How do you change?

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dangdonkey
Regular Member


Date Joined Jan 2009
Total Posts : 22
   Posted 1/8/2009 5:38 PM (GMT -6)   
Hey guys, had a colostomy on December 9th 2008. Since I'm a pouch newb I was wondering how everyone changes there pouch?
It's a very slow process for me thus far, actually I still need my spouse, a go for or grab me that, typical hand holding I guess.
Plus having perianal fistulas I sometimes have mobility issues which makes things difficult.
Currently we gather the needed supplies and I then lay down and precede to remove, clean, dry, replace.
Was wondering how other ostomates positioned themselves whether it be sitting, standing, etc....

Also for you guys how do you deal with hair removal around the stoma? Kinda nervous about breaking out a razor, not sure if irritation would be an issue.

Any advice would be greatly appreciated.
Thanks for looking!

Brian

slim18996
Regular Member


Date Joined Apr 2008
Total Posts : 99
   Posted 1/8/2009 8:11 PM (GMT -6)   
Well I will try to help by explaining my process.

- First, just like you I collect everything I can think I will need (at first I used a checklist so I would have everything)
- I empty my pouch so I am not working with a full pouch
- I then get my washcloth soaked with warm water and stand in front of the sink to catch any "activity"
- As soon as I remove the old pouch I wash down my belly real well with just warm water on the washcloth
- I then have a spray bottle of some stuff the hospital gave me for cleaning out a different wound I had but the hospitals label says ostomy skin cleaner, the use label on the back also says for ostomy care. It is made by hollister, labeled Skin Cleaner, hollister ref#517210 (I am not sure if insurance will pay for it but it works real well) I spray a few squirts on the skin around the stoma then shave using a disposable razor (I don't use any shaving cream just the spray)
- After I have done a quick shaving of the area I then take the washcloth and wash down the area real well again
- I use a towel to pat dry the area then start cutting the wafer, I then check the cut by placing it around the stoma without taking off the adhesive backing and use a mirror to see if there may be a need for more cutting or possibly for paste
- I then make sure the tail is closed on my bag (only forgot that once, LOL)
- I pat the area dry again with a towel to make sure the area is completely dry then remove the wafer backing and apply the wafer
- I rub the inside of the flange (I wear a two piece but should work for a one piece also) in a circular motion around my stoma for about 30 seconds to get the seal good and set
- if I need to use paste I apply it at this time, I know they say to put it on the flange before putting the flange on but I have found using the paste similar to caulking I have better results, after that I wait a minute or two for the paste to set up
- finally I snap the pouch on the flange and clean everything up

When I first started it would take me about a half an hour or so but now I have it down to five or ten minutes. I get at least seven days wear so I must be doing something right, LOL. I have never had problems with skin issues shaving. Oh yeah, I do the complete change standing up.

Hope this helps.

John

Total Colectomy with End Ileostomy May 27th, 2008


Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 1/8/2009 8:20 PM (GMT -6)   

Brian--welcome to the site!!  Those are some good questions!  I stand in front of a mirror, but when I was post-op (and had zero in the energy dept) I would sit in a chair in the bathroom...I change everything myself and just put a pouch/wafer/Eakin seal on the counter-put the Eakin seal on the wafer-take old pouch off-wash/rinse/dry my stoma area-put new wafer on (carefully to make sure I align the hole)-put pouch on wafer and close pouch-hold my hand on the wafer for 30 seconds to let my body heat warm it and have it stick well.  I don't do remover or adhesive anymore and only use stoma powder if irritated.

If you can look back through some of Summerstorm's posts, she has a really neat system where she put everything she'd need in a box and has several prepared so if she ever has an "emergency" she just grabs a box and it is all there!!!  I am NOT that organized!!!!!

Someone also has a good system for shaving...use an old TP roll tube/cut down papertowel roll tube and place it so your stoma is inside it and hold it there while you shave around it...that way you won't get too close to your stoma with a sharp object...just know that you may have to throw out the tube if your stoma becomes active :-)

Let us know if you have other questions...there is a TON of knowledge here!!


summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 1/8/2009 9:01 PM (GMT -6)   
lol woo hoo someone says i have a good idea!
this is what i do, i do keep boxes with all supplies, flanges precut so i am ready to go!

Then, i lay the stuff out, i put the paste on the flange, lay the flange and the bag onthe floor along with two towel squares. I take the brown plastic bag that i throw it away in, and put the end of the bag in there. then i peel down the top of the wafer and start drying, i dry as much as i can, most of the way down. When i get to where i can't do that anymore, then i take a towel square and cover the stoma to catch any mess. (oh i do this stuff standing up should have told you that!) finish cleanign and drying.
Then i lay down, put the bag, a towel square and new flange on my leg, bag and square onleft leg. I quickly remove the towel from teh stoma put the new flange on and cover with a new towel square. I hold that on with one hand then use the other to remove teh little bit of stuff that is covering the tape part, then push it down. Then i put the bag on, hold my hands around it for a few minutes, smushign it all down. I stand up and fix the bag to where i want it, makign sure it is clicked good and all. Then i take a hair dryer and use it on it to get it warm so that it will stick better. and that's it.
I know that sounded really difficult, takes me less than 8 minutes though. it only takes that long cause i hook and unhook the bag like 30 times (literally) before i am satisfied that it is good.

