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supernova
Regular Member


Date Joined Jul 2006
Total Posts : 69
   Posted 5/12/2011 10:52 PM (GMT -6)   
Quick question.. am I supposed to be using skin prep everytime I change my appliance? (only 2 1/2 months out, still kinda new to this) I haven't been and I am lucky to get 3 or 4 days. My skin looks fine. So, even if my skin looks fine, will the skin prep help to extend my wear time? Also, I have kind of a short stoma.. have recently switched to convatec, convex wafers which are working better than the regular wafers, but still not where I want the wear time to be. Is there anything else out there that can help my "shorty" get better wear time?
Thanks bunches!!

Serenitee
Regular Member


Date Joined Apr 2011
Total Posts : 463
   Posted 5/12/2011 11:51 PM (GMT -6)   
I just got my ileostomy 2-days ago, and I am using convatec products...I haven't tried any others. what is the skin prep that your talking about? Is it in a bottle or tube?

Would love to chat sometime, I'm sure I could learn a lot from you.

Serenitee
ileostomy in a few days, anxiety/panic-attacks, Bipolar 2/ Borderline

blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3332
   Posted 5/13/2011 6:46 AM (GMT -6)   
You don't have to use skin prep every time or even at all if the skin is good. I got the impression at first that skin prep was necessary, but then I was having trouble with the pouch not sticking well -- prep, powder, etc all make it not stick as well. Now I only use a little bit right on a very red spot -- clears it up right away (and those are rare). The prep shortens wear time, doesn't extend it (that's what people on this list and my stoma nurse have told me)

Blueheron
Veteran Member


Date Joined Feb 2010
Total Posts : 720
   Posted 5/13/2011 8:29 AM (GMT -6)   
I really like the Smith and Nephew No Sting ones too. I generally don't use them under the whole wafer, but if I have areas of irritation, I put powder on those and then use the Smith and Nephew to put a coating over the powder. I also sometimes dab it over hair follicles that have been inflamed before putting on a new wafer. There have been a few times when I have used it under a large portion of my wafer and I haven't noticed it interfering with adhesion, though I change my wafer every 3-4 days anyway due to my output eroding my Eakin Seals. My wafer seems to last fine with the skin prep for that long.
-39 years old
-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 dose of Remicade but had excruciating joint pain and discontinued
-Had permanent ileostomy surgery 11/8/201

supernova
Regular Member


Date Joined Jul 2006
Total Posts : 69
   Posted 5/13/2011 10:35 AM (GMT -6)   
Thanks! I didn't think that I was supposed to use the skin prep everytime (read somewhere that someone was doing that).. but I guess it's different for everyone.
Blueheron- I have the same issue of the output erroding the wafer around the stoma. I'm not sure why this happens.
Serenitee- I would be happy to talk to you anytime. I wouldn't say that I know nearly as much as the other people on this forum. I'm still kinda new to all of this. The skin prep that I have are like little alcohol wipes that I dab over the skin if I had to use the powder. The powder is for skin irritation. I'm assuming you are still in the hospital. Your ostomy nurse should explain all this to you before you leave. What I did when I was in the hospital was write down any question I had for her as they popped up in my head (I forget things a lot!). If you ever need to talk with someone, I would be happy to help you in anyway that I can! Email me if you would like.
Have a terrific day everyone!! :)
29 year old female
Ulcerative colitis- 13 years
Current meds- sulfasalzine
Meds tried- suppositories, enemas, asacol, prednisone, lialda, immuran, sulfa, remicade
End ileostomy surgery- March 1st

Blueheron
Veteran Member


Date Joined Feb 2010
Total Posts : 720
   Posted 5/13/2011 5:38 PM (GMT -6)   
I have no idea why my Eakin Rings don't last past four days either. I just know my nurse told me to never try to get them to go longer than that as she could see my stool was starting to erode them to the point of irritating my skin. At least they are better than the Adapt ones which didn't even last that long. Maybe I just have more acidic output or something. Perhaps that is why I seem to be able to eat anything lol! I ate a couple of ears of corn last week and was fully expecting to see it in my output by the next day, but never saw a trace. Strange.
-39 years old
-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 dose of Remicade but had excruciating joint pain and discontinued
-Had permanent ileostomy surgery 11/8/201

villager
Regular Member


Date Joined Aug 2010
Total Posts : 130
   Posted 5/13/2011 7:26 PM (GMT -6)   
hi, i have been using SkinSafe wipes to prep my skin each time before i apply a new wafer, this was my instruction since before leaving the hospital, on reading this thread i began to wonder what the purpose of this step is so i looked on the Opus website & apparently the reason is to protect the skin from output if it gets under the wafer & more likely to protect the skin from damage from continuous application & removal of the wafer & its adhesive i.e. skin stirpping - that makes sense to me & seems to have worked so far

i get 2 / 3 days from the Dansac one piece bags & my supplier who also uses these says this is ths norm - i also spoke to a nurse from Hollister recently at a promotion event about length of wear & she also suggested a max wear time of 2 days for their products - if i remember correctly her view on the wear time seem to be based on / limited by the ability of ones output to breakdown the material used in the wafer or seal, this would make sense of the big variation in the weartime of different users - everyones output will be different & may also depend on what has been eaten recently

blueheron - you are very brave to try corn -its one food i'd be too afraid of in case of a blockage - i tend to steer clear of raw or undigestible fruit/ veggies just in case - apart from these i eat anything - unfortunately i have to keep an eye on my weight now like 'normal' people, i never had this issue when UC kept me slim !!!

