My daughter is 3 weeks post step 1 surgery. The only thing we are still having trouble with is changing the wafer. She had Convatec in the hospital. The ostomy nurse recommended Hollister New Image Convex (her stoma does not protrude out much and it outputs straight down). The first 2 times we changed her wafer at home they leaked within 24 hours. Last week we made an emergency run to the hospital ostomy nurse. She explained some tricks to put on the wafer. Because my daughter's stomach is rolly, she said it would be best for her to stretch her skin above the wafer and also to push in on the skin just below the stoma to help the ostomy opening protude a bit more. We changed it on Saturday morning and it worked great!

So tonight she takes a shower (without the wafer on). We prep as we did the last time and it looks like the wafer is on good. She has something to eat. Goes to bed. And it leaks! So we remove the wafer. Of course the darn stoma is outputting like crazy! We finally put another wafer on (I think it looks like the stoma hole was pushed out better).

First of all, she knows it would be easier to change it after a shower in the morning when the stoma isn't outputting as much. She just couldn't wait till morning.

Does this ever get any easier? I feel like we are wasting more wafers and bags trying to get this thing to work right. Any ideas?

She is also having a terrible time taking the old wafer off. We've gotten better at getting a new one on (the first one took almost an hour between trying to figure out what we needed and what to do). But tonight it took her almost 45 minutes just to take the old wafer off. It pulls on her skin and it is still very close to the incision. It isn't overly red under the wafer. However she hates anything on her skin (she hates bandaids).

She is adjusting well to the temporary ostomy. She will probably be eligible to have her step 2 takedown around October. She is thinking about waiting until December so it doesn't interfere with school but everytime she has to change her wafer that thought goes out the window. And I can't imagine having to do this during school. She will have to get up 2-3 hours early just to shower and put a new one on. That sounds like a setback (albeit temporary) similar to when she had UC.

Please help.

Try some different wafers. I had a lot of problems after I got the loop. The Convatec stomahesive wafers worked best for me. The material they are made of seems to not leak as fast when the output is going strait into them. I would try getting a bunch of samples from different companies, and just play with it until you can get something that works for you. It can be very frustrating trying to get a system working. Just hang in there .

Bennie,
Our son is only 10 weeks old and we are doing well with our setup.

Check out the Hollister New image With Tape Flextend. Our son has an ileostomy and his output is very liquidy.

We also use a Eakins ring underneath, but that probably is not an option with a concave stoma.

I would call Hollister and see if you can get a sample of them. We went from 1-2 days before leaking with the convatec to 4-5 days and change the wafer proactively.

They recommend NO skin prep with this wafer so it saves a couple of steps and coming off does not hurt a 10 month old so it must not be two bad.

Try getting a wafer with more convexity. I was using one with "light convexity" and getting leaks. The one I'm now using is more convex. I also use an eakins ring, which i love. I had problems with nighttime leaks as well, before. You could ask the nurse to determine which wafers have more convexity - they are not all the same. Your daughter will eventually find something that works (that's what everyone told me - I didn't believe them, but they were right!)

Hi Benny,

I'm sorry too hear your daughter is having problems with her appliance.

You've had some excellent advice from the above members. I would also suggest you try Convatec's Moldable convex wafers. You shouldn't need any pastes or seals with them because they really do mold to every contour.

Also, if her skin is getting traumatised by removing the wafer then there are steps you can take to make it easier. Firstly never pull the wafer up away from the skin, always push the skin down away from the wafer. I use an orange oil based medical adhesive remover which is very kind to the skin. However, you must make sure that the skin is squeaky clean before putting on another wafer. If the skin is still greasy it will undermine the wafer.

Another thing I would recommend to help soothe her skin is to take a shower without her wafer on the days she changes it. Aim the shower head at the skin around (not on) her stoma. Not only is this really soothing but the warm water will stimulate the blood flow to the area and promote healing.

Always make sure everything is really dry before applying a new wafer. Use a hairdrier on a cool setting if you need to speed things up. The only prep I use is a no-sting barrier wipe. If you use one make sure it is completely dry before applying her wafer.

It really shouldn't take 2 hours to change her appliance. Once you have got a good system going you should be able to change it in about 5-10 minutes. Always make sure you have everything you need laid out before you even take her wafer off. That way it is all at hand and will save you time when you need to get the new wafer on. I always do my wafer change first thing in the morning before I've eaten or drank anything. The minute I so much as take one sip of water Wee Willie (my stoma) will start spewing but he remains quiet long enough to do a wafer change as long as I don't eat or drink.

I'm pretty sure that once you've worked out a system that things will seem less fraught and your daughter will be able to go about her daily life without having to worry about her stoma.

Good luck and take care.

Shell

Thanks for all your suggestions. Most of the time, the Hollister New Image wafer does the trick. I don't know if the leaks are because of the way we are putting it on (it really does make a difference when we stretch her skin and push to help the stoma lift its head) or because of the wafer itself.

Mack--what type of deep convexity wafer do you use?

Shell--I will contact Convatec for a sample of the moldable wafer. Preparation for changing the wafer is getting better (mostly my job for now). The problem is when she tries to take the old wafer off, the hysterics start, then the stoma kicks in, and all heck breaks loose. She knows she has to stay calm but it isn't always easy.

Right now she uses the wafer with paste on it. After she cleans the area well (free from soaps and oils), we put some stoma powder on (getting rid of the excess). The nurse said this will help any irritation. Luckily she doesn't have any big issues (no weeping or really red skin).
Then we put on the wafer. Are we doing this right? Are we missing a step (or adding something that shouldn't be there)?

Hi Bennie,
Everyone gave such great advice. I can only add from our own experience…

Are you using the extended wear wafers especially for ileo’s in the New Image line? They hold much longer I think. Also we use Alkare remover wipes by convatec to get the wafer off just the way Shell described. My son is allergic to the alcohol in other brands but this one is different so it does not irritate. He used to go into hysterics as well but that’s rare now. We then wipe really well with a baby wipe followed by a dry soft cloth. We got great ones at the hospital but Kleenex brand paper towels are similar. Hollister advises not using paste, barrier wipes or anything with these wafers because then they do not stick as well. We use a little powder just around his stoma only. We also use a convex adapt ring by Hollister instead of the Eakins. We just found them to be too sticky and hard to get off for us although I know lots of people swear by them.
The other thing that we have found is that if my son is in a hot bath or shower he really needs to let his skin cool down before applying. I don’t think it is the heat so much as the moisture from the heat so a hairdryer does help. She’s not changing her appliance everyday is she? You guys will get the hang of it.
Some people change at the same time each week but we do it when it needs it. I have a small supply of everything we need in a small Tupperware container so it’s all easily accessible and together when I need it. I also take our “kit” with us whenever we leave the house. In the early days we had a few incidents. I changed it successfully in the Babies r us bathroom early on. Not fun but we did it and I had everything I needed with me in my bag so I did not panic.
We live not too far from you in PA and it is HOT here. We definitely get less wear time by 2-3 days sometimes in the heat. My son is also in and out of the pool so that probably contributes to it. We do not cover up with anything in the pool. Just tape the end shut & make sure everything is secure. He does use “ostomy armor” because his stoma was bleeding badly when he played around and wore his ring around his waist. I never thought it would work but it does. Good luck.

If a mid-day change arises I use ice to calm down my output. It slows things down just enough to get the surrounding area clean and ready for a new wafer. I learned this tip from someone on this forum. By the way, Thanks, to who ever posted that tip.