Life Hack for Ostomy People (and others)

I have a two piece which is the best thing I ever did for myself.  I am 3 years out and finally at a point where I am looking into pieces that hold the ostomy in place on bad days and smaller bags for good days.  It's funny how set in a routine we get and then one day say, okay this isn't working.  Great hack.

John23 said:

Ostomy info

Ostomy info

I wrote some ostomy info into the "blog" section of my profile page, you may find some of it handy....

They usually use Convetec appliances in the hospitals, since that company provides the stuff freely as advertising.

I use Coloplast ostomy products. I use the "Assura" series with the "extended wear" wafer and the large size pouch. It's a bit different than the Convetec appliances, since the Coloplast Assura series uses a "click lock" pouch; you snap it onto the wafer and click the locking device to lock it into place.

I strongly suggest using the cut it yourself wafers, since the stoma can change in diameter over time. You want to make certain that the wafer's stoma opening fits snugly to the stoma, with no peristomal skin exposed to the output. The Coloplast Assura extra wear wafer has lasted up to a month for me, with two weeks as an average wear time. The pouch can be changed as needed without disturbing the wafer.

I experienced a lot of problems with Convetec pouches, all due to very poor quality of manufacturing. Seams splitting was very common, as well as wafer delamination (the wafer would peel apart from the adhesive coating). Their quality control apparently needed some work.... I will say though, that their Convetec Stomahesive Powder is one thing you would want to order and have on hand. If you get any sores on the peristomal area, that powder will heal the sore overnight, under the pouch. You dust the powder on the sore area and it will crust up on the wet spots. You DO NOT use any skin prep or adhesive remover under or over the powder. It is to be used alone on the skin, under the wafer.

The Velcro on the "Assura" series pouches have never failed me since I started using that brand/series in 2006/7. You have to accidently drop a clip into a McDonald's toilet to fully appreciate the Velcro alternative. Stop laughing.

So Jan..... The entire unit, both the one piece and two piece types are called an "appliance". You have a "wafer" and a "pouch" with the two piece types. The area around the stoma is called the "peristomal" area.

If you ever have a prolapse, where the stoma starts unreeling out of your abdomen like a snake, take some common table sugar and pour it on the stoma. The sugar will cause it to contract back into your body. Head for the hospital and tell 'em what happened. A surgeon will stitch it again and solve the problem.

There. enough for one day?

Be well,

John

My dear friend, you are too modest - your blog wasn't only "handy", it was an absolute Godsend!    For anyone new to using the pouches, John's blog is an absolute must read -  he really knows what he's talking about, trust me.  John, you will always hold a special place in my heart as you helped Rick immensely when we had no idea how to heal his stoma.  He was in so much pain, but using that ConvaTec powder he was healed within 24 hours like you mentioned. 

Take care, hugs (())!

Cyn

JanJan63 said:

I have meant to check out

I have meant to check out your blog so many times and then forget to do it,John. There's a link you can post, am I correct? Or do I go through your profile?

I use the Stomahesive powder every time I change my pouch. I put it around the stoma and then again after the wax wafer is on. I can't imagine going without it. The McDonald's episode? I didn't laugh but I gasped and my mouth dropped open. Yikes!! Extremely interesting about the sugar although I can't imagine having it come out like that. I think I'd have a heart failure. When I was in the hospital for the blood clot I went through a number of roommates. One had internal hemmorhoids (sp?) that would pop out and she'd be in excruxiating pain. The nurses would come in and put sugar on them to help them go back in. I wonder what it is about it that helps with that type of thing.

I'd like to add that when I was in the hospital with the blood clot the young nurses all had been trained to cut the stoma opening in the appliance to 6 mms oustide of the stoma. I kept telling them that my stomach acids will eat my skin but they always acted like I didn't know what I was talking about. Despit that they always did what I said and made it only slightly bigger. I'd forgotten about that. I meant to address it with the school they'd gone to.

Jan

Blogs, stomas and stuff

Jan........

