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May/June 2013

THRIVE METRO MARYLAND OSTOMY ASSOCIATION, INC.

How to contact us: Phone: 301-946-6661 Fax: 800-543-5870

E-Mail: [email protected] 12320 Parklawn Drive, Suite 241

Web: www.MarylandOstomy.org Rockville, MD 20852

In this Issue Birthday Thoughts & Wishes 2

Upcoming Meetings..………..…2

Bladder Cancer, spot it early....3 A NEW Law……………………....4

June Guest Speaker …………..5

Travel Tips……………………….5

MMOA Board Bios .................... 6

Membership Form .................... 7

Hospitals & Clinics ................... 8

What’s Normal ………………….9

New Technology ……………….9 Travel Documents ……………10

Support our Advertisers …… 11

May is Membership Month…..12

Metro Maryland Ostomy Association, Inc. is a registered 501(c)(3)

tax-exempt, non-profit organization dedicated to the education, rehabilitation, and Assistance of those living with an Ostomy.

Message from our President Dear Friends:

Warmer weather has finally arrived, and reminds us of the renewal that occurs in the spring. I hope with warmer weather all of you will be able to get out and enjoy the nice weather before we encounter the heat and humidity that can be sometimes oppressive in the Washington area.

Speaking of spring and renewal, I wanted to remind you that May is membership month. Dues are $40.00 per year, and are a major source of funding for MMOA, and allow us to continue the critically valuable work we do, as well as the service(s) we provide to the ostomy community here in the metropolitan area. I hope each of you will take a minute to complete the membership form on page 9 and return it with your dues.

If you would like to send a personal birthday note to Horace and Vi, please send via e-mail with “Horace and Vi” in the subject line to the office at [email protected] or via U.S. Mail to the office. All cards and e-

mails must be received no later than Monday, May 13, 2013.

Scott Bowling

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THRIVE – Metro Maryland Ostomy Association, Inc. May / June 2013

Upcoming Meetings: No May Meeting in observance of Mother’s Day

SUNDAY, JUNE 9, 2013 at 12:00 Noon

Jennifer Stein “Let me tell you about my 4 stomas”

SUNDAY, JULY 14, 2013 at 12:00 Noon

Noel Eldridge, MS Topic: “Being an educated patient, advocating for yourself; safe and patient-

centered healthcare.”

No Meeting in August due to summer vacations

Monthly Meetings held at: Holy Cross Hospital

Community Education Center 1500 Forest Glen Road

Silver Spring, MD 20910

From our Mailbag…

Dear Friends, Your generous donation of Ostomy supplies will be sorted and packed and distributed to Ostomates around the world that would otherwise not have access to adequate equipment. Thanks for all the wonderful work you do. Be well, Carol Heideman, [email protected]

We are blessed in life when we find someone who

changes our life…someone who helps us believe that there really is good in the world. For members of Metro

Maryland there are “two someone’s” who have changed our lives – Horace and Violet Saunders. They

“nourished the beginnings”, “the blessing… in the seed,” when founding Metro Maryland nearly 40 years ago. They both celebrate their birthdays in May. All of

us are joining to say,

“May the year in which your birthday begins, brings all the special things, that mean the most

to you…May you both be gifted with life's greatest joys.”

Horace and Vi

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Bladder Cancer – Spot it early, follow it closely

By Mayo Clinic Health Letter, March 2013 Adapted by MMOA

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About 73,000 Americans are expected to be diagnosed with new cases of bladder cancer in 2013. It can occur at any age, but the most significant increase in bladder cancer is in men (4th most common) and women (8th most common) older than 70. Most bladder cancers are diagnosed at an early stage, when it is highly treatable. However, even early-stage bladder cancer is likely to recur, so vigilant follow-up exams are typically continued for years to come. Inner lining changes - The bladder is a hollow, muscular organ that stores urine until it passes out of the body through a narrow tube called the urethra. The wall of the bladder consists of multiple tissue layers. The innermost lining is made up of transitional cells, which stretch as the bladder fills and shrinks when emptying the bladder. Most bladder cancers start in these transitional cells. Bladder cancer is assigned a stage based on how far the cancer has grown into the bladder tissue or if the cancer has moved beyond the bladder. Signs or Symptoms - In early stages of bladder cancer, you may or may not have signs or symptoms. Cancer may be suspected based on a microscopic amount of blood in the urine found during a routine urine test. The most common sign is blood in the urine (hematuria) that makes urine appear bright red or orange. Whatever the cause, the appearance of blood in urine should always be evaluated by a doctor. Other possible signs and symptoms of bladder cancer may include pain with urination, a change in bladder habits, such as increased frequency or an inability to urinate despite the urge to do so, pelvic pain and back pain. Cause and effect – It is not always clear what causes bladder cancer, but there are certain risk factors, in addition to aging. These include:

