Best appliances for ileostomy

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woofbarkboo
New Member


Date Joined Mar 2009
Total Posts : 3
   Posted 3/3/2009 6:02 AM (GMT -6)   
My dad has both a colostomy (non functioning but there non the less) and an ileostomy. He is in a convalescent home right now and he is so upset. The bag keeps leaking all over him. Every time I go to visit him he is almost in tears because either nobody released the air in the bag or it just loses the seal from the skin and leaks that way. Yes, he is older but he is "with it." His skin is excoriated around the stoma because of the leaks. I have been talking and questioning everyone including, nursing staff, nursing supervisors and they all tell me they know what they are doing. I think not!!!! They dont have the correct size bags for the stomas size .....that is just the first problem. He needs a 1 3/4 " bag but they have him in a 2 1/2." Right now he is using Hollister bags. I could go on and on. It is tough going to visit and seeing him so upset especially after all he has been through. Can anyone give me some advise? Today I am calling the Director of Nursing. Wish me luck!

Equestrian Mom
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Date Joined Mar 2008
Total Posts : 3115
   Posted 3/3/2009 6:21 AM (GMT -6)   
woofbarkboo--wow, you Dad's story just gave me chills...He is VERY lucky to have someone who checks in on him...you are doing a wonderful thing by getting yourself educated on his needs!
 
Can you get the appropriate medical supplies and change his appliance yourself?  Definitely start with the Nursing Director and Nursing Home Review Board (I think they'd have some say in this situation)after that!!!! 
 
Can a stoma cap be used on his colostomy?  That would make things less cumbersome on his stomach....Once you can get the correct sized pouches see how those work and maybe get a pouch with convexity if needed...they help pull the stoma out so it can prevent leaks.  Another good product, if he has any low spots, is the Eakin Seal or equivalent. It is a sticky ring that can be moulded to any need.
 
I'll be watching to see how the "talk" with the nursing director goes...welcome to the forum!

dilatante
Regular Member


Date Joined Jan 2009
Total Posts : 125
   Posted 3/3/2009 8:11 AM (GMT -6)   

the first thing you have got to do, after raising cane with the director, and everyone else you can think of, is get skin regrown on your dad's abdomen!! Until you have skin, you wont have a good seal. EVERY single time, it even thinks about leaking, they need to change it. NOT let him lay with it leaking all over the place. Is this more expensive?? heck yeah!! Is this more time consuming?? heck yeah!! but it is the ONLY way you will get a seal. I was excoriated from my stoma, to my left iliac crest, thanks to piss poor management of my ileostomy. On my part, home healths part, and most importantly the wound care center nurses part. (the first wound care center). I changed wound care centers.

Is he seeing an ET nurse?? Why are they not sending him to a wound care center to have something done to help this also?? I know at the wound care center I go to, they have people brought in from nursing homes, etc by ambulance.


summerstorm
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Date Joined Aug 2006
Total Posts : 6571
   Posted 3/3/2009 10:40 AM (GMT -6)   
thats awful for you dad! everyone up there has given you great advice.
And i really want to know what happens when you tell the directors about it. good luck!

RobinByrd
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Date Joined Dec 2008
Total Posts : 511
   Posted 3/3/2009 1:01 PM (GMT -6)   
I had leakage with my Hollister wafer as well, so I started using Coloplast two-piece click system. I really like it. I am new to the ileostomy situation and I hated the leaks so much...I know exactly how your dad feels. I pack on the adhesive cream b/c I do not want the leaks any more. I also like the Coloplast wafer better b/c it's a plastic-like substance I feel it just gives a better seal. I also like the bag b/c the velcro closure makes me feel more comfortable than the Hollister one did.

I am so sorry you're receiving poor services from his staff. I'm glad to hear you're taking matters into your own hands and kicking some bootie!!! We're going to do that as well in regards to my grandma's situation with a hospital she has been at for the past week (not the one here in Marshall...just FYI).

I wish you the best of luck!!!
: )  Robin
 
28 year old Mommy of an amazing 1 year old and Wife for 2 years!
Dx-May 2007 Moderate/Severe Pancolitis - failed all medications
 
Proctocolectomy w/ permanent ileostomy on 02/06/09!!!
 
"Your mind is like a parachute, it only works when it is open."  -Unknown


justjenjen
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Date Joined Nov 2003
Total Posts : 518
   Posted 3/3/2009 1:32 PM (GMT -6)   
I'm glad you're there to help your dad. I would inquire as to whether there is an ET nurse on staff. Regular nurses have no clue how the hell to put on an ostomy. It sounds mean but it is just plain true--I've had nurses not even know the difference between ileostomy and colostomy!! Going straight to the director is probably your best bet to get the appropriate action taken. Good luck.

woofbarkboo
New Member


Date Joined Mar 2009
Total Posts : 3
   Posted 3/3/2009 7:33 PM (GMT -6)   
Thank you for your support...we need it. I decided to give the nursing staff one more day to get their act together. They promised me they ordered the right sized appliances. Tonight I went in and AGAIN my father was full of a mess. The appliances did come in and they placed the correct size on him and told him that he was good now. I picked back the covers not five minutes after they left the room and the bag was already leaking. Since he has the colostomy and ileostomy there is not much belly space to adhere them so they think it is a good idea to overlap them. I told the nurse last night that she was breaking the seal if she adhered it to the other one. Again they did it. I am so PO'd now. I will take off from work and I will physically go and talk to the director of nursing tomorrow. Not to mention he has been nauseous and vomiting all day today.

