Stoma Care - How Do You Do It?

dirtyshirt

I have read others posts about how they hate their bag and from others who seem to think it's not that big a deal. Aside from the fact that we all have different levels of tolerance for different kinds of stressors (I may be able to handle a bag, but can't handle needles, for example) I wonder how much of it has to do with the particular system we are using.

Without being an advertisement for any particular company, I'm hoping folks can share their 'methodology' in this thread. Here's mine:

I bought a large stack of snow white wash cloths from the dollar store - so I could bleach the heck out of 'em after every use. I would stand at the sink, remove the old bag and wash the area around it with warm soapy water. This is the same treatment I gave all four of my kids when they got diaper rash - it cuts back on the bacteria which is causing so much of the problem. Then I dry the area with a clean cloth and apply the new bag. If there is any 'activity' while the new bag is going on, I found that you had to be really certain to keep drying it off, or the next bag had an increased chance of leakage.

The main thing, other than that ritual, was the choice of rings over paste. If you haven't tried rings, I highly recommend them. The skin will actually heal up underneath the ring! I also found that the throwaway bags are better - you just keep the flange thingy attached and throw away the bag, so replacing the bag can be done in the stall at work or anywhere.

My surgeon told me that he had never seen skin around a stoma in as good a shape as mine was. (BRAG, BRAG, LOL). Good thing. I'm going to be getting another temp iliostomy in a few weeks.

So. How do you handle yours?

coloCan

Good thing you didn't pick your name now, it mightov been
"Dirtybag"......From one colostamate to another, hello:
I use two piece from ConvaTec only because thats what they used in the hospitaL I was operated at.As i cannot pull a bandaid off my arm, girlfriend/caregiver is still dealing with removal/replacement of both flange and outer bag while I'm the pro at emptying it or releasing gas buildup.Flange is the part with adehesive that sticks to belly and has hole with ring within which snaps the outer bag that ends up containing the production from your stoma, as you know.Adhesive removal pad is used to loosen up flange and then its gently pulled off skin(prior to that GF usually removes outer bag by gripping tab by ring and pulling it from flange-if contents real loose-keep tail clip on til after removal from flange part.
Once stma is in the open
, she gently wipes it and area around with clean gauge dipped in saline solution tho water will do. Be hopeful stoma doesn't produce while so naked-keep your mouth closed at all times-piece once popped up and hit GF in chin-I thought it hilarious-she didn't.
GF will also use adhesive removal pad to erase any glue still on skin(keep this AWAY from stoma-it'll burn.
We then wait for skin to dry. Center of flange has to be cut down for circumference of my stoma so it fits over it nicely.Outer bag is attached to falange via ring system.Once skin dry, GF gently places circle on flange over stoma ,removed adehsive covering and gently presses adhevise part of flange all around area of stomach it falls upon.I make sure fit is snug and secure and thank her. I like bag to hang downwards, not sidewards.
If only outer bag is being removed (usually cos stuff is loose or stuck in there and can't be emptied (sorry for details)tab of outer bag is pulled and outerbag disengages from ring and is removed. New,clean bag is snapped into place after stoma area cleaned with gauge pad
I try to keep flange on 6-8 days if I can,unless it starts becoming loose,dirty,etc to avoid irritating skin as once a week is 52 times a year times 20 yesrs......
The outer bag itself gets changed whenever I can't really empty it-contents loose,stool gets stuck, gets squashed and then stuck--you know if you have a bag--. I usually cange it every 1 1/2 to 2 days; longest use was 8 days--good bowels that period, real good!!!
I've been lucky so far in my healing(front and back) and that GF is so good at this. Radiologist,onc and surgeon impressed with her care of my stoma (her "Stone").One day I'll care for it myself as I can do so in my mind.....


.....steve

PS:No offense meant at top

John23

Stoma care


A couple of things that I do for my ileostomy is the same for
any ostomy, and they are all what the manufacturers tell us to do.

1. Wash the peristomal area with warm/hot water only, do not use
soap of any kind, since they all leave a residue and degrades the
adhesive qualities of the appliance. Any type of adhesive remover
can damage the peristomal skin and lead to rashes and leakage.

2. Dry the peristomal area thoroughly, using a dry paper towel,
since many tissue products and cloths can leave a residue that
can degrade the adhesive qualities of the appliance.

3. Do not use any topical dressing under the appliance, since
most are not compatible with the adhesives, and can cause
rashes, and/or degrade the adhesive qualities of the appliance.

4. Pastes are for filling depressions in the skin and are not used
as an adhesive or as a sealant. Pastes will dissolve in liquid and
in human excretion.

5. Additional seals such as the "Eakin" brand, Hollister brand "Adapt"
rings, or other similar types, are best for adding additional sealing
quality to the appliance.