cherers
UC since 1990, not a lot of fun
Qualified as ileostomate May 2010, a much happier boy now
panproctocolectomy, abdomino perineal resection, perm ileostomy
my colon may not be, but my heart is in the right place !!

summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 5/13/2011 10:12 PM (GMT -6)   
someone at hollister told you to only wear a bag for 2 days? i'm on day 5 now, i will probably change tomorrow, but could actually probably get a few more days, but don't want to chance it.
skin prep, as a general rule, will lessen wear time, the less stuff you put between you and the wafer the better it is. it's made to stick to you, not to other stuff. skin prep and powders are made if you have sores. some people use a prep that's also sticky, which does extend wear time for some people. but the skin prep you get from the ET is not like that.
you guys who are having the "eroding" may be cutting the hole to big, check the size, esp if your stoma is new.
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!

Blueheron
Veteran Member


Date Joined Feb 2010
Total Posts : 720
   Posted 5/13/2011 11:03 PM (GMT -6)   
I don't think I am cutting it too big. In fact, last week my poor stoma was dark reddish purple around the base because I think I made my hole to small:( My stoma is really wiggly, gets quite fat and then skinny as it outputs, and seems to need some extra space to squirm around. It healed up when I cut the hole a little bigger the next time. When I put everything on, the wafer and Eakin extend to the base of my stoma, but after a while the Eakin wears away underneath leaving sort of a cavern around my stoma (the wafer on top still almost touching my stoma, but space underneath where the Eakin starts to erode). It's a bit hard to explain. My skin still looks perfect if I change it every four days, but beyond that, the stool starts to eat away at my skin. I have tried no Eakin seal, but it causes leaks and makes the skin right around my stoma very irritated.
-39 years old
-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 dose of Remicade but had excruciating joint pain and discontinued
-Had permanent ileostomy surgery 11/8/201

supernova
Regular Member


Date Joined Jul 2006
Total Posts : 69
   Posted 5/15/2011 8:54 PM (GMT -6)   
Blueheron- I was just thinking.. I wonder if taking probiotics would help decrease how acidic our output is. I think that is the problem I have too. I can also eat anything.. I had corn, salad, apples.. and everything was just fine. I'm gonna give the probiotic thing a try and see if I get a longer wear time.
29 year old female
Ulcerative colitis- 13 years
Current meds- None anymore!! Just a multivitamin
Meds tried- suppositories, enemas, asacol, prednisone, lialda, immuran, sulfa, remicade
End ileostomy surgery- March 1, 2011

blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3332
   Posted 5/15/2011 9:10 PM (GMT -6)   
Not an expert here, but I think the acidic output is due to not having a colon..... a lot of the harsh stuff would get absorbed if it were sitting in a functioning colon for a long time .... and having good stomach acid is probably why you can break down those foods. After the stomach, food is only in our small intestine for a few hours (as opposed to up to 30-40 in a colon) so it makes sense that there's more stomach acid in our output.

I've been very disappointed in probiotics overall.... love the idea, they just haven't helped me. But let us know how it goes; hope you have more success.
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 5/16/2011 3:45 PM (GMT -6)   
I used to use skin prep wipes from cavilon every time I changed my wafer but now don't bother unless there is any irritation. I usually get 7 days from a wafer and sometimes use a coloplast seal around base of stoma, sometimes I don't. Mostly I forget, brain mush but only seems to affect the wear time by a few days anyway so no big issue and I'm using the convatec mouldable wafers as well which cling ti the stoma and don't need cutting.
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.

polishdan
Veteran Member


Date Joined Mar 2010
Total Posts : 1595
   Posted 5/19/2011 7:13 PM (GMT -6)   
NASCARon and blueheron
The S & N skin prep....is it a wipe or spray bottle?
 
Villager
The people that said to change every 2 or 3 days are from the supplier or manufacturer right?.......they sell the pouches, right? ....the more often the better, right? Think about it. Try longer wear times and find out for yourself.
 
Dan

villager
Regular Member


Date Joined Aug 2010
Total Posts : 130
   Posted 5/19/2011 7:56 PM (GMT -6)   
hi dan, i see where you are coming from on this, funnily enough i have recently changed how i use stoma paste before putting on the seal & now i'm getting a more secure fit & a day or two more, just goes to prove that its still a learning process.

Cheers
UC since 1990, not a lot of fun
Qualified as ileostomate May 2010, a much happier boy now
panproctocolectomy, abdomino perineal resection, perm ileostomy
my colon may not be, but my heart is in the right place !!

polishdan
Veteran Member


Date Joined Mar 2010
Total Posts : 1595
   Posted 5/19/2011 8:10 PM (GMT -6)   
villager
Why do you use stoma paste?

