Worried About Using a Convex Wafer . . . What Are The Dangers?

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CrohnieCJ
Regular Member


Date Joined Jan 2011
Total Posts : 371
   Posted 10/13/2011 12:15 PM (GMT -6)   
I have a very nice 1-inch stoma which sticks out about 1/2 to 3/4 inch.  Due to my body type, stoma was placed above my belly button on my right side, so it is higher than some.
 
My problem has been L-E-A-K-I-N-G as I have a gooshy belly and my incision cuts right down through the middle of my belly and my stoma side turns inward towards the incision.   The wafers edges have to make this curve.
 
I read lots of comments on here about convex wafers so I tried them and have had very good luck the past 3 weeks with both Convatec and Hollister convex wafers and an Eakin seal.
 
However, I also read that convex can be bad if you don't need convex.   My wound care nurse told me I did not need convex, but out of desperation I tried them, and they have worked well.
 
What are the dangers of using convex with a stoma that does not require convexity, but body type and placement of the stoma does?
 
Thanks in advance :-)
 
 
 
57 year old Grandma in the Buckeye State.
Diagnosed in 2006 with UC and in 2007 with Crohn's Colitis.
June 2010 had 10 inches of my colon removed due to a stricture.
Refused Remicade and Humira and opted for what I was certain the end result would be.
July 2011 had a proctocolectomy and permanent ileostomy without reservation.
My stoma Lillie and I are doing great !!!

blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3073
   Posted 10/13/2011 12:20 PM (GMT -6)   
My stoma sticks out further than yours, and I was surprised when my nurse said to switch to a convex wafer.... I was a few months out then, like you are now, having some leaking issues, and my belly was soft. As I understand, that's one of the reasons for using a convex, it's not only for having a small stoma. So, it sounds to me like you do in fact need one.

But if there are dangers, I'd be interested to hear them too.
49 years old, female. Sick for way too long with Crohn's (or possibly UC) Proctocolectomy and permanent ileostomy in Feb 2011. Surgery for lingering perineal wound on Sept 26. Other than the wound, been feeling healthier than I have in years.

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 10/13/2011 12:32 PM (GMT -6)   
i've never heard of convex wafers causing any danger.... and i can't see how they can either. the only difference b/w a flat wafer to a convex one is that convex has a concave shape and pushes the belly a bit down so the stoma can stick out more. my stoma got retracted few mons after surgery, so i started using convex and it really helped with the leaking. after starting using an ostomy belt too, my stoma started to stick out a bit and it's not as retracted as it used to be.
 
i don't think you should quit using convex wafers, esp if they help you, cuz if they do, then apperantly you need them.

summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 10/13/2011 12:37 PM (GMT -6)   
I don't see how they could be dangerous either. If its working for you don't change it.
UC for 8 years, before finally kicking its butt and having a permanent ileostomy April 17 2007!
-I have gone to find myself, if i get back before i return, keep me here-
No matter what kind of day you are having, take five minutes to sing loudly and dance like a fool!

Ironmum
Veteran Member


Date Joined Oct 2010
Total Posts : 776
   Posted 10/13/2011 12:40 PM (GMT -6)   
I agree with all the other posts. I'm using a convex now.. after struggling with leaks. Thought I wouldn't need one, but my belly must be squidgier than I thought.. as they're working brilliantly ;-0 I can't see how it can cause any damage, and if its' working, then guess you need it. Stick with it if it's working!
Sarah - 39 year old mum of 2 boys, runner/triathlete from UK
June/Oct 2010 - Peritonitis/perforated diverticulitis. Sigmoid colectomy, temp ileo then reversed.
DX Colonic dysmotility.
July 2011 - Permanent end Ileostomy after begging surgeon to put it back
Follow my blog - http://bagthatruns.blogspot.com/

Another UC wife
Veteran Member


Date Joined Jun 2007
Total Posts : 2111
   Posted 10/13/2011 1:04 PM (GMT -6)   
Hubby's nurses told him he needed a convex one...plus he had to eakin seals & used paste to the right and left of center due to a crease....and leaking

the crease is gone as he has gained weight and it does protrude a bit more now however (this is the 3rd different wafer system and seems to be "the" one) it works really well and no leaking. No need for eakin seals or paste any longer. So unless someone has definite info on why continuing to use a convex wafer is not good, he will continue as well as it definitely works.
Wife of 64 yr old male suffered with UC & in May 06 had a severe flare & hospitalized 6 days...various prednisone treatments leading to steroid dependence and osteopenia, 12 asacol, 200 mg Imuran, failed remicade infusions Jan-May 2010 Dependence on pain meds. Made decision 6/10 to have surgery which was on 12/17/10 (total proctocolectomy & ileostomy - unable to have the j-pouch) & now pain free

tryingtokeepmyheadup
Regular Member


Date Joined Nov 2010
Total Posts : 215
   Posted 10/13/2011 1:09 PM (GMT -6)   
I have a gooshy belly too. When I started having problems with leaking I switched to convex wafers even though I had an end ileo that stuck out pretty far. It solved my problems but the regular convex wafers did push on my belly and irritated me some. I then switched to coloplast because they have a light convex wafer. It was convex enough to solve my leaking but not so deep that it hurt my stomach. Maybe you could try the light convex??
DX 2/10 UP. DX 07/10 UC. Pancolitis. tried: Canasa, Asacol, Bentyl, Imodium, Imuran, Prednisone, Flagyl, Cipro, Remicade, Codeine, Tramadol, Xanax, Morphine, Vicodin, Prozac, ~ nothing worked. 1st surgery 6/8/11 / steps 2 & 3 done at the same time 9/7/11.

