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Help with colostomy bag sticking better

Luv2lunch
Posts: 254
Joined: Aug 2010

Hi. I am new to this network. I just signed up tonight for me and my Mom who has rectal cancer. She has a permanent colostomy. She is currently living with me. I change the wafer for her and she has been handling the daily bag change quite well for herself. She is 79 years old. I am having trouble getting the wafer to stick properly. I am finding that after about 2 days, it will start leaking out. I have tried the paste and also the ring that you can form under the wafer. I just don't think I am doing something right. Does anyone have any tips or advice for getting the wafer to stick better? Thank you for your help.
Sincerely,
Lin and Ellie

Lawlak's picture
Lawlak
Posts: 21
Joined: Nov 2009

I had a bag for six months and I could never get them to last longer than two days. It also seemed to help if my skin was really dry when I used the glue. I know this is not much help. Welcome to the club that no one wants to be in!

Tony

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

I use the 2 piece and the wafer usually lasts about 2 days..The juices if you will seem to get to working on the rubber adhesive and if I try to keep them on more than 2 days I start getting whiffs of Hmmmmm...poop....Most of the bags seal with the warmth of the body, I try to run my finger around the outside of the stoma to help depress the wafer glue down. I have nicked my stoma and it bleed but don't worry about it, it will quit..If the skin starts to irritate try the adhesive remover wipes that ALLCARE makes. I simply rub the moist wipe around the adhesive about 3 minutes before I change the wafer and it comes off a lot easier. I have a permanent bag as well so ask anything you like about it. I will answer everything I can...Life is easy with the bag once you master the shortcuts with it..........Love to you both, Buzz

Luv2lunch
Posts: 254
Joined: Aug 2010

Hi Buzz,
Thank you for your advice as well. I was not sure what to expect when I came to this website but it truly is a blessing. Thank you for taking the time to write to us. Mom had the surgery in July so it is still new and we are trying our best to adjust. She is a real trooper. I'm trying my best to do everything the best I can for her. I hope you won't mind if I write you with more questions. Do I post my question to you here or do I send an email? If it's the email, how do I get your email?
Thank you again Buzz.
Lin and Ellie

Luv2lunch
Posts: 254
Joined: Aug 2010

Hi Tony,
Thank you so much for your advice. It did help to know that yours didn't last longer than two days also. At least we are not alone.
We appreciate your help and hope you are well.
Lin and Ellie

John23
Posts: 1832
Joined: Jan 2007

I have an ileostomy. An ileostomy are more difficult than a colostomy,
since the output is always more liquid; it is never more solid than
a thick gravy (yuck).

I use a two-piece system, where the wafer can be left on, and the
pouch changed as needed. My wafer stays on two to three weeks
average, and I get one to six days out of a pouch.

You didn't mention how your mom's "spout" is formed. The "spout"
is the stoma; the part of the intestine that is sticking out. It should
be out between 3/4 to 1". If it's recessed, you'll need a special
adapter called a "convex" adapter to help seal the stoma.

If the stoma is the normal length, and the skin around the stoma
is smooth; that is.... the wafer does not sit on an irregular surface,
or on a fold of skin, then it should be sticking fine... unless.....

Do -not- use soap to wash the peristomal area (the skin area around
the stoma). All soaps leave a residue, and that degrades the adhesive's
ability to stick properly.

Do -not- use any other topical dressing between the wafer (or appliance),
and the skin, since the manufacturers formulate their adhesives to stick
to -clean dry skin-, not other products.

Paste is not an adhesive, it is a filler, like spackle is on a wall. It will
dissolve when exposed to waste or liquid and degrade the integrity
of the adhesive.

The opening of the wafer (or appliance) should be cut as snugly to
the stoma as possible. That will help prevent seepage of waste that
erodes the adhesive.

Do -not- use any other topical dressing between the wafer (or appliance),
and the skin, since the manufacturers formulate their adhesives to stick
to -clean dry skin-, not other products. (I said that twice for a reason)

After applying the appliance to the skin, cup and press your hands around
the appliance and stoma to warm the entire area. That will help the adhesive
stick the way it was intended.

For added security, and "Eakin seal", or a "Hollister Adapt ring" can be
used between the appliance and stoma. It will help seal any area that
might not be as tight to the stoma as it should be.

