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Paste for ostomy?

JanJan63's picture
JanJan63
Posts: 2482
Joined: Sep 2014

I was changing my ostomy bag yesterday and was thinking about how some people have such a hard time with having to replace the bag often. I replace mine once a week now. I was able to get 5 to 7 days out of them previously while I was using a wax ring but it would eventually lift and seep and burn my skin. Without the wax ring I can get a good week and then I change it only because I think it's risky to go longer, not because it's burning or lifting.

I have had nureses who changed my bag in the hospital for me use the paste. The bag will only last a few days when they do that. I'm wondering what the paste is for? It doesn't seem to help the bag last longer and I'd think it would inhibit the stickiness of the adhesive on the appliance. I wonder if the reason some people have trouble making it last is because of using the paste?

I do use a powder that soothes the skin if it's ittitated and provides a barrier but it just goes around the base of the stome and that's it.

Just a thought, I hope it's helpful. I can't imagine changing mine every day or even every few days. They're stupid expensive for one thing, and it's a pain in the rear to time it so that its not leaking while I'm changing it.

On the other hand, I don't shower, I only have baths so that I can prevent it getting wet so maybe that helps mine. When I'm planning to change it I have a nice, hot, deep bath to soak it and help the adhesive let go and then I change it after my bath.

Jan 

Tunadog's picture
Tunadog
Posts: 235
Joined: Mar 2017

I don’t use paste or rings for my Colostomy. (I have 10 months supply due to insurance, guess I’m not using enough)

I take mine off with an adhesive in a little package. I then wipe the area with washcloth to clean, usually not much to clean, then dry the area.

I spray on moisture absorbing powder and brush it off with a paper towel. I then apply a skin barrier which is also in a little packet.

Finally I put on the bag which I precut.

No paste or rings. I was given all of that stuff and an Ostomy nurse she me how to use on her first home visit.

On the second visit we did it without and that’s how I do it. About 5 minutes to change.

BTW - I go in my spa almost everyday and don’t have any issues, I just put a little blue cover over the air exhaust hole (provided)

Bunny822
Posts: 23
Joined: Nov 2017

Hi Jan hi Tunadog...sounds like helpful information...I may face surgery with a permanent colostomy too but too soon to know at the moment...I have 1 more IV chemo then 4 wks off before I start 5 wks radiation daily. Surgery will depend on my response to chemo and radiation. Of course I chose life over cancer and was just wondering how long you both have had your appliances and how you were able to adjust to your new routine. I am trying to be positive here...my surgeon minimizes and says that it will become routine...well perhaps but still a life changing event...any feedback is appreciated thank you! Bunny

JanJan63's picture
JanJan63
Posts: 2482
Joined: Sep 2014

Hi Bunny, mine was supposed to be temporary. It's an illeostomy. I loathed it at first. I remember crying while my husband helped me with the first bag change after the surgery. I felt like Frankenstein. Now it's been almost four years since I got it and I have no intention of having it reversed, although I could. I had IBS my whole adult life before this. It was terrible and really affected my life negatively. I always had to be near a bathroom and even choose a job based on where the bathroom was located. It was an everyday thing. Now I don't have to worry about that at all. And my surgeon said the IBS would probably be worse if I get it reversed so I'm keeping it.

The life changes are things like wearing tops that cover it if it gets full. I wear looser tops than I used to. I and a friend who has had one since the seventies due to Chrohn's have both noticed that as soon as we eat something the bag will start filling. I don't know if everyone is like that. I make jokes about mine so people don't get weirded out. Nobody would know if I didn't tell them, though.

I've been lucky and have only had a couple of accidents where the bag failed and only once in public and it just got on my shirt but it was winter so my coat covered it. Some people have a tough time with theirs. Generally there's no smell when I empty it. I usually empty it several times a day, I don't wait for it to get full. Sometimes it's annoying when I empty it and have to do it again 20 minutes later but that's not usually how it is.

I probably hated it for the first year and then I realized that it's not that bad and has really improved my quality of life. I think part of my hatred initially was that it seemed like a symbol of the cancer. I just wanted to be the same as I was before the diagnosis.

I learned to change the bag when I hadn't eaten or drunk anything for a while so that it didn't dribble during the change. The change is very quick, it only takes a few minutes. I got over the creepiness of having a small inside part of me sticking out of my tummy. My stoma is small and doesn't look like some of the ones I had Googled before the surgery. 

Today it's just a thing I do. It helped save my life and is just part of me now. No worries about gas or anything like that. 

Jan

Tunadog's picture
Tunadog
Posts: 235
Joined: Mar 2017

Mine was supposed to be reversible but After 6 hours of surgery I woke up with the Colostomy. (Was supposed to be a 3 hour cruise)

Got mine December 29th 2015. I was very drugged and it didn’t bother me.

I adjusted quickly. No problems. My Ostomy nurse commented to my wife that I could probably handle anything.

I don’t like it but it’s not the worst thing in the world. 