6. If the stoma is inverted, or not protruding a sufficient amount from
the body, a convex seal may be required to gain the seal needed to
reject waste from exiting under the appliance.

7. After applying the appliance, warm the unit by cupping the hands
around the appliance, and pressing on the appliance firmly. Using fingers
to press in and around the stoma itself will help make a good seal. Body
heat is all that is necessary to set the adhesive.

All of that is basic. I get a haircut every three weeks, and I usually
change the wafer of my two-piece at about the same time. That's
the benefit of the two-piece appliances; you can leave the wafer on
as long as it stays on and doesn't begin to lift off or leak. The longer
you leave the thing on, the better your skin will be. They say that
each time you remove the appliance, you take some skin with it.
That's not too good for your skin's health....

The two piece appliances have many other benefits also. You can
change from your daily size pouch, to what is called a "stoma cap",
for short periods of time when you would like to feel less obstructed.
(did I say sex?) And it makes changing a worn out pouch to a new
one faster and easier, if the wafer is still in great shape.

Oh.. and you can easily shift the position of the pouch, if it's not
aiming the way you desire after you've applied it.

All brands make the two-piece units, and like vehicle brands,
everyone has their "best one". From what I've heard, Coloplast
has the fewest complaints regarding rashes and boo-boos.

I use the Coloplast Assura two-piece stuff, and have absolutely
no complaints.

-----
Unlike my friend "dirtyshirt", I am not afraid to advertise. That
is why I get a check from Coloplast each month, and "dirtyshirt"
does not. I will take "dirtyshirt" for a ride in my new Lexus
as soon as Coloplast delivers it as payment for this post.
-----


Stay healthy and happy!


John

Shayenne

John23 said:

Stoma care


A couple of things that I do for my ileostomy is the same for
any ostomy, and they are all what the manufacturers tell us to do.

1. Wash the peristomal area with warm/hot water only, do not use
soap of any kind, since they all leave a residue and degrades the
adhesive qualities of the appliance. Any type of adhesive remover
can damage the peristomal skin and lead to rashes and leakage.

2. Dry the peristomal area thoroughly, using a dry paper towel,
since many tissue products and cloths can leave a residue that
can degrade the adhesive qualities of the appliance.

3. Do not use any topical dressing under the appliance, since
most are not compatible with the adhesives, and can cause
rashes, and/or degrade the adhesive qualities of the appliance.

4. Pastes are for filling depressions in the skin and are not used
as an adhesive or as a sealant. Pastes will dissolve in liquid and
in human excretion.

5. Additional seals such as the "Eakin" brand, Hollister brand "Adapt"
rings, or other similar types, are best for adding additional sealing
quality to the appliance.

6. If the stoma is inverted, or not protruding a sufficient amount from
the body, a convex seal may be required to gain the seal needed to
reject waste from exiting under the appliance.

7. After applying the appliance, warm the unit by cupping the hands
around the appliance, and pressing on the appliance firmly. Using fingers
to press in and around the stoma itself will help make a good seal. Body
heat is all that is necessary to set the adhesive.

All of that is basic. I get a haircut every three weeks, and I usually
change the wafer of my two-piece at about the same time. That's
the benefit of the two-piece appliances; you can leave the wafer on
as long as it stays on and doesn't begin to lift off or leak. The longer
you leave the thing on, the better your skin will be. They say that
each time you remove the appliance, you take some skin with it.
That's not too good for your skin's health....

The two piece appliances have many other benefits also. You can
change from your daily size pouch, to what is called a "stoma cap",
for short periods of time when you would like to feel less obstructed.
(did I say sex?) And it makes changing a worn out pouch to a new
one faster and easier, if the wafer is still in great shape.

Oh.. and you can easily shift the position of the pouch, if it's not
aiming the way you desire after you've applied it.

All brands make the two-piece units, and like vehicle brands,
everyone has their "best one". From what I've heard, Coloplast
has the fewest complaints regarding rashes and boo-boos.

I use the Coloplast Assura two-piece stuff, and have absolutely
no complaints.

-----
Unlike my friend "dirtyshirt", I am not afraid to advertise. That
is why I get a check from Coloplast each month, and "dirtyshirt"
does not. I will take "dirtyshirt" for a ride in my new Lexus
as soon as Coloplast delivers it as payment for this post.
-----


Stay healthy and happy!


John

I've Never
Had any kind of irritations with my stoma. I also use a two-piece Convatech phalange and wafer. Along with the stomahesive powder and paste, and skin prep and remover.

I take the wafer/seal off with the alcohol "remover" and any residue off, anything sticky or gummy can come off with that remover stuff.

I then jump in the shower, and rinse that area with warm water, the stoma should be a nice, shiny beefy red, and I don't even use soap in that area, just the warm water rinse.