The pouch shouldn't be too big, since the more weight in the pouch,
the more drag on the surface of the skin when standing. That will
degrade the adhesive's ability to stick.

Always empty the pouch when it is no more than 1/3 full.

Always empty the pouch when it is no more than 1/3 full.

Always empty the pouch when it is no more than 1/3 full.

Every manufacturer tells the user to do that, yet for some reason
it's overlooked by many. In fact, the manufacturers tell the user
to do most all of the above........

I may have left out a thing or three, but that's the basics of
proper use of an ostomy appliance.

I would strongly suggest a two-piece system, if it's not being used
already; It makes the application of the appliance 100x's easier.

I use Coloplast Assura series, with the extended wear wafer,
and a Hollister Adapt ring between wafer and skin.

There really isn't any big deal with this stuff, once you get the
hang of doing things the way the manufacturers intended.

Good luck, stay dry.... and stay well!

John

Luv2lunch
Posts: 254
Joined: Aug 2010

Hi John,
Just wanted to thank you for all of your advice. You seem to know your stuff. Thank you for enlightening me on the proper terms to use when describing what I am trying to say. Like I said, we are new to this. Mom had the surgery in July. We were given one, ten minute training in the hospital and then we were on our own when she came home. I am doing the best I can and experimenting on different things. I'm even finding that certain types of scissors make a difference, when trying to cut the wafer to size. It seems the ones I am using leave a jagged edge. So much to learn.
Thank you again and I hope you are well.
Lin and Ellie

Lovekitties's picture
Lovekitties
Posts: 2960
Joined: Jan 2010

I too have a perm colostomy, since March.

First of all, do you have an Ostomy Nurse at your local hospital? Your surgeon should have put you in touch with one. If so you can get more hands on advice there. Do you have a local supply company? Mine is the local Home Health Care store. They also can be of assistance.

Second, all the major companies will send you samples of what is available, and believe me there are a lot of differnt things to choose from. I got supplies from ConvaTec and Hollister. The samples came with a video which could also be helpful.

I use the two piece system. I have tried two different types of wafers. The one which is like molded wax did not work as well for me. It sounds like that is what you are using since you have to cut it. The one I use now is more of a mesh material. It is by ConvaTec, the Natura series with "moldable stomahesive skin barrier with Hydrocolloid Flexible Collar. Mine lasts a week. No cutting required as it comes in vairous opening sizes. If mom bathes rather than showers, after she dries off be sure to use a hair dryer on COLD to dry the collar applying light pressure to get the adhesive to stick better again.

I buy my supplies locally so don't have as much flexibility on the sizing to fit the stoma. Since I have a colostomy and not an iliostomy like John does, the fit doesn't have to be as close since the stool is less liquid. I have had no problem with irritation or seeping under the collar. If you order you can get a better fit.

I too use the adhesive remover that Buzz recommended. Just be sure to follow the directions for washing after use to avoid irritation.

It is great that Mom has you to help her. If you have any more questions please just ask. We all were first timers once upon a time and will be glad to help. If you post your questions you will get the full experiences of all here, or you can send CSN email to any of us for more personal question/answer.

Let us know how you and Mom do.

Marie who loves kitties

John23
Posts: 1832
Joined: Jan 2007

A pair of cuticle scissors with the slightly curved tip, is what I use.
I keep one in the house, and one in the car with some supplies...

Cutting that hole as snugly to the stoma is important. Not too
tight, of course, but just so that no skin is exposed around the base
of the stoma. Using that Eakin or Hollister Adapt ring can add to the
sealing around the stoma, but isn't absolutely needed. I found
I get better wear-time using one.

Just using hot water alone to wash around the stoma, is best. Using
paper towels to dry that area, seems to be best also, since paper towels
do not have "skin softeners" added. Any "skin softener" leaves a residue,
and that residue will degrade the integrity of the adhesive.

My wife had bought new "soft" toilet paper. I had been using TP
to dry the peristomal area.... all of a sudden my wafer was only
staying stuck for a day! It was that toilet paper! I took another
ostomate's advice, and started using paper towels, and no problem
since. So be careful of -any- residue on the skin around the stoma!

Oh, by the way....

Try not to touch the adhesive while working on the application.
Handle it like a CD or DVD, or a film negative, by it's edges.
Oils from your fingers can also degrade the adhesive!

Say HI to mom...

