Time to change pouch

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Blueheron
Veteran Member


Date Joined Feb 2010
Total Posts : 720
   Posted 12/6/2010 4:03 PM (GMT -6)   
I have read that many of you change your pouch in less than 30 minutes. How is this possible? Granted, I have only changed mine about 8 times so far, but it is still taking me 1.5 to 2 hours to do this. I am not having issues with leaks or anything very tricky, but it still takes me a long time including:

-20 minutes to clean up my stoma and scrape off Adapt Barrier Ring residue

-30 minutes to create/revise my pattern (my stoma is new and is also an irregular oval shape that is a little wider on one end). I am super paranoid about getting too much bare skin around the stoma or making the opening too small. It is really hard to get it perfect

-5 minutes to cut the hole in the wafer using the pattern and then make sure it fits over stoma

-20 minutes to put on stoma powder and barrier wipe on a few minor raw areas very close to the stoma.

-5 minutes to put on the barrier ring and bag

-15 minutes to warm up the seal with my hands or a heating pad and make sure everything is sticking well.

Then, once everything is done and I take a look at my work, I always get frustrated because there is some little bit of skin showing along the stoma no matter how hard I tried to get it right. Today, I had the Adapt Barrier Ring perfectly snug qround my stoma (my ET nurse showed me this way instead of putting it on the wafer), yet, after i pressed the bag on top, I was once again able to see a little bit of bare skin (about 1/8 inch) on the underside of the stoma. The ring must have shifted or something. Now I have to wait 4 days to see if it causes any problems as I am not about to tear off the bag to try again. That would be horrible for my skin, not to mention that there are no guarantees I would do better the second time. My stoma tips over a bit which makes it hard too. If I hold the stoma straight up things look one way, but if I let it go, it tips towards my feet and touches the skin at its bottom edge a little. This makes it hard to create the perfect pattern.

I am also having trouble finding a time when my stoma is quiet and not spewing. It goes all night until around 10 a.m. and then quiets down until 2 p.m. before starting up again for the whole evening/night. This will not be convenient for work. Will my output slow a bit as my body gets used to this?

Will it always take me so long to change my appliance?
-Officially diagnosed with UC in 2006, though had symptoms since 1999.
-Had mild/moderate symptoms continuously until severe flare in autumn 2010 which required 2-week hospital stay
-Took Asacol, Rowasa, Canasa and Prednisone to manage flares but meds stopped working
-Tried 1 infusion of Remicade but had excruciating joint pain and discontinued
-Had permanent ileostomy surgery 11/8/2010

still a lot to learn
Regular Member


Date Joined Nov 2010
Total Posts : 33
   Posted 12/6/2010 5:16 PM (GMT -6)   
Dear Blue,

I've had my ileostomy since Aug 2009. My change time has decreased markedly from when I first started. At first, it was a big deal, took over an hour. Now, it takes 10 minutes tops, not including wafer/seal warm up time. I can put them in my bra to warm them so i dont count that time. You will get better with practice.

i've been getting 5 to 7 days of wear time lately. What I do is, if I plan on changing my wafer in the morning, I will take a couple of Immodiums before I go to bed the night before. Then I change it before I eat anything.

I use the Allkare adhesiver remover wipes (1 or 2) to get rid of any residue, but then I be CERTAIN to wash the oily residue from them off my skin to make sure the wafer sticks well.

Hang in there, you will be amazed at how proficient you will become.

Good luck
crohn's since 1983, many surgeries and way too many drugs later finally got a perm ileostomy & proctocoletomy in August 2009 (a life saver). meds: 6 mp, lomotil and immodium, vitamins. LIFE IS GOOD!

NewShinyCD
Regular Member


Date Joined Oct 2009
Total Posts : 474
   Posted 12/6/2010 6:46 PM (GMT -6)   
As your stoma starts to get to a normal size you really don't have to measure to cut. Mine ranges from 7/9" to 1". I did try the other week to cut the hole at 7/9" but that seemed to cause leaks so I went back to cutting a 1" circle.

I use Eakins instead of the Adapt rings, but I don't scrape the left over residue off; it actually seems to help.
I stopped using barrier wipes because it made the wear time shorter.
I also don't warm up the wafer. I might try it next change, but right now I'm getting 6-7 days consistently.