RiddleMeThis
Regular Member


Date Joined Nov 2010
Total Posts : 255
   Posted 10/13/2011 8:14 PM (GMT -6)   
I have never heard of convex wafers causing any problems either! I also use a convex wafer and an Eakin Seal. Started out firset because of the incision/stitches healing and leaking problems then because of PG. At this point the PG has mostly cleared up but I don't see any changes of my system in the future. I have no leaks anymore. It's great!

But yes, I agree, if anyone knows about any dangers involving convex wafers, please share!
Sarah, 21 y/o.
Thyroid Cancer, Crohn's Disease w/ Severe Perianal Involvement, low blood pressure w/ syncope involvement, etc

Current rx: Celexa, Lomotil, Pentasa, Humira, Klonopin, Prednisone, Synthroid, Zinc, Multivitamin, Calcium w/ Vitamin D, Fentanyl, Dilaudid, Ambien, Celebrex, Depo Provera, Align, Zofran, Lansoprazole

Past rx: Remicade, 6MP, Flagyl, Cipro, Entocort, Augmentin...

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 10/13/2011 8:48 PM (GMT -6)   
I was terrified of trying a convex wafer for a burn under my ileo stoma which sticks out about a half inch, but my stoma nurse suggested I try a convex just to try it along with the eakin. I was litterally terrified. BUT, then I thought, these companies would not make them if they were going to harm the stoma. It was just fine. Did not help with my burn right under the stoma so I went back to my old flat wafer and pouching system, but no harm was done.

Hollister at least does not dent in the skin THAT much, it's just a little denting in of the skin around the stoma. Hardly noticeable in my opinion.

Do post the dangers though if you find out what they are. The only thing I could think of was if a wafer had real deep convexity I would be afraid that it would literally pull the skin away from where it is anchored to the stoma. BUT I don't think any of the companies make anything that would be that deep of a convexity. Do correct me if I'm wrong and we'll all know what to stay away from.

Rosemary

CrohnieCJ
Regular Member


Date Joined Jan 2011
Total Posts : 371
   Posted 10/14/2011 9:41 PM (GMT -6)   
Thanks, everyone.  I am glad there are others using convex with perfectly fine stomas and no issues.
 
I did google it several ways and the only thing I came up with was there could be break-down of the skin & area around the stoma [whatever that means].  I also found a post on another board about redness under the convex wafer. 
 
In further checking, I found this pamphlet that really sets my mind at ease.
 
 
Since it is working for me, and I don't have any problems around the stoma [so far] I am going to continue to test the convex vs the flat and see if it really does make a difference with leaking.  I am betting I do need the convex, so we shall see . . .
 
 
 
 

57 year old Grandma in the Buckeye State.
Diagnosed in 2006 with UC and in 2007 with Crohn's Colitis.
June 2010 had 10 inches of my colon removed due to a stricture.
Refused Remicade and Humira and opted for what I was certain the end result would be.
July 2011 had a proctocolectomy and permanent ileostomy without reservation.
My stoma Lillie and I are doing great !!!

Post Edited (CrohnieCJ) : 10/14/2011 9:40:50 PM (GMT-6)


Another UC wife
Veteran Member


Date Joined Jun 2007
Total Posts : 2111
   Posted 10/15/2011 1:13 PM (GMT -6)   
Thanks for the link for that pamphlet...very informative and helpful.
Wife of 64 yr old male suffered with UC & in May 06 had a severe flare & hospitalized 6 days...various prednisone treatments leading to steroid dependence and osteopenia, 12 asacol, 200 mg Imuran, failed remicade infusions Jan-May 2010 Dependence on pain meds. Made decision 6/10 to have surgery which was on 12/17/10 (total proctocolectomy & ileostomy - unable to have the j-pouch) & now pain free

B'Dereh
Veteran Member


Date Joined Jun 2011
Total Posts : 1912
   Posted 10/15/2011 5:15 PM (GMT -6)   
I can only confirm that convex made the difference when I had leaking problems. I use coloplast convex light. You might try convex light, because they are less visible through your clothes than regular convex.

polishdan
Veteran Member


Date Joined Mar 2010
Total Posts : 1472
   Posted 10/17/2011 7:10 PM (GMT -6)   
I called Convatec this morning. The nurse I talked to said that the only time a convex could be a problem is if there is an abnormality in the abdomen that the pressure from the wafer could be detrimental. Otherwise no problem.