You’ll do fine- Good Luck 

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

My previous approach was with Convatec Stomahesive Paste and I did it that way because the WOC nurse did it that way. My new approach is Convatec Stmahesive Paste, Cavilon Spray (Barrier), and Convatec Stomahesive Powder. I changed the bag this morning which makes 5 1/2 days. I think that I should change them every four days but I've found that the Convex wafers work a lot better than the flat ones. So I'm doing it the way I do because that's what someone showed me. I've chatted with others that don't use paste and they say that it isn't needed but I'll just keep doing what's worked for the past two months.

Lovekitties's picture
Lovekitties
Posts: 3348
Joined: Jan 2010

Paste is usually recommended for patients where the area around the stoma is not even...hills and valleys.  It is to make the area all one level so that the appliance, which in most cases is rather ridged around the ring, can be seated evenly. 

Each of us comes to find what works best for us.  I have seen lots of different approaches in the 9+ years I have had mine.  The amount of time it will last can also be impacted by things like humidity, activity, heat, cold, the composition of the output, etc.

And yes Bunny822 it does become routine, but it will be one you find best for you.  Other users offering their approach is all good info and worth a try, but don't think that it will necessarily be what works for you.  That takes time and tial and error.  The manufacturers of the applicanes are very good about offering free samples so that you can try various styles and products to determine what works for you.  I have changed my choice of appliance 3 or 4 times thru the years.  Discarded one because it required that I cut the hole myself.  Discarded one because while it was good, I was apparently allergic to something in the product as it caused a rash.  You will also find that your choices and routine may change over time as your body changes...the stoma may shrink a bit, if you loose or gain weight the fit might change or the manufacturer may come out with a new style which you find works better.

Having an ostomy is not a static process, but it is certainly not a difficult one.  You would probably be surprised at the number of people you pass in your daily life who have an ostomy.

Marie who loves kitties

Kazenmax's picture
Kazenmax
Posts: 424
Joined: Feb 2016

Paste!

I was NEVER able to use the paste. I tried several times but usually ended up with paste everywhere but where it should be. The last time I had to stop because it got me laughing so hard.

I usually just use the wafer but sometimes I need the extra production of a barrier ring. Either way, I have wonderful insurance and get plenty of supplies. I use a closed bag and change it everyday. Sometimes every other day and occasionally twice a day. I usually change the wafer every other day. It's just easier for me.

I, too, hated it. I still do not sometimes. But I have adjusted. 

Good luck

BRHMichigan's picture
BRHMichigan
Posts: 368
Joined: Jul 2017

When I first got diagnosed the thought of a permanent Colostomy was an enormous fear for me. But, the nearer I approached surgery, the more I secretly hoped for a permanent bag. I have read so much about how difficult life can be after a reversal, that I was truly relieved to wake up to the colostomy. Also my surgeon relayed per surgery that there is less likelihood of to ed cancer returning to that area when you don't reverse. 

Jan,  I don't use any paste, powder, adhesive, nothing. I found a product that works well without much fuss. I swim and do saunas at the gym and take baths or showers daily. I just cover the filter with the little blue stickers.

With all of the issues I had prior to surgery, I don't miss going #2 in the usual way at all! I too was kind of house bound due to frequent and miserable trips to the bathroom. My only accidents have usually been at night, but never too serious or messy. 

It's really enhanced my life more than taken away from it. The only thing that can be a little overwhelming at times is that I'll need to order and rely on this durable medical equipment for the rest of my life. 

JanJan63's picture
JanJan63
Posts: 2482
Joined: Sep 2014

Thanks for your reply. What product do you use? I used the little stickers to cover the vent but they didn't work and they weren't blue so I assume you use something different than I do. I now have the bags without the vents. My output is pretty much always very liquid so it seeps out of the filter easily. 

Jan

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

I’ve never had a leak out of the vent in my Convatec pouches. What brand are you using?

JanJan63's picture
JanJan63
Posts: 2482
Joined: Sep 2014

Convatec. I think it's because mine is so liquid.

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

Stuff getting up around the filter can clog so I sleep with three pillows so that my upper body is at an angle so that liquid doesn't flow to the filter. Sleeping on your side can help too if you can tilt the bag to that side. I sometimes have liquidy output but haven't had anything leak out the filter with Convatec.

BRHMichigan's picture
BRHMichigan
Posts: 368
Joined: Jul 2017

I forgot you have an ileostomy, which is going to be more liquid. I use Colorfast products. The SenSura Mio. My output is pretty solid. I also like to use disposable close ended pouches. 

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

I did not realize that your kids were so young.

BRHMichigan's picture
BRHMichigan
Posts: 368
Joined: Jul 2017

Hi,  Mike. I initially thought you were responding to Jan. If that was directed to me, I am holding my sweet 2-year old granddaughter in my photo. She lights up my world and inspires me most to keep fighting. 

I thought you were taking a break from the forum. But am glad to read your posts and responses. Hope you are doing well. 

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

I'm posting and reading less. Chemo is tough the second round.

