They should have STARTED with the drain in place if it wasn't there already. There is bound to be drainage and run-off of bodily fluids after the surgery, and it has to go somewhere... the body can only absorb so much, which is why the drain is in place. Once the drainage goes consistently below 75mL per day then they can take out the drain. I woke up from surgery with a JP drain coming out of my belly opposite my stoma, and I went home from the hospital with it still in. It was draining between 400-500 mL per day for the first week before it started simmering down. I had it removed ten days after surgery.
1) B'Dereh is right - the mucous coming from his bum is normal. What drained out of my J-pouch when I sat on the toilet looked exactly like what was coming out of my JP drain for a couple of weeks. After that it turned milky clearish-white. I currently empty this type of mucous from my J-pouch - what looks like about
a handful - at least few times a day, and I am over three weeks out from my surgery. And even a small amount there does still feel like I really have to go, because the J-pouch doesn't realize it's new role is to STORE waste. Since it is made from small intestine, and small intestine's job is to just constantly push food/waste through, it will take a while for the J-pouch to learn that it doesn't have to push everything through right away.
2) Yes, irritation around the stoma is also normal, unfortunately. It is made worse when it is exposed to any waste output from the stoma. This happens when there is not a tight/close enough seal between the wafer
opening and the stoma.
Make sure when you/he changes his bag that there is no exposed skin between the edge of the wafer hole and the stoma. (First make sure you have supplies that fit properly - the proper fit should leave no exposed skin.) If there is exposed skin, then when you change the bag before you apply the wafer, use a thin ring of stoma adhesive paste around the back inner edge of the wafer hole where the stoma goes. After you press the wafer in place for a minute, the paste should expand and come out from behind the edges of the hole a bit to create a sort of "turtle-neck" effect around the stoma to create a nice seal. If you have already applied the wafer and still see exposed skin, you can also use a wet finger to dab some of this paste over the exposed part - it works like a barrier to protect the skin. Protecting the skin from making contact with any output is the biggest way to prevent the skin irritation in the first place.
If the irritation is already there, then just use the little skin barrier wipes they gave you to just dab/wipe on the red irritated part before you apply the bag. Let it air dry before applying the adhesive wafer. A hair-dryer on low/cool setting from kind of far away can really help dry the area. (I find my stoma likes to ooze moisture in all directions which makes it really hard to keep skin area around it dry during bag changes.)
The powder is supposed to only be for
open wounds. If the red irritated skin turns into an
open sore, then apply plenty of stoma powder to the
open part to protect it from the adhesive. I would do this after you have already used the skin barrier swab to dab on whatever skin is still red and irritated. I have the same problem, so I do I do it all in this order:
1) Remove old bag and wipe away any waste with a clean paper towel.
2) Use the skin barrier wipe to dab on any red/irritated skin.
3) Use the hair dryer from far away to dry the whole area.
4) Squirt the stoma powder liberally on the
open sore and blow away any extra powder. (But he doesn't need any powder if he don't have any
5) Apply a ring of paste to the back edge of the hole in my wafer (a sticky process).
6) Make sure the stoma area is still dry or the adhesive won't create a proper seal - dab with a paper towel or use hair dryer again if necessary.
7) Apply the wafer around the stoma - press and hold it there for a minute to ensure a good seal (the adhesive is triggered by our body heat).
8) I use a two-piece system, so at this point I can still check for any exposed skin and apply extra paste if necessary.
9) Attach the bag to the wafer and make sure the clip is in place.
Trust me. Things will DEFINITELY get easier. I started feeling a lot better around two weeks, but a lot of people say they start feeling better around week three. It may take a little bit longer for him since he had some post-op complications. Hopefully as he recovers and starts gaining his energy back he will be able to take more of a role in taking care of himself so that you can feel more confident leaving him alone. For now just let him sleep as often as he can, and encourage him to get up and walk at least a couple times a day. Sleeping and walking are the two things that will heal him up the fastest.
Feel free to come back with questions any time! Good luck and keep us posted!
Follow my story: ronnielee-fightingforit.blogspot.com
32-year-old single female (teacher)
10/4/12 - proctocolectomy / J-Pouch construction / loop ileostomy
Take-down scheduled December 11th
Dx mild/moderate UC 1995
Dx severe pancolitis 2011