What I do is basically like this:
Prep wafer (cut hole and cut a quarter piece of an eakin ring and apply it around the hole) and prep a hot washcloth.
Remove old bag and wafer and discard
Take the hot washcloth and clean around the stoma and where the wafer sticks on.
Dry off the area with paper towels
Stick on new wafer and hold it there for at least a minute.
Snap on new bag and reattach ostomy belt.
Done.

I do this in the morning and it takes me about 15 minutes tops.
21 y/o male livin' in Georgia. Diagnosed with Left-Sided Colitis in 2002; re-diagnosed with Pancolitis in Nov. 2009.
June 2010 I beat UC by having surgery.
Drugs tried: Just about every 5ASA medicine, enemas, prednisone, turmeric, fish oil, Remicade, psyllium seed powder, Metamucil.
Temp Ileostomy and colon removal surgery - 6/2/2010
Takedown - Sometime next year; busy with job/school.

Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 12/6/2010 8:21 PM (GMT -6)   
You can request a sample of the Convatec Moldable wafers...no cutting or measuring and they work with odd shaped stomas!

It's just like with anything new in life...it takes time to get used to and adjust things.

It's actually a good thing that your stoma points down, too :-) Have you tried the marshmallow trick? Eat one or two about 15 minutes before you change and it should slow things down so you can change your appliance when it works for your schedule.
Crohn’s dx 1989
some terrible years before my
temporary ileo in 2001
Proctocolectomy w/end ileo in 2008
...wish I knew then what I know NOW!

summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 12/6/2010 9:52 PM (GMT -6)   
if you are having to scrape the stuff off, you can probably get more wear time.

This is what i do takes about 8 minutes.

I have my supplies ready in a box, with one wafer, one bag, one trash bag, 5 towel squares, a sure seal and a thing of paste. I cut the wafers at one time, so they ready to go, but ive had mine for 3 and half years so stoma size isn't changing!

i put the paste on the new wafer, peel back the paper backing, and put the new bag, the new wafer and two towel squares on the floor

I stick the bottom of the bag in the dispose bag, i pull the wafer part way down, clean that area, just with a rag, it usually pulls right off no residue left behind.

I drop the bag to the floor, cover the stoma with a towel square and clean underneath it.

i keep the stoma covered, i lay down, still keeping it covered.

I put the new wafer and bag on my leg, remove the towelsquare put the new wafer on and cover wtih a clean towel square right away, my stoma is uncovered/not over the bag for a total of like 10 seconds. i push my hands around the outside for 30 seconds or so, smoothing it out. Snap the bag on

I stand up, repostion the bag the way i want it

get the hair dryer and use it on the wafer, run my hands around a few more times, its very important to put the bag on before you use the hair dryer.

i know that sounds like a lot, but it takes like 7-8 minutes tops, unless my stoma is bleeding then it takes a bit longer.

then i put the sure seal on, that takes me probably 3 or 4 minutes.
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!

Shaz032
Forum Moderator


Date Joined Feb 2003
Total Posts : 1251
   Posted 12/7/2010 6:23 AM (GMT -6)   
At first it will take a while - it's like anything - the more times you do it and get used to it, the quicker you get.

For me, I use a one piece bag with Eakin Seal. I just take the old bag off, step into the shower and let the water run over my stoma getting rid of any effluent. Any excess Eakin Seal I gently scrape off with a fingernail.

Once I've had my shower, I step out and put a tissue over my stoma in case she decides to spurt. I dry my skin thoroughly then I just stretch my Eakin Seal to a size to accommodate my stoma and put it on then put the one piece bag over the top. I use pre-cut bags which you will be able to do once your stoma size settles down so no cutting at all. Press down over the top with warm hands (over an already warm body - both help the wafer seal properly) and I'm done.
Ileostomy for 34 years due to UC. I had my surgery at 10 years of age.

Moderator of the Ostomy and Psoriasis Forums

_______________________________________________

I'm not a complete idiot - some parts of me are missing!

