Question about changing wafer

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Bennie
Veteran Member


Date Joined Nov 2006
Total Posts : 550
   Posted 7/22/2008 9:27 PM (GMT -6)   
My daughter is 3 weeks post step 1 surgery. The only thing we are still having trouble with is changing the wafer. She had Convatec in the hospital. The ostomy nurse recommended Hollister New Image Convex (her stoma does not protrude out much and it outputs straight down). The first 2 times we changed her wafer at home they leaked within 24 hours. Last week we made an emergency run to the hospital ostomy nurse. She explained some tricks to put on the wafer. Because my daughter's stomach is rolly, she said it would be best for her to stretch her skin above the wafer and also to push in on the skin just below the stoma to help the ostomy opening protude a bit more. We changed it on Saturday morning and it worked great!

So tonight she takes a shower (without the wafer on). We prep as we did the last time and it looks like the wafer is on good. She has something to eat. Goes to bed. And it leaks! So we remove the wafer. Of course the darn stoma is outputting like crazy! We finally put another wafer on (I think it looks like the stoma hole was pushed out better).

First of all, she knows it would be easier to change it after a shower in the morning when the stoma isn't outputting as much. She just couldn't wait till morning.

Does this ever get any easier? I feel like we are wasting more wafers and bags trying to get this thing to work right. Any ideas?

She is also having a terrible time taking the old wafer off. We've gotten better at getting a new one on (the first one took almost an hour between trying to figure out what we needed and what to do). But tonight it took her almost 45 minutes just to take the old wafer off. It pulls on her skin and it is still very close to the incision. It isn't overly red under the wafer. However she hates anything on her skin (she hates bandaids).

She is adjusting well to the temporary ostomy. She will probably be eligible to have her step 2 takedown around October. She is thinking about waiting until December so it doesn't interfere with school but everytime she has to change her wafer that thought goes out the window. And I can't imagine having to do this during school. She will have to get up 2-3 hours early just to shower and put a new one on. That sounds like a setback (albeit temporary) similar to when she had UC.

Please help.
--Mom of bratcat (17 years old)--
Daughter bratcat was diagnosed with pancolitis October 2006
Current meds:
Asacol - 4 pills/3Xday, 15 mg prednisone, Remicade
 
11/14/06 - started prednisone; 1/28/07 - finished prednisone!
3/3/07 - began to taper off hydrocortisone sloowwly! Summer 2007 - slowly began tapering Rowasa. 9/07 -- flaring? Nightly Rowasa. 9/21/07 -- added hydrocortisone enemas. 9/30/07--added prednisone. 10/31--started 6-mp, stopped the enemas. Started lowering prednisone. 3/08-another flare!  7/3/08-Step 1 j-pouch surgery


Ohio43
Regular Member


Date Joined Aug 2007
Total Posts : 212
   Posted 7/22/2008 9:50 PM (GMT -6)   
I received my "temporary" loop ileostomy July 23, 2007. It was to be first just 3 months, now it's July 2008. After several colorectal surgeries (to fix a fistula among other things), I'm looking to have it reversed in November. Hopefully, just two more surgeries.

I can tell you this - it does get better! The changes will get easier. It takes your body (skin, intestines, etc) a while to adjust to the stoma. Most people’s skin is very sensitive to the adhesives at first. You're probably looking at 2 to 4 months for the skin to really toughen up. Your daughter will learn when the best time is to change the appliance. I used to think mornings were best, but I've found that I can come home, eat dinner and have a couple hours before I need to get all my supplies in order and then take a shower. Have her eat 2-4 large marshmallows before doing a change. These help thicken up or even stop the output for some time. They work wonders for me.

Her skin will be very tender for the first couple of months, but in time, it won't hurt like it does now to remove the flange/barrier. Make sure she pushes down on the skin around the stoma to remove it instead of pulling it off. Also start at the side and do both sides before removing from below the stoma. This makes it less painful. Also, make sure she uses an adhesive remover. I use the ones called Allkare. I believe Convatec makes them. The Hollister brand seems to have alot of alcohol in them.

Lastly, make sure all your supplies are laid out and within reach. If you're using cut-to-fit, have several cut in advance. Use paper towels to wipe around the stoma instead of toilet paper too.