• Smoking – Whether in the past or currently, smoking is the major risk factor. When you smoke, the body has to process the chemicals in the smoke and excretes some of them in the urine. Smokers are

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four to seven times more likely to develop bladder cancer than nonsmokers. • Exposure to certain chemicals – Kidneys help filter harmful chemicals from the blood stream and move them into the bladder for excretion. Thus, it is thought that being around certain chemicals – including arsenic and chemicals used in manufacture of dyes, rubber, textiles, leather and paint products – may increase bladder cancer risk.

• Chemotherapy and radiation therapy – The use of certain anti-cancer drugs, notably cyclophosphamide (Cytoxan), can increase bladder cancer risk. Radiation therapy directed at the pelvis as treatment for other cancers such as prostate or endometrial cancers may elevate risk as well.

• Bladder infection – Although rare in the United States, infections with schistosomiasis (a parasitic infection), can give rise to a type of bladder cancer known as squamous cell cancer.

• Diabetes medications – Using pioglitazone (Actos) for more than a year, or a combination of diabetes drugs such as pioglitazone and metformin (Actoplus Met), pr pioglitazone and glimepiride (Duetact) may increase bladder cancer risk.

Continued on Page 4

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Continued from Page 3…

Tests and treatments – Several tests may be done when bladder cancer is suspected, including tests to help assign a stage and plan treatments. The Urine Test is for blood in the urine and for the presence of cancer cells. Imaging Studies, i.e. Computerized Tomography (CT) urogram, use dye to view the entire urinary tract. The gold standard test is Cystoscopy to check for abnormalities inside the urethra and the lining of the bladder. A narrow, flexible tube (cystoscope) that has a lens and fiber-optic lighting is inserted into the urethra and up into the bladder. Using local anesthesia is typical. If suspicious tissue changes are seen inside the bladder during Cystoscopy, a special tool may be passed through the scope to collect a cell sample (biopsy) for testing. Where the biopsy indicates a nonmuscle invasive bladder cancer, a small wire loop may be passed through the cystoscope to remove the cancer and burn away remaining cancer cells with an electric current. Tumors that are confined to the bladder have a tendency to recur at some point following treatment – that is the nature of this type of cancer. For that reason doctors will want to do regular bladder rechecks and follow-up tests. Be vigilant.

Part II will be in July/August edition of THRIVE - MMOA.■

Looking for a quick 100-calorie snack? via Kaiser Permanente Website

• All the choices below make the grade — except one. Can you spot which

snack is more than 100 calories? 2 cups baby carrots

1 ounce pretzels 1 plain bagel (5 ounces) 2 cups cantaloupe A 5-ounce bagel packs about 400 calories. The other options are roughly 100 calories each, making them great ways to satisfy your hunger between meals. • Snacks for energy try: Yogurt, add fresh fruit or berries ! B vitamins Bran muffins ! complex “carbos” and magnesium Hard-boiled egg ! protein and B vitamins.

New Law with a BIG IMPACT!

A law passed by the General Assembly and signed into law by Governor Martin O’Malley on April 19, 2013, expands access to an “employee only” bathroom in a retail store for Ostomy patients as well as individuals with Crohn’s disease, Ulcerative Colitis, or other medical conditions that require immediate access to a restroom. “When you’ve got to go, you’ve got to go,” said Del. Norman Conway, D-Wicomico, sponsor of HB 1183. As Governor Martin O’Malley signed HB 1183 into law, many remembered the testimony of a young man from the Eastern Shore who suffers from severe Crohn’s Disease, and his unbelievable experience at a local Best Buy retail store. Metro Maryland Ostomy Association President, Scott Bowling, who suffers from Crohn’s Disease himself, and had an Ileostomy at age 8, was there as the Governor signed the bill into law. “The signing of this bill into law by the Governor of Maryland is a major step forward for our Ostomy community and for tens of thousands of Marylanders suffering from various forms of IBD”, Bowling said■