EuroYank
New Member


Date Joined Dec 2010
Total Posts : 3
   Posted 12/8/2010 3:34 AM (GMT -6)   
Hey there... it get's better. I agree with Shaz032, a one-piece makes things quicker. I did it just like Shaz032 and it takes about 5 minutes -- and good to do it right after the shower as well. I changed the bag once a day at least and would have a leakage maybe once a week due to my hernia belt, but it wasn't such a bother.

Good luck!! smilewinkgrin
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
colorectal cancer diagnosed 8/2009
LAR surgery and temporary ileostomy 11/2009
Tumor stage IIIc / T3 N2 R0 M0
8 cycles adjuvant chemo with XELOX
ileostomy takedown 11/2010
Doing Great!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

privey
Regular Member


Date Joined Oct 2009
Total Posts : 453
   Posted 12/8/2010 9:11 AM (GMT -6)   
Hey,
I feel like I a new wearer when I read about how quick everyone is. I usually take 30 min. (and that is the shortest time) I've ever had. I remove the bag and wafer but not until I prepare the new one that is going on. I take off the pouch and wafer and put them in a zip lock bag. I use warm water and dial soap to clean her (privey) and dry her with the blow dryer. I use the skin protecor to every place where there is tape. My stoma is convex and a bit egg shaped 7/8 - 1" is the wafer size. I put my eakin seal on the wafer and trim it a lot and make it very thin. Then I use the stomadhesive around the wafer whole. When I put the wafer on the paste kind of comes around the stoma and looks like a turtle neck. My wear time is around 4 days and it seems like it takes me at least a hour or more to do this. I usually have toilet paper ready which we call (jic)just in case privey decides to poo while I'm working on her. I've had mine for a year and a half and really try to move quicker but -- so far it hasnt happened.
Cathy

cleo35
Regular Member


Date Joined Feb 2007
Total Posts : 430
   Posted 12/8/2010 3:51 PM (GMT -6)   
As summerstorm said - if you're scraping off sealant you're changing the system too often. I change mine every 4 days and the sealant is completely formed and kind of stiff by then so no scrapping off. The only time that happens is if somehow I get a leak and change way too early like 8 hours after changing the whole thing and the sealant hasn't had time to "cure" shall we say?

betsaronie
Regular Member


Date Joined Oct 2007
Total Posts : 318
   Posted 12/8/2010 4:22 PM (GMT -6)   
Agreed with everyone so far, you probably can get more wear time out of your appliance, and if you time it right you can change on the weekend! Once I figured out my system i started changing every Saturday, that way I never have to worry about what time to change because of work. Plus i don't have to try and remember when i last changed, i just do it every saturday after breakfast but before lunch. My colostomy is active 4 times a day unless i ate something that didn't agree with me, so i know when i'm safe to be bagless. Some times I even sit around for an hour after my shower without the bag on yet for more skin freedom time. I use an Eakin seal around my stoma and after 7 days almost all of it comes off with the wafer. I could probably even get 8 or 9 days but i don't like the idea of keeping my skin covered for that long. I, like many others, take a shower on my changing day to give my skin breathing time. this also helps get some of the eakin goo off (i use adhesive remover before hand to get most of it off.) I think with cleaning off the eakin and getting the wafer to the right size (I stairstep mine so it isn't right on the edge of the eakin) probably takes about 20 minutes, most of that being scraping off goo. Don't worry too much about 1/8 of an inch of your skin showing because both eakin/adapt seals and almost all wafers swell up after about an hour or so and thus will cover that 1/8 inch still showing. I usually end up with a little bit of skin showing around the top of my stoma because I can't see it as well and i haven't a problem with skin irritations since i got a system that worked for me. You'll get faster and your stoma will become a bit more regulated as it gets older. its always more unpredictable at first. You'll soon found a time and routine that works for you and it will all become old hat. 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 TBD (hopefully in January!)

cleo35
Regular Member


Date Joined Feb 2007
Total Posts : 430
   Posted 12/9/2010 10:31 AM (GMT -6)   
blue: I've got the change down to approx. 10 min with my ostomy. I do it first thing in the morning when I get up before the stoma becomes active so I don't have to worry about it discharging in the middle of the change. Believe me, you'll get more comfortable and therefore quicker at it as time goes on.
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