small leak..space..any suggestions?

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ENIGMAWRAP
Regular Member


Date Joined Nov 2010
Total Posts : 422
   Posted 4/24/2011 1:10 PM (GMT -6)   
All:
 
Had an inkling I needed to change pouch and wafer today...and was correct....was just smelling to much more ....when wafer was removed, found some leakage in the lower left quadrant....cleaned everything off with cold water.....then put on new wafer....here's where it gets interesting...
 
when in the hospital, I changed wafer with ostomy nurse...there was some skin in the upper right quadrant that was showing..she said the wafer would swell to cover...and, if we cut a smaller size, we might "cut-off" the stoma....anyway, changing this time, it seems the skin space is a little more....will the wafer swell to cover that?
 
Any ideas for small leakage area and skin space ?
 
Thanks!
enigma

blueglass
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Date Joined Dec 2010
Total Posts : 3332
   Posted 4/24/2011 1:30 PM (GMT -6)   
Enigma,

Your stoma will shrink after surgery, so you need to measure it at least once a week and cut the hole in the wafer smaller if need be. Mine has gone from 1 3/8 inches in diameter one week out of surgery to 1 1/8 inches now .... not sure if it's done. The skin space might be because your stoma shrank.

Are you using one of the moldable wafers? Otherwise, I don't think the wafer swells. The Eakin ring that a few of us mentioned in another post will swell, and the moldable wafers kind of have a built in eakin ring.

How many days did this pouch/wafer last? Was this your first time changing yourself? If so, congrats -- a big step.
48 years old, female.
2004 dx indeterminate colitis. Back and forth between Crohn's and UC dx. Many drugs, minimal success.
2010-11 Crazy skin and eye complications, high fevers, bad flaring. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

stripey
Veteran Member


Date Joined Feb 2011
Total Posts : 1059
   Posted 4/24/2011 4:36 PM (GMT -6)   
I use the mouldable wafers from convatec and have only just changed to them after 19 years of using the old cut to fit ones. The new mouldable ones are so much easier as they fit snugly around the stoma like a roll neck sweater and helps with leakage problems. Your stoma will shrink and possibly change shape slightly as the bowel recovers from the surgery and the swelling reduces. You can always ask the stoma companies to send you some samples of the mouldable wafers or if you want to keep to the cut to fit ones remember to remeasure your cutting guide every week for next few months to ensure it is the right size.
Crohn's dx 1989, loop ileo 1992, end ileo 1992. Arthritis developed 1990 Stoma abcess 1995. Azathioprine started 1995. Panprocolorectomy 1999. Stillbirth 2000, antiphospholipid syndrome dx 2000. Flare up 2004, stoma abcess and strictoplasty 2004. Low blood pressure dx with impaired kidney function 2006, fludrocortisone pres. flare up 2010, steroids, Humira, codeine.

ENIGMAWRAP
Regular Member


Date Joined Nov 2010
Total Posts : 422
   Posted 4/24/2011 4:53 PM (GMT -6)   
blueglass and stripey:
 
Yeah, first time changing myself! 
 
Also, I think you are both correct, stoma has gotten a little smalller...I cut a new wafer, to be installed in next 1-2 days, to 1-1/4" and will see if that covers more of the space..... 
 
So, the normal wear wafer will not swell?  Hmm.....that's not good...just a little dissapointed in my WOCN nurse with that piece of advice.....oh well...she's okay overall and she does have an ostomy herself so I give her word due favor....
 
Also, I wanted someone to talk about the moldable wafers.....are they that good?! 
 
I will call the companies monday for some of those samples.
 
Thanks!
 

blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3332
   Posted 4/24/2011 5:20 PM (GMT -6)   
I had the moldable wafer in the hospital, but I didn't like the hard wafer and clear bag, and haven't given it another chance since -- the moldable part was nice.

You can also get a sample of the eakin seal and try that under what you're using, and also get some samples of other types of bags.

I measure and then cut right after I measure. I change in the morning, when my stoma isn't that active and put a piece of paper towel over it while I'm cutting.
48 years old, female.
2004 dx indeterminate colitis. Back and forth between Crohn's and UC dx. Many drugs, minimal success.
2010-11 Crazy skin and eye complications, high fevers, bad flaring. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

Blueheron
Veteran Member


Date Joined Feb 2010
Total Posts : 720
   Posted 4/24/2011 9:42 PM (GMT -6)   
My stoma shrank like crazy after surgery and I had to create a new pattern each time. It was a pain, but I finally got the hang of it. After three months, my stoma finally stopped shrinking, and I have been using the same pattern I created in February.

I agree that the Eakin Seals are a lifesaver. They will swell and fill in that tiny space between the edge of your wafer and stoma. I do think the regular wafers swell to a small degree, but not nearly as much as an Eakin Seal.