Helen321's picture
Helen321
Posts: 1409
Joined: May 2012

Jan, would your insurance cover a two piece disposable system?  You have an ileostomy and not a colostomy so I'm not sure if it would be better but it has changed my life.  Those one piece bags that last a whole week are horrific.  I don't even know why they exist.  I hope your insurance covers the two piece disposable and it's an option for you, it'll change you whole comfort level and you won't have to deal with any of that stuff.  All of the companies will send you free samples.  Tell them to send you 5 wafers and 20 bags so you can try it. 

Meanwhile the thing to use to keep a wafer on is Cavilon no sting barrier film.  There is a protective powder call stomahesive protective powder.  This powder when used with the Cavilon wipes (have faith, it's powder so you're like how is powder going to make something stick ........the wipes do something to make the powder a glue, it works) give you a lot of relief to your skin and cause a good stick.  I hope the two piecedisposable system works for an ileostomy.  It's night and day over the one piece system.  You take the bag off, throw it out (I would guess you'd have to dump your contents in the toilet), put on a new bag and go on with your day.  Peel and stick.  No constant washing of the bag, no wet spots.  Everyone has blowouts.  Once in a while my bag fills so fast if I don't make it to the bathroom, blow out.  I don't use the powder and film though because my blowouts are rare and the regular stick works.

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

I've never reused a wafer before in this manner. I always change the wafer and the bag at the same time. When I order, I get the same number of wafers and bags. I prefer to assemble the two-piece before applying. Wafers with smaller flanges can take quite a bit of effort to get on and it's a lot easier to do it than to press it against your stomach.

Helen321's picture
Helen321
Posts: 1409
Joined: May 2012

I'm not sure if you can use the film without the powder.  I usually only use the powder if I develop a rash.  It clears up the rash same day.  If the rash stays, it's usually a fungus and you have to get a prescription powder for that.  I had that once, it was a hot summer and I was not drying the area good enough after my showers.  I also like that when you shower with the two piece, you can do it bagless.  It's awesome to shower that way.

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

The technique of Cavilon Spray and using powder is called crusting. My WOC nurse demonstrated it to me after I asked her about it. You apply powder from a bottle around the stoma, spray Cavilon on the powder, dry the Cavilon with a carboard fan, apply powder again, apply Cavilon again and fan dry. Apply one more layer if you're paranoid. I usually do either two or three layers.

The Cavilon can be used without the powder. I normally use the Cavilon by itself and only use the powder when there was stinging from the previous bag. My insurance doesn't cover the Cavilon Spray so I bought three small bottles for $10 each from Amazon. Insurance pays for wipes though. I have ConvaTec's barrier wipes and I also have an unused box of Cavilon Wipes. The regular barrier wipes have alcohol in them so they will sting if you have sores. The Cavilon spray and wipes don't contain alcohol. The spray is far easier to use though and it performs the same function. My process with the wipes was to use a glove so that the barrier paste wouldn't stick to my fingers (took several days to get it off) and I wouldn't have to tear open the package and get the wipe out (which was quite sticky). I find that the spray does a much better job than the wipes as far as coverage goes.

I think that a bottle of Cavilon will last for 8 or 10 bag changes. None of them are used up though - I've been using two bottles and they still have stuff in them. I will probably keep using the spray as it is far more convenient and results in far less pain. I can get stinging with the Cavilon if there's a lot of liquid output and I've left the bag on for too long.

JanJan63's picture
JanJan63
Posts: 2482
Joined: Sep 2014

I use the powder every time I change my bag. I'm not having any issues with mine, I'm quite happy with it. I'd originally posted this because I thought it might be helpful for people who do have problems. And because I really don't know what the paste is supposed to accomplish but I feel like it isn't helpful at all. The only tme I've had the paste was in the hospital when a nurse was changing my bag and they didn't last very long so I was thinking that might be the reason why some people have problems. 

I've had my ostomy for four years this month and have only had a few blow outs or leaks. I'm quite happy with my products. I feel bad for people who do have issues, though. Worrying about it has to be very stressful. 

Jan

Mikenh's picture
Mikenh
Posts: 777
Joined: Oct 2017

I've read from others that the paste isn't necessary but I use it because I'm used to using it and just keep doing what I've been trained to do and it works for me.

I've only had one leak and that was early on. Waking up twice a night to empty the bag has taken care of leaking/blowout issues for me but, of course, it's not a lot of fun waking up at 1:30 and 4:30 to empty it and then get back to sleep. I think that you need to find what works, even if it means doing something that's not strictly necessary as confidence in what you're doing is a factor.

Every time I am going to drive someplace, I want to empty the bag because it can fill up along the way.

One last thing: it's a pain at work when I need to empty between 1:00 and 2:00 at the office because the handicapped stalls are usually all taken. I sometimes walk to four different bathrooms to find one. I should probably plan better.

JanJan63's picture
JanJan63
Posts: 2482
Joined: Sep 2014

One thing I've noticed with the ostomy is that as soon as I eat or drink it fills right up. I've heard that from people I know that have them, too. If we go out for dinner we'll have to empty it for sure while at the restaurant.

Mikenh, I get up every two hours to go to the bathroom and I generally empty mine once during the night but not every night. I'm so used to getting up so often I don't really wake up sometimes.

Yup, ostomies are fun.

Jan

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