Best of luck! Mary

Booka
Regular Member


Date Joined May 2008
Total Posts : 60
   Posted 7/22/2008 11:43 PM (GMT -6)   
Hi,
We are new to this also,my daughter just had her illeostomy s/x on 7/9/08,and we have only had 1 leak,and that was when we used the paste. We have since been using the eakin wafer,and we have not had any more leaks,and she has even went swimming w/ her bag on,and did not have any leaks...we also take a long time removing the old wafer...we have started to use the adhesive remover,and that does seem to help alot...I know it will all get better as time goes by and she heals,and she is a tropper...this is so much better than being sick everyday,and she knows this pain will go away soon!! We are using a 1 peice bag at the moment from hollistrer...this semms to be working well...Hope this helps ,I'm glad to be going through the same thing w/ another MOM!!
Krista & Takera

summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 7/22/2008 11:51 PM (GMT -6)   
what kind of soap does she use? some soaps can make it harder for the wafer to stick. also, the skin prep stuff they send you home with, while it does help protect the skin, it also makes the wear time shorter. After she puts the new one on, use the hair dryer on it, for probably two minutes, to help melt it to the skin. If she will put it on laying down, her stomahc will flatten out on it's own.
it does get much easier to change it, i am at about 5 minutes now. Even when mine is active. This is gross, but i figured something out to help when it is active. Pull the wafer part way off, where the output will still fall in the bag, then use your thumb or something to press right above it, and it makes stuff come out! if you do that, then it gets the stuff out so it won't come out while you are tyring to change! in the want to join me thread, i posted a way to practice changing that might help ya'll.

Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 7/23/2008 9:27 AM (GMT -6)   

definately hold the wafer and push your skin away.  Soaps to use are non-residue (I use dial, but I think Ivory and Neutrogena also work).  I also used to change my appliance in the am but found that that is the WORST time for me!!!  Lots of mess(marshmellows do work great)...Another thing is depending on how many times a week you change, always do one on a weekend day.  When I worked full-time I did a Wed/Sun schedule and even if I could have gone a day or two longer, I changed it because knowing I didn't have to go to work on the weekend change was easier.  Be careful not to use a high setting on your hairdryer and I have found that I can even put my hand over the new appliance for a minute or so and that warms it up enough.

Before you know it her time will be up and she'll be having the reversal!  Just remember we are here and no question is silly!  I wish I knew all this at the beginning...


summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 7/23/2008 3:45 PM (GMT -6)   
i use dial, my ET told me not to use ivory, although some ETs tell their patients ivory is ok. You need to look for soaps that don't have any fragrances or anything, and no lanolin.

praying4healing
Veteran Member


Date Joined Dec 2007
Total Posts : 739
   Posted 7/23/2008 4:32 PM (GMT -6)   
ok i must admit that i read ur post, but not all of the responses. so if i repeat things that have already been said, please forgive me.

FIRST, TELL YOUR DAUGHTER IT WILL GET EASIER! i got my loop ileostomy in january...at first the thought of changing it made me sick...the smell, id get woozy and dizzy, and it would take me at least 45mins to an hour. This is before iv even started showering with it.

ok so...first i would say adhesive remover wipes work great with getting the flange off...i have a semi hairy stomach lol, not the kind someone else can see, but the kind i know are there. And so removing the flange was kind of hard at first, with the adhesive remover wipes it slides right off. Also, I started shaving the area around my stoma in the shower which made for easier removal. I think summer suggested that i use an empty toilet paper roll around the stoma if i was afraid of cutting my stoma, that worked great, but now i dont even bother.

I use safeguard soap, i've heard about the residue, and i dont know if it has it, but after getting out of the shower i always wipe with alcohol in the area that my flange will be in, cuz it kind of drys everything up.

Now as far as the output goes, ur right for some people its easier in the am, it is for me in most cases...but sometimes i just feel like changing at night. Only because I get up for work at 530 (or im supposed to anyway lol) and im usually late, and i hate the idea of trying to rush and change a flange b4 going to work. I wouldnt want to risk a leak at work, and even if i didnt leak, i wouldnt b able to focus b/c i'd be self concious about leaking. So when i do it at night i just give my self a few hours of not eating and change it at the sink or in the shower, either way i have everything pre cut and ready, and paper towels ready just in case, so i can catch whatever comes out.

O and the output does slow down! it doesnt run as much and it wont b so watery,or smell as much she could also try taking a couple of immodium to slow her down b4 changing.

It gets easier....i promise
25 y/o female- crohns disease since 14
Ileostomy pending-very worried
Tried asacol,pentasa,prednisone,remicade,6mp,azasan, no avail
Seatons placed
Worst year ever!

