Flush stoma right in belly crease. Leaks every time. Eakin? Paste? Belt? Advice please.

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

AB4054
New Member


Date Joined Sep 2008
Total Posts : 3
   Posted 9/26/2008 7:04 PM (GMT -6)   
Hi all-
 
My dad had a colon resection in early July because of colon cancer and has been dealing with leaking and blowing-out colostomy bags ever since.  He is overweight, (about 265), his stoma is very flush to his skin and is shaped like an eye-not round at all- and right in his belly crease.  He's just been discharged from the nursing home to go home and as he can't change his bag himself I am the one who is in charge of managing the changes, etc.
 
The way each hospital and nursing home he's been in has managed this is to use a convex wafer, an Eakin ring flattened on the edges and paste on top of this, paying particular attention to the edges where the crease runs. The outer edge stays put more often than the inner edge.  This is where it seems to give out out, toward his belly button (and right into his abdominal would, btw.)
 
It seems strange to me to build up the opening of the wafer so much with all these products. I wonder if just paying attention to the crease edges might be what is needed. 
 
Also maybe a belt might be useful? We were told by a nuse that belts tend to work better for thin people, rather than overweight individuals.  She says she sees them work up in the back and pull the appliance off, more often than not. Anyone of an overweight stature have luck with a belt?
 
We are making an appointment with the ostomy specialist at our local hospital so I hope we can get some answers from her.  These leaks and blow outs are very frustrating for both of us.
 
I appreciate any advice you can give me on this matter. I applaud each of you who live with these ostomy issues every day and I'm glad you have a forum in which to vent and get support.
 
Thanks so much-
Angie

Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 9/26/2008 8:58 PM (GMT -6)   

Angie, welcome!  This must be a difficult time for both of you, but you are doing the right thing by meeting with an ostomy specialist. 

There are many people who will be along to give you some help.  There are products out there to help build up creases/low spots, for better wear time...an example would be hollister's adapt barrier strips...Do you have a catalog for ostomy supplies?  It might help to just look through the pages and get an idea of what is out there.  You definately have "common sense" on your side with your comment about "building up the opening" not making sense (especially with a flush stoma)!! 

Your dad is lucky to have you.  Remember, no question is silly, so keep asking!


peggy113
Veteran Member


Date Joined Aug 2007
Total Posts : 1998
   Posted 9/27/2008 2:25 AM (GMT -6)   
Hello Angie and Welcome too! I also applaud you for your comment about not building up the opening when you have a flush stoma. You did mention that they were using a convex wafer - I believe this is accurate way to go. And maybe they should just be paying more attention to cutting the opening to "fit" the shape of the stoma, and try using less is often the answer people find work best. The strips that Ohio76 mentions to build up the low spots is an excellent idea - building the area that creases. I use a product called eakin seals and I am not overweight in the least, in fact bordering on the opposite.

I wish you the best of luck and certainly feel free to stop by and visit with us on this forum and ask any questions you may have any time.

I'm sure you will get many good ideas. Keep in mind, what works for one person may not work for the other person. Sometimes it is trial and error.
Peggy
      
Diagnosed with CD in 1979, many resections and meds
Perm Ileostomy July 1984 at Cleveland Clinic
Disease free since surgery 
 


Marsky
Veteran Member


Date Joined Jul 2007
Total Posts : 1956
   Posted 9/27/2008 7:19 AM (GMT -6)   
Hello there. I had a temporary colostomy 9 years ago after my rectal cancer, resection, etc. I was reconnected 2 months later and that's when all my troubles started (I spend a lot of time in the bathroom, experiencing multiple bm's each day). Our medical insurance copays and coverage is just lousy compared to what we had 9 years ago (my out of pocket expense for a total of 12 days in the hospital? A whopping $1400! I cringe imagining what our co-pay would be now.......probably triple that, at the very least).

Anyway when I tell my colon doctor how much I go (12, 15 even 20 bm's each day, but very small in size and usually easily passed if I eat a certain way), she suggests another colostomy. One that I would irrigate each day and wear an AM Patch (picture a large bandaid), covering the opening in between irrigations. She claims an irrigation would be easy but it would require another major colon surgery, the removal of my lower colon and rectum. For now, I am passing on this suggestion. I have done a google search and found an excellent message board for ostomy irrigators. She says think of an ostomy irrigation as a daily enema. It flushes out all the stool. And in theory if it works correctly, you won't experience stool output for anywhere between 24 and 48 hours. From what I can gather, the process takes an hour or so each day.

But again, mentally I am not ready for this major change in my life. Not that it's very convenient way to go here when having a colostomy. Perhaps down the road she could convince to have this surgery. She says the stoma would be flush with my skin, so when I'd put on the AM Patch it wouldn't show, so it would be like walking around w/o a colostomy in between irrigations.

I mention all of this to you because what I can also gather by reading and reading the links google found, this colostomy irrigation idea/approach is rather new. Some colon surgeons don't even mention the idea to the patient.

So if I were you, I would at least ask his doctor or his ET nurse if this is an option for him. You have to purchase the equipment (a cone you insert into the stoma, tubing, etc., a bag you fill with a specific amount of water you infuse into the colon, wait for it to "cook" (ie, similar to how you wait for an enema to work), then the process reverses out the same tubing, into your toilet). He would need to sit on the toilet. Or for bedridden patients, there's probably another way you could do this.

It certainly wouldn't hurt to ask someone if he could irrigate. He may feel better, in the long run. For 22 or 23 hours a day. I've gathered that irrigating frees the patient from having to empty the bag, change the wafer, the skin isn't irritated anymore, etc.

I wish you well.