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June Speaker

1. When traveling abroad request a copy of the current directory of English speaking physicians in various foreign cities, who charge a standard fee. The International Association for Medical Assistance to Travelers (IAMAT) publishes lists of English speaking physicians in over 2,500 cities around the world. 716-754-4883. 2. If traveling in the US, call the biggest hospital in the city you will be visiting for the name of the ostomy nurse or find names at www.wocn.org 3. TSA Cares is a helpline to assist travelers with disabilities and medical conditions. TSA recommends that passengers call 72 hours ahead of travel, toll free at 1-855-787-2227 about screening policies, procedures and what to expect at the security checkpoint. TSA Cares will serve as an additional, dedicated resource and deaf or hard of hearing can use a relay service to contact TSA Cares or can e-mail [email protected]. The website is www.tsa.gov. 4. Change your pouch 24 hours before departure to assure proper complete adherence. 5. Packing: Take twice as many supplies as you think you may need in your carry on case along with a change of clothing for emergencies.

• Separate'liquids'from'tape,'pouches,'and'flanges.'Include'baggies'or'plastic'bags'you'can'tie'for'disposal'of'used'pouches.'

• Make'a'list'of'the'supplies'you'use'with'stock'numbers'plus'the'name'and'number'of'your'supplier.'Take'a'list'of'ostomy'chapters'where'you'plan'to'visit.'

6. Protect supplies from extreme heat and cold. 7. Request an aisle seat close to the bathroom. 8. To counter dehydration, drink a glass of water or juice every hour. 9. Ask the airline about an extra hand bag allowance for medical supplies. 10 . Colostomates should not irrigate with water unfit to drink. Take a water purifier. To hang your bag, take an over-the-door hook and a package of shower curtain rings that open and close like safety pins. These can be hooked together for a chain of whatever length needed.

Jennifer Stein

"Let Me Tell You About My 4 Stomas"

At age 46, Jennifer Stein has had a long history with ileostomies. Hear her tell the story of how she has coped over the past almost-30 years with Crohn's disease, a temporary ileostomy, stage III rectal cancer, a permanent ileostomy, inability to eat for over a year due to adhesions, emergency surgery following a bowel perforation requiring a revised stoma, and finally, her fourth ostomy surgery in 2011. In the midst of all the sickness, surgeries, and stomas, this ostomate somehow managed to get her law degree, have 2 children, and lead a pretty normal life.■

TRAVEL TIPS: From Ostomates when Traveling… By: Local WOCN’s in 2012 Metro Maryland Ostomy Association

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Elected MMOA Board of Directors: January 1, 2013 – December 31, 2014 (Two year Term)

Marty Noretsky – Board Chairman I was diagnosed with ulcerative colitis a couple of months before my high school graduation. Three years later, after juggling my Bachelor’s degree coursework and multiple hospital stays, I had my ileostomy surgery, 42 years ago. Although a Virginia resident, I chose to join MMOA and have been a member for several decades. I have served on the MMOA Board since 2007 and am the new Board Chairman. After retiring from Gallaudet University as a Professor of Educational Technology, I began a small business selling an instructional sign language DVD. I have worked as a curriculum coordinator for the Egyptian Air Academy in Egypt; worked in Israel for a semester; and worked as an independent contractor developing instructional materials in the private and public sectors such as Kraft Foods, the National Automobile Dealers Association, D.C. Public Schools and the Department of Homeland

Cary Dawson I grew up in Mt. Rainier and Harpers Ferry, MD. After high school I received a BS in Commerce and Creative Advertising in Illinois. At present I am assistant manager at a liquor store. I was very familiar with an ostomy because my mother had Crohn’s and an ileostomy for 40 years before her death in 2001. In June of 1998 I was diagnosed with Crohn’s and had an ileostomy for 2 years. Because my mother knew Horace Saunders I learned of Metro Maryland and of Dr. Lee Smith who said I was a candidate for a rarely done “straight ileoanal anastomosis,” i.e. the ileum is connected directly to the anus. It took two years to decide to have this procedure during which time I attended Metro Maryland meetings for information and encouragement. Dr. Smith said I should get on with my life. I had the surgery in 2000, but still have the same health issues: diet and medications. The association was so helpful; Horace’s good advice and my mother’s common sense brought me to this point. I want to give something back by serving on the board and have continued since 2007.

Mildred Carter Upon retiring from the Department of State after 45 years, 14 years traveling on international assignments, I worked at Howard University recruiting and registering students for their certificate program in Simultaneous Interpreting, a program with employment opportunities for having multi-language capabilities for students in any business venture. I met with directors and faculty of the University program and other local contacts interested in promoting the program.