"For God has not given us the spirit of fear....."
Where does mine come from?!
 Temp Ileostomy performed 1/29/08
Still Adusting
 Healingwell.com has been my Godsend...Thank you


summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 7/23/2008 5:46 PM (GMT -6)   
lol praying, that isn't what i suggested the papertowel holders for, it was for practice, but that is a really reallygood idea!

Bennie
Veteran Member


Date Joined Nov 2006
Total Posts : 550
   Posted 7/23/2008 6:21 PM (GMT -6)   

You are all so wonderful! It is nice to know others understand what she is going through. And have suggestions to boot!

Mary--I will order some Allkare. It sounds like it will help alot. She's been using paper towels. Luckily we buy the jumbo packages from BJs (just like toilet paper)! I am getting better at helping her because I had everything prepared (cut, pasted, etc) so when she finally was ready we were able to get it on.

Krista--glad your daughter is doing well. You said you use Eakin seals. I have read several people use them. Do you know who makes them? The paste has some alcohol in it and it burns when we put the wafer on. But my daughter definitely needs something.

Summer--she might try "helping" her stoma poop! It doesn't bother her that it does it except when she has just wiped everything down and it makes a mess again. I will check out the other thread you mentioned.

Ohio--the marshmallows do work. We are aiming for a once during the week, once on the weekend change too.

Praying--she also has just enough hair that you can't see but that makes it hurt more to remove. We also feel that if she changes it right before having to go out for the day she will spend more time worrying about any leaks than what she is supposed to do. Plus if it does leak during the night, she still has a chance to fix it before morning.

We are hoping to work out most of the kinks in the whole changing the wafer routine before school starts (beginning of September). All your suggestions sound wonderful.


--Mom of bratcat (17 years old)--
Daughter bratcat was diagnosed with pancolitis October 2006
Current meds:
Asacol - 4 pills/3Xday, 15 mg prednisone, Remicade
 
11/14/06 - started prednisone; 1/28/07 - finished prednisone!
3/3/07 - began to taper off hydrocortisone sloowwly! Summer 2007 - slowly began tapering Rowasa. 9/07 -- flaring? Nightly Rowasa. 9/21/07 -- added hydrocortisone enemas. 9/30/07--added prednisone. 10/31--started 6-mp, stopped the enemas. Started lowering prednisone. 3/08-another flare!  7/3/08-Step 1 j-pouch surgery


Ohio43
Regular Member


Date Joined Aug 2007
Total Posts : 212
   Posted 7/23/2008 10:03 PM (GMT -6)   
Bennie, I use the Eakin Seals as well. Yes, they are wonderful. I've read alot of people use them too. They are made by Convatec as well. If you call Sterling Medical Services at 1-800-202-5700, they can give you the toll free phone numbers for all the major companies - Hollister, Convatec, and Coloplast. Once you get these numbers you can call them for samples. These companies are very eager to send you samples of their products. They all want your business. So, call Convatec and get samples of Allkare Adhesive Removals and Eakin Seals - probably the small ones. Most women wear this size. I believe they only come in two sizes. Also, I use 3M Cavilon Skin Barrier wipes. These help protect your skin and help the barrier/flange stay on. You'll probably hear controversy about skin barrier protection, but it's all in what works for her.

Something else I learned, once she finds a product that works - don't have her change just because she wants to try something new. She'll risk having a reaction. Just an FYI.

All the companies I wrote about have websites and phone numbers to contact them as well. You can also order samples through the sites. Sometimes calling them is more helpful because you can ask questions directly.

Mary

praying4healing
Veteran Member


Date Joined Dec 2007
Total Posts : 739
   Posted 7/23/2008 10:22 PM (GMT -6)   
summer! seriously thats not what u meant?! lol, well thats what i did, i used an empty toilet paper roll in the shower to put around the stoma and shaved around the role so i wouldnt cut myself! lol at how u inspired me unintentionally
 
Bennie, i was rushing so i didnt mention the eakin seals, but as ohio said they do work wonders! i love them.  Also, the convatec moldable wafers are pretty helpful, you dont have to spend the time cutting and trying to make sure the hole isnt too big or too small.   u literally just roll it back, put it on and it "turtle necks around ur stoma to prevent leaking.  These are ideal for right after surgery when ur stoma is still changing sizes and what not.  The only thing i didnt like, was that as i gained weight, the flange lifted off my skin on the edges, by my belly button. My stoma is a little closer and higher than most peoples i think. but even when that happened i just stuffed some eakin seals in there and never had a problem.  I just didnt dig the idea that i felt it showed a little more, my mom and family swore they couldnt see it.  But now that ive used the coloplast wafer, i love how it completelly seals to my skin!BUT the bag balloons and i can't let the air out.  I guess no system is going to have all of the features im looking for. I wish different company products were interchangeable lol!
 