John

kedwin1
Posts: 1
Joined: Apr 2013

I need help, my husband has colostomy. He was in hospital and nursing home for about four and half months. He is home now and I am at a lost. He is wearing Hollister one piece. I wash just with water and use skin prep, and I was showed to use Hollister Adapt Powder around Stoma.  I was getting 2 days now 1 or 2 times a day. His skin is getting real sore.  Any help would be appreciated. When you talk about adapt ring what one are you refering to.

Lucy

karguy's picture
karguy
Posts: 1024
Joined: Apr 2009

I have a permanant colostomy,and the wafers seem to last about 2 days.When I change wafers I clean the area with wet wipes,and I wet one to wipe it clean,then let it completely dry before I apply the wafer.When I first got it,and wasn't very active the wafers would last a few days longer.The ostomy nurse told me to let it seal with my body heat for about 10 minutes before I start doing anything.I hope this helps.

PamPam2's picture
PamPam2
Posts: 375
Joined: Jan 2009

Hi Lin and Ellie
The Convatec company will send you a free starter kit, and it has scissors that are made for cutting the wafers, they work really well. If you google you will find, I used the convetec brand two piece system and could even take a bath without leakage, could get several days out of each wafer.I did use the skin prep before applying, and this helps keep the skin from breaking down, and did not interfere with adhesion. If you google ostomy supplies many companies will send you free samples of their products to try, there are many different types out there. Good luck to you and your mom
Pam

Lovekitties's picture
Lovekitties
Posts: 2960
Joined: Jan 2010

removing duplicate

Annabelle41415's picture
Annabelle41415
Posts: 4304
Joined: Feb 2009

Sorry didn't read through all the other posts, but see if you can get an ostomy nurse to come out and help. It sure helped me several times and they will come out until everyone is comfortable with the fit and usage. Sometimes one appliance doesn't work for another like it would someone else. Hope that things get better.

Kim

Patteee's picture
Patteee
Posts: 949
Joined: Jul 2009

I had my colostomy done at Mayo, referred to an ostomy nurse in Mpls area, saw her once and back down to Mayo 3 times to work with ostomy nurses. I started off with a 2-piece wafer and bag. I struggled for months to get the seal good. Wore a belt around my butt, hooked on to both sides of the wafer- used putty- everything and the seal would leak on me usually within 1-2 days. Finally the Mayo nurse suggested a smaller one piece appliance. No belt needed, no putty, nothing like that. The wafer and bag are connected together. I would change it whenever, usually 2-3 times a day. (Insurance companies and MA pay for 2 changes a day). I LOVED IT- well as much as one loves this kind of thing, lol. First it never leaked- and second changing it, pulling it off my skin (then double bagging it in grocery store bags) and would clean up the area, let it dry and put on a new one. No more of this standing or sitting over the toilet and dumping the bag out, which led to ungodly splatters all over the bathroom. It just felt cleaner and no more leaks!

taraHK
Posts: 1961
Joined: Aug 2003

Hi. Unfortunately, there is a fair amount of trial and error involved, until you figure out what works best for you (mom). I use a one-piece system (Coloplast). In theory it is supposed to be changed every day, but I find I can go 3-4 if I wish. I experimented with various wipes, adhesives, etc. I found out what works best for me is NOTHING. I don't use soap when showering with no pouch (or, if I do, rinse VERY WELL). I only use paper towel to dry. And I don't use any 'products' at all. As others have said, holding your hands on the appliance for a little while after applying can help (body heat helps adhesion). I only do a few seconds. Don't shower or bathe soon after after putting on the appliance -- I try to wait about an hour.

If it is at all possible for you to see an ostomy nurse, try to do so. Some of the supplies companies have a nurse/consultant, if you can get to their offices (free).

Have you checked out the American Ostomy Association website? It is full of useful information and advice and nice folk (like here!)

Good luck!

Tara

just4Brooks's picture
just4Brooks
Posts: 987
Joined: Jun 2009

I alway got two to three days out of each one. Sounds like you're doing everything right.