Dan

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 10/17/2011 10:50 PM (GMT -6)   
Dan, good job. Will put a lot of minds at ease. Rosemary

run4pancakes
Veteran Member


Date Joined Oct 2008
Total Posts : 938
   Posted 10/18/2011 9:08 AM (GMT -6)   
Another convex user here. Leaking is way more damaging to your skin than any little bit of additional pressure from the convexity. Don't be scared. :-)
UC dx 2/08

Done with the drugs. Step 1 (of 3) J-pouch surgery 3/22/11, Step 2 10/20/2011, Step 3 TBD
http://life-takes-guts.blogspot.com/

CrohnieCJ
Regular Member


Date Joined Jan 2011
Total Posts : 371
   Posted 10/18/2011 11:57 PM (GMT -6)   
Thanks again, everyone.
And Dan, I don't know why I didn't think to call Hollister or Convatec and ask about it.  Duh, me  confused
 
 

57 year old Grandma in the Buckeye State.
Diagnosed in 2006 with UC and in 2007 with Crohn's Colitis.
June 2010 had 10 inches of my colon removed due to a stricture.
Refused Remicade and Humira and opted for what I was certain the end result would be.
July 2011 had a proctocolectomy and permanent ileostomy without reservation.
My stoma Lillie and I are doing great !!!

Post Edited (CrohnieCJ) : 10/18/2011 11:02:53 PM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24026
   Posted 10/19/2011 9:59 PM (GMT -6)   
i had an urostomy a year ago, and been using the hollister 2 piece convex device with great sucess. i can usually get 7-8 days use without a problem. the trick we learned early on, and the folks at hollister told us this, was to not use any skin prep. once we stopped that, leaks and failures have been a rarity. good luck to you.

david in sc
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

polishdan
Veteran Member


Date Joined Mar 2010
Total Posts : 1472
   Posted 10/20/2011 9:50 AM (GMT -6)   
Purgatory
Just a question.....with a urostomy do you have irritations and open skin problems at the stoma (?) as we do with ileo's?

Dan

Jackie_0mg
Regular Member


Date Joined Sep 2011
Total Posts : 427
   Posted 10/21/2011 12:25 AM (GMT -6)   
GET THE COVEX :D i got one today at my doctors and i have felt better than ever i tod my mom i think i would be able to sleep :D so excited
my stoma is really flat my momsaid they look like Mc jagar lips lol but now it's more plump !!!!! so u shouldnt have any problems and if u dont like u can always change it

RarelySeen
Regular Member


Date Joined Sep 2011
Total Posts : 42
   Posted 10/23/2011 1:11 AM (GMT -6)   
Hi I have been trying to find something comfortable in with a convex as i have a 1inch stoma that is about 19mm and it is in a depressing in my tummy, I was using Coloplast Altrena (14243) but i found the plastic ring in the plate was to stiff and would not go in and fill all the depressions on my soft belly, my stoma is also very close to my belly button which made it even harder, (But I love the locking device on the bag and the way the bag closes on the bottom, is very secure) but the ring on the base plate was not great for me, as it always had hollows in the depressions when i removed it, (which was scary ) confused so i tried Hollister New Image (14503) with a floating flange and tape, (22Mill they don't make them in 20 mill) (why not ? I have no idea ) anyway the flange is good and it sticks all around and gets into all the depressions, it is also lighter and more comfortable, but i am not happy about the way the bag fits on like a tupperware container and the bottom of the bag is a bit fiddly and you have to be sure you get the velcro in the right place for it to be secure, or it leaks, I tried the Hollister adapt barrier ring (7805) as I needed a ring that was smaller to go around the stoma, I found it was to thick, I contacted hollister and they sent me some samples of there one peice, but i had the same problem it didn't adherence to the skin around my belly and or attach to the depressions, although these come in 20mm , so i didn't need to use a barrier ring, and it was to thick around the wafer and uncomfortable, so i tried the eakin slim (839005) they work okay and are not as think as the Hollister adapt rings, but i am finding they are too thick, also and they push down on the skin around the stoma to much, so i have contacted Ainscorp they have a ring called Dermacol it is very thin and has a neck that will come up, like a collar and can be cut to suit the stoma, I am hoping this will do the job, of protecting the skin around my stoma, which is very red and broken away, because the convexity is made to deep and wide by the rings, I have been using and if i push them down to make them thinner they become to wide a convexity, it is a pain tiring to get the right product and help, it seems the convexity on the wafer is enough for me, and the barrier ring makes it just that little to much for me - to bad I can't get fit the Coloplast bag with it's great locking device and easy open and close at the bottom to the Hollister floating flange. Sometimes i think I should just design one for them it is not hard and I know what would work so much better, eyes Maggie
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