 
N e way, i digress....moldables often came in verrrrrrrry handle when i had my crisis at target and had to change in the bathroom stall
25 y/o female- crohns disease since 14
Ileostomy pending-very worried
Tried asacol,pentasa,prednisone,remicade,6mp,azasan, no avail
Seatons placed
Worst year ever!

"For God has not given us the spirit of fear....."
Where does mine come from?!
 Temp Ileostomy performed 1/29/08
Still Adusting
 Healingwell.com has been my Godsend...Thank you


summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 7/24/2008 9:38 AM (GMT -6)   
nope praying, i didn't say that, maybe someone else said it?

john boy
New Member


Date Joined Jul 2008
Total Posts : 1
   Posted 7/25/2008 1:25 PM (GMT -6)   
 HI ALL: I AM A NEW ONE.MY WIFE LUCY HAS A DOUBLE OSTOMY,SHE WENT THROUGH A 14 HOUR OPPERATION ON 4/17/08, THE DR. TOOK OUT EVERYTHING[REMOVAL OF THE BLADDER,URETHRA,UTERUS,BILATERAL TUBES,VIGINA,VULVA,RECTOSIGMOID AN ANUS ANPERINEUM] ANDOMENTAL PEDICLE GRAFT TO THE PELVIC FLOOR.THIS OPPERATION HAS ONLY BEEN DONE A COUPLE OF TIMES IN THE U.S. SHE IS DOING WELL NOW AFTER BEING IN THE HP. FOR 70 DAYS. WE USE [HOLLISTER 3603 AND 1439] THEY HAVE PRECUT HOLES TO FIT THE STOMAS,PUT THE WAFFER ON THE PRE CUT HOLE ,THEN PUT ON THE WAFFER,PUT SOME PASTE ON THE WAFFER, BE SURE TO WEAR A BELT,THE BAG WILL BE GOOD FOR AT LEAST FOUR DAYS,WASH OUT THE BAG EVERY TIME YOU EMPTY IT.[ GOD ANSWERS ALL PRAYERS,IT JUST TAKES TIME.JOHN BOY

Ohio43
Regular Member


Date Joined Aug 2007
Total Posts : 212
   Posted 7/28/2008 7:01 PM (GMT -6)   
Wow, John Boy...if you don't mind me asking, why was everything removed from your wife? That sounds extraordinary. I glad to hear she is doing well. Please keep us up to date on her recovery. God bless you!

pamysue
New Member


Date Joined Jun 2008
Total Posts : 15
   Posted 7/30/2008 9:45 PM (GMT -6)   
I have an innie oval shaped stoma as well.  My ostomy nurse taught me to cut small triangles out of the Hollister skin barriers.  I can get 6 triangles from 1 sheet.  Then I clip the points off.  I place 1 triangle on each east/west side of my stoma with the large side at the stoma side.  This completely stopped my leaking problem in the beginning along with the other tip she gave me.  I lay down for at least 30 minutes after changing my wafer and lay my hand on top of the wafer.  The warmth from your hand lets the adhesive spread out and the down time gives it time to set up.
Good luck!

lacey55
Regular Member


Date Joined Jun 2008
Total Posts : 29
   Posted 7/31/2008 4:09 PM (GMT -6)   
I have a lot of trouble with leaking because my output is very watery (due to chemo). By trial and error, finally found one that seems to work for me (and may not work for you, I understand it takes a while to find what works for you, personally) and it is the convatec convex. Also, my skin is very raw and painful from the leaks and the stoma powder works well. You put some on and blow or wipe off the excess. The day I got home from the hospital I had a leak as well, and it was terrifying trying to change so close to my incision (it is from the pubic bone to over my belly button) but have found that I can trim the outside of the wafers (the adhesive part) so it does not overlap on my incision as it is still very sensitive. Good luck but keep trying different products...call the company and they will send you samples...cost you a lot less to try!!
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