I became affiliated with MMOA in 2002 holding the posts of Treasurer, Secretary, and Vice President. I am presently the MMOA Office Manager. I almost forgot, my ileostomy surgery was in 1995.

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Membership Request for Metro Maryland Ostomy Association Today’s Date __________________________

Name __________________________________________________________ Birth Date _______________________________

Street Address ___________________________________________________ Occupation ______________________________

City ______________________________ State _____ Zip Code ___________ Spouse Name ____________________________

Home Phone _______________________ Cell Phone ____________________ Email __________________________________

Type of Ostomy: Colostomy___ Ileostomy ___ Urostomy ___ J-Pouch/Pull-thru ___

Continent Ileostomy ___ Continent Urostomy ___ Urinary Diversion ___ Other ____________________________

Date of Surgery __________________________

Reason for Surgery: Crohn’s ___ Ulcerative Colitis ___ Cancer ___ Birth defect ___ Other _________________________

Membership Dues are $40 per year, May-April, unless other arrangements are made. Donations are also needed and gratefully accepted. All contributions are Tax0Deductible.

Send Check to: Metro Maryland Ostomy Association, 12320 Parklawn Drive, Rockville, MD 20852

www.marylandostomy.org Email: [email protected] Telephone: 301-946-6661 ~ Fax: 1-800-543-5870

Noel Eldridge

I had ileostomy surgery in 1999 at age 35. The surgery was necessitated by severe Ulcerative Colitis. I am a biomedical engineer by education and currently work for the federal Agency for Healthcare Research and Quality. Previously I worked for the Department of Veterans Affairs' National Center for Patient Safety. I've been on the MMOA Board since 2007 and Program Chair and have visited ostomy patients in the

hospital and by phone. I'm married with a teenage son and live in Virginia. I am glad to report that I have scuba-dived, and hiked to the bottom of the Grand Canyon and back up, without any issues.

Our remaining 5 Board Members will be profiled in the July/August Newsletter

Elected MMOA Board of Directors: January 1, 2013 – December 31, 2014 (Two year Term)

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MARYLAND: ANNE ARUNDEL - Annapolis – 443-481-5508 Irene Repka, WOCN or Michelle Perkins, RN DOCTORS’ COMMUNITY - Lanham – 301-552-8118 x8530 HOLY CROSS - Silver Spring – 301-754-7000 Page WOCNs: Theresa Emmell, Rezia Lake, Toli Stopak HOWARD COUNTY GENERAL - Columbia - 410-740-7890 MONTGOMERY GENERAL - Olney - 301-774-8882 Wound Ostomy Consult Line: 301-774-8731 NAT’L INSTITUTE OF HEALTH - Bethesda - 301-451-1265 CWOCNs: Tye Mullikin, KC Chandler Axelrod, Ashley Buscetta PRINCE GEORGES - Cheverly - 301-618-2000 Barbara Smith, CWOCN, CWS, 301-618-6462 SHADY GROVE ADVENTIST – Rockville - 301-279-6000 WOCNs: Lyndan Simpson, Linda D’Angelo, Barbara Copenhaver Cancer Care Navigator – Jan Tapimeister, RN 240-826-6297 CHESAPEAKE-POTOMAC HH AGENCY, Clinton; 1-800-656-4343 x227 or 301-274-9000 x227; SUBURBAN - Bethesda - 301-896-3050 Melba Graves, WOCN WASHINGTON ADVENTIST - Takoma Park - 301-891-7600 Barbara Aronson-Cook, CWON – 301-891-5635 FOR MILITARY ONLY: MALCOLM GROVE MED CTR, ANDREWS AFB – Suitland, MD, Phone 240-857-3083 BETHESDA NAVAL/ WALTER REED NATIONAL MILITARY MEDICAL CENTER - Bethesda, MD - 301-319-8983 or 4288 Paz Aquino, WOCN & Sharon May, WOCN V.A. MEDICAL CENTER - Washington. D.C., 202-745-8000 page Erlinda Paguio, WOCN; RNs Leslie Rowan, Natalie Tukpak WASHINGTON DC: CHILDREN’S NATIONAL - 202-476-5086 June Amling, CWON GEORGE WASHINGTON UNIV- 202-715-4000 Debbie Sears, WOCN GEORGETOWN UNIV - 202-444-2801 Page WOCNs Dot Goodman, Kelsey Skeffington HOWARD UNIVERSITY - 202-865-6100 Page 769 Faith Winter, RN NATIONAL REHABILITATION - 202-877-1186 Carolyn Sorensen, CWOCN PROVIDENCE - 202-269-7548 or 7000 Page Beverly Styles, WOCN SIBLEY MEMORIAL - 202-689-9931 WOCNs: Dorothy Shi, Helene Hemus, Marie Newman SPECIALTY HOSPITAL of WASHINGTON (formerly Capitol Hill Hospital) is a nursing home with long term acute care beds. Wound Care Dept. 202-546-5700, ext. 2140 UNITED MEDICAL CENTER (UMC) - 202-574-6150 Donna Johnson, WOCN