I ordered some samples of the moldables, but they didn't work for me. My stoma is a 1" by 1.5" oval and wouldn't fit right in the round hole of the moldable wafer. I was right between sizes-- the medium was too small and the large was too big. The Convatec rep agreed that it would not work. I wish they made some with oval openings as they look great!
-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

stripey
Veteran Member


Date Joined Feb 2011
Total Posts : 1059
   Posted 4/25/2011 4:23 PM (GMT -6)   
I am lucky in that my stoma is near enough round rather than oval and so the mouldable wafers are brilliant. No need for paste or other seal stuff. The ones I use are the convatec ones and they find with more than one bag type, so you can choose the bag you like best. I know other companies do they as well but I don't like velcro opening on bags and so stick with the convatec ones as they do a bag that you use with a separate clip to close it.

Have a look at the stomacare company websites on line, most have photos and descriptions and you can ask for samples online as well.

Like I said I had used my old style wafers for years and changed to these a month ago and totally convinced by them, very comfy to wear as well. Sometimes if I cut the hole too small on old wafers they could dig into stoma if I was doing something active but with new ones I don't get this as the mouldable collar moves with stoma.
Crohn's dx 1989, loop ileo 1992, end ileo 1992. Arthritis developed 1990 Stoma abcess 1995. Azathioprine started 1995. Panprocolorectomy 1999. Stillbirth 2000, antiphospholipid syndrome dx 2000. Flare up 2004, stoma abcess and strictoplasty 2004. Low blood pressure dx with impaired kidney function 2006, fludrocortisone pres. flare up 2010, steroids, Humira, codeine.

ENIGMAWRAP
Regular Member


Date Joined Nov 2010
Total Posts : 422
   Posted 4/25/2011 4:43 PM (GMT -6)   
blueglass:
 
With regards to the EAkin seal......I actually had some in a box from convatec...apparently hollister has it's own type as well (they call it the adapt barrier ring.....)
 
As far as the eakin seal, how much of it do you actually use, and do you put it on your skin first or on the wafer adhesive side first and then attach to skin? 
 
Thanks,
enigma
 
 
blueglass said...
Enigma,

Your stoma will shrink after surgery, so you need to measure it at least once a week and cut the hole in the wafer smaller if need be. Mine has gone from 1 3/8 inches in diameter one week out of surgery to 1 1/8 inches now .... not sure if it's done. The skin space might be because your stoma shrank.

Are you using one of the moldable wafers? Otherwise, I don't think the wafer swells. The Eakin ring that a few of us mentioned in another post will swell, and the moldable wafers kind of have a built in eakin ring.

many days did this pouch/wafer last? Was this your first time changing yourself? If so, congrats -- a big step.

blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3332
   Posted 4/25/2011 5:00 PM (GMT -6)   
Enigma, I tried a sample of the adapt ring too; it's similar to the eakin seal, seemed to me it leaked a little (noticed when changing), just thought I'd stick w/the eakins, but probably the other is fine too.

I put the eakin seal on my skin first -- I use the whole thing, the 2" size. I just thought it was too complicated to warm the seal, fit it to the right size, warm the wafer, peel the backing from the wafer, put the seal on the wafer etc.... easier to just put the seal on my skin.
48 years old, female.
2004 dx indeterminate colitis. Back and forth between Crohn's and UC dx. Many drugs, minimal success.
2010-11 Crazy skin and eye complications, high fevers, bad flaring. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

Blueheron
Veteran Member


Date Joined Feb 2010
Total Posts : 720
   Posted 4/25/2011 5:09 PM (GMT -6)   
Enigma- I had answered your question about the Eakins in another thread, but decided to cut and paste it onto this thread. As far at the Adapt Rings, I used them for several months and thought I loved them. But then I tried the Eakins and they worked so much better. The Adapt ones seemed to erode really quickly for me, eventually exposing skin. The Eakins do not erode much at all. I use the whole ring, but some people just use portions of it.

My post from the other thread:

I use the Eakin Rings right on my skin around the stoma just like Blueglass said. I have found that putting them on the wafer doesn't get them quite as close to the stoma. They look like a thin donut and the hole in the middle stretches. They can be handled without losing their stickiness too... I confirmed this with the Convatec rep. They also make a thin version called "Eakin Cohesive Slims", but I like the regular ones so much that I haven't tried my samples of these.

One thing I do that is a little different is that I tear one side of the ring and then hook it around my stoma, getting it as close to the base of my stoma as possible. I then rejoin the broken ends by smushing them together and then pressing the whole thing down on my skin so it is nice and stuck. I found that when I was putting the ring over the stoma (like putting a shirt over one's head) the underside of the ring would get a bit wet from stoma mucous brushing against it and it wouldn't stick as well. My new method eliminates that, and the broken ends where I tear it fuse back together very easily.

Hope this makes sense. Basically, with whatever method you use, when you get done it looks like a thin donut of putty with your stoma sticking out of the middle. Then you put your wafer over the whole thing.
-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
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