Just click on my moniker to get to the profile page and at the top, click on the "blog". Once there, click on the header of an entry to get the full data. There's a "read more" link also, but clicking on the header is faster.

The hole in the wafer should be cut as snugly to the stoma as possible. I cut mine slightly smaller and the stoma slides into it just fine. The idea is to not allow any waste to get onto the skin. If it does, it will damage the skin and erode the adhesive, allowing more waste to get under the wafer and damage even more skin.

The pastes are useless. They are for filling in big depressions (dimples), but it is not of adhesive quality and is eroded easily by the waste. There are wafers and appliances designed for problem cases, some using Tagaderm type material as part of the wafer/appliance. It conforms better to very uneven geographic conditions of the body. I haven't had the need and haven't tried them; cannot offer an opinion.

You'll find (as I have) that there will be times that your body's chemistry will change and what's worked well for you will no longer work well. The adhesive each company uses are formulated to be used on "clean, dry skin", and do not attempt to conform to other products applied to the area surface. No "skin prep" should be used with an ostomy appliance for best results and wear time. No adhesive remover should be used, since they all leave a residue in the skin pores and degrade the integrity of the adhesives. And all manufacturers attempt to formulate their adhesive to accommodate various skin chemistry..... therein lies the problem!

After one surgery I endured, the Coloplast products would no longer stay stuck to my skin  for more than a few hours. I switched to Convetec (I had some samples on hand), and the Convetec stayed on for a week or more (as had my Coloplast ones).
Eventually my condition changed again, and I switched back to Coloplast. So body chemistry does matter, and is a reason that one product may be great for some, and not for others; you have to experiment. But your noting that the Convetec seams split is indeed a quality control problem. I sent numerous boxes of pouches back to Convetec engineering department (as requested), after noting and taking pictures of uneven and often misplaced seams that will result in the pouch splitting open with use. I guess not much has changed across the years since?

The engineering may be good, but the quality control stinks. I have never experienced the problem with Coloplast pouches. Other brands may be as good or better, also.

Use "Convetec Stomahesive Powder" sparingly and dust off any excess, especially on areas it isn't needed. It's a fantastic product that can heal any sore overnight, and is used by many wound care facilities! Just make sure it's used alone, without skin prep under or over the powder.

Oh, one other thing...... The peristomal area should be washed with only hot water and NO SOAP. All soaps leave a residue in the skin's pores, especially the skin softner types! And it's best to use paper towels to dry the peristomal area afterwards, since any paper or towel product that is "easy on the skin" usually contains a lubricant that makes the skin feel smooth. I had used toilet paper to dry the area, and the wafer lasted a few hours before leaking. My wife buys the toilet paper that's "soft to the skin".... it was the stupid stuff they add to the paper that kept the adhesive from sticking properly. Paper towels usually do not contain any additional junk. And using a wash cloth or towel that's been washed with a fabric softner or wrinkle free product will result in the same failures.

Sometimes the most simple things in life can be made to be so complicated. Basic is best!

Best wishes,

John

jen2012 said:

My husband always uses a

My husband always uses a small binder clip to keep his closed.  the pouch does has the velcro but twice early on, it opened and made A mess.  No more issues with that.

When I have to do the open end bags, I do the binder clip too, it works great!

Mikenh said:

You should definitely see

You should definitely see your Ostomy Nurse as it's hard to diagnose this stuff via forum board. They likely have supplies in their office that would work too.

My approach is convex wafers, ostomy paste and hypafix tape for a more secure hold on the wafer.

Thank you for your prompt response

JanJan63 said:

The crease in your tummy? I

The crease in your tummy? I used to use a wax spacer because of that and it helped a lot. Some people use the paste for that. You should talk to your ostomy nurse or the people where you get your supplies from. I have used tape to make it last longer. It's a white bandage tape and I used it to make sure the sides stayed down and there was less pressure on the flange.

Good luck,

Jan

Janjan63. What is the name of the white bandage tape ?