Can’t keep the wafer attached

I had an Ileostomy in October and required emergency surgery that night for a prolapse. Again in December, another emergency surgery, this one required removal of a foot of ileum.

Since day one, I have been unable to keep the wafer attached. Sometimes three or four in a day with multiple leaks and failures every week. I have pronounced scoliosis and a plate and screws in my neck. Even with the help of a home health nurse, the wafer comes off because of all the skin wrinkles from the scoliosis. I’m extremely thin and now in constant discomfort from my skin being damaged by all the wafer changes. Does anyone have any suggestions? I’m already using mastisol and wide barrier strips. I purchased an over the door mirror to help since I can’t bend my neck to see the wafer.

My doctor, ostomy nurse at the hospital and local ostomy association never mentioned that the sclerosis and limits of my neck would make this process almost hopeless. I had to cancel going to my only nephews wedding in January. I got sold a bill of goods and can use help.

OSTOMY APPLIANCE
STANDING POSITION IN FRONT OF SINK
CHECK LIST
- Hand mirror - Skin prep?
- Pouch - Blow dryer
- Wafer - Stoma powder?
- Sure seal - Tincture of Benzoin
- Q tips - Rubbing alcohol
- Few folds of toilet tissue - Warm, wet face cloth
- Paper towel - M-9 deodorant drops
- Zip lock bag - Few squares of gauze
- Ball point pen - Ostomy belt
Choose a time of day when the stoma is inactive. For me it’s the first thing in the morning.
I lay all of the above items out just like an operating-room nurse would do in the hospital. I don’t want to be hunting around for anything.
Prepare wafer. I cut hole to desired size. Remove release paper and heat gummy side for THREE seconds with blow dryer.
Prepare Sure Seal. Remove the release film on ONE side of seal and heat for THREE seconds with blow dryer.
Mate the heated sides of wafer with the Sure Seal.
With forefinger, pull enough Sure Seal through the wafer hole to form a “turtle neck”.
Now place wafer aside.
I place a fold of toilet tissue on the leading edge of the sink and lean on it with my abdomen just in case there are any spills. I don’t step back from this leaning position until I am ready to apply my pouch.
Remove old wafer and pouch from abdomen and place in sink.
Place hand mirror in sink and adjust for viewing.
Clean skin around stoma with dry toilet tissue.
Continue to clean skin around stoma with alcohol until all residue is removed. BLOW-DRY SKIN.
Keep your eyes on the mirror. No drips are allowed. If there is a drip of any kind dab with gauze. BLOW-DRY! BLOW-DRY!
Using a Q-tip apply a coating of Tincture of Benzoin to surrounding skin. BLOW-DRY.
Keep watching the mirror for drips.
Apply a second coating of Tincture of Benzoin to skin. BLOW-DRY.
Now heat the wafer and pouch that you’ve already prepared with blow dryer. THREE seconds is enough.
Place wafer over stoma and remove release paper.
Use M-9 if available.
Close end of pouch and done! 7 days guaranteed. It’s important for the wafer to stay in position for at least 5-6 days to allow the skin to heal and to allow the adhesive to break down naturally.
RAW SKIN is another matter. I would not use alcohol on raw skin because of the burning sensation. In the case of raw skin I would use a skin prep such as non-sting Nephew & Son. Somehow, someway, it is important to get the skin squeaky clean.
And then, I would continue with the directions using the Tincture of Benzoin. If skin is raw the Benzoin will sting, but it’s worth the few minutes of discomfort.
The Benzoin is anti-septic and provides a very sticky base for the wafer.