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Ostomy help

Pamcakes
Posts: 104
Joined: Jan 2018

Richard is recovering well from the surgery! I am learning and trying my best with changing the bag.  i Am worried I am doing this all wrong and going to cause him more issues. today there was redness. It looks like the pouch is not sticking to the skin. His stomach is more inward. I looked in our goody bag from the hospital and saw the barrier paste. Will this help? We used powder for the skin today. Do you use this often or only when there is redness? Does anyone change the pouch more than every 3-4 days? Yesterday Richard had a smaller BM. So far today he’s not had one. We pages the ostomy nurse to ask if this was normal or could he have a possiable blockage. how would we know if it’s a blockage? Any help is appreciated. I am so worried I am going hurt him or cause an infection. Poor guy may want to trade me in for a new wife! I know our insurance will cover the suppliesand the hospital gave us enough for a month, but I order a pack of 10 pouches from Amazon since I had to throw one away from my horrible measuring job. I think this will help with my worry some as well. Did it take you long to get the hang of this? Of course Richard’s stoma is shaped like a football.

 

 

caregiver81
Posts: 1
Joined: Mar 2019

Hey Pamcakes,

I've been in your shoes, my Husband is 37 and is going through the exact same thing total APR resection and permanant colostomy. First thing first, make a template to use every time. It helps the process go faster. This will help with getting the size right everytime. Cut a hole in the stoma ring that is a 1 cm bigger around, this will help with leakage. It sounds like he is having alot of leakage because of the redness. If he is having redness and you are using powder, make sure you use the powder very sparingly on the red area. Only use a little bit, it goes a long way. I use a tissue to help spread it evenly and to get any excess off. Also make sure you are drying the area really good with a small fan before you start anything to the skin, this helps the skin stay healthly. Once, you've dried the area good and applied a very small amount of powder, then be sure to apply the skin barrier prep. We like the pad but the spray works too. Then dry that really well. Then while he is drying, get the barrier paste and spread a small amount on the top of the cut opening about 1/2 an inch wide and not very think. Make the amount thin at the top of the opening and a little more think at the bottom to help with adhesion. Then place the new bag on the stoma opening. Have him hold very light pressure for about 5 minutes. The heat from his hands will help with adhesion. It takes me about 3 minutes tops now and we change his bag once every 3 days to help with any chance of infections and comfort level.

Hope this help,

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

I've had mine for five years now. Here's my point of view. For starters the stoma size may change as it heals. Second, I do not use paste. If I'm in the hospital they use it on me and the bags dn't last very long, they come unstuck and start to leak. I only use the stoma powder. I pur it just around the stoma and thenput the appliance on and add a little more around the stoma and bertween any open areas between it and the opening. Then I attach the bag. 

That being said, for a couple of years it was so hard to attach the bag after that I had to attach it to the appliance first and then put the whole thing on. The bags have changed a bit and now I can attach it after like I used to. 

I don't think the paste helps it stick. I don't like it. I've had my bags last as long as 9 days but typically I change it every week. Unless I get a leaker. It's happened a few times. Usually I get a tickly sensation when it first happens. And my output is very liquid so it really comes out. At this point changing it more often is better until it heals but he can probably go longer later on.

I make sure my tummy skin is totally dry and then I go lie down for ten minutes with either my hand over it for the warmth or a heating pad. I empty mine several times a day or more often if it fills up quickly. I have a friend with one and both of us have noticed that it seems to fill faster when we eat a meal. I've had to empty it every time I've gone out for dinner., sometimes partway through eating.

He'll get used to it eventually. When I first got home with it I was horrified by it and didn't want to look at it. And the first time I changed it my husband helped me hwile I stood there crying about being the Frankenstein monster. Now its just part of my life and really doesn't bother me. It hasn't after the first year or so, maybe less. I actually like it now and won't have it reversed even though they say I can.

Good luck!