Of those of you with an ileostomy does nausea and vomiting happen often? Is this something that comes with the territory? And is a low residue diet helpful?

summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 3/3/2009 9:48 PM (GMT -6)   
the nasuea and vomiting is only normal at first, and thats just until your insides get used to eating again, usually only a few days, nausea maybe for a few weeks,, from the pain meds.
i rarely get sick like that anymore, and when i have it hasnt been related to the ostomy.
A low residue diet would be good if he is getting blockages. But, sounds like he is having lots of output so thats probably not it.
Overlapping them is NOT going to work! there is no way!
Even if he has the right size appliance if they arent putting it on right it wont matter.
And honestly, they probably have very little experince with actually doing it. My husband is anurse and while he has training on how to do them, he doesnt have much field experince. And all he has is basiclaly what a book says and those books dont tell all the little things we have picked up and discovered from actually having them, like using a hair dryer.
this is a horrible situarion and i really hope it gets straightened out soon.

RobinByrd
Veteran Member


Date Joined Dec 2008
Total Posts : 511
   Posted 3/3/2009 11:18 PM (GMT -6)   
I'm going to be honest here...
 
WHAT MORONS!!!!  Overlapping the wafers?!  What the hell?!  Seriously?  Isn't it common sense to know there would be leakage if they are not individually completely touching the skin?! 
 
You really have a lot to be upset about, and I am just so so so sorry you and your father are goign through this.  Though I don't know you and your family, I would love to be a part of the ass chewing you want to give to this facility.  I guess that's part of what I do professionally...though I provide counseling services, I am an advocate for my clients, and normally there is someone that is involved with them not doing their job...so I get to be the one who goes in to lay down the law and call them on the b.s. 
 
Do you know my greatest disappointment and the one thing that really gets my blood boiling is when I find people not doing their job.  However, when I am involved or come across people doing their job and going above and beyond, I am the first person to tell them my appreciation and go out of my way to make sure they feel good about their job performance.  : )
 
I wish you luck tomorrow!!!  Please keep us posted!!!
 
(Sorry I got so mouthy at the start of this...I'm very passionate about everyone receiving approrpiate care and not being neglected...my heart goes out to your father).
: )  Robin
 
28 year old Mommy of an amazing 1 year old and Wife for 2 years!
Dx-May 2007 Moderate/Severe Pancolitis - failed all medications
 
Proctocolectomy w/ permanent ileostomy on 02/06/09!!!
 
"Your mind is like a parachute, it only works when it is open."  -Unknown


woofbarkboo
New Member


Date Joined Mar 2009
Total Posts : 3
   Posted 3/5/2009 7:19 PM (GMT -6)   
Well I told them what I thought and how upset I was that they dont know what they are doing. My father is upset with me cause now he feels they wont come in at all. You cant win!!! Hollister people came in to help or give advice with the appliance but according to my father the nurses told THEM what to do. Now thats funny. I am a former RN myself so I understand quite a bit but am my no means an expert about ostomy's. The bag is still leaking at times, they have about 5 towels across his belly just in case it does leak. He is like a petrie dish. They are still overlapping the appliances. I just give up. I am so disgusted. Nobody listens....nobody cares. I would rather he come home and I will learn and I will take care of him. He is getting depressed and losing hope.

I have another question. My father has lost almost 40lbs in a month. He is not eating well and having bouts of nausea and vomiting. The dietitian is trying to help but ....really, tonight he had a shrimp salad sandwich on a croissant ...it had raw red bell pepper in it and a side of cooked beans and macaroni. We told him not to eat it. My mom made some chicken soup with some rice, chicken, carrots and some saltines. He really enjoyed it. So my question is.... is tofu digestible when you have an ileostomy? We thought about making him smoothies with tofu. He can use the protein. Not sure that drinking lots of milk is a great idea. Any suggestions food wise that would be helpful or worked for you? Any help is very appreciated.

summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 3/5/2009 7:42 PM (GMT -6)   
anything is digestible (except seeds and nuts which are not digestible by anyone) with an ostomy, just some things go through faster and some come out lookign a good bit like they went in!
I dont see anything wrtong with what they served him, he should be able to eat those things, the red pepper might would have given him heart burn but wouldnt hurt the ostomy, just dont eat the seeds.

I think cheese would be something good, pasta is filling and easy to digest. Breads are good, or potatos, things like that. If you want weight on him, juice will pack on the pounds BUT its pretty much empty calories.

Shaz032
Forum Moderator


Date Joined Feb 2003
Total Posts : 1245
   Posted 3/6/2009 5:46 AM (GMT -6)   
I agree, that meal the dietitician provided was probably fine for him - it all sounded yummy to me and I would have eaten it. I LOVE prawns aka shrimp. Beans I'm not so fond of but i would have happily had the rest. Ostomates just need to remember to CHEW, CHEW, CHEW! I eat anything and everything even supposedly 'no no' foods eg mushrooms, corn, popcorn, nuts, skins, etc without a problem. I find raw capsicum (aka red and green peppers - to an Aussie, pepper is something that goes with salt :) ) actually helps reduce odour.

If food comes out my ileostomy looking the same as it did when I ate it, so be it. No matter how much I chew corn and peas, they always seem to regroup in my tummy and come out looking whole again. For the most part they do in 'bowel intact' people too, it's just you can't see readily see it and most don't examine their poop that closely.
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!


Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 3/6/2009 6:04 AM (GMT -6)   
Shaz032--that is interesting about the "raw capsicum"...I didn't know that!

woofbarkboo---can you move your father to another location? Will he have coverage if you get a home health nurse to come to the house daily or does he need round the clock care?

If if is leaking that quickly, my guess is they are not getting a good seal to the skin...they may have to "gently pull/move" his skin away from the stoma area so there aren't any folds that would pull away from the appliance when he moves...also, they should hold their hand over the appliance for at least 30 seconds to warm the adhesive so it adheres to his skin.

Please keep us posted on your outcome.
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