Dan

villager
Regular Member


Date Joined Aug 2010
Total Posts : 130
   Posted 5/19/2011 8:54 PM (GMT -6)   
hi dan, this is gonna be one of those rambling replies to describe something which a photo would explain in seconds but here goes, the initial reason for getting paste was because my stoma reduced in diameter a few months after the op so that the seal i am using (dansaz gt xrta) is not close against the stoma, it leaves a little skin exposed, the next size down is too small - so i decided to cut out a segment of the seal & make the diameter smaller to fit - the paste is to seal up the join ( ? you beginning to regret asking this) - that was ok but the output seemed often to still get dowm to skin after maybe 2 days - now my plan is to put a little paste around the stoma before the seal too - this seems to be better - it takes longer to type in the description than to actually do it - its also not as fidldly as it sounds - i have been tempted to try other makes of bag, etc but really i have had little or no problems with the ones i use & i have a sweet deal with a supplier which eases the financial end of things

? does any of this make sense
UC since 1990, not a lot of fun
Qualified as ileostomate May 2010, a much happier boy now
panproctocolectomy, abdomino perineal resection, perm ileostomy
my colon may not be, but my heart is in the right place !!

Blueheron
Veteran Member


Date Joined Feb 2010
Total Posts : 720
   Posted 5/19/2011 10:07 PM (GMT -6)   
Polishdan- The Smith and Nephew No Sting Skin Prep I use is a wipe.
-39 years old
-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 dose of Remicade but had excruciating joint pain and discontinued
-Had permanent ileostomy surgery 11/8/2010

Another UC wife
Veteran Member


Date Joined Jun 2007
Total Posts : 2111
   Posted 5/19/2011 10:27 PM (GMT -6)   
It seems like it is different for each and every person and what you do today may change tomorrow. Confusing? Yes....this is where my husband is at at 5 months after surgery. He is currently using the Convatech Natura SurFit moldable durahesive wafer 2 piece system and the only thing he uses underneath the wafer is a roll on skin barrier prep that he dabs on his skin. He has been using this with great success for the past month. I honestly think the snug fit of this wafer around his stoma and how it works is a very good product. I hope this is "THE" one for him for a long long time.

For the first 3 months he successfully used the Hollister 2 piece new image and then developed a skin reaction. During those 3 months he was using the eakin seal, paste to the right and left side for a crease to fill in, skin prep, or tincture of benzoan, & powder. He then developed a leaking situation and the wafers needed to be changed every 2-3 days when he was getting 5-7 days wear time for the first 3 months. I think we were using way too much stuff trying to heal the skin and made things too convex and contributing to the leaking possibly. For a month we tried several products off and on to treat the skin irritation and it helped but did not take it away and we needed to stop using the hollister wafer that he and I were so comfortable with and nervous about switching to something else. His skin irritation was not where the pectin was but the entire outer area of the adhesive area.

His skin was still irritated when we started using the convatech convex wafer and we decided to try just the wafer with no seal or ring underneath, & no powder, just some skin barrier prep. This wafer with just a light bit of prep is giving him 7 days wear time, no leaking whatsoever and his skin is really good now. We were quite surprised that there was no leaking, no itching, the wafer and its adhesive seemed to be ok and still is. Whether or not he needs the skin barrier prep we are not sure but it isn't adversely affecting the wafer or wear time and we are thinking it is giving the skin that little bit of protection so we are currently using it.

My husband has put on about 8-10 lbs so it appears the convexity in the wafer might be all that he needs now and not the extra he needed when he used the Eakin Seals or Adapt Ring and the crease to the right and left that needed the paste must have filled out with the additional weight. Sorry I am rambling too but giving you all this info so you newbies can see how things will change and you will need to do the trial and error thing and see if you can reason out along the way what you might need to do to make things work better.
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) and no longer in pain.

Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 5/20/2011 6:31 PM (GMT -6)   
Everyone is different, but to be honest, 3-4 days wear time is pretty normal. It really depends on YOUR stoma. It sounds like the fact that your stoma is 'short' is the culprit. Yes, convexity will help, but the erosion around your stoma is because the output is probably not able to clear the area as easily because.

I don't use Skin Prep anymore and do get longer wear time...but my skin looks great if I change every 4 days. If I go an extra couple days (laziness) by skin doesn't look as good.

I would judge when to change for you by the appearance of your skin. Don't worry too much if someone else gets 5-7 days wear time. We all have different bodies and stomas:)
formally known as OHIO76 ~ honoring my daughter's passion!
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!

polishdan
Veteran Member


Date Joined Mar 2010
Total Posts : 1595
   Posted 5/20/2011 6:53 PM (GMT -6)   
villager
Holy cow! Usually less is better, but whatever works.


Dan

polishdan
Veteran Member


Date Joined Mar 2010
Total Posts : 1595
   Posted 5/20/2011 6:56 PM (GMT -6)   
blueheron
I did not know Smith & Wesson made the prep as a wipe. I have it in a spray bottle but have not tried it yet. I use Friars.

Dan
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