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lifeinterrupted
Regular Member


Date Joined Mar 2011
Total Posts : 103
   Posted 6/20/2011 11:56 AM (GMT -6)   
Ok another appliance application question LOL! ;-) can someone please tell me if I'm using paste wrong? So after I apply along inside edges where I cut I let it set maybe 30sec to 1min then I apply. So after several hours it starts to creep up the side of my stoma but it doesn't hug it, it starts to pull away. So I'm wondering if this could cause a leak? I cut my size out the wafer pretty snug and I have a loop ileo, and have had a home nurse come out 1 time and she wasn't an ostomy nurse, and the hospital I had my surgery at ucsf theirs just left. I have my check up this wed with my surgeons nurse practitioner and she is an ostomy expert so I will get some input from her but it always better from actual users so...... Any suggestions or advice would be soooo appreciated flying kinda blind.. ;-) oh ya and I've sorta tried Eakin seal but can't get that application down either....:-(
Thank you all, Dee
Dee stay at home mom of my 2 beautiful children
dx with uc July '10
June 02 '11 the creation of Stella the stoma LOL! ;-)

Prov3:5,6

run4pancakes
Veteran Member


Date Joined Oct 2008
Total Posts : 938
   Posted 6/20/2011 12:02 PM (GMT -6)   
Have you noticed any leaks with it pulling away like that? When you take it off to change, can you see where it's been compromised (output starting to seep under the ring, etc.) If not...then I'd say you're doing just fine. I do the same thing as far as putting a bead of paste around the opening I cut, letting it sit for about a minute, and then applying. Seems to work fine for me. I don't know what mine does as far as going up around the stoma because I don't wear a clear pouch anymore and I can't see it. All I know is, when I change it out it looks fine and my skin is not all red around the stoma anymore. Definitely ask your nurse at your visit Wednesday.
UC dx 2/08

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

lifeinterrupted
Regular Member


Date Joined Mar 2011
Total Posts : 103
   Posted 6/20/2011 12:10 PM (GMT -6)   
Yes 1 time I did notice a little area right along side of my stoma, I know we are suppose to leave a little extra room 1/8 of in when we cut but is it really necessary? I feel somehow I just am missing a trick here or something!
Dee stay at home mom of my 2 beautiful children
dx with uc July '10
June 02 '11 the creation of Stella the stoma LOL! ;-)

Prov3:5,6

villager
Regular Member


Date Joined Aug 2010
Total Posts : 130
   Posted 6/20/2011 1:54 PM (GMT -6)   
Hi, this is how i use paste - again i dont know if its the way any one else does but it works for me - i use a one-piece pre-cut danzac drainable bag & because my stoma is smaller than the hole I use a seal ring ( a flat circular strip of stuff about 1cm wide) - i used to find it hard to get the seal right up against the stoma so there was a little irritation of the skin around the base - so now once i'm all cleaned & ready for the new bag, i squeeze some paste all around the base of the stoma, then after 2 or 3 mins i put the seal on pressing it down onto the paste which fills in any gap where the skin might have been at risk - on goes the bag next - i find this makes a really solid attachment & there has been no skin irritation since -- probably sound compplicated but its really not

? does 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 6/20/2011 2:03 PM (GMT -6)   
I just got back from an appointment with my stoma nurse and will be the next to try a bit of paste:) My stoma has some lobes on the bottom from where it healed around the stitches and some of these sort of lift up. They are perfectly attached underneath, the lobes just kind of overhang my peristomal skin ever so slightly in some spots. The nurse said it is just the way some stomas heal and it is not a big deal. Anyway, I was having a painful spot under one of these lobes. She put some silver nitrate on it in case there was some granulated growth happening, but she more thought it was just stool getting under the lobe and causing irritation. I also have another slightly irritated spot that has plagued me since surgery. My stoma is a little long at 1.25 inches tall (which is also a huge blessing since I never have leaks because it never pumps stool under my wafer), but there is one little spot that gets irritated under wear my stoma flops downward toward the bottom of my pouch. I had her check that out too. Both of these issues are so minor... about 1/16" or less of skin involved in two spots and something I could easily live with. Still, might as well get my skin looking as good as possible since I am going to live with my stoma buddy for the rest of my life:)

First, she recommended putting skin prep on the skin just surrounding my stoma. I had been doing this sometimes, but she recommended the Cavillon brand, as she felt it was the most waterproof and stool resistant. Then, she recommended that I get my Eakin seal on even tighter so it really snugs up under these lobes. Up to this point, I was just putting the Eaking up to the lobes. She confirmed that the "hook"method I mentioned in another post was good. (Tear the Eakin ring/doughnut shape in one spot, hook it snuggly around the stoma pressing it on to the skin and then fuse the broken spot back together instead of stretching the Eakin hole over your stoma. It is easier to get it very snug this way as you don't have to worry about stretching it too much and getting center hole in the Eakin too big for your stoma, or getting it wet as it rubs over your stoma). Then, she said to put squeeze a tiny bit of paste between the Eakin and my stoma to further "caulk" any spots that might be exposed. Finally, put the wafer on. This seems to make a lot of sense, so I hope it works. Maybe a combo of Eakin and paste would work for you? I know everyone says less is more, but if you have tried less (as I have) and it isn't working, perhaps this combination will be the key. I will keep you posted.