WASHINGTON HOSPITAL CENTER - 202-877-7000, page WOCNs Joseph Kisanga, Robert Ebeling, Michael Kingan, Donna Stalters, Debra Engels

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REMINDER: A doctor's referral is required to take with you or to be faxed to the clinic before your visit. Be sure your

referral covers additional visits with the nurse if that might be needed. This will help with your insurance coverage.

George Washington University Hospital Main Level

Tuesdays & Thursdays, 12:30-3:00 pm By Appointment Only - Call 202-715-5302

Georgetown University Hospital Thursday mornings, 8:30 AM to 12:30 PM.

4th floor, Pasquerilla Healthcare Center For appointment, call 202-444-5365.

Holy Cross Hospital Tuesday, Wednesday and Thursday

By Appointment Only - Call 301-754-7295

Washington Hospital Center Surgical Clinic - Ostomy Care, Ground Level, Rm GA48

Wednesdays, 12:30 PM to 4:30 PM By Appointment Only - Call 202-877-7103

“It is one of the most beautiful compensations of this life that no one can sincerely try to help another without helping

himself.” ~ Emerson

HOSPITALS AND WOC NURSES OUTPATIENT OSTOMY CLINICS

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What is normal for my stoma? This is a frequently asked question. Here are some answers from your stoma to you: My color should be a healthy red. I am the same color as the inside of your intestine. If my color darkens, the blood supply might be pinched off. First make sure your pouch is not too tight. (It should fit 1/16th to 1/8th of an inch from the base of the stoma.) If this is not a solution, call your WOCN and physician. If I should turn black (very unlikely - but it happens occasionally), seek treatment AT ONCE. Go to an Emergency Room if you cannot readily locate your doctor. (BE SURE YOU REMOVE YOUR POUCH FOR THEM TO EXAMINE THE STOMA. TAKE EXTRA POUCHES ALONG.

I might bleed a little when cleaned. This is to be expected. Do not be alarmed. Just be gentle, please, when you handle me.

If I am an ileostomy, I will run intermittently and stool will be semi-solid. If you should notice that I am not functioning after several hours and if you develop pain, I might be slightly clogged. Try sipping warm tea and try getting in a knee-chest position on the bed or on the floor. (Have your shoulders on the floor in an attempt to dislodge any food that might be caught. If I do not begin to function after about an hour of this, call your physician.) If you cannot locate him/her readily, go to the Emergency Room. In the meantime, I have begun to swell. Remove the tight pouch and replace it with a flexible one cut slightly larger.

If I am a colostomy located in the descending or sigmoid colon, I should function according to what your bowel habits were before surgery. (Daily, twice daily, three times weekly, etc) I can be controlled in most cases with diet and/or irrigation. This is a personal choice. There is no right or wrong to it, as long as I am working well. My stool will be fairly solid.

If I am a colostomy in the transverse colon, I will have a more loose stool than a descending or sigmoid colostomy. There is more water in this part of the bowel. That accounts for the consistency being different.

If I am a urinary diversion, I should work almost constantly. My urine should be yellow, adequate in amount, and will contain some mucous. If my urine becomes too concentrated or dark, try increasing your fluid intake. If my mucous is very much more excessive than usual, I might have an infection. I will probably also

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have an odor and possibly a fever. Consult your physician if this is the case. If at any time you doubt that I am functioning normally, please seek help for me. The cause needs to be evaluated. If the problem is a serious one, it needs immediate evaluation and correction. If it is not, you will be relieved to know I am alive and well.■