Jan 

Annabelle41415's picture
Annabelle41415
Posts: 6547
Joined: Feb 2009

You are a wonderful caregiver and wife to help your husband adjust to this new device.  It's going to take some time and redness is very common with it.  The skin around the stoma can become very raw as the acid from the stool gets on it so a barrier is a good thing to use.  Changing the appliance every 3-4 days can be common.  You should have a home health care person coming out a couple times a week at this point.  I'm not sure if you have insurance or not but it should cover most of your supplies.  Ask the different suppliers of appliances to send you samples as they will do this for free.  Some work better than others for your own specific type of stoma as doctors make them all different and different manufactuers work better than others for one's special stoma.  My distributor was changed three times before finding one that worked better for me.  Wishing him well and thanks for being such a great wife.

Kim

Nazareth
Posts: 88
Joined: Nov 2017

if it's just a little redness, i wouldn't worry too much and just keep an eye on it- if the redness has soem weeping however, then you will need to 'crust' the area- put a thin layer of powder on area, and spray or wipe some skin tac over top to seal it in and allow pouch seal to stick on top of skin tac- you could also try soem tincture of benzoin- cover the area- this iwll sting- but wont last long- and put pouch directly on that- some people use maalox, coat the area, allow to dry- then attach pouch- I read the other day that using an asthma inhaler on the affected area helps heal it as it's a steroid, and dries quickly and won't affect pouch adhering- Hollister also has a new product pouch with Ceramide in it that heals the skin- go to their site to read up on how it works- don't know how well they work though-

Don't worry too much about hurtign him- the ostomy sites are usually pretty tough- and don't worry about causign infection- just keep the area clean with warm water- don't use soap- and that sdhould be enough- hold down o nthe seal for 1-2 minutes so that heat from skin will help it adhere better- soem folks use a hiar dryer on low heat to help with that-

You can also try Eakin seals- they are expensive, but soem folks love them- while others claim it doesn't work well- It is messy to change though as the Eakins seal melts to skin and is hard to get off- hollister has their own brand of seal- as does convatec i believe-

If your husband is not too long out from surgery, the blockage may just be due to the anesthesia still at work putting bowels to sleep- sometimes it takes awhiel to get back to normal- go slow with food durign htis period- and eat soft food easily digestable for a bit-

usually for weeks after surgery, the skin around stoma will be red, perhaps a little inflamed- but another possibility is that he might be allergic to the seal- but that isn't likely-

Also- make sure tyou don't hit the stoma with the seal when placign the pouch onto the skin- the stoma is usually a bit moist- and htis will affect how well the seal sticks if it hits it- Dry the stoma with toilet paper right before you put it on-

another thing to try is changing it more frequently- pouches will usually stick right uo to edge of stoma for a day, then moisture starts to work under the seal, which will cause the redness-

it's all a massive tiral and error learnign thing- but you and he will get used to it and find htings that work better than other things- changign will becoem quic nd easy-

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

Nazareth brought up something I'd forgotten. The ostomy nurse taught me to use cheap J cloth type cloths with warm water to wipe the area. For the past few years I've used unscented baby wipes for sensitive skin. 

What I do is have a nice, hot bath. It doesn't loosen the adhesive but it makes it a little easier to remove. After the bath I sit on the toilet with everything I need at hand. I put several squares of toilet paper on one knee in case it leaks while changing it. I remove the old one and let it sit open to the air for as long as possible, before it leaks. Often when I take the appliance off the stoma is swollen but it shrinks. First thing I do is wipe the area so that it will be fully dry before I put the new one on.

I try to never change it when it's active but sometimes I get caught off guard and then it's a race to do it and a challenge and it often makes me talk to it when that happens. Things like "no!" or "stop!" or "are you kidding me?" or "seriously??". For the record, it doesn't help, ha ha.

