few and far between right now, so I don’t need to venture too far. Research your trail. You might find that there are toilets along the way and be able to change there. If you’re backpacking and don’t want to deal with catholes, make sure your campground/campsite has a toilet.

Q: What supplies should be brought on a short hike, long day hike, or overnight? And how much weight will this add to someone’s pack?

For me, a colostomate, here’s what I bring. For a day hike, short or long, I bring about 2-3 extra sets of the two-piece pouch system that I use -- a flat wafer against my abdomen and a closed-end pouch that attaches to the wafer. I’ll bring one blue bag for each extra pouch for carrying used bags back to the trailhead, and I’ll bring a gallon ziplock bag to put the used blue bags in. I also bring toilet paper, hand sanitizer, and wet wipes for cleaning things up. I wear a maternity band to keep my ostomy setup held tight against my abdomen, so sometimes I’ll bring an extra band as well. You could also bring extra clothes if you’re really concerned, but I typically don’t. For backpacking trips, the only extra thing I bring along is a trowel for digging catholes that I can dump the contents of a used bag into. This reduces the weight of used supplies that I have to carry out. If I know I’ll have access to a trail town or a proper bathroom during a trip, I’ll bring along my irrigation supplies. As far as weight, all of the above adds about 1.5 - 2 pounds for a 3-4 day backpacking trip.

Q: Do you use a support belt? Why or why not?

Nope. I got back in the gym after I ended treatment, and worked on building up my core strength, which I’ve maintained in the years since treatment. I’ve mentioned I wear a maternity band, but this more of a habit than anything else -- I wear a band every day. But, I will say that a band is useful while hiking because if your ostomy setup fails in the woods, the band contains the mess a bit.

Q: Personally, how has spending time in nature enriched your life?

The outdoors is my church. Before cancer, I spent a lot of time outside backpacking, climbing, cycling, and hiking. I feel very fortunate that I can continue to do all the activities that I enjoy, plus any new ones that I can think of, even though I have an ostomy. It doesn’t slow me down.

Q: Any final tips?

Don’t let your ostomy slow you down either. Don’t forget to talk to your doctor before starting a new exercise routine. If you experience anything abnormal (for example: heart palpitations, chest pain, increased shortness of breath, dizziness, pressure or pain in your chest, neck, arm, jaw, or shoulder) call your doctor right away. Also, if you’re new to hiking, you may experience some muscle soreness. The American Academy of Family Physicians recommends calling your doctor if you have soreness that lasts for more than a week and/or sore muscles or joints that feel warm to the touch, or are swollen or red.