Shaz032
Forum Moderator


Date Joined Feb 2003
Total Posts : 1246
   Posted 1/9/2009 5:17 AM (GMT -6)   
All I use is a one piece bag (I use pre-cut which you can use once your stoma has reached it's optimal size - saves heaps of 'cutting out' time) plus an Eakin Seal. I put them on the bathroom sink (along with a box of tissues that's permanently housed there anyway). I then turn on the sink tap (one of my kitty's loves drinking from the tap and I'm not allowed in the bathroom unless I turn it on for her - sometimes I even get summonsed if I'm in another room!). When she jumps up there I then shift her paw off the bag that's on the sink waiting for me and put my bag and Eakin Seal to one side (out of harm's way).

I use scented nappy (diaper) disposable plastic bags (extremely cheap) to put my used stuff in, so I put that down on the floor next to the shower. Then I take my bag off (remember, push the skin, don't pull the wafer!) and put it in the nappy bag. Then I put a tissue over Harriet in case she decides to spurt. Turn on the shower and hop in.

Whilst in the shower, I gently use a fingernail to wipe off any excess Eakin Seal that may still be lurking (it's not essential to get rid of it all, as long as there's no stool left on your skin you'll be ok - stool on your stoma is fine, it's used to it, it's your intestine after all). Then I let the warm water run over my stoma and do it's job as I soap down the rest of me.

Once my shower is finished, I hop out and put another tissue over Harriet, quickly pat the kitty to thank her for guarding me while I'm in the shower (otherwise she complains that I'm ignoring her) then towel dry the skin around Harriet. Once it's dry, I put the Eakin Seal on (after having stretched the opening to an appropriate size). Next I put my one piece bag on, hold the palm of my hand over the wafer to help it seal better (my skin is still warm from the shower so that helps too), do the end up and I'm done :)
 
I do this all while standing up.

Minus the shower (that doesn't really count cos I'm washing the rest of me too) and the kitty, I can do the whole thing in 3 minutes :)

PS if you have to shave the area put the middle of an empty toilet roll (the cardboard part) over your stoma to stop you from accidentally knicking it.


I have had an ileostomy for 33 years now due to UC.
 
Moderator of the Ostomy Forum
_______________________________________________
 
I'm not a complete idiot - some parts of me are missing!

Post Edited (Shaz032) : 1/9/2009 4:22:06 AM (GMT-7)


dangdonkey
Regular Member


Date Joined Jan 2009
Total Posts : 22
   Posted 1/9/2009 8:45 AM (GMT -6)   
Thank you guys so much!
Some great help here and I'm sure grateful.
A couple of points, showering, and spray bottle crossed my mind, but being a newb I wasn't quite sure;-)
The TP roll idea is just perfect, will give this a whirl on next change.
Standing seems to be the way to go. I figure a mirror of some sort would be a good idea as well. Should help with positioning the pouch.

I have a couple of Eakin seals here, may have to try one of those.
Since my surgery in December my stoma is still shrinking. So now it looks like I need to downsize my pouch. I too use the pre-cut 1 piece pouch. Can the paste be used as a temporary filler until I get the correct sized pouch? I don't think I'm getting the proper fit, have some itching thats stool related. Not sure how much paste I can get away with;-)

Again thanks all.
I'm sure I'll have more questions till I get the hang of it.
Greatly appreciated.
And thank you all for sharing.

Brian

badbaggirl
Regular Member


Date Joined Jul 2007
Total Posts : 275
   Posted 1/9/2009 9:08 AM (GMT -6)   
I guess I don't have much of a ritual in changing mine. Upon returning home, I just did it myself. The only time my partner has actually seen the process was when I was in the hospital. I just stand up in the bathroom close up to the sink, carefully pull my skin away from the wafer, clean around my stoma with a wet piece of gauze, dry it, mold an Eakin seal around it (I HATE paste!) and slap on a fresh one piece. Done. I don't even think it takes a couple of minutes. I do it fast because my stoma spouts off all the time! My stoma isn't the size of pre cut ones, so I cut them all at once when I first get them ... saves time if I have an emergency changing!)
BadBagGirl
Crohn's Disease, Colostomy due to cancer and I make darned good dill pickles.


Shaz032
Forum Moderator


Date Joined Feb 2003
Total Posts : 1246
   Posted 1/9/2009 9:12 AM (GMT -6)   
If you're still within the first few months of surgery, you should be using the 'cut to size' wafers since your stoma will definitely still be shrinking. Measure it every time you change to make sure you're cutting the wafer to the correct size. Once it settles down, then you can measure it and order the appropriate 'pre cut' sized wafer.
 
Paste can be used as a filler but it will erode during weartime. Getting the correct size in the wafer cut is much better in order to try and ensure less skin excoriation.
 
Some people hate to shower with an exposed stoma as they consider it unhygienic. I always shower on change day (unless I'm really in a hurry) and if Harriet decides to 'work' whilst I'm showering it all goes down the drain anyway. If you wish you can always clean the shower with bleach or similar afterwards if you feel the need.


I have had an ileostomy for 33 years now due to UC.
 
Moderator of the Ostomy Forum
_______________________________________________
 
I'm not a complete idiot - some parts of me are missing!

Post Edited (Shaz032) : 1/9/2009 8:19:07 AM (GMT-7)

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