Jan

Pamcakes
Posts: 104
Joined: Jan 2018

Thank you for all of the suggestions! It wasn’t a blockage, thank goodness. We have an appointment with the ostomy nurse in the morning. All of this is so new. After a good cry last night I’ve decided it will work out and knowing that others had the same issues helps take some of the pressure off. Thank you so much for the support! 

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

I suspected it wasn't a blockage. I've had partial blockages a number of times. They always rectify themselves but a few times they've had to give me fluids until it passes and I've been in the hospital overnight a few times for it as well. If you need help with what he shouldn't be eating I can share what my experience has been. Let me know.

Jan

betula's picture
betula
Posts: 86
Joined: Mar 2017

My husbad has had his colostomy for two years now and it was very stressful in the beginning.  I do know that his skin took some time to heal after the surgery and we used the powder a lot. One thing that was great was we had a home health nurse come out once a week in the beginning.  She was an ostomy nurse and was so awesome with educating us, checking on healing, answering our many questions and even helping set up our first supply order.  She had great insight into which type of bag would be best for my husband, etc.  I know you have an appointment with an ostomy nurse but am wondering if you can get a referra for home health? 

Just know that it does get easier.  It was so scary at first wondering if bowels were working as they should, etc.  Hang in there, it will get better!

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

Air is the best thing for it. I have a colostomy so my output is not too loose. if I see redness starting, I will shower with everything off (wonderful feeling!). Afterwards I will use aloe around the stoma and lay down while it air dries (Holding onto unscented baby wipes just in case it starts up). I found that it really helps.

I sometimes change the bag a couple times a day and others not for 2. My system has always been like that. I change my wafer every other day unless there’s a problem. It sometimes pancakes and I have to change it sooner. I use the eakin adhesive rings. I tried the paste and ended up with more on everything in the bathroom but the wafer (picture the 3 stooges here). I found that some foods make my output slower... pasta, caramels, marshmallows, bananas.... and others speed it up... nuts, avocados, pineapple, salads, etc.

I tried several brands and I use Colosplast sensura mio bags and wafer. They are expensive but I usually meet my deductible so it’s not too bad. I also use the Eakin adhesive ring. It an be shaped to fit closely around the stoma.

good luck!

k

Pamcakes
Posts: 104
Joined: Jan 2018

We visited the ostomy nurse this morning. As soon as he looked he said that bag is not going to work. Richard’s stoma is very smal and close to the skin. He put on a new pouch with a different waffer. This is a 2 piece system. They gave us the very basic in the hospital. We will go back on monday. we Will be in Texas for another week before we head home to WV so hoping we figure out which pouch / system will work I must say it was reassuring ro know it wasn’t me rather the wrong pouch!! Thanks so much for all of the tips and help!!!

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

I use the two piece system. My stoma is small too. 

one other thing... I do not use the skin conditioning stuff at all. it seems like my wafer would not stick good with it. I just use the aloe or nothing. I use the unscented baby wipes or wet paper towel. 

Nazareth
Posts: 88
Joined: Nov 2017

One more thing to try- which I've been using lately and it works really well to heal redness and weeping skin- I have asthma, and had to use an inhaler for awhiel back when i was smoking like a dummy- well, i had soem inhalers left over after i quit smoking and didn't need inhaslers anymore- and there was a report about using them on broken skin around ostomy- as it is a corticosteroid- and it goes on completely dry- and won't affect the pouch seal sticking to skin-

If you have access to an inhaler- spray a couple of puffs on skin, the red parts- let it sit for about am inute or so- then i put soem stomahesive paste very thinly over the top, allow it to dry for a minute or so-  just to kind of seal the corticosteroid in for a little longer- and apply pouch on top of it all- by day 2 it's almost healed if hte skin wasn't too bad- the redness is gone-

sounds crazy- but it works- talk to your doc about it- here's a link if you want to give to doc to show them so that they might prescribe it for you as an off use- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276280/

it's a good hting to have aroudn if you can get it, to use in addition to other techniques in posts above for broken skin-

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