Medic Alert and Emergency Medical File –Metro MD Each day we learn of new technologies that may help us access our medical documents. Two such aides are Medic Alert and Emergency Medical File. Medic Alert is a nonprofit company that stores your medical history, medications, allergies, your MD and family numbers. You may wear a bracelet or necklace and have an ID card in your wallet. Emergency medical personal know to call the number to get the information to help you. The patient may also have the information printed on a piece of paper in a wallet. Check www.medicalert.org or call 1-800-432-5378 Emergency Medical File is a 512-megabyte, credit card-shaped product combines the power of portable, PC-based USB technology with vital patient medical information you may carry. The device delivers critical information to first-responders immediately allowing for a better understanding of the patients medical history during an emergency. It may save time and money by providing relevant patient health information quickly and easily. Check http://emergencymedicalfile.com or locally call 1.301.807.6210.■

What's Normal? Answers From Your Stoma to You By Liz 0 'Connor RN WOCN, Metro Maryland (reprinted 2005)

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Upon arrival at Heathrow Airport, London, in 2012, the immigration agent said my husband and I needed more pages added to our US passports. However, he stamped the last page and let us fly, but in some countries we would not have been allowed to continue our journey until more pages were added to our passports. And some countries expect that your passport be valid anywhere from one to six months after your arrival. One week later, on our way to Pakistan, no one said anything at immigration even though they had to search for a page on which to stamp our passport. The same thing happened when we returned to the US – no one reminded us to add more pages. So even with a valid passport sometimes things go unnoticed or overlooked.

In 2005 my husband (originally from Pakistan, but a US citizen) and I applied for Pakistani ID cards, valid for 10 years. The cards take the place of a visa for each trip. On our way to Pakistan, again at Heathrow Airport standing at the Emirates check-in counter, we handed the agent our e-tickets, passports and Pakistani ID cards. After checking each he said, “This card has expired.” It was my ID card, (a seven-year card) which expired in March 2012. He said we could not travel until I got a visa for Pakistan. Pakistan International Airlines (PIA) would have had me sign a waiver, let me fly and take care of the card once in Pakistan. But Emirates Airlines has no such procedure or allowance.

We had to put our luggage in the “Left Luggage” at the airport, stay with friends overnight and go to the Pakistan Embassy the next day, which was across the city. They said it would take five days, but after pleading with them, they called within three days to collect my visa. Of course, we had to pay the fee for changing our flights. After 35 years of traveling internationally (always by way of London) we had become too complacent. If only we had double-checked our passports and ID cards.

As an ostomate I do not need any more than the usual concerns of airport screening when traveling.

A few South American countries, specifically Argentina and Chile, charge US visitors an extra $160 fee in retaliation for the fee the US imposes on their citizens. Chile lets you pay upon entry. Argentina may allow entry visa for five years. Check out prior to traveling what additional fees may be imposed by a particular country. Chile lets you pay upon entry. Argentina may allow entry

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visa for five years. Check out prior to traveling what additional fees may be imposed by a particular country.

Before 9/11, driving or flying into Canada without a passport was common. Not long after 9/11 I flew into Canada with a photocopy of my passport that I thought would be sufficient. I was shepherded to their special window and told that I'd better never travel there again without my original passport. I was very happy that I was allowed into the country, and quickly learned to be more diligent with post 9/11 rules and expectations. Be prepared with current and updated documents. Do your homework. Check with your airline’s web site,(e.g., Delta Airlines’ site has basic important, pertinent information) or try Travel.state.gov/travel and VisaCentral (you can enter your country destination and purpose). If you arrive in a country without the proper documentation, they will refuse to admit you. You will be forced to fly back to where you came from, at your expense.■

Necessary travel documents need to be checked: by Sue Rizvi, Metro Maryland

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May is Membership Month We appreciate and depend on your support for Metro Maryland. Your dues help with the rental of our office space, phone, web site and computer service, for emailing about 400 newsletters, copying and the mailing of about 135 paper copies of the newsletters. We have only one fund raiser each year; our annual raffle in December. This year we are planning a celebration of the 40th Anniversary of Metro Maryland in 2014. Most of us learned how to live with our ostomies because of other ostomates. Our purpose is to be there for ostomates either by telephone or in person. At MMOA’s meetings we have experienced the generosity of our members sharing themselves and their experiences with ostomates, not only to gain confidence in ourselves, but to reach out to new ostomates who just need a little word of encouragement. MMOA wants to continue to be there for ostomates… for YOU. Our dues are $40 for period of May 2013 to April 31, 2014. Please remember to let us know when you change your email address to continue to receive the newsletter.

Mail your check to:

Metro Maryland Ostomy Association 12320 Parklawn Drive, Suite 241

Rockville, MD 20852

OR

Pay on our website at: www.MarylandOstomy.org

MMOA, Inc. 12320 Parklawn Drive, Suite 241 Rockville, MD 20852