Brooks

coolvdub's picture
coolvdub
Posts: 410
Joined: Aug 2009

I was having a terrible problem with mine also. You and Mom really need to see an ostomy nurse, they have so much to share with getting it all to work properly. I ended up going from a 2-3/4inch flange to a 1-3/4 and it helped tremendously. I also have my odd shaped stoma in a valley so getting a good seal can be difficult. My flanges are convex and I also use a barrier ring in between my stomach and flange. Another thing is to make sure the area is as flat as can be, make sure to apply everything while standing up. Pull the area flat with your fingers if need be. I also always use Cavilon to protect my skin before applying the barrier and flange. As others have said make sure the area is clean and dry. Lastly I also use an ostomy belt to keep things firmly against my body, I actually am using two belts now. The first is by Nu-Hope and applies enough pressure to keep the flange stuck well and the other is by Stealthbelt so I can conceal the bag above my beltline. The weight of the bag hanging down can also contribute to shorter wear time as well, that's why they recommend to not get over 1/3 full on the bag. Empty more frequently and try a belt for support of the system. I typically get 3-4 days of wear time.

Don

steve g
Posts: 55
Joined: Dec 2008

I use the Hollister 2 piece as does Buzzard, although I have to keep a calendar in the bathroom to keep track of when I last changed the wafer. I try to change every 4 days, without the calendar it would be 6 or 7 days then I would notice an odor(70 year old brain doesn't remember like it should). I remove the wafer before showering then wash the area around the stoma while in the shower and dry off with a towel then use a hair dryer to dry the area around the stoma before applying a new one. I also use Hollister stoma paste around the edge, and found that after about 3 months the stoma shrunk to what is now the size of the precut wafer that I presently use. Cutting the circle each time was a pain and left an uneven edge where the precut are smooth. I also use a 1 quart zip lock bag for disposal, fold the top (zipper section) down, place around the bag and let the bag or bag and wafer fall into it then pull up the folded part and lock. No mess and clean hands. Hollister will provide you with a sheet of various patterns and just place around the stoma to select the proper size, I have about 1/16 of an inch from stoma to edge. This is my second year and it is now just another thing like brushing your teeth, you will get use to it. Best of luck Steve

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

It comes with a stoma chart so that you can order them precut...in each box of wafers there should be a guide to measure diameter and order as it shows...Mine is 32mm...it fits around it perfectly and insurance covers it. I started out cutting and yes cuticle scissors are the best I found also.......Buzz

coloCan
Posts: 1858
Joined: Oct 2009

the stoma may decrease so you need to remeasure size of hole to be cut, using template sent with bags, as Buzz stated. As also stated, curved-tipped scissors work best to cut hole in wafer. Up til July my wafer was lasting 6,7 days. Maybe due to heat and humidity I now get 2-3 days use of wafer; also ,could be I gained a bit of weight, even with exercise, in stomach area so that may also affect staying-power of wafer adhesive; never used pastes or powders,etc on skin.I might have to experiment with other products/types if this continues in winter time as I've used ConvaTec two-piece since rebirth as colostomate last September. Enjoy the new life.....steve

Crow71's picture
Crow71
Posts: 681
Joined: Jan 2010

Hey there. You've already gotten a lot of good advice here already, but I love a good ostomy talk and wanted to jump in. I've had an ileostomy since April and had a colostomy for eights months prior to that.

Hopefully you can find a good ostomy nurse. My ostomy nurse helped my many times. She has helped with lots of practical advice and knowledge about different products and which may be right for me. She also helped me deal with it emotionally. At the beginning she said, "There will come a time when your ostomy will not be the first thing you think about in the morning." She was right. She told my wife Kim, who changes the wafer most of the time, "When changing the appliance, step one is to pour a glass of wine and relax."
Relax. You'll get the hang of it.

It's important for the skin to be clean and dry. Like John said, soap residue really prevents the wafer from sticking to the skin. When I had my colostomy I would shower without the wafer. That way I could really clean Stewie the Stoma and rinse off well. I only crapped in the shower twice in 8 months. My new ileo stoma, Mr. Dribbles, is almost always "running," so showering without the bag doesn't work so well.

I use paste. It's good for sealing cracks and wrinkles, but it doesn't help with sticking. It's like caulk not glue.

I use a Convatec 2 piece. With the colostomy, once I got good at changing the wafer and managing the whole thing, I could get 5 - 7 days out of a wafer. Mr. Dribbles is really close to my incision, which got infected after surgery in April and still hasn't completely healed. Kim has to do a lot t******** on the wafer and each time is a little different. Sometimes I get 3 or 4 days.

Hang in there. You'll get this figured out. Don't hesitate to ask more questions. I could talk about this @&*$ all night.

Take care - Roger

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