As far how much space to leave when cutting the wafer... she said to just experiment with closeness to the stoma and find out which gives me the least irritation without constricting the stoma, but she did say it is okay make it a little bigger (1/8" or less), as the Eakin and paste will protect the skin as long as these things are up against the stoma and no skin is showing. I know from personal experience that if I make my wafer too snug to my stoma, my stoma turns a dark color and is not happy. I have a real squirmer that expands and constricts quite a bit, so I have to leave room for that movement. Some people's stomas may not be so wiggly:)

Remember too to be patient with yourself. I was so obsessed with my stoma and skin at first. I would put my clear pouch on and see this tiny bit of skin showing that I missed, and would live in fear for the next four days thinking I was just going to destroy my skin. I worried about getting things absolutely perfect. I have learned that if you do get an irritated spot from doing something wrong, it is usually quick to heal when you fix it at the next change. As long as you are not ignoring any major problems, you should be fine.

Good luck!
-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

lifeinterrupted
Regular Member


Date Joined Mar 2011
Total Posts : 103
   Posted 6/20/2011 2:05 PM (GMT -6)   
So you use an Eakin seal with paste? And put the seal on first then paste at the of seal or stoma? Then slap on pouch over? Is that right? Or you use just paste now cause the seal wouldn't stay against the stoma? I think I understand? ;-)
Dee stay at home mom of my 2 beautiful children
dx with uc July '10
June 02 '11 the creation of Stella the stoma LOL! ;-)

Prov3:5,6

lifeinterrupted
Regular Member


Date Joined Mar 2011
Total Posts : 103
   Posted 6/20/2011 2:12 PM (GMT -6)   
Blueheron, thank you so much that is some good info for me to try!!!! I love it it totally makes good sense!!!! That is so funny I do that too stressing over the exposed spot I can see in my clear bag LOL!!! ;-) I m doing a change today and will try that!!!! Thank you again for that info!!!!
Dee stay at home mom of my 2 beautiful children
dx with uc July '10
June 02 '11 the creation of Stella the stoma LOL! ;-)

Prov3:5,6

Blueheron
Veteran Member


Date Joined Feb 2010
Total Posts : 720
   Posted 6/20/2011 3:30 PM (GMT -6)   
You have it right.

1. Skin barrier prep right around the stoma (1/4 inch or so).

2. Put the Eakin seal on.

3. Fill in any little gaps with some paste between the stoma and Eakin (my nurse said everything will sort of "melt" together eventually).

4. Put the wafer on.

I will give an update next week as to how this goes as I want to give it a couple of tries... unless it causes a major leak:)

-Heidi
-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

peggy113
Veteran Member


Date Joined Aug 2007
Total Posts : 1998
   Posted 6/20/2011 9:35 PM (GMT -6)   
Heidi,
I have been using the method your nurse prac told you for some time now --- found it by suggestions, trial, and error. You describe almost exactly what I do with one exception... I only use a band of the Eakin Seal around the stoma - not a whole wafer. The area that needs the most attention, of course, is snug around the stoma. So, that is where I concentrate on making the seal the best that I can. I apply the Eakin to the edge of the cut opening of the wafer, making sure that it adhers well to it, then slide the wafer over the stoma, press firmly in place, and pop on the pouch. P.S. I have a wiggler too! Thanks for posting all of the great information.
CD diagnosed in 1979. Ileo in 1984. No recurrence of CD! Some issues with adhesions still.
Husband diagnosed with ALS March 2008 - taking one day at a time, enjoying our time together.

ENIGMAWRAP
Regular Member


Date Joined Nov 2010
Total Posts : 417
   Posted 6/26/2011 10:07 PM (GMT -6)   
Blueheron:

I felt exactly the same way about seeing skin! Of course, I didn't know what to do and I had been scared pretty good by the medical folks.

Now, per my WOCN, I make sure there is a "halo" of skin around the stoma...at present, I am trying paste to fill in the "halo", but...

NASACARon: you are right, EAKINS stick much better than paste...I have tried the paste the last two times, and it seems to pull right off when I take off the wafer...so, I will probably go back to EAKINS and use the paste as Blueheron is using it..just to fill in the "bald" spots.....

jimmy
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