I then jump out of the shower, put the stomadhesive powder, on any redness, and then I use the skin-prep, which is a barrier, that you wipe on your skin, which goes between your skin and the wafer. I also use paste, because it does help my wafer seal really good, with no holes, or gaps, and I then put my hands over the wafer, so that the body heat seals it, and sometimes I even use a hair dryer to help seal it.

I then snap the bag on, and voila! it's done. I do it myself, as I'd honestly be embarrassed if someone else had to do it for me, hubby did it for me during my recovery for a few weeks, but as soon as I was able to do it, I did, it takes me one, two, three now...the more I did it, the quicker I got it, and yep, I still do it in front of a mirror, to make sure the hole is even big enough that's going over my stoma. So far, I've had no problems with irritations, infections, nothing, it's just pretty much become part of my daily routine now, like brushing your teeth, I change it at least 3 times a week, every 4 days, or else, the smell does get strong, and you want to keep it clean. I don't even do this in front of my hubby or kids.

Hugsss!
~Donna

Patteee

When I had mine-
I started
When I had mine-

I started off with a 2-piecer- worked hard with the Mayo stoma nurse, then one up in the cities and then 2 times back to Mayo- I could not get a good seal. And everybody knows if you don't get a good seal, it will stink or leak. I tried everything from a belt to hold the ring in place, to pastes, and super glue (no, not really, lol). Finally a Mayo nurse suggested I try a one piecer- and woa-la, the problem was fixed. Bags were smaller, gas filter at the top (no more balloon down my pants), would change the entire thing 1-3 times a day- peeled right off, throw the entire thing in a plastic bag along with wipe ups I used, tie it up and throw it away. No more mess, no more leaks, no more smell.

I did have a hard time seeing the stoma and getting the hole in the bag over it. My eyesight is bad and got worse with chemo. I got one of those 50X magnifying mirrors, worked great on the bathroom counter- would stand right in front of it and then couldn't miss it.

dirtyshirt

Interesting Stories
I don't know what that says about me, but I find this thread fascinating. Thanks for the responses folks.

Seems like everyone was told not to use soap and water. I don't remember the stoma nurse saying that!! At any rate, I agree that careless use of soap would affect the seal. I rinsed very well and dried afterward. It worked well for me.

John made me laugh. Family is wondering what's so funny about stomas.

But, as long as we're naming names, I used Hollister. Got the stuff over the internet from the company website, and the even sent me samples of things I hadn't yet tried. Their rings were by far the best result I had from anything! As I mentioned earlier, if the skin ever got bad on me, it would heal under one of those rings. Better than a bandage! Really quite amazing.

About having your partner help with the stoma care: my wife wanted to, but I wouldn't let her. I took care of mine from the first day - took the appliance out of the stoma nurse's hand, and took over.

snommintj

dirtyshirt said:

Interesting Stories
I don't know what that says about me, but I find this thread fascinating. Thanks for the responses folks.

Seems like everyone was told not to use soap and water. I don't remember the stoma nurse saying that!! At any rate, I agree that careless use of soap would affect the seal. I rinsed very well and dried afterward. It worked well for me.

John made me laugh. Family is wondering what's so funny about stomas.

But, as long as we're naming names, I used Hollister. Got the stuff over the internet from the company website, and the even sent me samples of things I hadn't yet tried. Their rings were by far the best result I had from anything! As I mentioned earlier, if the skin ever got bad on me, it would heal under one of those rings. Better than a bandage! Really quite amazing.

About having your partner help with the stoma care: my wife wanted to, but I wouldn't let her. I took care of mine from the first day - took the appliance out of the stoma nurse's hand, and took over.

Ditto
I'll second everyone's observations and add only that a good hand held shower head comes in very handy. I would pressure wash my stoma. I added one to my bathroom sink as well and cleaned the inside of my bag every time I emptied it.

Mchapp

snommintj said:

Ditto
I'll second everyone's observations and add only that a good hand held shower head comes in very handy. I would pressure wash my stoma. I added one to my bathroom sink as well and cleaned the inside of my bag every time I emptied it.

Echo
I echo all about comments! I did forget lesson # 1...close the bag first - before attaching - or there will be a mess to clean!!!
I use diper wipes to clean my stoma...but love the am with the power wash!

angelsbaby

Mchapp said:

Echo
I echo all about comments! I did forget lesson # 1...close the bag first - before attaching - or there will be a mess to clean!!!
I use diper wipes to clean my stoma...but love the am with the power wash!

The Hospice
nurse suggested to angel and I to use a tampon while changing angels always came out when i had the bag off so you put the tampon gently in the opening and that keeps the liquid in so you don't have a mess in the middle of changing. It worked for us just a thought

michelle