Mary/Marsky

AB4054
New Member


Date Joined Sep 2008
Total Posts : 3
   Posted 9/27/2008 9:27 AM (GMT -6)   
Thanks so much for taking the time to share your excellent suggestions. I will research each of them.

So much to learn!


Take care-
Angie

Marsky
Veteran Member


Date Joined Jul 2007
Total Posts : 1956
   Posted 9/27/2008 12:45 PM (GMT -6)   
Angie - yes there is much to learn! I'm sure all of this is new to your father and to you as well.

One of the best forums I have found for colostomy irrigators was from the United Ostomy Associations of America, Inc. main page. Their website is a .org one, not .com. Go to their website, you'll see a link on the lefthand side for Discussions. Scroll down to find their "irrigation option" forum.

Even if your father could not irrigate, that entire website seems to be an excellent source of info. As well, as this forum (lots of supportive members at Healing Well.).

Mary

Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 9/27/2008 12:52 PM (GMT -6)   

it's a great site...the link is www.uoaa.org

 


AB4054
New Member


Date Joined Sep 2008
Total Posts : 3
   Posted 9/27/2008 12:55 PM (GMT -6)   
Thank you!

Marsky
Veteran Member


Date Joined Jul 2007
Total Posts : 1956
   Posted 9/27/2008 1:23 PM (GMT -6)   
Thanks Ohio76, I wasn't sure if we were permitted to post other website links or not. Didn't want to break a rule...LOL!

jimmysue
New Member


Date Joined Jul 2011
Total Posts : 2
   Posted 7/5/2011 12:38 PM (GMT -6)   
Am having EXACT same issue w/ hubby ... at first I wondered if you were my daughter posting this question!! Did you come up with a solution? My hubby apx same weight, eye shaped "innie" & the whole thing ... We worked with awesome ostomy nurse in the hospital, but after he came home & stoma healed, it changed shape quite a bit and the home health nurse set us off in a different path with appliances. What ended up working for you? Help MUCH appreciated! We're SOOO frustrated, and under-rested -- changed the wafer last night at 7 pm, 11 pm & again at 2 am. I'm TRYING to get back to work, but am a zombie after night after night of this. It's not a quick fix to replace blow-outs either, since there's a large surgical wound navel to pelvis just inches from the ostomy that needs to be cleaned out each time.

betsaronie
Regular Member


Date Joined Oct 2007
Total Posts : 318
   Posted 7/5/2011 10:35 PM (GMT -6)   
My colostomy was in my belly fold as well and an oval. I kept getting leaks after i healed because my stoma became flush and the leaks all went towards my belly button too. Why they would site it in a crease is beyond me. But I found a system that worked perfectly for me for 5 months. (1 month of trying to figure it out and then after that i got an ileostomy) I would change once a week, every Saturday. First the main reason i did this instead of going the traditional convex wafer route was because convex wafers would not stick to me at all. Within an hour of putting a convex wafer on, regardless of brand it would pop off and only the very edge of the dip area would be attached to my skin and thus I would leak. Belts didn't work for me because my ostomy was so close to my natural waist that the belt would slide up to it and get all loose and useless. (I have a 10 inch difference between my natural waist and hips) So what I did was this. I used Coloplast Sensura wafers, FLAT with an eakin ring around the stoma and then some more eakin (you could use strip paste too) in the fold next to my ostomy. that's it. The reason I specifically say the coloplast wafer is because they are larger and oval so you get more surface area in which to help pop the stoma out when you initially place the wafer on. Also they are extremely flexible so they will move with you resulting in less leaks because of a ridge wafer. I did this with hollister too, but since they are smaller and more ridge it didn't last as long and I hated hollister bags and the tape gave me a rash. I love Coloplast products. I used the adhesive coupling but I don't think that had any baring on how well it worked. But anywho... When you cut the wafer for this method cut it about 1/8 inch to 1/4 inch larger all the way around and then place the eakin directly around the stoma so that the products are stair stepped. This way the eakin will swell and the wafer will swell but not compounded on top of each other giving you less areas for leakage. i say completely nix the paste. Its a filler not an adhesive so you could use to fill the fold but I think stripe paste or eakin works better. You don't need to use a lot either. You're just trying to fill the fold so that the plain for the wafer is more flat. If you put too much on, it will swell and stick up and leak and then you know use less next time.

Another option that some people here have loved is the hollister convex adapt ring with a flat wafer. Some use it with convex too but that may be overkill. It didn't work for me because my skin was too sensitive and it began to break down after only 6 hours of wear time. (Probably the reason the convex wafers popped off me so fast too) I just couldn't take any constant pressure on my skin. But this has worked really well for lots of people. You can get samples from hollister by calling or going to their website so you don't have to buy them and then have them not work.

I think your right on building it up too much. General consensus among all the peeps I know with ostomies is less is always better. Unless the ostomy nurses have had one themselves they really don't get that idea. But they can give you more insight so definitely go see one.
I hope you and jimmysue can figure something out soon, leaks stink! Good luck!
-diagnosed with UC Dec 2006 at 22
-allergic or intolerant to all 5ASAs, sulfa and 6-mp
-emergency transverse colostomy on 9/13/10 from perforated colon
-J-pouch surgery step 1 of 2 3/21/11
-Takedown 6/13/11
New Topic Post Reply Printable Version
Forum Information
Currently it is Saturday, October 21, 2017 12:59 AM (GMT -6)
There are a total of 2,885,081 posts in 316,552 threads.
View Active Threads


Who's Online
This forum has 157657 registered members. Please welcome our newest member, uqmcgjdi.
283 Guest(s), 5 Registered Member(s) are currently online.  Details
Chask, 07kr5, Dimitri71, vinwill, uqmcgjdi


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest
Advertisement
Advertisement

©1996-2017 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer